Antonio Vinicius Soares

Dinamometria de preensão manual como parâmetro de avaliação funcional do membro superior de pacientes hemiparéticos por acidente vascular cerebral

A forca muscular e a valencia fisica mais importante. E provavel que exista correlacao entre a forca de preensao manual e outros testes para o membro superior afetado por um acidente vascular cerebral (AVC). O proposito deste estudo e analisar o valor preditivo da dinamometria de preensao manual (DPM) para recuperacao do membro superior paretico por AVC. Foram avaliados 43 pacientes hemipareticos pos-AVC (60,7 anos±12,1). Varios testes (Escala de movimento da mao (EMM), Estesiometria, Teste de caixa e blocos, 9 buracos e pinos, Escala de Ashworth modificada e Indice de Barthel) foram relacionados com a DPM. Os resultados apontaram que a DPM apresenta boa correlacao com EMM e, contrariamente, os testes de destreza manual, a sensibilidade e o indice de independencia funcional nao apresentaram valores significativos. A DPM e um teste rapido, facil e acessivel, e pode fazer parte dos protocolos de avaliacao funcional do membro superior de pacientes hemipareticos por AVC.

The use of Virtual Reality for upper limb rehabilitation of hemiparetic Stroke patients

Introducao O Acidente Vascular Cerebral (AVC) e um disturbio neurologico que acarreta grave impacto na funcionalidade e na qualidade de vida dos sobreviventes. Faz-se necessario o desenvolvimento de novas ferramentas com fins reabilitacionais, neste contexto, a Realidade Virtual (RV) apresenta-se como um recurso terapeutico util para recuperacao motora, de forma atrativa e eficiente, restaurando funcoes por meio de jogos adaptados. Objetivo Analisar os efeitos terapeuticos da Realidade Virtual (Jogo Serio) na recuperacao do membro superior de pacientes hemipareticos por AVC. Metodos Pesquisa quase experimental tipo series de tempo, havendo realizacao de tres pre e tres pos-testes apos 20 sessoes de RV. Nas avaliacoes foram utilizados os seguintes instrumentos de medida: Escala de Fugl-Meyer - sessao do membro superior (EFM-MS); amplitude de movimento (ADM) para flexao e abducao do ombro; Teste da Caixa e Blocos (CB); Teste de Nove Buracos e Pinos (9BP); o Perfil de Saude de Nottingham (PSN); e Escala de Ashwhorth Modificada (EAM). Resultados Ganhos significativos foram observados nos testes da EFM-MS, com incremento 25,6%; ADM do ombro com 34,0% para abducao e 19,8% para flexao; CB 25,0%; os pacientes tambem relataram melhora na qualidade de vida pelo PSN; nao ocorreram alteracoes significativas para 9BP e na EAM. Conclusao Embora os resultados encontrados nesta pesquisa sejam preliminares, eles sao sugestivos de que a RV pode contribuir para a recuperacao do membro superior de hemipareticos por AVC.

Biorretroalimentação para treinamento do equilíbrio em hemiparéticos por acidente vascular encefálico: estudo preliminar

Since balance dysfunction is frequent among poststroke hemiparetic patients, balance training is a fundamental goal in their rehabilitation. The purpose of this study was to assess the effects of biofeedback balance training on an unstable computerized platform in six hemiparetic patients (three men and three women, mean age 56,2 years old). Subjects were assessed, before and after treatment, as to functional mobility (by the timed up-and-go test, TUGT), functional reach, health-related quality of life (by the Nottingham health profile), and as to equilibrium on the unstable platform. The training on an unstable computerized platform took place along 23, 30-minute sessions for 8 weeks. Results showed significant improvement (p<0.001) in standing balance, of 119.1% with feet apart, and of 79.6% with feet together; a 15% increase (p<0.001) in functional reach; a 25.6% improvement in TUGT (p<0.001); and a slight improvement in self-reported quality of life. The program brought thus significant improvements for the sample studied, suggesting that the biofeedback balance training as here proposed may be a valuable tool in the rehabilitation of stroke hemiparetic patients.

Postural control in blind subjects

OBJECTIVE To analyze postural control in acquired and congenitally blind adults. METHODS A total of 40 visually impaired adults participated in the research, divided into 2 groups, 20 with acquired blindness and 20 with congenital blindness - 21 males and 19 females, mean age 35.8 ± 10.8. The Brazilian version of Berg Balance Scale and the motor domain of functional independence measure were utilized. RESULTS On Berg Balance Scale the mean for acquired blindness was 54.0 ± 2.4 and 54.4 ± 2.5 for congenitally blind subjects; on functional independence measure the mean for acquired blind group was 87.1 ± 4.8 and 87.3 ± 2.3 for congenitally blind group. CONCLUSION Based upon the scale used the results suggest the ability to control posture can be developed by compensatory mechanisms and it is not affected by visual loss in congenitally and acquired blindness.

Dinamometria lombar: um teste funcional para o tronco

| Context: Muscle strength is the main physical valence. Clinical evaluation is performed using manual tests. However, these tests although reproducible are very subjective and imprecise. The torso evaluation has been performed by means of the the lumbar dynamometry (LD). This information is valuable in admission and periodic examinations of employees working on tasks that require repetitive effort, lifting, and transfer of loads. Objectives: As literature does not have reference values for this test, the objective of this research was to present values that can be used as reference for future study of normative values. Methods: The study was conducted with 691 healthy participants of both the genders and practitioners that do not practice regular physical activity, all with normal body mass index (BMI). Their ages ranged between 18 and 45 years, 382 were men, with an average age of 27.1 years (±7.5), and 309 women, with an average age of 28.2 years (±8.1). A portable digital system is composed of a dynamometer connected to a load cell and platform, and a digital indicator. Results: The average value of force measured in men with the LD system was 114.0 kgf (±25.4), and 48.5 kgf (±18.8) in women. Men had 235,1% more strength than women. Conclusion: This study presents an initial contribution to establish normative values for this dynamometer test, but further studies are needed, given the fact that the measurements are preliminary and specific to the geographic region studied.

Use of visual feedback for balance training in hemiparetic Stroke patients

Introduction Hemiparetic Stroke patients have their daily activities affected by the balance impairment. Techniques that used visual information for training this impairment it seems to be effective. Objective To analyze the effects of the unstable balance board training and compare two ways of visual feedback: the biomechanical instrumentation and the mirror. Materials and methods Eight chronic hemiparetic Stroke patients participated in the research, randomized in two groups. The first group (G1) accomplished the training with biomechanical instrumentation, and the second group (G2) trained in front of the mirror. Sixteen training sessions were done with feet together, and feet apart. The evaluation instruments that were used before and after the period of training were the Time Up and Go Test (TUGT), Berg Balance Scale (BBS) and the Instrumented Balance Board (IBB), that quantified the functional mobility, the balance and the posture control respectively. Results The TUGT showed significant results (p 0.05). A strong correlation between all the applied tests was observed in this research. Conclusion Although the advantages found were different between the groups, in both it could be observed that the training brought benefits, with the transference to the functional mobility.

Peripheral perfusion index does not accurately reflect hypoperfusion in healthy dogs undergoing elective ovariohysterectomy

This study evaluated the variability of the peripheral perfusion index (PI) in 22 anaesthetised female dogs undergoing elective ovariohysterectomy and examined the relationship between peripheral PI and heart rate, blood pressure, blood pH, end tidal CO2 (EtCO2), O2 saturation (SpO2), core-peripheral temperature gradient (ΔTc-p), partial pressure of CO2 (PCO2), and concentrations of glucose, cortisol, lactate and bicarbonate (HCO3-). Blood pH, lactate and glucose concentrations were determined 15, 30, 45min into the ovariohysterectomy procedure and after extubation. Cortisol concentrations were assessed before anaesthesia and after extubation. Other variables were recorded at every 5min throughout the ovariohysterectomy procedure. Hyperglycaemia was observed in 59% of bitches during surgery, but serum cortisol concentrations remained unchanged. Most measures of perfusion (ΔTc-p, pH, PCO2, EtCO2, SpO2) and heart rate remained unchanged throughout anaesthesia and did not correlate with peripheral PI. Mean arterial pressure increased during the ovariohysterectomy procedure, while peripheral PI decreased, resulting in negative correlations between these variables at 30 and 45min. Lactate concentrations decreased from baseline to the time of measurement post-extubation. Peripheral PI gradually decreased during the ovariohysterectomy procedure, probably reflecting vasoconstriction induced by nociceptive stimuli. Using lactate concentrations as the reference standard for peripheral perfusion, low peripheral PI in healthy bitches undergoing ovariohysterectomy might not represent peripheral hypoperfusion.

Relation between functional mobility and dynapenia in institutionalized frail elderly

RESUMO Objetivo Investigar a relacao entre mobilidade funcional e dinapenia em idosos frageis institucionalizados. Metodos Estudo descritivo, correlacional conduzido com 26 idosos institucionalizados de ambos os sexos com media de idade de 82,3±6 anos. Os instrumentos utilizados foram o Mini-Exame do Estado Mental, Escala de Depressao Geriatrica, Questionario Internacional de Atividade Fisica, teste Timed Up and Go, dinamometro de preensao manual e dinamometro portatil para avaliar grandes grupos musculares (flexores do ombro, flexores do cotovelo, flexores do quadril, extensores do [...]

Serious Games for Balance Improvement: A Systematic Literature Mapping

Rehabilitation using video games is more motivating than standard rehabilitation. There are several games developed for balance rehabilitation however, they focus on different aspects, apply a variety of assessment and were developed using a myriad of approaches. In order to provide an overview about specially purposed games for balance rehabilitation, a systematic literature mapping was conducted to assess how they were developed, what software evaluation and clinical assessment were applied and the devices they used. A total of 514 studies were analyzed, but only 44 of them satisfied the inclusion and exclusion criteria. As a result, we verified that most studies used attachment based commercial devices; usability is the most used criteria to evaluate the game and questionnaires are used for it. There is no consensus on clinical assessment metrics and a remarkable lack of design methodology used. From the plethora of serious games found in the literature it is clear that much research need to be done but games can already be considered an acceptable approach for balance promotion.

Physiotherapeutic treatment Schedule for chronic low back pain: influence on pain, quality of life and functional capacity

BACKGROUND AND OBJECTIVES: Low back pain is a public health problem affecting population regardless of social and economic class. Segmental stabilization is a kinesiotherapeutic technique being considered treatment option for this disorder. Primary objective of this study was to evaluate the effects of a treatment schedule for low back pain based on segmental stability principles. The secondary objective was to propose and adaptation of Nottingham Health Profile, which is a tool to evaluate quality of life. METHODS: This is a pre-experimental study involving 25 chronic low back pain patients of both genders, mean age of 50.5 years. The study consisted of 16 sessions of a segmental stabilization exercises program, carried out twice a week during six months. Measurement tools were: visual analog scale, Roland-Morris questionnaire and two versions of Nottingham Health Profile, namely translated and modified. RESULTS: At treatment completion, all patients had significant improvement in variables controlled by the study. Modified Nottingham Health Profile version had strong and significant correlation with the translated version (r 0.88) and with functional incapacity level evaluated by Roland Morris questionnaire (r 0.85). CONCLUSION: Proposed treatment schedule was beneficial for patients involved in the study. Modified version of Nottingham Health Profile may be used to evaluate quality of life perception especially of chronic low back pain patients.