Sandra Regina Alouche

Different protocols of physical exercise produce different effects on synaptic and structural proteins in motor areas of the rat brain

The plastic brain responses generated by the training with acrobatic exercise (AE) and with treadmill exercise (TE) may be different. We evaluated the protein expression of synapsin I (SYS), synaptophysin (SYP), microtubule-associated protein 2 (MAP2) and neurofilaments (NF) by immunohistochemistry and Western blotting in the motor cortex, striatum and cerebellum of rats subjected to TE and AE. Young adult male Wistar rats were divided into 3 groups: sedentary (Sed) (n=15), TE (n=20) and AE (n=20). The rats were trained 3 days/week for 4 weeks on a treadmill at 0.6 km/h, 40 min/day (TE), or moved through a circuit of obstacles 5 times/day (AE). The rats from the TE group exhibited a significant increase of SYS and SYP in the motor cortex, of NF68, SYS and SYP in the striatum, and of MAP2, NF and SYS in the cerebellum, whereas NF was decreased in the motor cortex and the molecular layer of the cerebellar cortex. On the other hand, the rats from the AE group showed a significant increase of MAP2 and SYP in the motor cortex, of all four proteins in the striatum, and of SYS in the cerebellum. In conclusion, AE induced changes in the expression of synaptic and structural proteins mainly in the motor cortex and striatum, which may underlie part of the learning of complex motor tasks. TE, on the other hand, promoted more robust changes of structural proteins in all three regions, especially in the cerebellum, which is involved in learned and automatic tasks.

Analysis of reporting of systematic reviews in physical therapy published in Portuguese

BACKGROUND Systematic reviews are considered the best design to synthesize all existing information of a given research topic. To date, there is no study that investigated the quality of reporting of systematic reviews relevant to physical therapy published in Portuguese. OBJECTIVE To analyse the quality of reporting of systematic reviews in the field of physical therapy published in Portuguese by using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist. METHOD All systematic reviews published in Portuguese that were indexed on PEDro database up to August 2011 were included. The quality of reporting of the eligible papers was analysed by using the PRISMA checklist. Each quality assessment was performed by two independent reviewers with arbitration of a third reviewer if necessary. RESULTS A total of 37 systematic reviews were identified. These studies were published between 2003 and 2010. Less than 30% of the PRISMA checklist items were satisfied, being most of the items related to the introduction and discussion sections. No improvements over time were observed. CONCLUSIONS Most of the studies did not satisfy the items from the PRISMA Checklist. It seems that most of authors did not know the existence of this checklist. The implementation of reporting statements such as the PRISMA statement by Portuguese-written journals is likely to help authors to write their systematic reviews in a more transparent and clear way.

Clinimetric testing supports the use of 5 questionnaires adapted into Brazilian Portuguese for patients with shoulder disorders.

STUDY DESIGN Clinical measurement. OBJECTIVES To cross-culturally adapt the Shoulder Pain and Disability Index (SPADI) into Brazilian Portuguese and to test the measurement properties of the Brazilian Portuguese versions of the SPADI, the short form of the Disabilities of the Arm, Shoulder and Hand, the Patient-Specific Functional Scale, a numeric pain rating scale, and the Global Perceived Effect scale in patients with shoulder disorders. BACKGROUND Most instruments for shoulder disorders were developed in English. For their use in Brazil, translation into Brazilian Portuguese, cross-cultural adaptation, and testing of measurement properties of these instruments are required. METHODS The SPADI was translated and cross-culturally adapted according to current guidelines. Measurement properties of internal consistency, reproducibility, construct validity, ceiling and floor effects, and responsiveness of all instruments were tested in 100 patients with shoulder disorders. The patients filled out the questionnaires on 3 occasions: at baseline, 24 to 48 hours after baseline, and 4 weeks after baseline. RESULTS The instruments showed adequate internal consistency (Cronbach alpha between .78 and .93) and a good level of agreement, as reflected by low standard errors of measurement and minimal detectable change. The reliability (intraclass correlation coefficients) of the instruments varied from 0.82 to 0.96. Most instruments presented good levels of construct validity. All instruments showed acceptable levels of internal and external responsiveness. CONCLUSION The Portuguese Brazilian versions of the SPADI; the short form of the Disabilities of the Arm, Shoulder and Hand; a numeric pain rating scale; the Patient-Specific Functional Scale; and the Global Perceived Effect scale are reproducible, valid, and responsive instruments for assessing patients with shoulder disorders.

Gait characteristics of younger-old and older-old adults walking overground and on a compliant surface

BACKGROUND Walking across unstable surfaces disturbs normal stability and efficient strategies must be used to avoid falls. This study identified age-related changes in gait during unstable surface walking. METHOD Eight healthy younger-old adults (YOG, mean age, 68.6 years) and eight healthy older-old adults (OOG, mean age, 82.1 years) were assessed. Both groups performed the Timed Up and Go Test (TUG) and walked on a rigid and on a compliant surface while kinematic data were obtained. RESULTS The OOG needed more time to complete the TUG test compared to YOG (F1,14=5.18; p=0.04). The gait speed, stride length and vertical displacement of the foot were similar for both groups, but they were slower (F1,14=5.64; p=0.03) when walking on the compliant surface. The knee and hip range of motion on the sagittal plane (F1,14=191.9; p<0.001 and F1,14=36.4, p<0,001, respectively) increased on the complaint surface but no group effect was found. The displacement of upper trunk on the frontal plane was similar between groups (F1,14=2.43; p=0.14) and conditions (F1,14=1.15; p=0.3). The OOG had greater displacement of the pelvic segment on the frontal plane than the YOG (F1,14=4.9; p=0.04) mainly for the complaint surface. CONCLUSIONS Older-old individuals have slower TUG test and greater displacement of the pelvic segment on a compliant surface. More challenging tasks and/or environment should be used for gait assessment and intervention of older adults with risk of falls.

Uso da informação somatossensorial adicional no controle postural: efeito da dominância manual

In this study we investigated the effect of handedness and vision on the use of additional somatosensory information provided by the light touch in postural control. Fifteen right-handed, young adults quietly stood on a force plate with a) eyes open or closed and b) arms hanging along the body or with the right or left index finger in contact with a rigid bar. We assessed the center of pressure (CP) area and CP mean sway amplitude and velocity in anterior-posterior and medial-lateral directions. The results revealed a reduction of these measures in the touch conditions and increase with the eyes closed, except when the touch was performed with right index fingertip. The grip strength was greater for the right hand, while the cutaneous sensitivity and the forces applied on the bar were similar between the two sides of the body. These results suggested an effect of the handedness and vision in the use of additional somatosensory information on the postural control.

Uncertainty in aiming movements and its association to hand function

El proposito de este estudio fue evaluar la influencia de la incertidumbre ubicacion de la diana en la planificacion y ejecucion de movimientos dirigidos a la diana realizado por direcciones ipsilateral y contralateral por los miembros superiores derecho e izquierdo. Ademas, se investigo la asociacion entre el rendimiento de movimiento dirigido a la diana y el rendimiento de la mano para tareas funcionales. Se propusieron dos tareas: con el conocimiento previo de la direccion del movimiento (tiempo de reaccion simple) o no (tiempo de reaccion del eleccion). Se evaluo la fuerza de prension y la destreza manual. La opcion de eleccion en responder (Incertidumbre por ejemplo.) influido en la planificacion del movimiento dirigido a la diana, pero no su aplicacion, mientras que el movimiento de la direccion contralateral tuvo un peor rendimiento en comparacion con la direccion ipsilateral. La destreza manual se correlaciono significativamente con los tiempos de reaccion, mientras que el rendimiento durante la realizacion del movimiento se correlaciono significativamente con la fuerza de prension / pinzas.

Effects of Direction and Index of Difficulty on Aiming Movements after Stroke

Background. Brain hemispheres play different roles in the control of aiming movements that are impaired after unilateral stroke. It is not clear whether those roles are influenced by the direction and the difficulty of the task. Objective. To evaluate the influence of direction and index of difficulty (ID) of the task on performance of ipsilesional aiming movements after unilateral stroke. Methods. Ten individuals with right hemisphere stroke, ten with left hemisphere stroke, and ten age- and gender-matched controls performed the aiming movements on a digitizing tablet as fast as possible. Stroke individuals used their ipsilesional arm. The direction (ipsilateral or contralateral), size (0.8 or 1.6 cm), and distance (9 or 18 cm) of the targets, presented on a monitor, were manipulated and determined to be of different ID (3.5, 4.5, and 5.5). Results. Individuals with right hemisphere lesion were more sensitive to ID of the task, affecting planning and final position accuracy. Left hemisphere lesion generated slower and less smooth movements and was more influenced by target distance. Contralateral movements and higher ID increased planning demands and hindered movement execution. Conclusion. Right and left hemisphere damages are differentially influenced by task constraints which suggest their complementary roles in the control of aiming movements.

Two-Man Bobsled Push Start Analysis

Abstract The importance of push start times on bobsled performance was evidenced by some studies, but at this moment there is no article to the authors’ knowledge that describes the bobsled push start. Thus, the objectives of this study were to describe the two-man bobsled push start, analyze the differences between teams, and estimate the most important variable analyzed. We hypothesized that the pilot and brakeman athletes’ movement patterns during a bobsled pushing start can be described. The images used in this study were obtained during the men’s two-man XIV World Championship of Bobsled (2004). Fifteen best teams participating in the championship were recorded, and four start runs for each team were analyzed. The videos were captured by two digital video cameras. The pilot athletes were analyzed during the moment that they touched the lateral push bar of the sled, and the brakemen were analyzed during the first take-off and first landing. The teams were pooled in three groups of five teams using the final ranking of pushing time. We concluded that there was a distinct pattern movement for pilots and brakemen. The initial position of the majority of the pilots was localized slightly behind the bar. After touching the lateral bar, the pilots remained in a semi-squat position, pushing the sled forward in a pattern of marching movement. All brakemen used the board attached to the track as a support for both feet at the start. The brakeman gave the greatest contribution to break the inertia of the sled. There was no significant difference of movement between the three groups analyzed for the pilot and the brakeman.

The influence of a real job on upper limb performance in motor skill tests: which abilities are transferred?

To investigate whether the specificities of real jobs create distinctions in the performance of workers in different motor tests for the upper limbs, 24 participants were divided into two groups according to their specific job: fine and repetitive tasks and general tasks. Both groups reproduced tasks related to aiming movements, handling and strength of the upper limbs. There were no significant differences between groups in the dexterity and performance of aiming movements. However, the general tasks group had higher grip strength than the repetitive tasks group, demonstrating differences according to job specificity. The results suggest that a particular motor skill in a specific job cannot improve performance in other tasks with the same motor requirements. The transfer of the fine and gross motor skills from previous experience in a job-specific task is the basis for allocating training and guidance to workers.

Functional Capacity and Motor Performance of Upper Limbs in Individuals with Cerebellar Disorders: A Pilot Study

In simple daily activities carried out by the upper limbs, the cerebellum is responsible for the adaptations required for the accurate movement based on previous experiences and external references. This paper aims to characterize the performance of the upper limbs after a cerebellar disease. We evaluated the digital and handgrip strength, dexterity, and function of the upper limbs. The motor performance of the upper limbs was assessed through the use of a digitizing tablet by performing aiming movements with the upper limb most affected by cerebellar disease and the paired limb of the healthy group. The results showed differences between groups: the cerebellar group had higher latency to movement onset, was slower, and presented less smooth trajectories and higher initial direction errors. Moreover, the movement direction influenced the peak velocity and the smoothness for both groups (contralateral directions were slower and less smooth). We concluded that cerebellar disorder leads to movement planning impairment compromising the formulation of an internal model. Alterations on movement execution seem to be a consequence from disruptions in the anticipatory model, leading to more adaptations. These findings are compatible with the roles of the cerebellum on the control of voluntary movement.