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1.
Brain Topogr ; 37(6): 1232-1241, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39162868

RESUMO

The purpose of this study is to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with body weight-support treadmill training (BWSTT) for improving walking function of individuals with chronic incomplete spinal cord injury (iSCI). A 4-week, double-blinded, randomized, sham-controlled pilot study involved 12 sessions of real (10 Hz, 1800 pulses) or sham rTMS combined with BWSTT (15-20 min, moderate intensity). Walking independence was assessed using the Walking Index for Spinal Cord Injury II (WISCI-II). Lower extremity motor function (lower extremity motor score [LEMS]) and spasticity, sensory function, functional independence (Spinal Cord Injury Measure III [SCIM-III]), and quality of life were also assessed. Walking independence (WISCI-II) after the 6th session was higher in the BWSTT/rTMS real (n = 7) (median change (IQR): 3 (1.5 to 3.5)) than in the sham group (n = 8) (median change (IQR): 0 (0 to 0.25), but there was no difference between groups after 12th session (BWSTT/rTMS real median change (IQR): 4 (2 to 5); BWSSTT/rTMS sham median change (IQR): 0 (0 to 3.25). Compared to baseline, LEMS and SCIM-III mobility scores were increased after 12 sessions in the BWSTT/rTMS real but not in the sham group. Within- and between-group sensory function, functional independence, and quality of life remained similar. This preliminary result suggests that combining BWSTT with rTMS could lead to earlier gait improvement in patients with chronic iSCI.


Assuntos
Terapia por Exercício , Traumatismos da Medula Espinal , Estimulação Magnética Transcraniana , Caminhada , Humanos , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/reabilitação , Traumatismos da Medula Espinal/terapia , Projetos Piloto , Masculino , Feminino , Estimulação Magnética Transcraniana/métodos , Caminhada/fisiologia , Pessoa de Meia-Idade , Adulto , Método Duplo-Cego , Terapia por Exercício/métodos , Peso Corporal/fisiologia , Resultado do Tratamento , Qualidade de Vida , Doença Crônica
2.
Hum Mov Sci ; 96: 103246, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38905821

RESUMO

Nonlinear analyses have emerged as an approach to unraveling the intricate dynamics and underlying mechanisms of postural control, offering insights into the complex interplay of physiological and biomechanical factors. However, achieving a comprehensive understanding of the application of nonlinear analysis in postural control studies remains a challenge due to the various nonlinear measurement methods currently available. Thus, this scoping review aimed to identify existing nonlinear analyses used to study postural control in both dynamic and quiet tasks, and to summarize and disseminate the available literature on the use of nonlinear analysis in postural control. For this purpose, a scoping review was conducted and reported following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) Checklist and Explanation. Searches were conducted up to July 2023 on PubMed/Medline, Embase, CINAHL, Web of Science, and Google Scholar databases, resulting in the inclusion of 397 unique studies. The main classes employed among the studies were entropy-based, fractal-based, quantification of recurrence plots, and quantification of stability, with a total of 91 different algorithms distributed among these classes. The most common condition used to study postural control was quiet standing, followed by dynamic standing and gait tasks. Although various algorithms were utilized for this purpose, sample entropy was employed in 43% of studies to explore mechanisms related to postural control. Among them, 28% were in quiet standing, 3.27% were in dynamic standing, and 4.78% to study postural control during the gait. The results also provide insights into nonlinear analysis for future studies, concerning the complexity and interactions within the postural control system across various task demands.


Assuntos
Dinâmica não Linear , Equilíbrio Postural , Humanos , Equilíbrio Postural/fisiologia , Fenômenos Biomecânicos , Algoritmos , Postura/fisiologia , Marcha/fisiologia , Entropia
3.
Spinal Cord ; 62(8): 468-478, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38907085

RESUMO

STUDY DESIGN: Mixed-method approach. OBJECTIVES: To develop and assess the content validity of a semi-structured interview that captures the lived experience of using a manual wheelchair among individuals with SCI in the real world, the Wheelchair Mobility Activity Log (WC-MAL). SETTING: SCIR-Group (UDESC)/Brazil. METHODS: Developing the WC-MAL comprised five steps: (1) defining the construct-based on the International Classification of Functioning, Disability and Health (ICF); (2) identifying relevant activities from other assessment instruments and interviews with the end-users (14 Individuals with SCI and 13 rehabilitation professionals); (3) Selecting the items - activities were linked to ICF codes and grouped into sets; (4) developing the scoring scales based on interviews with the end-users; and, (5) evaluating content validity in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The content validity ratio (CVR) for each item and scale and the overall instrument content validity index (CVI) were calculated. RESULTS: From an initial draft of 295 activities identified, a set of 222 activities was linked to the ICF domain of "Mobility (d4)" and further refined to generate the 23 items in the WC-MAL. Three scales were developed to assess Frequency (how often), Performance (how well), and Assistance (assistance needed) levels. The items and scales showed a CVR superior to the critical value established (≥0.64). The general CVI value was 0.96. CONCLUSION: The WC-MAL is a promising clinical instrument with adequate content validity to assess the spontaneous use of the manual wheelchair in the real world among individuals with SCI.


Assuntos
Traumatismos da Medula Espinal , Cadeiras de Rodas , Humanos , Traumatismos da Medula Espinal/reabilitação , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Atividades Cotidianas , Avaliação da Deficiência , Entrevistas como Assunto , Pessoas com Deficiência/reabilitação , Brasil
4.
J Spinal Cord Med ; 47(1): 15-50, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37707365

RESUMO

CONTEXT: A spinal cord injury or disease (SCI/D) is a devastating condition that affects all areas of a person's life, including quality of life (QoL). Assessing this construct using clinical instruments with adequate measurement properties is fundamental for an effective multi-professional treatment. OBJECTIVE: To identify the clinical instruments for assessing the QoL that present the best recommendation for use in people with SCI based on their measurement properties. METHODS: The overall methodology was conducted according to Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) systematic review guidance and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted up to March 2023 on MEDLINE/PubMed, Web of Science, Scopus, CINAHL, and Embase databases. RESULTS: Seventy-seven studies were included in this review, and 49 instruments were identified. The overall methodological quality of all studies ranged from insufficient to sufficient, and the level of evidence ranged from very low to high confidence. Twenty-six instruments may have the potential to be recommended, and the other 23 should not be recommended. CONCLUSION: None of the QoL instruments can be highly recommended as the most suitable instrument for the construct and population of interest. The generic instruments SF-36, SF-12, QWB, WHOQOL-DIS, WHOQOL-BREF, QLI-SCI, QOLP-PD, LS Questions, Lisat-9, and BRFSS are the clinical instruments that have the best measurement properties tested and have the potential to be the current best recommendation for assessing QoL in individuals with SCI.


Assuntos
Qualidade de Vida , Traumatismos da Medula Espinal , Humanos , Consenso , Psicometria , Reprodutibilidade dos Testes , Traumatismos da Medula Espinal/fisiopatologia , Inquéritos e Questionários
5.
Spinal Cord ; 61(2): 119-124, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36064765

RESUMO

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To document the labour market participation rate and investigate the impact of social and economic characteristics on this outcome among individuals with spinal cord injury or disease (SCI/D) who participated in a multidisciplinary rehabilitation programme in Brazil. SETTING: A specialised rehabilitation centre in southern Brazil. METHODS: An interview was performed with former rehabilitation clients with SCI/D. A total of 111 community-dwelling individuals with SCI/D who had been previously rehabilitated in a large regional rehabilitation centre were considered. Employment status and demographic, injury, work, and economic characteristics were self-reported via interview. Descriptive statistical analyses were performed. RESULTS: The labour market participation rate was 21.6% (24 individuals). Five respondents were employed in formal work activities, and the other 19 were involved in informal activities (self-employed). Since the onset of injury, a shorter time was associated with nonparticipation in occupational work. Individuals with a higher level of education were more likely to be working. Household income was higher among the participants who had returned to work than among those who had not returned. CONCLUSION: There is a relatively low labour market participation rate among rehabilitated individuals with SCI/D in southern Brazil. The rehabilitation services should emphasise vocational training, access to education, and employment support for individuals with SCI/D from early onset after the injury. Public policies must be revised to support labour market participation among individuals with SCI/D in Brazil.


Assuntos
Traumatismos da Medula Espinal , Humanos , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/reabilitação , Estudos Transversais , Brasil/epidemiologia , Emprego , Ocupações
6.
Rev Bras Ortop (Sao Paulo) ; 57(3): 384-391, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35785125

RESUMO

Objective The "Self-report S4-5 sensory and motor function questionnaire (S4-5Q)" is a short questionnaire that aims to assess the function of the sacral segments, S4 and S5, after a spinal cord injury (SCI), with the purpose of replacing the rectal exam test. The aim of the present study was to carry out a cross-cultural adaptation of the S4-5Q to the Brazilian Portuguese language and to investigate the test-retest reliability of this version. Method The translation and cross-cultural adaptation was performed using the methodology of translation and backtranslation. Initially, translations were done by three independent translators. Their synthesis was then submitted to an expert committee for analysis (SCI health professionals); then, the backtranslation to the original language was sent to the original author and, after all the adjustments, the final version was completed. For test-retest reliability, 24 individuals with chronic SCI were recruited (2 evaluations with an interval of 7 to 14 days between them). Statistical analysis was performed using IBM-SPSS (Version 20, SPSS Inc, Chicago, IL, USA) with data pretabulated in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA). Reliability was tested with Cohen Kappa, and internal consistency with Cronbach α, both adopting p < 0.05 as significant. Results In the reliability analysis, the results of all questions showed almost perfect agreement (Kappa > 0.81) and good internal consistency (Cronbach α: 0.65-0.77) between the questions and final classification. Conclusion The cross-culturally adapted S4-5Q is reliable to be applied to the Brazilian population with chronic SCI to determine their S4-5 sensory and motor function.

7.
Rev. Bras. Ortop. (Online) ; 57(3): 384-391, May-June 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1388028

RESUMO

Abstract Objective The "Self-report S4-5 sensory and motor function questionnaire (S4-5Q)" is a short questionnaire that aims to assess the function of the sacral segments, S4 and S5, after a spinal cord injury (SCI), with the purpose of replacing the rectal exam test. The aim of the present study was to carry out a cross-cultural adaptation of the S4-5Q to the Brazilian Portuguese language and to investigate the test-retest reliability of this version. Method The translation and cross-cultural adaptation was performed using the methodology of translation and backtranslation. Initially, translations were done by three independent translators. Their synthesis was then submitted to an expert committee for analysis (SCI health professionals); then, the backtranslation to the original language was sent to the original author and, after all the adjustments, the final version was completed. For test-retest reliability, 24 individuals with chronic SCI were recruited (2 evaluations with an interval of 7 to 14 days between them). Statistical analysis was performed using IBM-SPSS (Version 20, SPSS Inc, Chicago, IL, USA) with data pretabulated in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA). Reliability was tested with Cohen Kappa, and internal consistency with Cronbach α, both adopting p < 0.05 as significant. Results In the reliability analysis, the results of all questions showed almost perfect agreement (Kappa > 0.81) and good internal consistency (Cronbach α: 0.65-0.77) between the questions and final classification. Conclusion The cross-culturally adapted S4-5Q is reliable to be applied to the Brazilian population with chronic SCI to determine their S4-5 sensory and motor function.


Resumo Objetivo O "Self-report S4-5 Sensory and Motor Function Questionnaire (S4-5Q)" é um breve questionário de avaliação da função dos segmentos sacrais S4 e S5 após uma lesão medular (LM), cuja finalidade é substituir o exame de toque retal. O objetivo do presente estudo foi realizar uma adaptação transcultural do questionário S4-5Q para a língua portuguesa do Brasil e investigar a confiabilidade teste-reteste desta versão. Método A tradução e a adaptação transcultural foram realizadas utilizando a metodologia de tradução e retrotradução. Inicialmente, as traduções foram realizadas por três tradutores independentes. Sua síntese foi então submetida a um comitê de especialistas (profissionais de saúde com experiência em LM). Em seguida, a retrotradução para o idioma original foi enviada ao autor original, sendo que a versão final foi concluída após todas as adaptações. Para a confiabilidade teste-reteste, foram recrutados 24 indivíduos com lesão medular espinal (LME) em fase crônica (2 avaliações com intervalo de 7 a 14 dias entre elas). A análise estatística foi realizada no IBM-SPSS (Version 20, SPSS Inc, Chicago, IL, USA) com dados pré- tabulados no programa Microsoft Excel (Microsoft Corporation, Redmond, WA, EUA). A confiabilidade foi testada por meio do coeficiente Kappa de Cohen, e a consistência interna foi medida através do α de Cronbach, ambas adotando p < 0,05 como significante. Resultados Na análise de confiabilidade, os resultados de todas as perguntas apresentaram concordância quase perfeita (Kappa > 0,81) e boa consistência interna (α de Cronbach: 0,65-0,77) entre as perguntas e a classificação final. Conclusão O questionário S4-5Q adaptado culturalmente é confiável, podendo ser aplicado à população brasileira com LME crônica, com o objetivo de avaliar a função sensorial e motora nos segmentos sacrais S4-S5.


Assuntos
Humanos , Região Sacrococcígea , Traumatismos da Medula Espinal , Comparação Transcultural , Inquéritos e Questionários
8.
Neurochem Res ; 44(9): 2230-2236, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31486011

RESUMO

Upper limb nerve injuries are common, and their treatment poses a challenge for physicians and surgeons. Experimental models help in minimum exploration of the functional characteristics of peripheral nerve injuries of forelimbs. This study was conducted to characterize the functional recovery (1, 3, 7, 10, 14, and 21 days) after median and ulnar nerve crush in mice and analyze the histological and biochemical markers of nerve regeneration (after 21 days). Sensory-functional impairments appeared after 1 day. The peripheral nerve morphology, the nerve structure, and the density of myelin proteins [myelin protein zero (P0) and peripheral myelin protein 22 (PMP22)] were analyzed after 21 days. Cold allodynia and fine motor coordination recovery occurred on the 10th day, and grip strength recovery was observed on the 14th day after injury. After 21 days, there was partial myelin sheath recovery. PMP22 recovery was complete, whereas P0 recovery was not. Results suggest that there is complete functional recovery even with partial remyelination of median and ulnar nerves in mice.


Assuntos
Nervo Mediano/fisiopatologia , Recuperação de Função Fisiológica , Remielinização , Nervo Ulnar/fisiopatologia , Animais , Masculino , Nervo Mediano/lesões , Nervo Mediano/metabolismo , Camundongos , Proteína P0 da Mielina/metabolismo , Proteínas da Mielina/metabolismo , Compressão Nervosa , Nervo Ulnar/lesões , Nervo Ulnar/metabolismo
9.
Adv Exp Med Biol ; 1088: 139-151, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30390251

RESUMO

In muscle tissue there is a balance between the processes muscle synthesis and degradation. The mammalian target of rapamycin (mTOR) signaling pathway plays a critical role in regulating protein synthesis in order to maintain muscular protein turnover and trophism. Studies have shown that both down- and upregulation mechanisms are involved in this process in a manner dependent on stimulus and cellular conditions. Additionally, mTOR signaling has recently been implicated in several physiological conditions related to cell survival, such as self-digestion (autophagy), energy production, and the preservation of cellular metabolic balance over the lifespan. Here we briefly describe the mTOR structure and its regulatory protein synthesis pathway. Furthermore, the role of mTOR protein in autophagy, aging, and mitochondrial function in muscle tissue is presented.


Assuntos
Envelhecimento , Autofagia , Músculos/fisiologia , Biossíntese de Proteínas , Transdução de Sinais , Serina-Treonina Quinases TOR/metabolismo , Humanos
10.
Top Spinal Cord Inj Rehabil ; 24(2): 177-193, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29706762

RESUMO

Background: Evidence of intervention effectiveness depends on, among other things, the use of a common set of valid and reliable measures that are responsive to change and reflect clinically important outcomes. Objective: To identify clinical assessment instruments with properties for measuring unsupported sitting balance in subjects with spinal cord injury (SCI). Methods: Bibliographic databases (PubMed, Science Direct, CINAHL, and Central) were searched for articles with the key words "spinal cord injury," "unsupported sitting," and "outcome assessment" in combination with a specific methodological search filter for each database. Studies describing the application of any assessment instrument for measuring unsupported sitting balance in subjects with SCI, which had the evaluation of any measurement property, were included in the review. Publication details, measure's name, setting, summary statistics, measurement properties (reliability, validity, responsiveness), and statistical significance (p values) were extracted. Results: Eight hundred forty publications were identified; 8 articles were included in the systematic review. Twelve instruments were identified and analyzed, showing limited and incomplete measurement properties. Among them, 10 addressed activity, 1 addressed structures/body functions, and 1 addressed both activity and structures/body functions domains of the International Classification of Functioning, Disability and Health (ICF). Conclusion: Based mainly on the measurement properties and the development of the instruments analyzed in this review, the Sitting Balance Measure, the Trunk Control Test, and the Set of Assessment Tools for Measuring Unsupported Sitting seem to be the most appropriate and recommended measures to assess unsupported sitting in subjects with SCI.


Assuntos
Avaliação da Deficiência , Equilíbrio Postural , Postura , Traumatismos da Medula Espinal/complicações , Humanos , Avaliação de Resultados em Cuidados de Saúde , Traumatismos da Medula Espinal/reabilitação
11.
Neurochem Res ; 43(6): 1258-1268, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29737479

RESUMO

Assisted-treadmill training, may be helpful in promoting muscle mass preservation after incomplete spinal cord injury (SCI). However, biological mechanism involved in this process is still not fully understood. This study investigated the effects of locomotor treadmill training on muscle trophism mediated by protein kinase B (Akt)/mammalian target of rapamycin (mTOR)/p70 ribosomal protein S6 kinase (p70S6K) in paraplegic rats. Adult female Wistar rats underwent an incomplete thoracic SCI induced by compression using an aneurysm clip. After 7 days, injured animals started a 3-week locomotor treadmill training with body weight-support and manual step help. Soleus trophism was measured by muscle weight and transverse myofiber cross-sectional area (CSA). An enzyme-linked immunosorbent assay (ELISA) and western blot analysis were used to detect brain-derived neurotrophic factor (BDNF), tropomyosin-related kinase B (TrkB), Akt, mTOR and p70S6K in paretic soleus. Trained animals did not show locomotor improved, but present an increase in muscle weight and myofiber CSA. Furthermore, the levels of Akt, p70S6K phosphorylation, mTOR and TrkB receptor were increased by training in soleus. In contrast, muscle BDNF levels were significantly reduced after training. The results suggest locomotor treadmill training partially reverts/prevents soleus muscle hypotrophy in rats with SCI. Furthermore, this study provided the first evidence that morphological muscle changes were caused by Akt/mTOR/p70S6K signaling pathway and TrkB up-regulation, which may increase the sensitivity of muscle, reducing autocrine signaling pathway demand of BDNF for cell growth.


Assuntos
Teste de Esforço/métodos , Locomoção/fisiologia , Músculo Esquelético/metabolismo , Atrofia Muscular/metabolismo , Paraplegia/metabolismo , Serina-Treonina Quinases TOR/biossíntese , Animais , Feminino , Músculo Esquelético/patologia , Atrofia Muscular/patologia , Atrofia Muscular/prevenção & controle , Paraplegia/patologia , Paraplegia/reabilitação , Ratos , Ratos Wistar
12.
Top Spinal Cord Inj Rehabil ; 24(1): 6-17, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29434456

RESUMO

Background: Physical therapists frequently use neuromuscular electrical stimulation (NMES) therapy in an effort to increase the voluntary strength of partially paralyzed muscles in people with spinal cord injury (SCI), but it is not clear whether this treatment is effective. Objective: To determine the effectiveness of NMES for increasing voluntary strength in the partially paralyzed muscles of people with SCI. Methods: A systematic review of scientific literature was conducted in MEDLINE, CINAHL, PEDro, ScienceDirect, and Embase. Inclusion criteria were randomized controlled trials and controlled trials that compared NMES aimed at increasing strength in partially paralyzed muscles versus placebo/nothing or versus a nonstrengthening intervention or versus any other type of strengthening intervention in adults with SCI. Results: Five studies were included. Two studies found an increase in strength measured by peak force and manual muscle force test after an NMES protocol. One study found a between-group difference in favor of the NMES associated with progressive resistance training, and the other study showed an increase in the number of muscles improved by at least 1 degree of strength after NMES in combination with a cycle ergometer. The other 3 studies made several comparisons and found no differences between groups that received NMES and the controls. Conclusions: There is some suggestion that NMES increases voluntary strength in partially paralyzed muscle following SCI. However, there is no strong evidence to affirm the superiority of NMES over other treatment strategies used to gain strength in partially paralyzed muscles after SCI. These findings need replicating in large high-quality randomized controlled trials.


Assuntos
Terapia por Estimulação Elétrica , Força Muscular/fisiologia , Músculo Esquelético/fisiopatologia , Traumatismos da Medula Espinal/reabilitação , Humanos , Treinamento Resistido/métodos , Traumatismos da Medula Espinal/fisiopatologia , Resultado do Tratamento
13.
Anat Rec (Hoboken) ; 300(9): 1654-1661, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28463452

RESUMO

Peripheral nerve injuries constitute a significant medical problem and the recovery is critically dependent on post-injury treatment. In this study, following sciatic nerve crush, we investigated the effects of a 4-week endurance training program (ET) and balance and coordination training program (BCT) on the ultrastructural features of the sciatic nerve and soleus muscle. The animals were randomly divided into Sham, non-trained (NT), ET, and BCT groups each of which included three animals. Ultra-thin cross and longitudinal sections (70-85 nm) were digitized and analyzed comparatively. The electron micrographic analysis of the sciatic nerve showed similar organelles features in the injury groups (myelin debris and swelling mitochondria). Nonetheless, the ET group presented better ultrastructural features as demonstrated by the greater predominance of rounded fibers and more defined organization in the myelinated axon bundles. In the soleus muscle's analyses, the injured groups demonstrated similar organelles' features (nucleus contained highly heterochromatic nuclei and smaller mitochondria). However, ET and BCT groups showed apparently enlarged myofibril cross-sectional areas and less collagen around muscle fibers, although, the ET group displayed reduced intermyofibrillar spaces and more closely aligned myofilaments when compared with the BCT group. Based on electron micrographic analysis, our findings suggest the presence of ultrastructural differences between the Sham, NT, and the trained groups. Therefore, exercise type seems to be responsible for producing some different positive features in the trained groups, while ET seems to have a more pronounced influence on the ultrastructural features of the sciatic nerve and the soleus muscle after a crush injury. Anat Rec, 300:1654-1661, 2017. © 2017 Wiley Periodicals, Inc.


Assuntos
Terapia por Exercício/métodos , Condicionamento Físico Animal/métodos , Nervo Isquiático/lesões , Neuropatia Ciática/terapia , Animais , Masculino , Músculo Esquelético/ultraestrutura , Distribuição Aleatória , Ratos Wistar , Nervo Isquiático/ultraestrutura
14.
Disabil Rehabil ; 39(17): 1759-1770, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27685369

RESUMO

PURPOSE: The PROFILE PD scale was developed specifically to evaluate patients with Parkinson's disease (PD) within the context of the International Classification of Functioning, Disability and Health, directly applied to physical therapy practice. The study aimed to translate and cross-culturally adapt the PROFILE PD scale to Portuguese-Brazil, and to analyze its psychometric domains. METHODS: Fifty participants with PD participated in the study. We assessed the clarity of the Brazilian version of the scale by physiotherapists, presence of floor and ceiling effects, interrater and test-retest reliabilities, in addition to discriminant, concurrent (UPDRS) and construct validity, internal consistence, minimal detectable change (MDC), and responsiveness. RESULTS: The scale was considered highly clear for physical therapists. The interrater ICC was 0.74 and Wk was 0.89 for the total score. For test-retest reliability, the total ICC score was 0.99. The analysis of concurrent validity showed the Spearman correlation between Brazilian version of PROFILE PD and UPDRS (ρ = 0.77; p < 0.001). Factor analyses demonstrated that the test comprises a single scale. Brazilian version of PROFILE PD was able to discriminate the subject with PD in mild and moderate stages, and in mild and severe stages. A high internal consistency was found (α = 0.99). MDC was 2.41 points and there were no floor and ceiling effects. Also, the scale was responsive to physical therapy intervention, with improvement in 8 points after two months (effect size = 0.85). CONCLUSION: The Brazilian version of PROFILE PD is an instrument reliable, valid, and responsive to physical therapy intervention, that can be used to quantify impairments and limitations in patients with PD and can provide an overall summary of the impact of disease, useful for physiotherapy practice. Implications for Rehabilitation PROFILE PD is a reliable and valid instrument to be applied in Brazilian Parkinson disease patients. This scale is design specially to be used in physical therapy practice within the contexts surrounding the International Classification of Functioning, Disability and Health. PROFILE PD was able to discriminate between patients in mild and moderate stages of disease which is difficult in clinical practice mainly because the scale used for this relies on balance and gait rather than a global profile.


Assuntos
Avaliação da Deficiência , Doença de Parkinson/reabilitação , Modalidades de Fisioterapia , Psicometria/métodos , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Brasil , Comparação Transcultural , Análise Fatorial , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Índice de Gravidade de Doença
15.
Eur J Phys Rehabil Med ; 53(5): 664-675, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27050084

RESUMO

BACKGROUND: The Modified Parkinson Activity Scale (PASm) and Lindop Parkinson's Disease Mobility Assessment (LPA) scales were developed to assess the functional mobility in patients with Parkinson's disease (PD) being directly applied to physical therapy practice. AIM: To translate and perform the cross-cultural adaptation of PASm and LPA scales to Portuguese-Brazil, and to analyze some psychometric properties. DESIGN: Cross-cultural validation study. SETTING: Clinical environment. POPULATION: Thirty-two Brazilian subjects with Parkinson's disease. METHODS: The study consisted of two stages: 1) cross-cultural adaptation process; 2) evaluation of psychometric properties. RESULTS: Considering the total score, the interrater and test-retest reliabilities showed a coefficient of intra-class correlation that ranged between 0.97 and 0.98. Both scales showed excellent internal consistency (α=0.83 and 0.94). Positive correlations were obtained between the Brazilian versions of the LPA and PASm and PAS (ρ=0.63 and 0.92). The concurrent validity between scales and part III of UPDRS, established a moderate negative correlation, (ρ=-0.54 and -0.65). The one way ANOVA showed that LPA-Brazil discriminates the individual with PD between all stages according HY, and the PASm- Brazil between mild and severe stages, and moderate and severe. The MDC of scales ranging from 1 to 2 points. There was Ceiling effect only for the LPA-Brazil. CONCLUSIONS: Brazilian versions of PASm and LPA are valid and reliable instruments to assess the functional mobility in patients with PD, being directly applied to physical therapy clinical practice. CLINICAL REHABILITATION IMPACT: The major goal of physical therapy in PD is to maintain functional mobility and independence of the patient. The results of study are relevant and could improve the physical therapy practice in Brazil, since it provides the Brazilian version of two mobility scales (one of them recommended by the European Guidelines for Physical Therapy Practice in patients with Parkinson disease).


Assuntos
Avaliação da Deficiência , Limitação da Mobilidade , Doença de Parkinson/psicologia , Doença de Parkinson/reabilitação , Modalidades de Fisioterapia/organização & administração , Idoso , Brasil , Comparação Transcultural , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Doença de Parkinson/diagnóstico , Psicometria , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Traduções , Resultado do Tratamento
16.
Rev. bras. neurol ; 52(1): 2-17, jan.-mar. 2016. graf, tab
Artigo em Português | LILACS | ID: lil-779349

RESUMO

OBJETIVO: O objetivo deste estudo foi realizar a validação transcultural de um instrumento de autorrelato utilizado para avaliar o nível de independência funcional nas atividades de vida diária em pessoas com lesão da medula espinal (LME), a Spinal Cord Independence Measure? Self-Reported Version (SCIM-SR) para a língua portuguesa do Brasil. MÉTODOS: Duas traduções independentes da versão original do instrumento em inglês e síntese de uma versão em português foram realizadas, seguidas pela consulta de um painel de profissionais de reabilitação e confecção da versão pré-final, pré-teste (n = 13), retrotradução para a língua original e aprovação da autora original do instrumento. RESULTADOS: A comparação do instrumento original com a retrotradução e aprovação garantiu que a equivalência semântica e a manutenção do conteúdo do instrumento tenham sido adequadamente mantidas. CONCLUSÃO: A brSCIM-SR foi adequadamente validada transculturalmente ao português e pode ser utilizada como um instrumento de autorrelato para avaliar o nível de indepen-dência das pessoas com LME no Brasil.


OBJECTIVE: The objective of this study was to do the cross-cultural validation of a self-reported instrument used to evaluate the functional independence in the activities of daily living in people with spinal cord injury (SCI), the Spinal Cord Independence Measure? Self-Reported Version (SCIM-SR) into Portuguese of Brazil. METHODS: Two independent translations of the original version in English and the synthesis of a Portuguese version has been made, followed by a panel consensus of rehabilitation professionals and confection of a prefinal version, pretest (n = 13), back-translation to the English and original instrument author approval. RESULTS: The comparison of the original with the back-translation version and its approval ensured that the semantic equivalence and the content of the instrument were maintained. CONCLUSION: The brSCIM-SR was cross-culturally validated to the Portuguese and can be used as a self-report instrument to assess the level of independence in people with SCI in Brazil.


Assuntos
Humanos , Adulto , Adulto Jovem , Traumatismos da Medula Espinal/reabilitação , Traduções , Atividades Cotidianas/psicologia , Comparação Transcultural , Inquéritos e Questionários/estatística & dados numéricos , Autorrelato , Brasil , Reprodutibilidade dos Testes
17.
Muscle Nerve ; 53(4): 617-25, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26316168

RESUMO

INTRODUCTION: Numerous rehabilitation treatments have been shown to be useful for peripheral and central restoration after (PNI). METHODS: After sciatic nerve crush, we investigated 4 weeks of endurance training (ET) and balance and coordination training (BCT) with sciatic function index, hind-paw stride length, and spinal cord dorsal horn synaptophysin and neurotrophin-3 immunoreactivity. RESULTS: Our results demonstrated no significant differences between the non-trained (NT), ET, and BCT groups in sciatic functional index, and in stride-length analysis, but the ET showed higher values compared with the NT group. Synaptophysin immunoreactivity was higher in the BCT group compared with the NT group, and neurotrophin-3 immunoreactivity in the BCT group was greater compared with the other groups. CONCLUSION: BCT can positively affect spinal cord plasticity after a (PNI), and these modifications are important in the rehabilitation process.


Assuntos
Neurotrofina 3/metabolismo , Condicionamento Físico Animal/fisiologia , Equilíbrio Postural/fisiologia , Neuropatia Ciática/metabolismo , Medula Espinal/metabolismo , Sinaptofisina/metabolismo , Animais , Vértebras Lombares , Masculino , Atividade Motora/fisiologia , Compressão Nervosa/métodos , Neurotrofina 3/análise , Condicionamento Físico Animal/métodos , Resistência Física/fisiologia , Desempenho Psicomotor/fisiologia , Ratos , Ratos Wistar , Medula Espinal/química , Sinaptofisina/análise
18.
Muscle Nerve ; 51(1): 83-91, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24752648

RESUMO

INTRODUCTION: Different rehabilitation treatments have proven useful in accelerating regeneration. METHODS: After sciatic nerve crush in rats, we tested balance and coordination training (BCT) and endurance training (ET) through sensorimotor tests and analyzed nerve and muscle morphology. RESULTS: After BCT and ET, rats performed better in sensorimotor tests than did non-trained animals. However, only BCT maintained sensorimotor function during training. Furthermore, BCT and ET produced significantly larger muscle area than in non-trained animals. CONCLUSIONS: These findings indicate that BCT and ET, when initiated in the early phase after sciatic nerve injury, improve morphological properties of the soleus muscle and sciatic nerve, but only the task-oriented BCT maintained sensorimotor function. The success of rehabilitative strategies appears to be highly task-specific, and strategies that stimulate sensory pathways are the most effective in improving balance and/or coordination parameters.


Assuntos
Terapia por Exercício/métodos , Resistência Física/fisiologia , Equilíbrio Postural/fisiologia , Desempenho Psicomotor/fisiologia , Neuropatia Ciática/fisiopatologia , Neuropatia Ciática/reabilitação , Animais , Modelos Animais de Doenças , Locomoção/fisiologia , Masculino , Músculo Esquelético/patologia , Compressão Nervosa/métodos , Fibras Nervosas Mielinizadas/patologia , Ratos , Ratos Wistar , Recuperação de Função Fisiológica/fisiologia , Neuropatia Ciática/patologia
19.
Geriatr Gerontol Int ; 15(1): 89-95, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24456087

RESUMO

AIM: Following the substantial growth of the elderly population in Brazil, there has been an increase in cases of Parkinson's disease (PD), which raises the need for reliable and culturally adapted scales specific to the disease. The Parkinson Activity Scale (PAS) was developed in order to assess the activity level of people with PD through tasks related to mobility. The aims of the present study were to translate the cross-cultural adaptation of the PAS into Brazilian Portuguese and analyze its reliability during the "on" phase of PD. METHODS: A total of 25 patients with PD participated in the study. The intrarater reliability was evaluated using a test-retest design with a 1-week interval. RESULTS: The interrater reliability was tested twice on the same day by two different raters. The intraclass correlation coefficient (ICC), and the Bland and Altman plots were calculated to examine the test-retest and interrater reliabilities for total score of the PAS, whereas the weighted Kappa (Wk) was used to assess interrater agreement. The interrater ICC was 0.89 and Wk was 0.65 for the total score. For intrarater reliability, the total score ICC was 0.88. CONCLUSIONS: The present study suggests that the Brazilian version of the PAS is a reliable instrument for the assessment of mobility in elderly patients with PD.


Assuntos
Adaptação Psicológica , Avaliação Geriátrica/métodos , Limitação da Mobilidade , Doença de Parkinson/diagnóstico , Psicometria/métodos , Tradução , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Comparação Transcultural , Características Culturais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/epidemiologia , Doença de Parkinson/psicologia , Prevalência , Reprodutibilidade dos Testes , Inquéritos e Questionários
20.
J Neurosci Methods ; 226: 66-72, 2014 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-24486876

RESUMO

BACKGROUND: This study was conducted to test whether the IBB Forelimb Scale (Irvine et al., 2010) which was originally developed for rats with spinal cord injury, is also capable of measuring the functional performance of Swiss mice with lesions of the median and ulnar nerves inflicted via crushing with standardized strength. NEW METHOD: This test was performed at days 1, 3, 7, 10, 14 and 21 after surgery and each animal gives a score of 9, where 0 represented the worst functionality and 9 represented the habitual behavior. RESULTS: The control animals usually exhibited movements in the task that were scored as 9 during the experimental period. The lesion group began with a score of 2 on the 1st and 3rd post-operative days. On the 7th and 10th postoperative days, respectively, they scored 7, and on the 14th post-operative day, they achieved a score of 8. Only on the 21st post-operative day, did they exhibit habitual skillful behaviors. COMPARISON WITH EXISTING METHOD(S): IBB Forelimb Scale is effective for determining how the animals perform the movements in detail, which is not readily revealed by other methods. Furthermore, this test show similar recovery periods with grasping test, staircase test and seems to be more sensitive than paw print analysis for this type of lesion. CONCLUSIONS: Our data demonstrate that IBB scale was capable of measuring gradual improvements in motor forelimb functions in this model and may be a new and effective assessment tool for peripheral nerve injury.


Assuntos
Avaliação da Deficiência , Membro Anterior , Nervo Mediano/lesões , Traumatismos dos Nervos Periféricos/diagnóstico , Recuperação de Função Fisiológica , Nervo Ulnar/lesões , Animais , Fenômenos Biomecânicos , Diagnóstico Diferencial , Modelos Animais de Doenças , Membro Anterior/fisiopatologia , Masculino , Camundongos , Destreza Motora/fisiologia , Traumatismos dos Nervos Periféricos/fisiopatologia , Distribuição Aleatória , Índice de Gravidade de Doença , Análise e Desempenho de Tarefas , Fatores de Tempo
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