ORCID Profile
0000-0002-6792-0819
Current Organisation
Universidade Federal do Espírito Santo
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Publisher: FapUNIFESP (SciELO)
Date: 12-2014
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.JPHYS.2022.05.018
Abstract: In people who have had a stroke, how comparable are the effects of home-based exercises with those of equivalent centre-based exercises for improving walking speed, balance, mobility and participation? Is the comparability of the effects of these two types of exercise maintained beyond the intervention period? Systematic review of randomised controlled trials. Searches were conducted on MEDLINE, AMED, EMBASE, Cochrane, PsycINFO and PEDro databases, without date or language restrictions. Participants in the reviewed studies were ambulatory adults at any time after stroke. The experimental intervention consisted of home-based exercises, which was compared with equivalent doses of centre-based exercises. Walking speed, balance, mobility and participation. The quality of included trials was assessed using the PEDro scores. Outcome data were extracted from the eligible trials and combined in random-effects meta-analyses. The quality of evidence was determined according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Nine trials involving 609 participants were included. Random-effects meta-analyses provided high-quality evidence that home-based and centre-based exercises provide similar effects on walking speed (MD -0.03 m/s, 95% CI -0.07 to 0.02) and balance (MD 0 points, 95% CI -1 to 2). Results regarding mobility (SMD -0.4, 95% CI -1.3 to 0.4) and participation (MD -5 points, 95% CI -19 to 10) were imprecise. For most outcomes, the effects of home-based exercises and centre-based exercises remained similar beyond the intervention period. Effects of home-based prescribed exercises on walking speed, balance, mobility and participation are likely to be similar to improvements obtained by equivalent doses of centre-based exercises after stroke. PROSPERO (CRD42021254642).
Publisher: FapUNIFESP (SciELO)
Date: 09-2011
DOI: 10.1590/S1020-49892011000900003
Abstract: To assess the perception of patients with chronic hemiplegia regarding the use of assistive walking devices (AWD). Twenty-three in iduals who met the inclusion criteria and used AWD were recruited from a database of 360 stroke survivors. Their mean age was 58.4 years, mean time since stroke was 80.8 months, and mean time using AWD was 67.6 months. To assess the participants' perception, was used a standardized questionnaire covering the impact of AWDs on five aspects: weight-bearing on the paretic limb ability to move the paretic limb confidence safety and walking style. Possible answers were "improved," "unchanged," or "decreased." Fourteen in iduals used canes and nine used elbow crutches 21 (91.3%) used AWDs on public roads and only two (8.7%) used AWDs at home. The perception regarding the use of AWDs were positive in the first four questions (6.87 < χ2 < 29.83 0.0001 < P < 0.03), with reports of improvement in weight-bearing (82.6%), ability to move the paretic limb (39.1%), confidence (82.6%), and safety (86.9%). No significant differences were found in terms of walking style (χ2 = 1.09 P = 0.30). The perception of chronic hemiplegic subjects regarding the use of AWD were positive, suggesting that these devices can improve mobility and independence in activities of daily living.
Publisher: Wiley
Date: 12-02-2020
DOI: 10.1002/PMRJ.12324
Abstract: Although the significance of respiratory muscle training has been established in the literature, there is a need to understand the participants' perceptions of the benefits of this intervention. To understand how in iduals who had a stroke perceive changes in their body functions and structures, activities, and participation after a high-intensity respiratory muscle training intervention and to understand their perceptions of the benefits and limitations of a home-based intervention. Qualitative study. Community-dwelling patients. Fifteen in iduals who had a stroke. For this qualitative study, interviews were conducted using a semistructured questionnaire about topics related to participation in a home-based respiratory muscle training intervention. The interviews were transcribed and analyzed using thematic content analysis. Fifteen participants were interviewed. Most of the participants reported positive perceptions of body functions and structures, grouped into two thematic categories (breathing and speech) activity, also grouped into two thematic categories (walking and domestic activities) and participation, grouped into one thematic category (community-leisure activities). Answers about the benefits of a home-based intervention were grouped into three thematic categories (no need to leave home, commitment to training, and comfort). All participants reported that they would recommend the intervention to other stroke patients and that they were either satisfied or very satisfied with the intervention. Most (80%) participants did not consider the intervention difficult to perform. In iduals who had experienced a stroke perceived the benefits of high-intensity home-based respiratory muscle training in all components of function.
Publisher: FapUNIFESP (SciELO)
Date: 04-2009
Publisher: Wiley
Date: 08-02-2019
DOI: 10.1002/PMRJ.12008
Abstract: The ABILOCO is a self-reported questionnaire, specific for in iduals with stroke, for the assessment of ability of locomotion. The ABILOCO has been investigated using the Rasch model and has shown satisfactory measurement properties. However, its test-retest reliability has not been investigated. To investigate the test-retest reliability, that is, agreement, systematic and random variability of the ABILOCO Questionnaire in in iduals with chronic stroke. A test-retest reliability study. Research laboratory. Thirty-one in iduals (21 men and 10 women mean age, 60 years), who had poststroke hemiparesis. Not applicable. The ABILOCO was applied twice, on two occasions, 5 to 7 days apart. Test-retest reliability was investigated, as follows: agreement by the calculation of intraclass correlation coefficients (ICCs) systematic variability by the change in the mean random variability by the standard error of measurement (SEM) and smallest real difference (SRD). Two outliers were identified in the s le. The ICC values for the whole s le were 0.76 (CI 95% 0.56 to 0.88), whereas the SEM (SEM%) and SRD (SRD%) were 0.55 (21%) and 1.52 (58%), respectively. The ABILOCO showed to be reliable to be applied within clinical and research contexts for the assessment of changes in locomotion ability of a group of in iduals with chronic stroke. However, it appears to be less suitable to detect changes at in idual levels. III.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Elsevier BV
Date: 10-2021
Publisher: Universidade de Sao Paulo, Agencia USP de Gestao da Informacao Academica (AGUIA)
Date: 30-11-2018
DOI: 10.11606/ISSN.2238-6149.V29I3P230-236
Abstract: A Modified Gait Efficacy scale (mGES) avalia a percepção do in íduo sobre o seu nível de confiança na marcha, em circunstâncias desafiadoras. Para sua aplicação na população brasileira, é necessário que seja realizada a sua adaptação transcultural. Este estudo objetivou realizar a adaptação transcultural do mGES para uso no Brasil. O processo de adaptação seguiu diretrizes padronizadas, sendo realizado em cinco etapas: tradução, retrotradução, síntese das traduções, avaliação pelo comitê de especialistas e teste da versão pré final. A versão pré final foi aplicada em 12 in íduos pós-Acidente Vascular Encefálico (AVE), que foram indagados sobre como interpretaram cada item. O processo de adaptação seguiu todas as recomendações propostas, sendo necessárias apenas pequenas alterações em três itens, para possibilitar melhor compreensão. Resultados satisfatórios foram obtidos no teste da versão pré final, uma vez que não houve nenhum problema quanto à redação e clareza dos itens ou ao objetivo da escala. A versão final da mGES-Brasil demonstrou satisfatório grau de equivalência semântica, conceitual e cultural, em relação à versão original, e pode, ser utilizada em contextos clínicos e de pesquisa no Brasil, para avaliar o nível de confiança na marcha de in íduos pós-AVE.
Publisher: Daedalus Enterprises
Date: 29-05-2018
Abstract: The aim of this study was to systematically review all current interventions that have been utilized to improve respiratory function and activity after stroke. Specific searches were conducted. The experimental intervention had to be planned, structured, repetitive, purposive, and delivered with the aim of improving respiratory function. Outcomes included respiratory strength (maximum inspiratory pressure [P The 17 included trials had a mean PEDro score of 5.7 (range 4-8) and involved 616 participants. Meta-analyses showed that respiratory muscle training significantly improved all outcomes of interest: P This systematic review reports 5 possible interventions used to improve respiratory function after stroke. Respiratory muscle training proved to be effective for improving inspiratory and expiratory strength, lung function, and dyspnea, and benefits were carried over to activity. However, there is still no evidence to accept or refute the efficacy of aerobic, breathing, and postural exercises, or the addition of electrical stimulation in respiratory function.
Publisher: Elsevier BV
Date: 03-2018
Publisher: Elsevier BV
Date: 11-2020
Publisher: FapUNIFESP (SciELO)
Date: 06-2014
Publisher: Informa UK Limited
Date: 21-06-2018
Publisher: Elsevier BV
Date: 04-2021
Publisher: Elsevier BV
Date: 06-2013
Publisher: Elsevier BV
Date: 09-2017
Publisher: Elsevier BV
Date: 07-2021
Publisher: Elsevier BV
Date: 07-2021
Publisher: Elsevier BV
Date: 07-2012
DOI: 10.1016/J.JBMT.2012.01.002
Abstract: The purpose of this study was to examine the relationships between isometric hand grip (HG) strength and isokinetic strength data of the glenoumeral and scapulothoracic muscles in 12 in iduals with chronic hemiparesis due to stroke. Measures of maximal grip strength were obtained on the HG dynamometer Jamar(®). Isokinetic measures of peak torque and work during shoulder rotations and scapular protraction-retraction movements were obtained with the isokinetic dynamometer at a speed of 60°/s. Pearson correlation coefficients between isometric HG and isokinetic strength data ranged between 0.60 and 0.82 for the peak torque and between 0.59 and 0.86 for the isokinetic work. The findings suggested that, in absence of isokinetic dynamometers, isometric HG strength measurements could be clinically used to monitor strength levels of the shoulder stabilizers and to guide load progressions during strengthening interventions for people with chronic hemiparesis.
Publisher: FapUNIFESP (SciELO)
Date: 06-2022
DOI: 10.1590/1413-81232022276.13202021
Abstract: Abstract This study aimed at estimating the prevalence of stroke in older adults in Brazil, and at identifying the sociodemographic, health-related, health service-related, and environmental factors associated with independence in daily activities. Across-sectional, population-based study (Brazilian Longitudinal Study of Aging 2015-2016) was conducted. 536 in iduals (≥ 50 years), from 9,412 participants, have had stroke and were included. Prevalence of stroke was 5.3% among in iduals aged 50 years and over, increasing up to 8.0% among in iduals aged 75 years and over, showing a dissimilar pattern between sex. Independence was associated with walking speed (Prevalence Ratio (PR) 2.72, 95%CI: 1.96 to 3.77), physical activity (PR 1.24 95%CI: 1.04 to 1.47) and use of walking devices (PR 0.63 95%CI: 0.41 to 0.96). A significant interaction was found between walking speed plus home adaptations and performance of daily living activities (PR 3.42 95%CI: 1.04 to 11.29). The probability of independence was 40% among slow walkers ( 0.4 m/s), increasing up to 70% among fast walkers ( 0.8 m/s), and to 90% among those who also have home adaptations. Faster walking speed combined with home adaptations was the main factor associated with long-term independence after stroke.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.JBMT.2018.02.001
Abstract: It is well known that clinical decisions, which include prescription of canes after stroke, should not only be based on biomechanical research. According to the principles of evidence-based medicine, patients' perceptions and preferences should also be investigated to help planning good clinical decisions. The purpose of this study was to comprehend how ambulatory people with stroke, naïve to the use of canes, perceive using a cane during walking. An exploratory, qualitative study was conducted. Twenty-four people, on average 6 years after a stroke, were included. Participants were categorized as slow ( 0.8 m/s), based on their baseline walking speed. Participants' spontaneous perceptions regarding the use of a cane were collected during a timed-walk test and analyzed, following standardized recommendations. The discourse of each participant was categorized into "positive perceptions" or "negative perceptions". Overall, the nature of the perceptions was both positive (i.e., improvements of mobility and/or independence, and improvement of safety/balance and/or reduced risk of falls) and negative (i.e., social stigmatisms, and interference with use of the non-paretic upper limb). However, participants' perceptions were erse, depending on their walking ability. Participants categorized as slow walkers perceived the use of a cane as positive, but this positive perception decreased, as walking ability increased. The most positive perceptions came from in iduals with severe and moderate walking limitations, who tended to believe that using a cane may be helpful for improving walking, safety, and promoting independence. Fast walkers provided negative perceptions, and may not choose to use canes for walking due to social stigmatisms or interference with use of the non-paretic upper limb.
Publisher: Universidade Federal de Sao Paulo
Date: 30-09-2015
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 2018
Abstract: Study Design Systematic review with meta-analysis. Background The addition of hip strengthening to knee strengthening for persons with patellofemoral pain has the potential to optimize treatment effects. There is a need to systematically review and pool the current evidence in this area. Objective To examine the efficacy of hip strengthening, associated or not with knee strengthening, to increase strength, reduce pain, and improve activity in in iduals with patellofemoral pain. Methods A systematic review of randomized and/or controlled trials was performed. Participants in the reviewed studies were in iduals with patellofemoral pain, and the experimental intervention was hip and knee strengthening. Outcome data related to muscle strength, pain, and activity were extracted from the eligible trials and combined in a meta-analysis. Results The review included 14 trials involving 673 participants. Random-effects meta-analyses revealed that hip and knee strengthening decreased pain (mean difference, -3.3 95% confidence interval [CI]: -5.6, -1.1) and improved activity (standardized mean difference, 1.4 95% CI: 0.03, 2.8) compared to no training lacebo. In addition, hip and knee strengthening was superior to knee strengthening alone for decreasing pain (mean difference, -1.5 95% CI: -2.3, -0.8) and improving activity (standardized mean difference, 0.7 95% CI: 0.2, 1.3). Results were maintained beyond the intervention period. Meta-analyses showed no significant changes in strength for any of the interventions. Conclusion Hip and knee strengthening is effective and superior to knee strengthening alone for decreasing pain and improving activity in persons with patellofemoral pain however, these outcomes were achieved without a concurrent change in strength. Level of Evidence Therapy, level 1a-. J Orthop Sports Phys Ther 2018 (1):19-31. Epub 15 Oct 2017. doi:10.2519/jospt.2018.7365.
Publisher: Wiley
Date: 26-06-2020
DOI: 10.1002/PPUL.24912
Abstract: To investigate the adherence and the self‐reported barriers to general and respiratory exercises reported by in iduals with cystic fibrosis (CF). An exploratory, experimental study. Community‐dwelling in iduals aged 16 years and over, diagnosed with CF, who were accompanied in referral centers were included. Information regarding adherence to exercises was obtained by a questionnaire and reported as a ratio between prescribed exercises and self‐reported adherence. The weekly frequency was used to verify adherence to exercise initiation, and the amount of session duration concluded was used to verify adherence to exercise duration. Values above 0.70 were considered as high adherence. Eight demographic and clinical factors were examined to explore their relationships with adherence, and the barriers to exercises were also collected by questionnaire. Thirty‐four participants met the inclusion criteria. Overall, adherence to exercise initiation was 0.40 (standard deviation [SD] = 0.3) for general exercises and 0.63 (SD = 0.4) for respiratory exercises. Adherence to exercise duration was 0.76 (SD = 0.4) for general exercises and 0.73 (SD = 0.4) for respiratory exercises. Forced vital capacity ( r = 0.39 P = .02) was associated with adherence to the duration of general exercises, and body mass index ( r = −0.33 P = .05) was associated with adherence to the duration of respiratory exercises. The main reported barriers were lack of interest, motivation and time, tiredness, noncommitment, and do not recognize the benefits of exercises. In iduals with CF minded completing the sessions of prescribed exercises once they have initiated it, but most of the days they did not practice general or respiratory exercises.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2020
Publisher: FapUNIFESP (SciELO)
Date: 04-2012
DOI: 10.1590/S1413-35552012005000008
Abstract: To evaluate the effects of different instructions for the assessment of maximum walking speed during the ten-meter walking test with chronic stroke subjects. Participants were instructed to walk under four experimental conditions: (1) comfortable speed, (2) maximum speed (simple verbal command), (3) maximum speed (modified verbal command--"catch a bus") and (4) maximum speed (verbal command + demonstration). Participants walked three times in each condition and the mean time to cover the intermediate 10 meters of a 14-meter corridor was registered to calculate the gait speed (m/s). Repeated-measures ANOVAs, followed by planned contrasts, were employed to investigate differences between the conditions (α=5%). Means, standard deviations and 95% confidence intervals (CI) were calculated. The mean values for the four conditions were: (1) 0.74m/s (2) 0.85 m/s (3) 0.93 m/s (4) 0.92 m/s, respectively, with significant differences between the conditions (F=40.9 p<0.001). Comfortable speed was significantly slower than the maximum speed, indicating that the participants were able to increase speeds when required. Significant differences were observed between the second condition with the third (p=0.002 95%CI=-0.13 to -0.03) and the fourth conditions (p=0.004 95%CI=-0.12 to -0.02) with no differences between the third and fourth conditions (p=1.00 95%CI=-0.04 to 0.05). The results indicated that simple verbal commands were not sufficient to capture maximum gait speed with chronic stroke subjects. Thus, for clinical assessments and research purposes, where measurements of the maximum gait speed are necessary, modified verbal commands or demonstration strategies could be employed by physical therapists to ensure accurate information.
Publisher: Elsevier BV
Date: 04-2018
Publisher: Informa UK Limited
Date: 26-06-2019
DOI: 10.1080/09638288.2019.1631396
Abstract: To determine, in Brazil, the proportion of in iduals who return to a paid work after stroke, and the factors which predict this. A prospective observational cohort study was carried out for six months. Participants were recruited early after stroke from four public hospitals. The outcome of interest was return to work, and the following predictors were investigated: age, sex, education, marital status, contribution to household income, type of work, independence, and depression. Logistic regression was used to identify multivariate predictors of return to work. Of the 117 included participants, 52 (44%) had returned to work by 6 months. Contribution to household income (OR 2.4 95% CI 1.0 to 5.9), being a white-collar worker (OR 4.0 95% CI 1.8 to 8.6) and being independent in daily activities at 3 months (OR 10.6 95% CI 2.9 to 38.3), in combination, positively predicted return to work. Less than 50% of stroke survivors returned to work six months after stroke. Among predictors, only the level of dependence in daily activities is a modifiable factor. Interventions aimed at reducing disability after stroke might increase rates of return to work.Implications for rehabilitationIn Brazil, less than 50% of stroke survivors returned to work six months after stroke.Clinicians may collect information regarding household income, type of work and dependence in daily activities to estimate chances of returning to work, in developing countries.Being independent at 3 months was the strongest predictor of return to work therefore, interventions aimed at reducing disability after stroke may increase rates of return to work.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Universidade de Sao Paulo, Agencia USP de Gestao da Informacao Academica (AGUIA)
Date: 09-12-2008
DOI: 10.11606/ISSN.2317-0190.V15I4A103003
Abstract: Após o acidente vascular encefálico, mais de 80% dos sobreviventes apresentam hemiparesia e a fraqueza muscular é citada como uma importante deficiência responsável pela redução do uso funcional do membro superior parético. Nesse contexto, evidências científicas sugerem o treinamento resistido como um importante componente dos programas de reabilitação. Estudos relacionados à recuperação destes in íduos apresentam fundamentação que apóia a utilização do treinamento resistido para a recuperação da função do membro superior parético. Entretanto, esta modalidade de treinamento pode não resultar em benefícios para todos os in íduos hemiparéticos e seus efeitos estariam condicionados ao nível de acometimento inicial do in íduo. Ainda não há resultados conclusivos sobre a influência do fortalecimento muscular no desempenho motor do membro superior parético, o que sugere a aplicação do treinamento resistido como intervenção terapêutica complementar à reabilitação funcional. O objetivo deste estudo foi analisar, por meio de revisão bibliográfica, a influência do fortalecimento muscular no desempenho motor dos membros superiores de in íduos.
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.JPHYS.2016.05.014
Abstract: After stroke, does respiratory muscle training increase respiratory muscle strength and/or endurance? Are any benefits carried over to activity and/or participation? Does it reduce respiratory complications? Systematic review of randomised or quasi-randomised trials. Adults with respiratory muscle weakness following stroke. Respiratory muscle training aimed at increasing inspiratory and/or expiratory muscle strength. Five outcomes were of interest: respiratory muscle strength, respiratory muscle endurance, activity, participation and respiratory complications. Five trials involving 263 participants were included. The mean PEDro score was 6.4 (range 3 to 8), showing moderate methodological quality. Random-effects meta-analyses showed that respiratory muscle training increased maximal inspiratory pressure by 7 cmH2O (95% CI 1 to 14) and maximal expiratory pressure by 13 cmH2O (95% CI 1 to 25) it also decreased the risk of respiratory complications (RR 0.38, 95% CI 0.15 to 0.96) compared with no/sham respiratory intervention. Whether these effects carry over to activity and participation remains uncertain. This systematic review provided evidence that respiratory muscle training is effective after stroke. Meta-analyses based on five trials indicated that 30minutes of respiratory muscle training, five times per week, for 5 weeks can be expected to increase respiratory muscle strength in very weak in iduals after stroke. In addition, respiratory muscle training is expected to reduce the risk of respiratory complications after stroke. Further studies are warranted to investigate whether the benefits are carried over to activity and participation. PROSPERO (CRD42015020683). [Menezes KKP, Nascimento LR, Ada L, Polese JC, Avelino PR, Teixeira-Salmela LF (2016) Respiratory muscle training increases respiratory muscle strength and reduces respiratory complications after stroke: a systematic review.Journal of Physiotherapy62: 138-144].
Publisher: SAGE Publications
Date: 25-08-2022
DOI: 10.1177/02692155221121015
Abstract: This systematic review aimed to examine the effects of home-based exercises in comparison with centre-based exercises for improving the paretic upper limb after stroke. AMED, MEDLINE, EMBASE CINAHL, Cochrane, PsycINFO, and PEDro databases. Only randomized clinical trials were included. Participants in the reviewed studies were adults at any time after stroke. The experimental intervention was home-based exercises compared with centre-based exercises. Outcome data related to strength, motor recovery, dexterity, activity, and participation were extracted from the eligible trials and combined in meta-analyses. The quality of included trials was assessed by the PEDro scores. The quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Eight trials, involving 488 participants, were included. Most trials (63%) delivered semi-supervised interventions (amount of supervision 3–43%), and three trials provided full supervision. Random-effects meta-analyses provided moderate- to high-quality evidence that home- and centre-based exercises provide similar effects on motor recovery (MD 1.4 points 95% CI −0.9 to 3.8), dexterity (MD −0.01 pegs/s 95% CI −0.04 to 0.05), upper limb activity performance (SMD −0.04 95% CI −0.25 to 0.18), and quality of movement (0.1 points 95% CI −0.2 to 0.4). Effects on strength were also similar but the quality of the evidence was rated as low. No trials examined effects on participation. Effects of home-based prescribed exercises on upper limb motor recovery, dexterity, and activity are likely to be similar to improvements obtained by centre-based exercises after stroke.
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.JPHYS.2013.12.002
Abstract: Does electrical stimulation increase strength after stroke and are any benefits maintained beyond the intervention period or carried over to activity? Systematic review with meta-analysis of randomised or controlled trials. Adults who have had a stroke. Cyclical electrical stimulation applied in order to increase muscle strength. Strength measures had to be representative of maximum voluntary contraction and were obtained as continuous measures of force or torque, or ordinal measures such as manual muscle tests. Activity was measured using direct measures of performance that produced continuous or ordinal data, or with scales that produced ordinal data. Sixteen trials representing 17 relevant comparisons were included in this systematic review. Effect sizes were calculated as standardised mean differences because various muscles were studied and different outcome measures were used. Overall, electrical stimulation increased strength by a standardised mean difference (SMD) of 0.47 (95% CI 0.26 to 0.68) and this effect was maintained beyond the intervention period (SMD 0.33, 95% CI 0.07 to 0.60). Electrical stimulation also improved activity (SMD 0.30, 95% CI 0.05 to 0.56) and this effect was also maintained beyond the intervention period (SMD 0.38, 95% CI 0.09 to 0.66). Cyclical electrical stimulation increases strength and improves activity after stroke. These benefits were maintained beyond the intervention period with a small-to-moderate effect size. The sustained effect on activity suggests that the benefits were incorporated into daily life. Review registration: PROSPERO (CRD42013003895).
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.PHYSIO.2015.10.005
Abstract: To investigate the effect of the provision of a cane on walking ability in ambulatory people with chronic stroke. Experimental study. Clinics within the community. Twenty-four people on average 6 years after a stroke, who were not regular users of walking sticks. Participants were categorized as slow ( 0.8 metres/second) on the basis of their baseline walking ability. Walking with and without a cane. Walking ability was measured using the 10-m Walk Test and reported as speed (metres/second), step length (metres), and cadence (steps/minute). Overall, the provision of a cane produced no significant change in speed (0.05 metres/second, 95% CI -0.01 to 0.11) or cadence (-3 steps/minute 95% CI -8 to 3), but a small increase in step length (0.04 metres, 95% CI 0.03 to 0.06). For the intermediate walkers, the cane increased speed by 0.18 metres/second (95% CI 0.11 to 0.24), step length by 0.07 metres (95% CI 0.05 to 0.09), but not cadence. The provision of a cane to the intermediate walkers also produced 0.27 metres/second (95% CI 0.18 to 0.36) more increase in speed compared with the fast walkers, and 0.12 metres/second (95% CI 0.03 to 0.21) more increase compared with the slow walkers. The provision of a cane produced most benefit to a subgroup of intermediate walkers in a group of community-dwelling people with chronic stroke whose walking had stabilized, without detriment to quality of walking.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.APMR.2018.09.115
Abstract: To examine whether high-intensity home-based respiratory muscle training, that is, with higher loads, delivered more frequently and for longer duration, than previously applied, would increase the strength and endurance of the respiratory muscles, reduce dyspnea and respiratory complications, and improve walking capacity post-stroke. Randomized trial with concealed allocation, blinded participants and assessors, and intention-to-treat analysis. Community-dwelling patients. Patients with stroke, who had respiratory muscle weakness (N=38). The experimental group received 40-minute high-intensity home-based respiratory muscle training, 7 days per week, for 8 weeks, progressed weekly. The control group received a sham intervention of similar dose. Primary outcome was inspiratory muscle strength (via maximal inspiratory pressure), whereas secondary outcomes were expiratory muscle strength (maximal expiratory pressure), inspiratory muscle endurance, dyspnea (Medical Research Council score), respiratory complications (hospitalizations), and walking capacity (6-minute walk test). Outcomes were measured at baseline, after intervention, and 1 month beyond intervention. Compared to the control, the experimental group increased inspiratory (27cmH High-intensity home-based respiratory muscle training was effective in increasing strength and endurance of the respiratory muscles and reducing dyspnea for people with respiratory muscle weakness post-stroke, and the magnitude of the effect was higher, than that previously reported in studies, which applied standard protocols.
Publisher: Elsevier BV
Date: 04-2021
Publisher: FapUNIFESP (SciELO)
Date: 10-2014
Publisher: FapUNIFESP (SciELO)
Date: 03-2012
DOI: 10.1590/S0004-282X2012000300008
Abstract: The Motor Activity Log (MAL) assesses the spontaneous use of the most affected upper limb with the amount of use (AOU) and quality of movement (QOM) scales during daily activities in real environments in in iduals with chronic stroke. Objectives: This study translated the testing manual into Portuguese and assessed the inter-rater and test-retest reliabilities of the MAL, based upon the Brazilian manual version. Methods: The inter-rater reliability was evaluated by comparing the results of two examiners, and the test-retest reliability was tested by comparing the results of two evaluations, repeated one-week apart with 30 in iduals with chronic hemiparesis (55.8±15.1 years). Results: The intra-class correlation coefficients (ICCs) for the total scores were adequate for both the inter-rater (0.98 for the AOU and 0.91 for QOM) and test-retest reliabilities (0.99 for both scales). Conclusions: The results suggested that the MAL was reliable to evaluate the spontaneous use of the most affected upper limb after stroke.
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.JPHYS.2014.11.015
Abstract: After stroke, is walking training with cueing of cadence superior to walking training alone in improving walking speed, stride length, cadence and symmetry? Systematic review with meta-analysis of randomised or controlled trials. Adults who have had a stroke. Walking training with cueing of cadence. Four walking outcomes were of interest: walking speed, stride length, cadence and symmetry. This review included seven trials involving 211 participants. Because one trial caused substantial statistical heterogeneity, meta-analyses were conducted with and without this trial. Walking training with cueing of cadence improved walking speed by 0.23 m/s (95% CI 0.18 to 0.27, I(2)=0%), stride length by 0.21 m (95% CI 0.14 to 0.28, I(2)=18%), cadence by 19 steps/minute (95% CI 14 to 23, I(2)=40%), and symmetry by 15% (95% CI 3 to 26, random effects) more than walking training alone. This review provides evidence that walking training with cueing of cadence improves walking speed and stride length more than walking training alone. It may also produce benefits in terms of cadence and symmetry of walking. The evidence appears strong enough to recommend the addition of 30 minutes of cueing of cadence to walking training, four times a week for 4 weeks, in order to improve walking in moderately disabled in iduals with stroke. PROSPERO (CRD42013005873).
Publisher: Elsevier BV
Date: 07-2019
Publisher: Elsevier BV
Date: 02-2012
DOI: 10.1016/J.CLINBIOMECH.2011.08.003
Abstract: There are robust clinical paradigms against the prescription of walking sticks for people with stroke. However, there is little information on the biomechanics of gait with and without these devices to guide clinical practice. Therefore, this study investigated how the use of walking sticks (canes or crutches) affected both the kinematics and kinetics of gait in people with chronic stroke after their walking had stabilized. Nineteen people with chronic stroke walked at both comfortable and fast speeds. A 3-D motion analysis system and one force platform were used to obtain kinematic and kinetic data of the paretic lower limb during four conditions: With and without walking sticks, and at comfortable and fast speeds. Outcomes included linear kinematics (walking speeds) and angular kinematics (maximum joint angles), power, and work of the paretic hip, knee and ankle joints in the saggital plane. The use of walking sticks resulted in increases in speed during both fast (P<0.001) and comfortable (P=0.001) walking, but did not result in changes in maximum joint angles. This also led to increases in ankle plantar flexion (P<0.01), knee extension (P<0.01), and hip flexion (P<0.001) power generation, but did not result in changes in work. There were no greater changes as a result of using walking sticks during fast versus comfortable walking for any outcome. INTERPRETATIN: The outcomes with the use of walking sticks were beneficial, which suggests that the prescription of these devices is not detrimental to walking that was stabilized in people with stroke.
Publisher: Elsevier BV
Date: 09-2019
Publisher: Research, Society and Development
Date: 18-09-2022
DOI: 10.33448/RSD-V11I12.34590
Abstract: O objetivo deste estudo foi descrever o cenário da Fisioterapia na Saúde da Mulher nas Instituições públicas e gratuitas do Brasil. Foi realizado um estudo transversal exploratório, baseado em dados de domínio público. Os documentos norteadores para a coleta dos dados foram o Projeto Pedagógico do Curso, a matriz curricular, plano de ensino, ementário, nome e conteúdo programático das disciplinas. Foram identificados 52 cursos públicos de Fisioterapia, dos quais 51 (98%) oferecem a disciplina teórico-prática de Fisioterapia em Saúde da Mulher. A carga horária da disciplina foi superior à carga horária média das disciplinas obrigatórias (DM 26 horas IC 95% 14 a 37) e à carga horária média das disciplinas de especialidades fisioterapêuticas (DM 11 horas IC 95% 2 a 20), mas apresentou alta variação entre as instituições (45 a 250 horas). Metade das Instituições não ofertam estágio em Saúde da Mulher ou não informam se é ofertado. Nas Instituições que ofertam, a carga horária de estágio em Saúde da Mulher é inferior à carga horária das demais especialidades (DM -38 horas IC 95% -61 a -14). A diferença média de carga horária de estágio apresentou correlação com carga horária total (r=0.38, p=0.04) e com carga horária de disciplina teórico-prática de Fisioterapia na Saúde da Mulher (r=-0.44, p=0.02). São necessárias reflexões e discussões acerca da importância da Fisioterapia na Saúde da Mulher pelos Colegiados de Curso e revisões nos projetos pedagógicos de modo a refletir os avanços científicos e o reconhecimento da área no Brasil.
Publisher: Informa UK Limited
Date: 28-08-2020
DOI: 10.1080/09638288.2020.1808088
Abstract: To examine whether using a cane would improve spatiotemporal parameters of walking, i.e., speed, stride length, cadence, and symmetry after stroke. Searches were conducted in eight databases. The experimental condition was walking with a cane. Four outcomes were of interest: walking speed, stride length, cadence, and symmetry. Twelve studies were included. Results from nine studies suggested that in iduals with stroke walked 0.01 m/s (SD 0.06) slower with a single-point cane, compared with no cane. Two studies suggested a reduction in cadence (MD-5 steps/min, SD2) and an increase in stride length (MD 0.08 m, SD 0.01). Three studies suggested that in iduals walked 0.06 m/s (SD 0.07) slower with a four-point cane, compared with no cane. Four studies suggested that in iduals walked 0.06 m/s (SD 0.04) faster with a single- point cane compared with a four-point cane. Results regarding other outcomes were inconclusive. Results showed no worthwhile improvements in spatiotemporal parameters of walking with a single-point cane and a slight reduction with a four-point cane, compared with no cane. In iduals walked slightly faster with a single-point cane compared with a four-point cane, but the evidence is insufficient to support this superiority.IMPLICATIONS FOR REHABILITATIONA single-point cane may not improve spatiotemporal parameters of walking after stroke.Walking with a four-point cane may slightly decrease spatiotemporal parameters of walking.Canes may be prescribed without the fear of negatively impairing walking kinematics.
Publisher: Research, Society and Development
Date: 19-03-2022
Abstract: O Bruxismo é um comportamento motor frequente na população, atualmente idido em bruxismo da vigília e do sono. As disfunções temporomandibulares (DTM) são desordens que envolvem os músculos da mastigação, a ATM e estruturas associadas. Ambos os conceitos muitas vezes são confundidos entre os profissionais e, dessa forma, diagnosticados e tratados erroneamente. O tratamento dessas desordens ainda é motivo de discussão por ersos profissionais da área da saúde, tendo em vista seu caráter multidisciplinar. Objetivo: O Objetivo dessa pesquisa é avaliar o conhecimento acerca dos conceitos e tratamento adotados por dentistas e fisioterapeutas, assim como a interação interdisciplinar entre as duas áreas. Método: A avaliação foi feita através de um questionário e os dados obtidos computados, comparados e analisados estatisticamente. Resultado/conclusão: O estudo demonstrou que, apesar de entenderem a importância da multidisciplinaridade, ainda há falta de conhecimento sobre os conceitos e opções de tratamento possíveis.
Publisher: Elsevier BV
Date: 07-2019
Publisher: SAGE Publications
Date: 30-05-2021
DOI: 10.1177/02692155211020864
Abstract: To examine the effects of the provision of a cane, delivered to ambulatory people with chronic stroke, for improving walking and social participation. Two-arm, randomized trial. Community-based. Ambulatory in iduals with chronic stroke. The experimental intervention was the provision of a single-point cane during one month. The control group received a placebo intervention. Walking speed, step length, cadence, walking capacity, and walking confidence were measured without the cane to examine its rehabilitative effect. Walking speed was also measured with the cane for inclusiveness, and social participation was measured for examining carry over effects. Outcomes were measured at baseline, and after one and two months. Fifty in iduals were included. In the experimental group, mean age was 69 years (SD 14), and walking speed was 0.58 m/s (SD 0.17). In the control group, mean age was 68 years (SD 13), and walking speed was 0.63 m/s (SD 0.15). When walking without the cane, after one and after two months, there were no between-group differences in any measures. When walking with the cane, after one month, the experimental group walked 0.14 m/s (95% CI 0.05–0.23) faster than the control group and after two months, they were still walking 0.18 m/s (95% CI 0.06–0.30) faster. Use of a cane improved walking speed, only when participants walked with the cane. Use of cane for one month did not improve walking outcomes, when walking without the cane. People with stroke would need to continue to use the cane to maintain any benefits in walking speed.
Publisher: Research, Society and Development
Date: 22-12-2021
DOI: 10.33448/RSD-V10I17.24451
Abstract: With the social distancing required by the coronavirus (COVID-19) pandemic, the creation of a new pedagogical model became a sudden challenge for educational institutions. This study sought to assess health science professors’ experiences and perceptions during the COVID-19 pandemic. An epidemiological, descriptive, cross-sectional, observational, and quantitative approach was applied and included the application of a structured and self-administered virtual questionnaire containing objective and multiple-choice questions on demographic data, online teaching activities, continuing education, learning environments, and difficulties faced. Seven questions from the Generalized Anxiety Disorder Screening Tool (GAD-7) were added to assess anxiety. One hundred and thirty-eight university professors in Brazil completed the questionnaire. Of these, 87 were employed by public institutions and 51 worked at private institutions. Geopolitical region in the country and university funding type were associated with universities’ ability or decision to offer courses online. Among the professors, being of female gender and a decrease in household income were the factors most closely associated with increased anxiety. Professors also reported difficulties in interacting with students online, the need to assume more childcare, and difficulty in concentrating at home to be the main barriers to successful online teaching.
Publisher: Medical Journals Sweden AB
Date: 2017
Abstract: To establish the deficits of motor coordination of the lower limbs after stroke, in comparison with healthy controls, and to investigate whether the magnitude of the deficits would be influenced by the levels of motor recovery. Cross-sectional study. Chronic stroke patients and healthy subjects. Lower-limb motor coordination of both stroke and healthy volunteers was measured using the Lower Extremity Motor Coordination Test (LEMOCOT). The motor coordination deficits of the participants with stroke were analysed all together and separated, according to their levels of motor recovery, measured using the Fugl-Meyer lower-limb motor section scores. Ninety-seven in iduals with chronic stroke, 55 men, mean age 58 years, were evaluated. Motor coordination was significantly impaired on both paretic (mean: -22 touches 95% confidence interval (95% CI) -24 to -19 deficit: 61%) and non-paretic (mean -6 touches 95% CI -8 to -4 deficit: 17%) lower limbs. Significant differences in the LEMOCOT scores were found between the levels of motor recovery (p < 0.01), except between the participants with marked and moderate impairments. Motor coordination of the lower limbs is significantly impaired after stroke, but the deficits of the non-paretic lower limb (17%) appear not to be clinically relevant. These findings suggest that interventions prescribed to improve motor coordination after stroke should focus on the paretic lower limb and/or include bilateral activities.
Publisher: Research, Society and Development
Date: 13-12-2021
DOI: 10.33448/RSD-V10I16.23895
Abstract: No Brasil não existe uma base de dados nacional que contemple o perfil dos pacientes vítimas de queimadura, portanto, o objetivo desse estudo foi descrever as características epidemiológicas, clínicas e da internação de crianças internadas em um centro de referência de tratamento de queimados (CTQ) do Espírito Santo. Foi realizado um estudo epidemiológico do tipo transversal e descritivo baseado em dados de prontuários eletrônicos e físicos das crianças internadas no CTQ no período de agosto de 2019 a julho de 2020. Dentro da amostra estudada, a maioria tem menos de cinco anos de idade, são do sexo masculino e apresentam como principal causa etiológica o calor (93,1%). Em média, 14% (DP 11) de superfície corporal queimada. As regiões corporais mais acometidas foram: tronco (64,7%), membros superiores (55,9%) e cabeça e pescoço (44,1%). A profundidade da maioria das queimaduras foi de segundo grau (86,3%) e com gravidade classificada como médio queimado (48%). Os pacientes permaneceram em média 23 dias internados (DP=27, mínimo 3 e máximo 115 dias), sendo que 91,2% realizou pelo menos um procedimento de desbridamento da ferida. Os resultados desse estudo, somado ao conhecimento específico de uma região (Espírito Santo), podem auxiliar na elaboração de estratégias a fim de aumentar a conscientização acerca das queimaduras e fornecer orientação aos pais e ao público em geral, por meio de programas educacionais e c anhas de prevenção.
No related grants have been discovered for Lucas Nascimento.