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1.
Curr Opin Anaesthesiol ; 35(5): 600-604, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-35942700

RESUMO

PURPOSE OF REVIEW: This article aims to summarize the current literature describing the application of erector spinae plane (ESP) blocks for regional anesthesia of upper and lower limbs and to discuss the advantages and limitations. RECENT FINDINGS: Investigations are still at an early stage but results are promising. High thoracic ESP blockade can relieve acute and chronic shoulder pain through local anesthetic diffusion to cervical nerve roots, although it may not be as effective as direct local anesthetic injection around the brachial plexus. It does, however, preserve motor and phrenic nerve function to a greater extent. It will also block the T2 innervation of the axilla which can be a source of pain in complex arthroscopic shoulder surgery. Lumbar ESP blocks provide effective analgesia following hip arthroplasty and arthroscopy, and appear comparable to lumbar plexus, quadratus lumborum, and fascia iliaca blocks. Unlike the latter, they are motor-sparing and are associated with improved postoperative ambulation. SUMMARY: High thoracic and lumbar ESP blocks have the potential to provide adequate analgesia of the upper and lower limbs respectively, without causing significant motor block. They are thus alternative methods of regional anesthesia when other techniques are not feasible or have undesirable adverse effects.


Assuntos
Analgesia , Bloqueio Nervoso , Analgesia/métodos , Anestésicos Locais , Humanos , Bloqueio Nervoso/efeitos adversos , Bloqueio Nervoso/métodos , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Tronco
3.
Fish Shellfish Immunol ; 128: 676-683, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35985630

RESUMO

Invertebrates only have an innate immunity in which haemocytes play an important role. In our lab, 5 subpopulations of haemocytes were identified in the past by an iodixanol density gradient: hyalinocytes, granulocytes, semi-granulocytes and two subpopulations of non-phagocytic cells. For the two latter subpopulations, the haemocytes have small cytoplasm rims, do not adhere to the bottom of plastic cell-culture grade wells and present folds in the nucleus. These characteristics are similar to those of mammalian lymphocytes. Therefore, they were designated lymphocyte-like haemocytes. Although little is known about their function, we hypothesize, based on their morphology, that they may have a cytotoxic activity. First, a fast isolation technique was developed to separate the non-adherent haemocytes from the adherent haemocytes. After 60 min incubation on cell culture plates, the non-adherent haemocytes were collected. The purity reached 93% as demonstrated by flow cytometry and light microscopy upon a Hematoxylin and Eosin (H&E) staining. Cytotoxicity by lymphocytes is mediated by molecules such as perforin and granzymes and therefore, we searched for their genes in the shrimp genome. Genes coding for a torso-like protein, granzyme B and granzyme G were identified. Primers were designed and RT-PCR/RT-qPCR assays were developed. The results demonstrated that torso-like protein, granzyme B and granzyme G were mainly expressed in non-adherent haemocytes. The shrimp torso-like protein gene was most related to that of the crab torso-like protein; granzyme B gene was most related to that of mouse granzyme B and granzyme G gene was most related to that of zebrafish granzyme G. In a 72-hour in vivo WSSV infection challenge, the mRNA expression of shrimp torso-like protein, granzyme B and granzyme G in haemocytes was increasing over time, which indicated that torso-like protein, granzyme B and granzyme G of shrimp haemocytes are involved in the immune response during a viral infection. In the future, antibodies will be raised against these proteins for more in-depth functional analyses.


Assuntos
Linfócitos T Citotóxicos , Peixe-Zebra , Animais , Amarelo de Eosina-(YS)/metabolismo , Granzimas/genética , Hematoxilina/metabolismo , Mamíferos/metabolismo , Camundongos , Perforina/metabolismo , Plásticos , RNA Mensageiro/metabolismo , Tronco , Regulação para Cima , Peixe-Zebra/metabolismo
4.
Am J Sports Med ; 50(11): 3083-3089, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35970180

RESUMO

BACKGROUND: The softball pitch is a full-body motion, where efficient proximal to distal energy flow through the kinetic chain is said to reduce stress at the upper extremity. Although altered trunk kinematic parameters are associated with upper extremity pain in softball pitchers, further research is needed to determine whether differences exist in proximal energy flow between softball pitchers with and without pain. HYPOTHESIS/PURPOSE: To examine pelvis and trunk energy flow during the acceleration phase of the pitch in collegiate softball pitchers with and without upper extremity pain. It was hypothesized that those with upper extremity pain would have less energy flowing into the proximal ends of the pelvis and trunk as well as less energy flowing out of the distal ends of the pelvis and trunk during the acceleration phase when compared with pitchers who did not have upper extremity pain. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 54 female National Collegiate Athletic Association Division I softball pitchers (age, 20.2 ± 2.0 years; height, 173.5 ± 6.9 cm; weight, 78.5 ± 11.5 kg) were assigned to pain (n = 17) and pain-free (n = 38) groups. Participants pitched 3 maximal effort rise-balls for a strike, and the average of the 3 trials was used for analysis. Kinematic data were collected at 100 Hz using an electromagnetic tracking system. A segment power analysis was performed to quantify energy flow for the pelvis and trunk. The Mann-Whitney U test was used to compare pelvis and trunk energy flow during the acceleration phase of the pitch as well as pitch velocity between collegiate softball pitchers with and without upper extremity pain. RESULTS: No significant differences were found between pelvis and trunk energy flow during the acceleration phase or pitch velocity between collegiate softball pitchers with and without upper extremity pain (all P values >.057). CONCLUSION: Previous research determined that kinematic parameters differ between collegiate pitchers with and without upper extremity pain. However, the current study found no difference in pelvis and trunk energy flow or pitch velocity. Although altered kinematics in collegiate pitchers with upper extremity pain may serve as compensation patterns to maintain pitch velocity and proximal energy flow, future research is needed to confirm this postulation. CLINICAL RELEVANCE: The lack of energy flow differences between upper extremity pain groups suggests that pitchers may adapt their biomechanics to maintain trunk and pelvis energy flow patterns. Coaches, athletes, and clinicians should know that movement adaptations can allow for maintained performance levels but may result in the presence of pain that may manifest in other deleterious and injury-susceptible biomechanics.


Assuntos
Beisebol , Adolescente , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Dor , Pelve , Rotação , Tronco , Extremidade Superior , Adulto Jovem
5.
Knee ; 37: 143-152, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35779432

RESUMO

BACKGROUND: This study was performed to (i) compare gait parameters obtained from inertial sensors attached to the lower trunk and foot between patients in the early postoperative period after total knee arthroplasty (TKA) and healthy age- and sex-matched controls and (ii) elucidate the association between the gait parameters and patient-reported outcome measures (PROMs). METHOD: The gait performance of 19 patients who had undergone TKA was assessed using inertial sensors and PROMs obtained from the Knee Injury and Osteoarthritis Outcome Score (KOOS) 1 week before hospital discharge. The patients walked along a 15-m walkway and we calculated the following gait parameters: walking speed, coefficient of variation (CV) of stride time, unbiased autocorrelation coefficient (AC), harmonic ratio (HR), and symmetry index (SI). The same gait parameter data from 19 age- and sex-matched healthy adults (controls) were obtained from our past study. RESULTS: The TKA group demonstrated slower walking speed, larger CV of stride time, lower HR in all three directions, lower AC in the vertical direction, and higher SI in the vertical direction than the healthy control group (all p < 0.05). Correlation analysis revealed that the SI in the anteroposterior direction was significantly correlated with the KOOS symptoms subscore and ADL subscore (p < 0.05). CONCLUSIONS: Patients in the early postoperative period after TKA exhibited worse gait performance as assessed by inertial sensors compared with healthy controls. Gait symmetry was correlated with PROMs. These results indicate the usefulness of assessing gait parameters after TKA.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Adulto , Artroplastia do Joelho/métodos , Marcha , Humanos , Osteoartrite do Joelho/cirurgia , Período Pós-Operatório , Tronco , Caminhada
6.
Artigo em Inglês | MEDLINE | ID: mdl-35886153

RESUMO

BACKGROUND: As obesity increases throughout the developed world, concern for the health of the population rises. Obesity increases the risk of metabolic syndrome, a cluster of conditions associated with type-2 diabetes. Correctly identifying individuals at risk from metabolic syndrome is vital to ensure interventions and treatments can be prescribed as soon as possible. Traditional anthropometrics have some success in this, particularly waist circumference. However, body size is limited when trying to account for a diverse range of ages, body types and ethnicities. We have assessed whether measures of torso shape (from 3D body scans) can improve the performance of models predicting the magnitude and distribution of body fat. METHODS: From 93 male participants (age 43.1 ± 7.4) we captured anthropometrics and torso shape using a 3D scanner, body fat volume using an air displacement plethysmography device (BODPOD®) and body fat distribution using bioelectric impedance analysis. RESULTS: Predictive models containing torso shape had an increased adjusted R2 and lower mean square error when predicting body fat magnitude and distribution. CONCLUSIONS: Torso shape improves the performance of anthropometric predictive models, an important component of identifying metabolic syndrome risk. Future work must focus on fast, low-cost methods of capturing the shape of the body.


Assuntos
Síndrome Metabólica , Tecido Adiposo , Adulto , Antropometria/métodos , Índice de Massa Corporal , Humanos , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Obesidade/complicações , Tronco
8.
PLoS One ; 17(7): e0270705, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35793326

RESUMO

The effects of compression load to a specific body part, e.g. leg, arm, or trunk, evoke many functions and are applied in various fields including clinical medicine, sports, and general health care. Nevertheless, little is known about the functional mechanism of compression load, especially regarding its effects on metabolic function. We investigated the effects of compression load to the trunk on the metabolism. We designed adjustable compression clothes for mice and attached them to ten-week-old C57BL/6N male mice in a controlled environment. The mice were divided into compression and no-compression groups, the latter only wearing the clothes without added compression. The evoked metabolic changes were evaluated using indirect calorimetry and transcriptomics with liver tissue to investigate the mechanism of the metabolic changes induced by the compression load. The results indicated decreases in body weight gain, food intake, and respiratory exchange ratio in the compression group compared to the no-compression group, but these effects were limited in the "light period" which was an inactive phase for mice. As a result of the transcriptome analysis after eight hours of compression load to the trunk, several DEGs, e.g., Cpt1A, Hmgcr, were classified into functional categories relating to carbohydrate metabolism, lipid metabolism, or immune response. Lipid metabolism impacts included suppression of fatty acid synthesis and activation of lipolysis and cholesterol synthesis in the compression group. Taken together, our results showed that activation of lipid metabolism processes in an inactive phase was induced by the compression load to the trunk.


Assuntos
Metabolismo dos Lipídeos , Tronco , Animais , Lipólise , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fenômenos Físicos
9.
J Manipulative Physiol Ther ; 45(3): 202-215, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35879124

RESUMO

OBJECTIVE: The aim of this systematic review and meta-analysis was to study the effects of motor control training (MCT) on trunk muscle morphometry measured by ultrasound imaging and pain and disability in individuals with chronic low back pain. METHODS: PubMed, Web of Science, Scopus, and Cochrane Library databases were searched from study inception until January 2021. Randomized control trials evaluating both muscle morphometry and pain or disability in individuals with chronic low back pain were included. Study selection, data extraction, and quality assessment were performed by 2 reviewers independently. Modified Downs and Black tool and the Grading of Recommendations Assessment, Development and Evaluation approach were used to assess the risk of bias and quality of evidence, respectively. A meta-analysis was performed using a random effects model with mean difference or standardized mean difference (SMD). RESULTS: Of 3459 studies initially identified, 15 studies were included, and 13 studies were selected for meta-analysis. The results revealed no differences in the resting thickness of the transversus abdominis, internal and external oblique, and lumbar multifidus muscles in studies that compared MCT with other interventions. The transversus abdominis muscles contraction ratio was greater (SMD = 0.93; 95% confidence interval [CI], -0.0 to 1.85) and lower pain (weighted mean difference: -1.07 cm; 95% CI, -1.91 to -0.22 cm; P = .01) and disability (SMD = -0.86; 95% CI, -1.42 to -0. 29; P < .01) scores were found in the groups who underwent MCT compared with other interventions. CONCLUSION: This systematic review and meta-analysis found that motor control exercise training increased the transverse abdominis contraction ratio (muscle activation) and improved the level of pain and disability compared to other interventions in people with chronic low back pain. However, motor control exercise training was not superior to other interventions in increasing the resting thickness of deep abdominal and lumbar multifidus muscles in intervention times less than 12 weeks.


Assuntos
Dor Crônica , Dor Lombar , Músculos Abdominais/diagnóstico por imagem , Músculos Abdominais/fisiologia , Dor Crônica/terapia , Humanos , Dor Lombar/diagnóstico por imagem , Dor Lombar/terapia , Região Lombossacral , Músculos Paraespinais/diagnóstico por imagem , Músculos Paraespinais/fisiologia , Tronco
10.
PLoS One ; 17(7): e0272382, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35905083

RESUMO

The aim of this study was to explore differences in trunk muscle activity on a stable and mobile seat for people after stroke and healthy participants. Trunk control exercises are known to have a beneficial effect on trunk control, balance, and mobility after stroke. The effect of such exercises could be enhanced by the use of a mobile seat to provide further training stimuli. However, little research on the musculoskeletal effects of trunk training on mobile seats has been carried out. On a stable and a mobile seat, thirteen people after stroke and fifteen healthy participants performed two selective trunk control exercises, which were lateral flexion initiated by the pelvis and the thorax. The maximal surface electromyography relative to static sitting of the muscles multifidus, erector spinae, and obliquus externus was recorded bilaterally. The effects of group, seat condition, trunk control exercise, and muscle side were investigated employing within-subject linear-mixed-models. Compared to the stable seat, the maximal muscle activity of people after stroke on the mobile seat was higher during the thorax-initiated exercise and lower during the pelvis-initiated exercise. Healthy participants showed opposite results with higher muscle activity on the mobile seat during the pelvis-initiated exercise. For trunk control training on a mobile seat with high muscle activation people after stroke should perform trunk control exercises initiated by the thorax, for training with lower muscle activity people after stroke should initiate selective trunk movements by the pelvis. The results can support the planning of progressive trunk control rehabilitation programs.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Músculos Abdominais/fisiologia , Eletromiografia , Terapia por Exercício/métodos , Humanos , Músculo Esquelético/fisiologia , Tronco
11.
Percept Mot Skills ; 129(5): 1458-1476, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35790385

RESUMO

The three-dimensional movement of the horse in physical therapy is a valuable kinesio-therapeutic phenomenon that simultaneously affects several body systems, including particularly the neuromuscular system. However, the effects of equine-assisted services (EAS) on neuromuscular activation patterns in older adults have not been thoroughly investigated. In this study, we evaluated the impact of a 10-weeks EAS program on trunk muscles in older adults who used a saddle and placed their feet in stirrups for the first 15 minutes and out of stirrups for the remaining 15 minutes of 30-minute EAS sessions. We gathered electromyographic (EMG) data of the trunk muscles five times each on the first, fifth, and 10th sessions: pre-EAS and post-EAS on a stationary horse and at 1-minute, 15-minutes, and 30-minutes on a horse in motion. Participants were 20 adults, aged 60-79 years. We analyzed normalized EMG data with 5 (session time) by 3 (session number) analyses of variance (ANOVAs) with repeated measures and with Bonferroni's testing (p ≤ .05). There was a significant difference over the number of interventions for the right thoracic paravertebral muscle (p = .025) and session time effect for the left trapezius (p = .042), right thoracic paravertebral (p < .001), right and left multifidus (p < .001), and right and left rectus abdominis muscles (p < .001). Thus, trunk muscles in older adults showed complex neuromuscular activation synchronized with the horse's movement, which was influenced by session time and number of interventions. The practical implication of these findings is that EAS can reduce fall risk among elderly adults of both sexes.


Assuntos
Terapia Assistida por Cavalos , Animais , Eletromiografia , Terapia Assistida por Cavalos/métodos , Feminino , Cavalos , Humanos , Masculino , Movimento , Músculo Esquelético/fisiologia , Tronco
12.
Sci Rep ; 12(1): 11762, 2022 07 11.
Artigo em Inglês | MEDLINE | ID: mdl-35817835

RESUMO

This study investigates the contribution of external trunk morphology and posture to running performance in an evolutionary framework. It has been proposed that the evolution from primitive to derived features of torso shape involved changes from a mediolaterally wider into a narrower, and antero-posteriorly deeper into a shallower, more lightly built external trunk configuration, possibly in relation to habitat-related changes in locomotor and running behaviour. In this context we produced experimental data to address the hypothesis that medio-laterally narrow and antero-posteriorly shallow torso morphologies favour endurance running capacities. We used 3D geometric morphometrics to relate external 3D trunk shape of trained, young male volunteers (N = 27) to variation in running velocities during different workloads determined at 45-50%, 70% and 85% of heart rate reserve (HRR) and maximum velocity. Below 85% HRR no relationship existed between torso shape and running velocity. However, at 85% HRR and, more clearly, at maximum velocity, we found highly statistically significant relations between external torso shape and running performance. Among all trained subjects those with a relatively narrow, flat torso, a small thoracic kyphosis and a more pronounced lumbar lordosis achieved significantly higher running velocities. These results support the hypothesis that external trunk morphology relates to running performance. Low thoracic kyphosis with a flatter ribcage may affect positively respiratory biomechanics, while increased lordosis affects trunk posture and may be beneficial for lower limb biomechanics related to leg return. Assuming that running workload at 45-50% HRR occurs within aerobic metabolism, our results may imply that external torso shape is unrelated to the evolution of endurance running performance.


Assuntos
Hominidae , Cifose , Lordose , Corrida , Animais , Fenômenos Biomecânicos , Humanos , Masculino , Corrida/fisiologia , Tronco/fisiologia
13.
BMC Pediatr ; 22(1): 399, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35799155

RESUMO

BACKGROUND: During the growth period, before and after maturity, considerable biological changes occur. It seems that these changes are related to neuromuscular patterns and have significant differences in the functional movements performed of young boys and girls during the maturation process. The current study aimed to look at the movement quality scores of school-aged girls and boys. METHODS: This Cross-Sectional Study assessed the movement quality of 700 school-aged boys and girls aged 8 to 17, divided into 10 groups of 35 girls and 10 groups of 35 boys. Movement quality was evaluated by the Fusionetics scoring system, which includes 7 tasks: two-leg squat, two-leg squat with heel raise, one-leg squat, push-up, shoulder, trunk, and cervical movements that require a person to complete different movement patterns. The data was analyzed using the Wilcoxon signed-rank and McNemar tests (p <0.05). RESULTS: This is the first study to our knowledge to examine the movement quality scores in a large school age child with Fusionetics. The overall results showed that the most errors were recorded in all age groups during the double leg squat, double leg squat with heel lift, single leg squat, and push-up and school-age children showed less errors during the shoulder movements, trunk/lumbar spine movements and cervical spine movements. Furthermore, younger girls and boys made more errors than older girls and boys. In relation to gender, this study found that girls scored better on the total Fusionetics score than boys. CONCLUSIONS: The Fusionetics scoring system explains how well school-aged children perform fundamental movements. Under the guidance of coaches and physical educators, students' movement compensation should be assessed and relevant training interventions implemented. Taking steps to address movement compensation could help to avoid injuries and improve school-age children performance.


Assuntos
Movimento , Tronco , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Instituições Acadêmicas , Estudantes
14.
Sensors (Basel) ; 22(13)2022 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-35808522

RESUMO

Nowadays, the better assessment of low back pain (LBP) is an important challenge, as it is the leading musculoskeletal condition worldwide in terms of years of disability. The objective of this study was to evaluate the relevance of various machine learning (ML) algorithms and Sample Entropy (SampEn), which assesses the complexity of motion variability in identifying the condition of low back pain. Twenty chronic low-back pain (CLBP) patients and 20 healthy non-LBP participants performed 1-min repetitive bending (flexion) and return (extension) trunk movements. Analysis was performed using the time series recorded by three inertial sensors attached to the participants. It was found that SampEn was significantly lower in CLBP patients, indicating a loss of movement complexity due to LBP. Gaussian Naive Bayes ML proved to be the best of the various tested algorithms, achieving 79% accuracy in identifying CLBP patients. Angular velocity of flexion movement was the most discriminative feature in the ML analysis. This study demonstrated that: supervised ML and a complexity assessment of trunk movement variability are useful in the identification of CLBP condition, and that simple kinematic indicators are sensitive to this condition. Therefore, ML could be progressively adopted by clinicians in the assessment of CLBP patients.


Assuntos
Dor Lombar , Teorema de Bayes , Fenômenos Biomecânicos , Humanos , Dor Lombar/diagnóstico , Aprendizado de Máquina , Movimento , Tronco
18.
Clin Biomech (Bristol, Avon) ; 97: 105710, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35763887

RESUMO

BACKGROUND: Upper limb movement patterns have not yet been identified in bimanual conditions despite the difficulties children with unilateral cerebral palsy have performing bimanual activities. The aim was to identify specific motor patterns from kinematic deviations during bimanual tasks in this population. METHODS: Twenty children with unilateral cerebral palsy and 20 age-matched, typically developing children performed the five tasks of a 3D bimanual protocol. To evaluate upper limb kinematic deviations, 10 Arm Variable Scores were calculated for the affected /non-dominant upper limb of each participant for each task. Sparse K-means cluster analysis was applied to the 50 Arm Variable Scores of all the children to identify motor patterns and determining variables. Clinical tests of impairment (muscle strength, selectivity, spasticity) and function (Assisting hand assessment, Abilhand-Kids) were compared between the clusters obtained. FINDINGS: Three different motor patterns were identified using the data from all the children: mild, proximal-distal and proximal-distal with trunk. The most important cluster determinants were the Arm Variable Scores for pronation-supination and wrist extension. In the cerebral palsy group, scores of impairments (p < .01) and function (Assisting Hand Assessment [p < .001] and Abilhand-Kids [p = .004]) differed for each motor pattern. Supination and wrist extension deviations differed significantly between the groups (p < .001). INTERPRETATION: During performance of bimanual tasks, children with unilateral cerebral palsy used distinct motor patterns that each corresponded to a specific clinical profile. Elbow-wrist deviations were the largest and most decisive and were specific to the cerebral palsy group: they should be the target of interventions to enhance bimanual function. CLINICALTRIALS: gov identifier: NCT03888443.


Assuntos
Paralisia Cerebral , Fenômenos Biomecânicos , Criança , Mãos , Humanos , Tronco , Extremidade Superior
19.
J Stroke Cerebrovasc Dis ; 31(8): 106582, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35759843

RESUMO

OBJECTIVES: Improved gait performance in patients with stroke requires trunk control. This study investigated the effect of lumbar rotational mobilization on improving trunk control and gait parameters. MATERIALS AND METHODS: This study recruited 42 patients with stroke who were randomly assigned to the grade III (experimental group, n=21) and grade I (control group, n=21) lumbar rotational mobilization groups. Grade III lumbar mobilization with right and left rotation was performed in the experimental group with patients lying on their sides. The control group performed grade I rotation mobilization using the same method. Among outcome measurements, the trunk impairment scale was used for trunk control, while gait parameters were measured using the BTS G-WALK. RESULTS: The trunk impairment scale score and gait performance were significantly higher in the experimental group than those in the control group. CONCLUSIONS: Grade III lumbar rotational mobilization improved trunk control and increased gait performance in patients with stroke.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Marcha , Humanos , Equilíbrio Postural , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Tronco
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