Letícia Cardoso Rodrigues

Using an accelerometer for analyzing a reach-to-grasp movement after stroke

O objetivo deste estudo foi usar um acelerometro para avaliar a cinematica do movimento de alcance e preensao de individuos com hemiparesia. Participaram deste estudo oito individuos (59,4 ± 6,9 anos) com hemiparesia cronica (50,9 ± 25,8 meses pos-AVE). A avaliacao cinematica foi realizada atraves de acelerometro triaxial (EMG Systems do Brasil) fixado no antebraco. Os individuos realizaram 10 movimentos de alcancar uma garrafa de 500 ml pelo membro superior (MS) paretico e nao paretico. As seguintes variaveis espaco-temporais foram calculadas e utilizadas para comparar o MS paretico e nao paretico: tempo de movimento (TM), tempo para alcancar o pico de velocidade, absoluto e relativo (TPV e TPV%TM), duracao relativa da desaceleracao(DEC%TM), tempo para alcancar o pico de aceleracao (TPA) e pico de aceleracao da mao (PA). Os movimentos foram mais lentos no MS paretico com maiores TM, TPA e DEC. A utilizacao do acelerometro permitiu identificar alteracoes no movimento de alcance em individuos com hemiparesia. Quando sistemas mais compexos nao sao disponiveis, acelerometros podem ser uma alternativa para medir o movimento do MS.

Reliability of the Balance Evaluation Systems Test (BESTest) and BESTest sections for adults with hemiparesis

BACKGROUND: The Balance Evaluation Systems Test (BESTest) was recently created to allow the development of treatments according to the specific balance system affected in each patient. The Brazilian version of the BESTest has not been specifically tested after stroke. OBJECTIVE: To evaluate the intra- and inter-rater reliability and concurrent and convergent validity of the total score of the BESTest and BESTest sections for adults with hemiparesis after stroke. METHOD: The study included 16 subjects (61.1±7.5 years) with chronic hemiparesis (54.5±43.5 months after stroke). The BESTest was administered by two raters in the same week and one of the raters repeated the test after a one-week interval. Intraclass correlation coefficient (ICC) was calculated to assess intra- and interrater reliability. Concurrent validity with the Berg Balance Scale (BBS) and convergent validity with the Activities-specific Balance Confidence scale (ABC-Brazil) were assessed using Pearsons correlation coefficient. RESULTS: Both the BESTest total score (ICC=0.98) and the BESTest sections (ICC between 0.85 and 0.96) have excellent intrarater reliability. Interrater reliability for the total score was excellent (ICC=0.93) and, for the sections, it ranged between 0.71 and 0.94. The correlation coefficient between the BESTest and the BBS and ABC-Brazil were 0.78 and 0.59, respectively. CONCLUSIONS: The Brazilian version of the BESTest demonstrated adequate reliability when measured by sections and could identify what balance system was affected in patients after stroke. Concurrent validity was excellent with the BBS total score and good to excellent with the sections. The total scores but not the sections present adequate convergent validity with the ABC-Brazil. However, other psychometric properties should be further investigated.

Feasibility and effectiveness of adding object-related bilateral symmetrical training to mirror therapy in chronic stroke: A randomized controlled pilot study.

ABSTRACT Purpose: To evaluate the feasibility and effectiveness of adding object-related bilateral symmetrical training to mirror therapy (MT) to improve upper limb (UL) activity in chronic stroke patients. Method: Sixteen patients with moderate UL impairment were randomly allocated to either the experimental (EG) or control (CG) group. Both groups performed 1 hour sessions, 3 days/week for 4 weeks, involving object-related bilateral symmetrical training. EG performed the tasks observing their nonparetic UL reflected in the mirror, while CG observed the paretic UL directly. The primary outcome measure was unilateral and bilateral UL activity according to the Test d’Évaluation des Membres Supérieurs de Personnes Âgées (TEMPA). All measurements were taken at baseline, post-training, and follow-up (2 weeks). Results: TEMPA total score showed the main effect of time. Significant improvement was found for bilateral but not unilateral tasks. Both groups showed gains after training, with no differences between them. Conclusions: This study showed the feasibility of adding object-related bilateral training to MT. Both types of training improved UL bilateral activity; however, a larger sample is required for a definitive study. Other studies need to be carried out to evaluate the effectiveness of combining more distal-oriented movements and object-related unilateral training to improve these effects in chronic stroke patients.

El uso de un acelerómetro para analizar un movimiento de alcance i e preensão después del accidente cerebrovascular

O objetivo deste estudo foi usar um acelerometro para avaliar a cinematica do movimento de alcance e preensao de individuos com hemiparesia. Participaram deste estudo oito individuos (59,4 ± 6,9 anos) com hemiparesia cronica (50,9 ± 25,8 meses pos-AVE). A avaliacao cinematica foi realizada atraves de acelerometro triaxial (EMG Systems do Brasil) fixado no antebraco. Os individuos realizaram 10 movimentos de alcancar uma garrafa de 500 ml pelo membro superior (MS) paretico e nao paretico. As seguintes variaveis espaco-temporais foram calculadas e utilizadas para comparar o MS paretico e nao paretico: tempo de movimento (TM), tempo para alcancar o pico de velocidade, absoluto e relativo (TPV e TPV%TM), duracao relativa da desaceleracao(DEC%TM), tempo para alcancar o pico de aceleracao (TPA) e pico de aceleracao da mao (PA). Os movimentos foram mais lentos no MS paretico com maiores TM, TPA e DEC. A utilizacao do acelerometro permitiu identificar alteracoes no movimento de alcance em individuos com hemiparesia. Quando sistemas mais compexos nao sao disponiveis, acelerometros podem ser uma alternativa para medir o movimento do MS.

Usando um acelerômetro para analisar o movimento de alcance e e preensão após o AVE

O objetivo deste estudo foi usar um acelerometro para avaliar a cinematica do movimento de alcance e preensao de individuos com hemiparesia. Participaram deste estudo oito individuos (59,4 ± 6,9 anos) com hemiparesia cronica (50,9 ± 25,8 meses pos-AVE). A avaliacao cinematica foi realizada atraves de acelerometro triaxial (EMG Systems do Brasil) fixado no antebraco. Os individuos realizaram 10 movimentos de alcancar uma garrafa de 500 ml pelo membro superior (MS) paretico e nao paretico. As seguintes variaveis espaco-temporais foram calculadas e utilizadas para comparar o MS paretico e nao paretico: tempo de movimento (TM), tempo para alcancar o pico de velocidade, absoluto e relativo (TPV e TPV%TM), duracao relativa da desaceleracao(DEC%TM), tempo para alcancar o pico de aceleracao (TPA) e pico de aceleracao da mao (PA). Os movimentos foram mais lentos no MS paretico com maiores TM, TPA e DEC. A utilizacao do acelerometro permitiu identificar alteracoes no movimento de alcance em individuos com hemiparesia. Quando sistemas mais compexos nao sao disponiveis, acelerometros podem ser uma alternativa para medir o movimento do MS.