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INTRODUCTION: People with Amyotrophic Lateral Sclerosis (ALS) can present initially muscle weakness, which is a debilitating symptom that may be improved by engaging in muscle strengthening activities. Currently, the effects of motor interventions for muscle strengthening in people with ALS are unclear. This review intends to analyze the effects of motor interventions for muscle strengthening in individuals with ALS. METHODS AND ANALYSIS: Randomized, non-randomized, and quasi-experimental clinical trials assessing individuals with ALS of both sexes, aged 18 years or older, who have received motor interventions for muscle strengthening considering all practices that can lead to increased strength, endurance, power and muscular hypertrophy will be included. No restriction on language, location, or publication date will be applied. MEDLINE, EMBASE, Cochrane Library (CENTRAL), SPORTDiscus, and Physiotherapy Evidence Database (PEDro) databases will be searched. The US National Institutes of Health Ongoing, ClinicalTrials.gov, and the reference lists of included studies will also be searched. Two reviewers will independently screen titles and abstracts and extract data from included studies. The methodological quality of the included studies will be assessed by the PEDro scale and the certainty of the evidence by the GRADE approach. Disagreements will be resolved by a third researcher. Findings will be presented in text and table formats. A meta-analysis will compare the effects of motor interventions for muscle strengthening versus placebo or other interventions.

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INTRODUCTION: The prescription of an intervention plan can be challenging for the physical therapist, considering clinical phenotypes, individual prognosis and the rapid, progressive and deteriorating nature of amyotrophic lateral sclerosis (ALS). In this context, therapeutic exercises (eg, resistance and aerobic exercises) for patients with ALS remain controversial and may influence the treatment plan. Therefore, this review aims to critically assess whether physical therapy interventions are effective for improving functional capacity, quality of life and fatigue of individuals with ALS. METHODS AND ANALYSIS: Studies will be selected according to eligibility criteria, and language, geographical area or publication date will not be restricted. Four databases will be used: MEDLINE, EMBASE, Cochrane Library (CENTRAL) and Physiotherapy Evidence Database (PEDro). Searches will also be conducted on ClinicalTrials.gov and references from included studies. We plan to conduct the searches between October and December 2022. Two independent authors will examine titles and abstracts and exclude irrelevant studies and duplicates. We will assess the quality of studies and quality of evidence, and disagreements will be resolved with a third researcher. The findings will be presented in the text and tables; if possible, we will perform meta-analyses. ETHICS AND DISSEMINATION: No ethical approval is required because this study does not involve human beings. We will publish our findings in peer-reviewed journals. PROSPERO REGISTRATION NUMBER: CRD42021251350.

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INTRODUCTION: Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease with variable and complex clinical manifestations that requires a multidisciplinary approach. However, face-to-face treatment in this population may experience barriers, such as difficulty accessing physical therapists or other professionals. As a result, strategies (eg, telerehabilitation) emerged to facilitate treatment and physical therapy monitoring. This study aims to evaluate the effects of remote versus face-to-face home-based exercise programmes on clinical outcomes and treatment adherence of people with ALS. METHODS AND ANALYSIS: This is a single-blind randomised clinical trial protocol that will include 44 people with clinical diagnosis of ALS at any clinical stage and aged between 18 and 80 years. Participants will be randomised into two groups after face-to-face evaluation and perform a home-based exercise programme three times a week for 6 months. A physical therapist will monitor the exercise programme once a week remotely (phone calls-experimental group) or face-to-face (home visits-control group). The primary outcome measure will be functional capacity (Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised). Secondary outcomes will include disease severity (Amyotrophic Lateral Sclerosis Severity Scale), fatigue (Fatigue Severity Scale), pain (Visual Analogue Scale and body pain diagram), adverse events and adherence rate. Outcomes will be initially evaluated face-to-face and revaluated remotely every 2 months and 1 month after interventions. Linear mixed models will compare outcome measures between groups and evaluations (α=5%). ETHICS AND DISSEMINATION: This study was approved by the research ethics committee of Hospital Universitário Onofre Lopes/Universidade Federal do Rio Grande do Norte (no. 3735479). We expect to identify the effects of an exercise programme developed according to ALS stages and associated with remote or face-to-face monitoring on clinical outcomes using revaluations and follow-up after interventions. TRIAL REGISTRATION NUMBER: Brazilian Registry Clinical Trials (RBR-10z9pgfv).

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RESUMO Após um acidente vascular cerebral (AVC), o membro superior pode apresentar déficits motores que podem levar a incapacidades funcionais. A terapia espelho (TE) é uma possibilidade terapêutica na reabilitação do membro superior (MS). Este estudo objetivou reunir evidências que pudessem mostrar quais são os efeitos da TE na recuperação motora e funcional do MS com paresia pós-AVC. Foi realizada uma busca eletrônica nas bases de dados SciELO, LILACS, PubMed, PEDro e ScienceDirect, utilizando como critérios de inclusão: ensaios clínicos, nos quais os indivíduos acima de 18 anos apresentassem AVC de qualquer etiologia e em qualquer tempo após a lesão encefálica, com sequela no MS; estudos publicados na íntegra em revistas indexadas nas bases supracitadas entre 2010 e 2015, nos idiomas inglês e português, que utilizassem a TE para reabilitação do MS de pacientes com AVC, apresentando como desfechos função motora e independência funcional. Os artigos resultantes foram avaliados pela escala PEDro quanto à qualidade metodológica. Treze ensaios clínicos avaliaram efeitos da TE no MS parético. Os testes mais utilizados foram escala de Fugl-Meyer e Medida de Independência Funcional. Nesses estudos, a TE foi eficaz na recuperação motora do MS e na independência funcional dos pacientes, especialmente nos quesitos transferências e autocuidados. Os artigos foram considerados de moderada a alta qualidade metodológica. Conclui-se que a TE promoveu melhora significativa da função motora e da independência funcional do MS parético pós-AVC independente do tempo decorrido após a lesão encefálica.

RESUMEN Debido al accidente cerebrovascular (ACV), los miembros superiores pueden presentar problemas motores, que pueden llevar a incapacidades funcionales. La terapia del espejo (TE) presenta una posibilidad terapéutica de rehabilitar los miembros superiores (MS). El propósito de este estudio es reunir evidencias que muestran cuáles son los efectos de la TE en la rehabilitación motora y funcional de MS con paresia pos-ACV. Se buscó en las bases de datos SciELO, LILACS, PubMed, PEDro y ScienceDirect, empleando los siguientes criterios de inclusión: estudios clínicos, en los cuales los sujetos de más de 18 años presentaron ACV de cualquier etiología y de cualquier tiempo tras la lesión cerebral, con secuela en MS; textos publicados integralmente entre 2010 y 2015 en revistas científicas de las citadas bases de datos, en lengua inglesa y en portugués brasileño, que empleasen la TE en la rehabilitación de MS de pacientes con ACV y presentasen como resultados función motora e independencia funcional. Los textos recolectados fueron evaluados por la escala PEDro en función de la calidad metodológica. Trece estudios clínicos evaluaron los efectos de la TE en MS parético. Las pruebas más empleadas fueron la escala Fugl-Meyer y la Medida de Independencia Funcional. En estos estudios se comprobó la eficacia de la TE en la rehabilitación motora de MS y en la independencia funcional de los pacientes, especialmente en los aspectos transferencia y autocuidado. Se evaluaron los textos como de moderada a alta calidad metodológica. Se concluye que la TE mejora significativamente la función motora y la independencia funcional de MS parético pos-ACV independiente del tiempo transcurrido de la lesión cerebral.

ABSTRACT After a stroke upper limbs may display motor deficits that could lead to functional disability. Mirror therapy (MT) is a therapeutic tool in the rehabilitation of upper limbs (UL). This study aimed to bring together evidence to show the main effects of MT in the motor recovery of paretic upper limbs after a stroke. An electronic search on the Lilacs, Scielo, PubMed, PEDro and ScienceDirect databases was performed, in accordance with the inclusion criteria: clinical trials, in which individuals should have had a stroke of any etiology and in any stage of recovery, with UL impairment, published in full in journals indexed in those databases, between 2010 and 2015, in English or Portuguese, using MT for the rehabilitation of these patients’ UL, with motor function and functional independence as main outcomes. The remaining articles were evaluated with the PEDro scale to assign their methodological quality a score. Thirteen clinical studies evaluated the effects of MT in the motor function and functional independence of the upper limbs after a stroke. Fugl-Meyer scale and the Functional Independence Measure were frequently used in the studies, which showed that MT is efficient in upper limb motor recovery and functional independence, especially concerning transferring and self-care. Regarding the methodological evaluation, the articles were considered as having moderate or high quality. In conclusion, MT promotes significant improvement of the motor function and functional independence of paretic upper limbs after a stroke, regardless of the time elapsed after the encephalic lesion.

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Descrever os métodos e recursos fisioterapêuticosutilizados na Paralisia Facial Periférica, e verificar de queforma a paralisia facial periférica (PFP) vem sendo consideradano processo de reabilitação. Material e Métodos: Foi realizadauma revisão de literatura através de busca em publicaçõescientíficas indexadas nas bases de dados Scielo, PubMed eScience Direct, que permitem o uso da terminologia comumem português, inglês, francês e espanhol. As palavras-chavesutilizadas na busca, em português, foram: Paralisia FacialPeriférica, Fisioterapia, e Reabilitação; na língua francesa:Paralysies Faciales, physiothérapie e réhabilitation; no idiomaespanhol: Parálisis Facial, Fisioterapia, rehabilitación; e eminglês, Facial Paralysis, Physical Therapy e Rehabilitation. Abusca foi realizada de março a maio de 2012. Resultados:Foram selecionados 10 artigos, dentre eles estudos de casos,estudos longitudinais e experimentais, referentes a condutasterapêuticas que contribuem para o tratamento da PFP. Sãoelas recursos manuais, cinesioterapêuticos,eletrotermofototerapêuticos, mecânicos, terapia cognitiva etreinamento funcional. Todos os estudos incluídos nestapesquisa ressaltaram que o acometimento da PFP ultrapassao limite da doença física levando ao comprometimentopsicológico e social. Conclusão: Conclui-se que existem váriosmétodos de tratamento para a PFP e que utilizam-se dediferentes recursos e técnicas. Os estudos incluem estimulaçãoelétrica, massagens, exercícios faciais e reeducaçãoneuromuscular isolados, ou combinações desses e, ainda,variação de parâmetros para um mesmo recurso. Os métodose recursos fisioterapêuticos mais usados na reabilitação daPFP são: massagem, método Kabat e a estimulação elétricafuncional (FES)...

To describe the methods and resources used inphysical therapy for peripheral facial paralysis (PFP), andinvestigate how PFP has been considered in the rehabilitationprocess. Material and Methods: A literature review was performedby searching scientific publications indexed in the databasesScielo, PubMed and Science Direct, which allow the use ofcommon terminology in Portuguese, English, French andSpanish. The keywords used in the search in Portuguese were:Paralisia Facial Periférica, Reabilitação e Fisioterapia; inFrench: Paralysies faciales, physiothérapie and réhabilitation;In Spanish: Parálisis Facial, Rehabilitación, Fisioterapia; andin English: Facial Paralysis, Physical Therapy andRehabilitation. The searches were carried out from March toMay 2012. Results: A total of 10 papers were selected, includingcase studies, longitudinal and experimental studies related totherapeutic procedures contributing to the PFP treatment. Themain procedures were: manual resources; kinesiotherapy;electrothermal, mechanical and cognitive therapy; andfunctional training. All studies included in this review pointedout that the involvement of the PFP exceeds the limit ofphysical illness leading to psychological and social issues.Conclusion: There are various approaches to treat PFP whichinclude different features and techniques, such as electricalstimulation, massage, facial exercises and neuromuscularreeducation exclusively, or combinations of these, and alsovariation of parameters in the same technique. The methodsand physical therapy resources most commonly used for PFPrehabilitation are massage, Kabat method and functionalelectrical stimulation (FES)...

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Pacientes com sequela de AVC possuem, dentreoutros, distúrbios na marcha. A reabilitação deve focar nessedéficit através de diversos métodos, desde os maistradicionais até os mais modernos, como o método Bobath ea esteira com suporte parcial de peso corporal (ESPP).Objetivo: Verificar na literatura a existência de estudosclínicos que comparam o método Bobath com a ESPP nareabilitação da marcha de indivíduos pós-AVC. Material eMétodos: Foi realizada uma revisão sistemática, com buscaeletrônica nas bases de dados Scielo, PubMed, PEDro e Lilacsdurante o mês de agosto de 2014. Foram incluídos ensaiosclínicos que tratassem especificamente do tema destarevisão, publicados na íntegra em revistas científicas. Foramutilizados os descritores acidente vascular cerebral, acidentevascular encefálico, fisioterapia, reabilitação, esteira comsuporte parcial de peso e Bobath, nos idiomas português,inglês e espanhol. Resultados: Foram encontrados dezestudos, destes, quatro foram excluídos. Assim, os seisestudos restantes foram utilizados, sendo cinco ensaiosclínicos controlados randomizados e um estudo de caso,publicados entre 1995 e 2008. Nesses estudos, foramanalisados aspectos como cadência, comprimento do passo,velocidade e qualidade da marcha, deambulação funcional,equilíbrio e funcionalidade do paciente. Conclusão: Otreinamento de marcha utilizando a ESPP mostrou melhoresefeitos na reabilitação da marcha, com maior duração dosbenefícios alcançados, em combinação com outrasintervenções ou isoladamente, quando comparado ao treinode marcha apenas com o método Bobath...

Patients after stroke have disturbance in gait,besides other impairments. Gait rehabilitation should focuson this deficit through the use of different methods from themost traditional to the most current ones, such as Bobathand treadmill with partial body weight support (TPBS).Objective: To check in the literature the existence of clinicalstudies comparing the Bobath method with TPBS in gaitrehabilitation of individuals after stroke. Material and Methods:A systematic review with electronic searches in thedatabases SciELO, PubMed, PEDro and Lilacs was performedin August 2014. It was included clinical trials that addressedspecifically the topic of this review, published in scientificjournals in full and using the keywords “stroke, physiotherapy,rehabilitation, treadmill with weight support and Bobath”, inPortuguese, English and Spanish. Results: Ten studies werefound, of which four were excluded. The remaining sixstudies were used in this review: five randomized controlledclinical trials and one case study, published between 1995and 2008. In these studies, aspects such as cadence, steplength, speed and gait quality, functional ambulation, balanceand functionality of the patient were analyzed. Conclusion:Gait training using TPBS was found to show the best effectsin the rehabilitation of gait, with longer duration of achievedbenefits when in combination with other interventions oralone, as compared to gait training by the Bobath method...

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A melhora da capacidade de manutenção do equilíbrio é essencial para quem apresenta algum comprometimento motor, como a Paralisia Cerebral (PC). A realidade virtual (RV) já se destaca na reabilitação neurológica, porém com poucos estudos que abordem pacientes adultos com PC. Este estudo teve comoobjetivo investigar a influência da RV por meio de jogos de vídeo Wii no equilíbrio em posição ortostática de um paciente com PC Espástica Hemiparética. Foi utilizado o equipamento Nintendo® Wii, com o jogo Wii Fit Plus, em treinamentos que estimularam o equilíbrio látero-lateral e ântero-posterior do paciente. Osinstrumentos aplicados foram: Escala de Equilíbrio de Berg, Medida de Independência Funcional, além de 3 testes do Neurocom Balance Master: Limits of Stability, Tandem Walk e Step/Quick Turn. O protocolo de tratamento consistiu de 10 sessões, 30 minutos cada, duas vezes por semana por 38 dias. Ao final foi possível observar um aumento expressivo na pontuação de vários itens dos testesrealizados, implicando na melhora da capacidade de equilíbrio do paciente. Esses resultados sugerem a influência benéfica do Wii no que concerne o equilíbrio e capacidade funcional do portador de PC, tornando-o mais confiante para realizar suas atividades diárias.

The improvement of maintaining postural balances its essential i for those who have some motor impairment, such as Cerebral Palsy (CP). Virtual Reality (VR) is a feature that is standing out in neurological rehabilitation, but there are few studies regarding adult patients with CP. This study aimed to investigatethe infl uence of the VR through the Wii on balance in standing position from a patient with Spastic Hemiplegic CP. It was used the equipment Nintendo® Wii, with the game Wii Fit Plus, where the training chosen stimulated the latero-lateral and anterior-posterior patient’s balance. The instruments used were: Berg Balance Scale, Functional Independence Measure, and 3 Neurocom Balance Master Systems tests: Limits of Stability, Tandem Walk and Step/Quick Turn. The treatment protocol consisted of 10 sessions, with30 minutes each, performed twice a week for 38 days. At the end oftreatment, a significant increase in the scores of various test items performed was observed, which resulted in an improvement of patient’s balance. Results suggest a beneficial influence of the video game Wii regarding to postural balance and functional capacity of patients with PC, which become more confident to carry out their activities of daily living.

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O objetivo do estudo foi verificar a concordância de nomeação e familiaridade de um conjunto de figuras de objetos/animais e de atividades funcionais. Participaram 26 crianças entre 5 e 7 anos e 24 estudantes universitários entre 18 e 25 anos, de ambos os sexos. Os participantes observaram 90 figuras, 45 de atividades funcionais e 45 de objetos/animais, nomearam uma a uma e referiram o grau de familiaridade. Os dados foram analisados pelo coeficiente de Kappa, correlação de Spearman e teste de Mann-Whitney. Os resultados mostraram que a concordância com o nome original foi maior do que a freqüência de outras nomeações. As crianças tiveram mais dificuldades em fazer a nomeação. As figuras de objetos/animais foram consideradas mais familiares. O estudo mostrou diferenças significativas entre as figuras e entre as crianças e adultos, sugerindo o uso de figuras de atividades funcionais em estudos neuropsicológicos.

This study was done with the aim to examine the naming agreement and familiarity of a set of objects/animals and functional activities pictures. Twenty six children were used between 5-7 years old and 24 university students between 18-25 years old of both sexes. Participants should watch 90 pictures, being 45 of functional activities and 45 of objects/animals, nominate one by one, moreover, to refer the familiarity degree. Data were analyzed by coefficient of Kappa, Spearman correlation test and Mann-Whitney test. The original name agreement was bigger than the frequency of other nominations. The children had more difficult than adults to make the pictures nomination. The objects/animals pictures were considered more familiar, as well children as adults. This way, the study showed significant differences between the pictures and between children and adults, suggesting the use of functional activities pictures in neuropsychological studies.

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O objetivo do estudo foi verificar a concordância de nomeação e familiaridade de um conjunto de figuras de objetos/animais e de atividades funcionais. Participaram 26 crianças entre 5 e 7 anos e 24 estudantes universitários entre 18 e 25 anos, de ambos os sexos. Os participantes observaram 90 figuras, 45 de atividades funcionais e 45 de objetos/animais, nomearam uma a uma e referiram o grau de familiaridade. Os dados foram analisados pelo coeficiente de Kappa, correlação de Spearman e teste de Mann-Whitney. Os resultados mostraram que a concordância com o nome original foi maior do que a freqüência de outras nomeações. As crianças tiveram mais dificuldades em fazer a nomeação. As figuras de objetos/animais foram consideradas mais familiares. O estudo mostrou diferenças significativas entre as figuras e entre as crianças e adultos, sugerindo o uso de figuras de atividades funcionais em estudos neuropsicológicos.(AU)

This study was done with the aim to examine the naming agreement and familiarity of a set of objects/animals and functional activities pictures. Twenty six children were used between 5-7 years old and 24 university students between 18-25 years old of both sexes. Participants should watch 90 pictures, being 45 of functional activities and 45 of objects/animals, nominate one by one, moreover, to refer the familiarity degree. Data were analyzed by coefficient of Kappa, Spearman correlation test and Mann-Whitney test. The original name agreement was bigger than the frequency of other nominations. The children had more difficult than adults to make the pictures nomination. The objects/animals pictures were considered more familiar, as well children as adults. This way, the study showed significant differences between the pictures and between children and adults, suggesting the use of functional activities pictures in neuropsychological studies.(AU)

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