Lislei Jorge Patrizzi

Mental practice and mirror therapy associated with conventional physical therapy training on the hemiparetic upper limb in poststroke rehabilitation: a preliminary study.

Abstract Background: The presence of sensory and motor deficits is common in patients post stroke. Mental practice (MP) and mirror therapy (MT) can be used as therapeutic techniques for poststroke rehabilitation. Important results have been demonstrated, although they have not established the patients’ functional gain or related results of muscle electromyographic (EMG) data to functionality. Objective: The aim was to investigate EMG activity and sensory, motor, and functional performance in hemiparetic limbs of patients with stroke after intervention with MP and MT associated with conventional physical therapy training (CPTT). Methods: Seven patients were treated twice weekly during 8 weeks with MP and MT associated with CPTT of the affected upper limb. The Fugl-Meyer scale and the Barthel Index (BI) were applied to assess sensorimotor ability and independence of patients. Activation of the upper trapezius, biceps brachii, triceps brachii, flexor carpi ulnaris, and extensor carpi radialis was evaluated by means of EMG symmetry index and muscle co-activation measurements. Results: There were statistically significant differences between pre- and postassessment findings for the motor, sensory, and mobility domains of the Fugl-Meyer scale, as well as for BI evaluation. No statistically significant differences were observed when the pre- and posttest symmetry and co-activation data were compared, although there were qualitative changes. Conclusions: The protocol was effective for improving motor, sensory, and mobility aspects, as well as function involved in activities of daily living. Qualitative changes in symmetry and muscle co-contraction were found, indicating a possible improvement in upper limb rehabilitation of patients with stroke.

Dupla tarefa e mobilidade funcional de idosos ativos

INTRODUCTION: Dual task can be defined as the ability to perform a primary action embedded in a second activity. In the elderly, it is presumed that the performance of concurrent actions disturb the postural balance, favoring falls in this population. AIMS: To evaluate the effect of dual tasks in functional mobility of active seniors and correlate the time used for its realization with the individuals age. METHODS: Cross-sectional, observational study with a convenience sample. Nineteen elderly from Universidade Aberta a Terceira Idade, Universidade Federal do Triângulo Mineiro, Minas Gerais state, Brazil, aged between 60 and 87 years, classified as physically active by the International Physical Activity Questionnaire IPAQ and with a minimum score that reaches 23 points on the Mini-Mental State Examination MMSE were evaluated during 9 sequential tests. The first one required a single task, which was represented by the Timed Up & Go TUG test, used to assess functional mobility of seniors. TUG was repeated in all other tests, in which was included a second action - manual activity in two tests and cognitive activity in six tests. RESULTS: The elderly spent longer period performing associated tasks considering both motor and motor-cognitive combined actions when compared with time spent during the simple task. Positive correlation between age and the tests that incorporate cognitive activity to achieve the TUG was established. CONCLUSION: Physically active seniors require a longer period to perform the dual motor task involving distinct functions and coordinates between the upper limbs, and the same occurs for the performance of motor-cognitive dual tasks. The higher the age, the greater the time to perform double tasks, especially when associated with activities requiring short-term memory.

Immediate effect of mental practice with and without mirror therapy on muscle activation in hemiparetic stroke patients

Mental practice (MP) consists of the repeated mental rehearsal of a physical skill without movement, called motor imagery (MI). Studies show that MP and MI associated mirror therapy (MPMT) may improve muscle control of the upper limbs in hemiparesis. This study aimed to evaluate muscle activation during active flexion of the wrist (MA), MP, and MPMT in patients with history of stroke and hemiparesis. Individuals diagnosed with stroke showing sequelae of upper limb hemiparesis were enrolled. The flexor carpi ulnaris was analyzed using electromyography during tasks (MA, MP, MPMT) involving wrist flexion. Greater electromyographic activity was detected during MP and MPMT techniques compared to active movement (pxa0=xa00.02). There was no significant difference between MP and MPMT (pxa0=xa00.56). These results were found in both the affected limb and unaffected limb. Immediate effects on muscle activation are experienced during MP and MPMT, and muscle activity was similar with both therapies.

Exercícios físicos, mobilidade funcional, equilíbrio, capacidade funcional e quedas em idosos.

Introduction: The motor skill is essential to preserving the functional capacity of the elderly. Objective: To compare groups of active and sedentary elderly, Basic Health Units users in the city of Uberaba/MG, with respect to functional mobility, dynamic balance, functional capacity and falls. Methods: The elderly were divided into two groups, one of sedentary and other whit actives. The evaluation of the falls was self reported, functional mobility was evaluated by the test Timed Up and Go, the dynamic balance by the maximum walking speed test and the assessment of functional capacity by SF36. Results: There was significant difference for functional capacity, indicating higher levels for the active elderly. Conclusion: Further studies with greater control in the intervention program, longitudinal design, can demonstrate the results of physiological adaptations induced by physical activity in those variables should be encouraged.

Oxigenoterapia inalatória em idosos internados em um hospital público

Objectives: To describe the characteristics of oxygen inhalation therapy used on elderly patients of the medical clinical department of a Brazilian public hospital, and to evaluate the knowledge of those accompanying them about the therapy. Method: An observational, descriptive cross-sectional study was carried out. The sample comprised 52 elderly persons who had been hospitalized in the medical clinical department of a public hospital in Minas Gerais for two months. The characteristics of the application of the oxygen inhalation therapy, the sociodemographic aspects and the general health characteristics of the group were evaluated through the analysis of hospital records, medical prescriptions and in loco observation. The knowledge of the persons accompanying the elderly patients was evaluated through a structured interview. Statistical analysis included exploratory univariate analysis, study of the frequencies of the categorical variables and descriptive statistical analysis of the continuous variables. Results: There was a predominance of females (53.8%); a mean age of 75 years; a low educational level (two years) and per capita income (between one and three minimum wages); a marital status of married (42.2%); and nonsmokers (48.1%). A total of 67.3% of the elderly persons had not previously used mechanical ventilation and 61.5% were undergoing physical therapy. The most common outcome was hospital discharge without OIT (53.8%). The nasal cannula was the most commonly used device (51.9%); 42.0% of prescriptions were not documented; monitoring was present in 76.9% of cases; 81.8% of those accompanying the elderly patients did not know what the OIT device was and 27.0% reported having changed the oxygen supply device. Conclusion: This study identified the relevant characteristics of the application of oxygen inhalation therapy among elderly patients of a public hospital, demonstrating the need for standardization of information, prescriptions and monitoring of such individuals during oxygen inhalation therapy, with educational measures for the healthcare team and those accompanying the patients.

Quality of life evaluation, sleep and Burnout Syndrome the residentes of the multidisciplinary residency program in health

Model Study: Cross-sectional study, exploratory, descriptive and quantitative character. Objective: To evaluate quality of life (QL), Quality of sleep and Burnout Syndrome (SB) in multi professional residents along the residence. Methodology: 60 multi professional residents were analyzed, of which 24 were freshmen residents, attending the first week of the program (RIN), 18 at the end of the first year (R1) and 18 at the end of the second year (R2). The application of the WHOQOL-BREF was performed Sleep Quality Index of Pittsburgh and Maslach Burnout Inventory (MBI). Results: Quality of sleep decreased over the residence and was identified less involvement in all areas of QL for RIn. As for the isolated dimensions of MBI, R1 showed a higher number of residents with emotional exhaustion (EE) high and professional fulfillment (RP) low and R2 depersonalization (DE) high. Two individuals of R2 showed the SB; R2 also excelled in completing a criterion. R1 had a higher percentage of subjects at risk. Most RIn there has been no classification in any of the dimensions. The average of the results of EE was high for R2, R1 and borderline low for RIn. Conclusions: Considering 1ue the physical and emotional exhaustion can be understood as a gradual process that can lead to illness, QL impairment and services, points to an increasing need to propose solutions to better planning and organization of work, for improvements in the general conditions, contributing to better health of residents