Camila Rocha Simão

Effects of treadmill inclination on the gait of children with Down syndrome

The goal of this study was to analyze the effects of upward treadmill inclination on the gait of children with Down syndrome (DS). Sixteen children with a mean age 8.43 ± 2.25 years, classified at level I of the Gross Motor Function Classification System (GMFCS) and able to walk without personal assistance and/or assistive devices/orthosis were evaluated. Spatial-temporal variables were observed as well as the angular variation of hip, knee and ankle in the sagittal plane, while children walked on the treadmill carried out on 0% and 10% upward inclination. The results showed that children with DS presented changes in spatio-temporal variables (reduced cadence and increased cycle time and swing time) and in angular variables (increased hip, knee and ankle angles at initial contact; increased maximum hip flexion and maximum stance dorsiflexion; and reduced plantarflexion at pre-swing). Treadmill inclination seemed to act positively on the angular and spatio-temporal characteristics of gait in children with DS, demonstrating a possible benefit from the use of this type of surface in the gait rehabilitation of this population.

Effects of treadmill inclination on hemiparetic gait: controlled and randomized clinical trial.

ObjectiveThe aim of this study was to analyze the effects of inclined treadmill training on the kinematic characteristics of gait in subjects with hemiparesis. DesignA blind, randomized, controlled study was conducted with 28 subjects divided into two groups: the control group, submitted to partial body weight–support treadmill gait training with no inclination, and the experimental group, which underwent partial body weight–support treadmill training at 10% of inclination. All volunteers were assessed for functional independence, motor function, balance, and gait before and after the 12 training sessions. ResultsBoth groups showed posttraining alterations in balance (P < 0.001), motor function (P < 0.001), and functional independence (P = 0.002). Intergroup differences in spatiotemporal differences were observed, where only the experimental group showed posttraining alterations in velocity (P = 0.02) and paretic step length (P = 0.03). Angular variables showed no significant differences in either group. ConclusionsIn subjects with hemiparesis, the addition of inclination is a stimulus capable of enhancing the effects of partial body weight–support treadmill gait training.

Effects of Treadmill Training with Load on Gait in Parkinson Disease: A Randomized Controlled Clinical Trial.

ObjectiveThe aim of this study was to assess the effects of 3% of body weight loads (0%, 5%, and 10%) on treadmill gait training in subjects with Parkinson disease. DesignThis study used a randomized controlled single-blind trial. ResultsSpatiotemporal variables demonstrated significant intragroup alterations in all three groups at pretraining and posttraining, with an increase in speed (m/sec; F = 4.73, P = 0.04), stride length (m; F = 12.00, P = 0.002), and step length (m; F = 16.16, P = 0.001) and a decrease in the double-stance phase (%; F = 6.59, P = 0.02) and stance phase (%; F = 4.77, P = 0.04). Intergroup pretraining and posttraining did not exhibit significant differences (F < 2.18, P > 0.14). Angular variables showed significant intragroup alterations, with an increase in knee range of motion (F = 5.18, P = 0.03), and intergroup comparison revealed no significant changes (F = 1.87, P = 0.17). ConclusionsPosttraining improvements in speed, stride length, step length, double-stance, stance phase, and knee range of motion were observed in all groups, where no load (0%, 5%, or 10%) had any significant effect, suggesting that the influence of load did not make one experimental condition better than another. All participants benefitted from treadmill gait training, irrespective of the use of load.

Robotic assisted gait as a tool for rehabilitation of individuals with spinal cord injury: a systematic review

BackgroundSpinal cord injury (SCI) is characterized by a total or partial deficit of sensory and motor pathways. Impairments of this injury compromise muscle recruitment and motor planning, thus reducing functional capacity. SCI patients commonly present psychological, intestinal, urinary, osteomioarticular, tegumentary, cardiorespiratory and neural alterations that aggravate in chronic phase. One of the neurorehabilitation goals is the restoration of these abilities by favoring improvement in the quality of life and functional independence. Current literature highlights several benefits of robotic gait therapies in SCI individuals.ObjectivesThe purpose of this study was to compare the robotic gait devices, and systematize the scientific evidences of these devices as a tool for rehabilitation of SCI individuals.MethodsA systematic review was carried out in which relevant articles were identified by searching the following databases: Cochrane Library, PubMed, PEDro and Capes Periodic. Two authors selected the articles which used a robotic device for rehabilitation of spinal cord injury.ResultsDatabases search found 2941 articles, 39 articles were included due to meet the inclusion criteria. The robotic devices presented distinct features, with increasing application in the last years. Studies have shown promising results regarding the reduction of pain perception and spasticity level; alteration of the proprioceptive capacity, sensitivity to temperature, vibration, pressure, reflex behavior, electrical activity at muscular and cortical level, classification of the injury level; increase in walking speed, step length and distance traveled; improvements in sitting posture, intestinal, cardiorespiratory, metabolic, tegmental and psychological functions.ConclusionsThis systematic review shows a significant progress encompassing robotic devices as an innovative and effective therapy for the rehabilitation of individuals with SCI.

Efeitos da adição de carga na marcha de crianças com paralisia cerebral: relato de três casos

Our purpose in this study was to analyze the immediate effects of locomotor gait training with different loads on a treadmill on the kinematic parameters of gait in children with Spastic Hemiparetic Cerebral Palsy (SHCP), as well as investigating which load prompted the most adequate motor responses to promote the propulsion of the Paretic Lower Limb (PLL). This case report included 3 children of both sexes, aged 8-12 years. The children walked on the treadmill with loads on their ankles that corresponded to 40, 50 and 60% of the weight of the Lower Limb (LL), on 3 different non-consecutive days. The kinematic parameters were assessed during the pre-training phase (PTPH) and immediately after training (PHI). The spatiotemporal variables did not change immediately after gait training with the aforementioned loads. On the other hand, we observed wider joint angles in the hip and knee during the swing phase immediately after training, especially with a load of 60% of the weight of the lower limb. These findings indicate that the 60% load is the most appropriate to prompt immediate changes in the joint kinematics of the PLL. These alterations can be important in improving propulsion during the swing phase of gait in children with SHCP.O objetivo deste estudo foi analisar os efeitos imediatos do treino locomotor na esteira com diferentes cargas, sobre os parâmetros cinematicos da marcha de criancas com Paralisia Cerebral Hemiparetica Espastica (PCHE), e investigar qual carga promove repostas motoras mais adequadas para favorecer a propulsao do Membro Inferior Paretico (MIP). Participaram deste relato de caso 3 criancas de ambos os sexos, com idades de 8-12 anos. As criancas realizaram treino na esteira com carga nos tornozelos equivalentes a 40, 50 e 60% do peso do Membro Inferior (MI), em 3 dias diferentes e nao consecutivos. Os parâmetros cinematicos foram avaliados nas fases pre-treinamento (FPT) e imediatamente apos o treino (FI). As variaveis espaco-temporais nao sofreram alteracoes imediatamente apos o treino de marcha com carga. Por outro lado, foi observado aumento dos ângulos articulares de quadril e joelho durante a fase de balanco imediatamente apos o treino, principalmente com carga de 60% do peso do membro inferior. Estes achados indicam que a carga de 60% seja a mais apropriada para solicitar alteracoes imediatas na cinematica articular do MIP. Tais alteracoes podem ser importantes para favorecer a propulsao durante a fase de balanco da marcha de criancas com PCHE.

Effects of adding load to the gait of children with cerebral palsy: a three-case report

Our purpose in this study was to analyze the immediate effects of locomotor gait training with different loads on a treadmill on the kinematic parameters of gait in children with Spastic Hemiparetic Cerebral Palsy (SHCP), as well as investigating which load prompted the most adequate motor responses to promote the propulsion of the Paretic Lower Limb (PLL). This case report included 3 children of both sexes, aged 8-12 years. The children walked on the treadmill with loads on their ankles that corresponded to 40, 50 and 60% of the weight of the Lower Limb (LL), on 3 different non-consecutive days. The kinematic parameters were assessed during the pre-training phase (PTPH) and immediately after training (PHI). The spatiotemporal variables did not change immediately after gait training with the aforementioned loads. On the other hand, we observed wider joint angles in the hip and knee during the swing phase immediately after training, especially with a load of 60% of the weight of the lower limb. These findings indicate that the 60% load is the most appropriate to prompt immediate changes in the joint kinematics of the PLL. These alterations can be important in improving propulsion during the swing phase of gait in children with SHCP.O objetivo deste estudo foi analisar os efeitos imediatos do treino locomotor na esteira com diferentes cargas, sobre os parâmetros cinematicos da marcha de criancas com Paralisia Cerebral Hemiparetica Espastica (PCHE), e investigar qual carga promove repostas motoras mais adequadas para favorecer a propulsao do Membro Inferior Paretico (MIP). Participaram deste relato de caso 3 criancas de ambos os sexos, com idades de 8-12 anos. As criancas realizaram treino na esteira com carga nos tornozelos equivalentes a 40, 50 e 60% do peso do Membro Inferior (MI), em 3 dias diferentes e nao consecutivos. Os parâmetros cinematicos foram avaliados nas fases pre-treinamento (FPT) e imediatamente apos o treino (FI). As variaveis espaco-temporais nao sofreram alteracoes imediatamente apos o treino de marcha com carga. Por outro lado, foi observado aumento dos ângulos articulares de quadril e joelho durante a fase de balanco imediatamente apos o treino, principalmente com carga de 60% do peso do membro inferior. Estes achados indicam que a carga de 60% seja a mais apropriada para solicitar alteracoes imediatas na cinematica articular do MIP. Tais alteracoes podem ser importantes para favorecer a propulsao durante a fase de balanco da marcha de criancas com PCHE.

Efectos de la adición de carga sobre la marcha de niños con parálisis cerebral: relato de tres casos

Our purpose in this study was to analyze the immediate effects of locomotor gait training with different loads on a treadmill on the kinematic parameters of gait in children with Spastic Hemiparetic Cerebral Palsy (SHCP), as well as investigating which load prompted the most adequate motor responses to promote the propulsion of the Paretic Lower Limb (PLL). This case report included 3 children of both sexes, aged 8-12 years. The children walked on the treadmill with loads on their ankles that corresponded to 40, 50 and 60% of the weight of the Lower Limb (LL), on 3 different non-consecutive days. The kinematic parameters were assessed during the pre-training phase (PTPH) and immediately after training (PHI). The spatiotemporal variables did not change immediately after gait training with the aforementioned loads. On the other hand, we observed wider joint angles in the hip and knee during the swing phase immediately after training, especially with a load of 60% of the weight of the lower limb. These findings indicate that the 60% load is the most appropriate to prompt immediate changes in the joint kinematics of the PLL. These alterations can be important in improving propulsion during the swing phase of gait in children with SHCP.O objetivo deste estudo foi analisar os efeitos imediatos do treino locomotor na esteira com diferentes cargas, sobre os parâmetros cinematicos da marcha de criancas com Paralisia Cerebral Hemiparetica Espastica (PCHE), e investigar qual carga promove repostas motoras mais adequadas para favorecer a propulsao do Membro Inferior Paretico (MIP). Participaram deste relato de caso 3 criancas de ambos os sexos, com idades de 8-12 anos. As criancas realizaram treino na esteira com carga nos tornozelos equivalentes a 40, 50 e 60% do peso do Membro Inferior (MI), em 3 dias diferentes e nao consecutivos. Os parâmetros cinematicos foram avaliados nas fases pre-treinamento (FPT) e imediatamente apos o treino (FI). As variaveis espaco-temporais nao sofreram alteracoes imediatamente apos o treino de marcha com carga. Por outro lado, foi observado aumento dos ângulos articulares de quadril e joelho durante a fase de balanco imediatamente apos o treino, principalmente com carga de 60% do peso do membro inferior. Estes achados indicam que a carga de 60% seja a mais apropriada para solicitar alteracoes imediatas na cinematica articular do MIP. Tais alteracoes podem ser importantes para favorecer a propulsao durante a fase de balanco da marcha de criancas com PCHE.