Eliane Araújo de Oliveira

Transcranial direct current stimulation over the primary motor vs prefrontal cortex in refractory chronic migraine: A pilot randomized controlled trial

Although transcranial direct current stimulation (tDCS) represents a therapeutic option for the prophylaxis of chronic migraine, the target area for application of the electrical current to the cortex has not yet been well established. Here we sought to determine whether a treatment protocol involving 12 sessions of 2mA, 20min anodal stimulation of the left primary motor (M1) or dorsolateral prefrontal cortex (DLPFC) could offer clinical benefits in the management of pain from migraine. Thirteen participants were assessed before and after treatment, using the Headache Impact Test-6, Visual Analogue Scale and Medical Outcomes Study 36 - Item Short - Form Health Survey. After treatment, group DLPFC exhibited a better performance compared with groups M1 and sham. On intragroup comparison, groups DLPFC and M1 exhibited a greater reduction in headache impact and pain intensity and a higher quality of life after treatment. No significant change was found in group sham. The participants in group M1 exhibited more adverse effects, especially headache, heartburn, and sleepiness, than did those in the other two groups. Transcranial direct current stimulation is a safe and efficacious technique for treating chronic migraine. However, it should be kept in mind that the site of cortical stimulation might modulate the patients response to treatment.

Construção e evidências psicométricas de uma escala de avaliação da percepção visual

Este estudo teve como objetivo construir e conhecer os parâmetros psicometricos de um instrumento para analise da percepcao visual de adultos. Para a construcao da escala participaram 295 adultos saudaveis, sem deficits cognitivos ou perceptivo-visuais. Nesta etapa foi formulada uma escala tetrafatorial constituida por 20 itens que avaliam quatro dimensoes referentes a percepcao visual: constância da forma, figura-fundo, posicao e relacao espacial. Para obter evidencias de validade foi utilizada uma amostra de 183 voluntarios com boa saude fisica e mental e acuidade visual normal ou corrigida. Os dados obtidos relatam a existencia de concordância interjuizes, adequacao semântica e significância no teste-reteste do instrumento. Os coeficientes de fidedignidade variaram de 0,84 a 0,93. Os quatro fatores esperados foram encontrados, cada um contendo 5 itens, e juntos explicaram 57,52% da variância do constructo. O instrumento apresentou parâmetros psicometricos adequados, o que pode justificar sua utilidade em pesquisas basicas e na pratica clinica.

Constraint-Induced Movement Therapy Combined with Transcranial Direct Current Stimulation over Premotor Cortex Improves Motor Function in Severe Stroke: A Pilot Randomized Controlled Trial

Objective. We compared the effects of transcranial direct current stimulation at different cortical sites (premotor and motor primary cortex) combined with constraint-induced movement therapy for treatment of stroke patients. Design. Sixty patients were randomly distributed into 3 groups: Group A, anodal stimulation on premotor cortex and constraint-induced movement therapy; Group B, anodal stimulation on primary motor cortex and constraint-induced movement therapy; Group C, sham stimulation and constraint-induced movement therapy. Evaluations involved analysis of functional independence, motor recovery, spasticity, gross motor function, and muscle strength. Results. A significant improvement in primary outcome (functional independence) after treatment in the premotor group followed by primary motor group and sham group was observed. The same pattern of improvement was highlighted among all secondary outcome measures regarding the superior performance of the premotor group over primary motor and sham groups. Conclusions. Premotor cortex can contribute to motor function in patients with severe functional disabilities in early stages of stroke. This study was registered in ClinicalTrials.gov database (NCT 02628561).

Stroke Treatment Associated with Rehabilitation Therapy and Transcranial DC Stimulation (START-tDCS): a study protocol for a randomized controlled trial

BackgroundTraditional treatment for motor impairment after stroke includes medication and physical rehabilitation. The transcranial direct current stimulation associated with a standard physical therapy program may be an effective therapeutic alternative for these patients.MethodsThis study is a sham-controlled, double-blind, randomized clinical trial aiming to evaluate the efficacy of transcranial direct current stimulation in activities of daily living and motor function post subacute stroke. In total there will be 40 patients enrolled, diagnosed with subacute, ischemic, unilateral, non-recurring stroke. Participants will be randomized to two groups, one with active stimulation and the other with a placebo current. Patients and investigators will be blinded. Everyone will receive systematic physical therapy, based on constraint-induced movement therapy. The intervention will be applied for 10 consecutive days. Patients will undergo three functional assessments: at baseline, week 2, and week 4. Neuropsychological tests will be performed at baseline and week 4. Adverse effects will be computed at each session. On completion of the baseline measures, randomization will be conducted using random permuted blocks. The randomization will be concealed until group allocation.DiscussionThis study will investigate the combined effects of transcranial direct current stimulation and physical therapy on functional improvement after stroke. We tested whether the combination of these treatments is more effective than physical therapy alone when administered in the early stages after stroke.Trial registrationNCT02156635 - May 30, 2014. Randomization is ongoing (40 participants randomized as of the end of December 2015).

A TERAPIA AQUÁTICA COMO COADJUVANTE NA VARIAÇÃO DO HUMOR EM MULHERES PÓS-MENOPÁUSICAS

Objective: To observe the influence of an aquatic therapeutic exercise program on menopausal symptoms and depression in a group of menopausal women. Material and Methods: This was a longitudinal intervention study, with a quantitative approach and pre- and post-treatment measures in a population of menopausal women. Instruments for data collection: Blatt and Kuppermann Menopausal Index and Black & Yesavage Geriatric Depression Scale. Data were analyzed using the software Statistical Package for Social Sciences (SPSS) version 16.0 for Windows, in addition to Wilcoxon statistical test and Spearman’s correlation test. Results: The mean (SD) of menopausal symptoms before and after intervention was found to be 11.73 (9.90) and 7.60 (5.60), respectively, with a significant difference (z=-3.293; p=0.001) between pre- and post-treatment measures. For symptoms of depression, means (SD) of 13.3 (5.5) and 9.0 (5.9) were observed before and after intervention, with a significant difference (z=-2.003; p=0.045) between pre- and post-treatment measures, confirmed by the Spearman correlation test. Conclusion: Hydrotherapy was found to provide physical and functional benefits, such as relief of heat waves and improvement in mood and body image, increasing female self-esteem and reducing depression symptoms abundantly found in menopausal women. DESCRIPTORS Climacteric. Menopause. Depression. Hydrotherapy. Exercise.

ASPECTOS BIOPSICOSSOCIAIS DE PUÉRPERAS ADOLESCENTES NO MUNICÍPIO DE JOÃO PESSOA, PARAÍBA, BRASIL

Objective: To identify the biopsychosocial characteristics of pregnant adolescents assisted in the maternities of Lauro Wanderley University Hospital and Candida Vargas Institute, in the city of Joao Pessoa, Paraiba, Brazil. Material and Methods: This was a descriptive, observational and cross-sectional study, whose sample consisted of 104 adolescents, aged between 13 and 19 years, whom were approached in the immediate postpartum period. The data were collected from medical records and interviews with the mothers in the immediate postpartum period. Results: The mean age of participants was 18.5±1.4 years; 52.4 % had mixed ethnicity; 61.5% had dropped out of school; 90% had studied in a public school. There was a predominance of the elementary education level (55.8%). The family and the partner supported the adolescent during pregnancy in 94.2% and 87.5% of cases, respectively. Conclusion: The most common age group of adolescent mothers was between 16 and 19 years, although there was a significant rate of mothers aged between 17 and 19 years. In addition, there was a high prevalence of mothers who dropped out of school due to pregnancy; however, in general, the adolescents were supported by their family and childs father. DESCRIPTORS Teenage pregnancy. Living conditions. Health profile.