RESUMO
OBJECTIVES: To evaluate the effects of a rehabilitation program in terms of balance, gait and muscle strength in a population of patients with myotonic dystrophy. PATIENTS: Twenty patients benefited, as outpatients in a hospital setting, from a rehabilitation program with clinical and instrumental evaluations. The evaluation focused on quantitative balance measurement by clinical and stabilometer tests, gait assessed by Locometre and extensors and flexors knee muscle strength measured in isokinetic concentric mode at 60°/s. RESULTS: After the rehabilitation program, we observed a significant improvement in the patients' balance capacities measured with the Berg Balance Scale (BBS), fast gait speed and muscle strength. However, the instrumental evaluation did not report any gains for static balance and spontaneous gait speed after the training program. No correlation was found between the various improvements. CONCLUSION: A rehabilitation program focused on strength, gait and balance allowed for significant improvements in some parameters of myotonic dystrophy. These results attest to the relevance of a short-term rehabilitation protocol for these patients in the framework of a multidisciplinary therapeutic care. The disparity observed in the results measured for these patients suggest the contribution of cognitive involvement in the limitations felt by patients with myotonic dystrophy in the areas of gait and balance.
Assuntos
Transtornos Neurológicos da Marcha/reabilitação , Distrofia Miotônica/fisiopatologia , Distrofia Miotônica/reabilitação , Equilíbrio Postural , Adulto , Feminino , Transtornos Neurológicos da Marcha/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Exercícios de Alongamento Muscular , Resistência Física , Avaliação de Programas e Projetos de Saúde , Treinamento Resistido , Resultado do TratamentoRESUMO
Child meningomyeloradiculitis is a rare complication form of schistosomiasis, even in hyperendemic area. Its diagnosis is very difficult, especially if there are not history or signs of Schistosoma mansoni or hematobium infections. It must be evocated in case of acute flask paralysis occurring in children living in Schistosoma infections endemic area. The authors report a 14-year-old boy's case and suggest etiopathogeny of the disease.
Assuntos
Neuroesquistossomose/diagnóstico , Adolescente , Anti-Helmínticos/uso terapêutico , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Proteína C-Reativa/metabolismo , Diagnóstico Diferencial , Quimioterapia Combinada , Doenças Endêmicas/estatística & dados numéricos , Humanos , Lactamas , Madagáscar/epidemiologia , Masculino , Neuroesquistossomose/sangue , Neuroesquistossomose/complicações , Neuroesquistossomose/tratamento farmacológico , Neuroesquistossomose/epidemiologia , Paralisia/parasitologia , Praziquantel/uso terapêutico , Prednisona/uso terapêutico , Retenção Urinária/parasitologiaRESUMO
In the framework of the poliomyelitis program eradication, the World Health Organization suggests two markers to survey the circulation of the poliovirus: notification of all cases of acute flask paralysis (AFP) and etiological research of these AFP from two stool samples. The authors reported the case of a AFP, occurring after a polio vaccination in a 5-year-old boy who had later an acute rhinopharyngitis treated by antibiotics and quinine intramuscular injections. A left lower limb AFP justified his hospitalisation. The isolation of a Sabin type 3 poliovirus was a pitfall because clinical and complementary investigations demonstrate a peripheral neuromuscular paralysis. This demonstrative case shows the need for health staff to be trained to perform correctly an usual act like intramuscular drug injections.