Search

RESUMO O acidente vascular encefálico pode deixar sequelas neurológicas, motoras e sensitivas. Para avaliar e acompanhar o prognóstico do paciente, são usados diversos instrumentos funcionais de medida, como a escala de Fugl-Meyer, que apesar de amplamente utilizada para estimar a recuperação sensório-motora, é uma avaliação longa e que exige treinamento. Diante disso, o objetivo deste estudo é analisar se a força de preensão manual, o timed up and go e a medida de independência funcional podem predizer os resultados da escala Fugl-Meyer, com o intuito de otimizar o tempo de avaliação da recuperação sensório-motora, tanto para o acompanhamento da resposta ao tratamento quanto para pesquisas científicas. Para tanto, avaliou-se a força de preensão manual de 35 hemiparéticos crônicos, e em seguida foram aplicadas à escala Fugl-Meyer, que avalia a recuperação motora, a medida de independência funcional nas atividades motoras e o timed up and go, indicativo de mobilidade funcional. Para análise estatística utilizou-se a regressão linear múltipla (r2). A força de preensão manual mostrou-se preditora da recuperação motora (r2=0,46; p=0,001), enquanto a mobilidade (r2=0,255; p=0,007) e a independência funcional (r2=0,054; p=0,2) não foram capazes de predizer os resultados da escala Fugl-Meyer. Após análise, pôde-se inferir que a força de preensão manual é preditora moderada da recuperação motora pós-acidente vascular encefálico, enquanto mobilidade e a independência funcional, não. RESUMEN El accidente cerebrovascular puede ocasionar secuelas neurológicas, motores y sensoriales. Para evaluar y monitorear el pronóstico del paciente, se utilizan diversos instrumentos funcionales, como la escala de Fugl-Meyer, que aunque es ampliamente utilizada para estimar la recuperación sensoriomotor, presenta una evaluación larga y que requiere entrenamiento. Teniendo en cuenta lo anterior, este estudio pretende analizar si la fuerza de prensión manual, el timed up and go y la medición de independencia funcional pueden predecir los resultados de la escala de Fugl-Meyer para que se mejore el tiempo de evaluación de la recuperación sensorial y motora, tanto para monitorear la respuesta al tratamiento como para estudios científicos. Por tanto, se evaluó la fuerza de prensión manual de 35 hemiparéticos crónicos, y luego se aplicaron a la escala de Fugl-Meyer, que evalúa la recuperación motora, las medidas de la independencia funcional en las actividades motoras y el timed up and go, indicativo de movilidad funcional. Para el análisis estadístico se utilizó la regresión lineal múltiple (r2). La fuerza de prensión manual ha demostrado ser predictiva de la recuperación motora (r2=0,46; p=0,001), mientras que la movilidad (r2=0,255; p=0,007) y la independencia funcional (r2=0,054; p=0,2) no fueron capaces de predecir los resultados de la escala de Fugl-Meyer. Del análisis se puede inferir que la fuerza de prensión manual es una predictora moderada en la recuperación motora posaccidente cerebrovascular, mientras que no lo son la movilidad y la independencia funcional. ABSTRACT Cerebrovascular accidents can leave neurological, motor and sensory sequelae. To assess and monitor the patient’s prognosis, several functional measuring instruments are used, such as the Fugl-Meyer scale, which, although widely used to estimate the sensorimotor recovery, is a long evaluation that requires training. Therefore, the objective of this study is to analyze if the handgrip strength (HGS), the Timed up and Go test (TUG) and the Functional Independence Measure (FIM) can predict the results of the Fugl-Meyer scale, in order to optimize time during sensorimotor recovery assessment, both to monitor treatment responses and for scientific research. Thus, the HGS of 35 chronic hemiparetic patients was evaluated and then applied to Fugl-Meyer Scale, which evaluates motor recovery, the FIM, which evaluates motor activities and the TUG, which is an indicative of functional mobility. Statistical analysis was performed using multiple regression (r2). The HGS was predictive of motor recovery (r2=0.46; p=0.001), while mobility (r2=0.255; p=0.007) and functional independence (r2=0.054; p=0.2) were not capable of predicting the results of the Fugl-Meyer scale. After analysis, it was concluded that HGS is a moderate predictor of motor recovery after cerebrovascular accident, while mobility and functional independence are not.

Supplementary material related to this article can be found, in the online version, at doi:https://doi.org/10.1016/j.carbpol.2018.09.088., The global demand of prebiotics such as xylooligosaccharides (XOS) has been growing over the years, motivating the search for different production processes with increased efficiency. In this study, a cloned Bacillus subtilis 3610, containing the xylanase gene xyn2 of Trichoderma reesei coupled with an endogenous secretion tag, was selected for XOS production through direct fermentation of beechwood xylan. A mixture of XOS with a degree of polymerization ranging from 4-6 was obtained, presenting high stability after a static in vitro digestion (98.5±0.2%). The maximum production yield expressed as total XOS per amount of xylan (306±4mg/g) was achieved after 8h of fermentation operating under one-time impulse fed-batch. The optimal conditions found were pH 6.0 and 42.5°C, using 2.5g/L of initial concentration of xylan increased up to 5.0g/L at 3h. Xylopentaose was the major oligosaccharide produced, representing 47% of the total production yield., CA, SCS, ACP, EC and LRR acknowledge their grants (PD/BD/ 105870/2014, SFRH/BPD/88584/2012, SFRH/BPD/ 101181/2014, SFRH/BPD/70589/2010 and SFRH/BSAB/142873/2018) from Portuguese Foundation for Science and Technology (FCT). The study received financial support from FCT under the scope of the strategic funding of UID/BIO/04469/2013 unit; COMPETE 2020 (POCI-010145-FEDER-006684); QOPNA research Unit (FCT UID/QUI/00062/ 2013), through national founds and where applicable co-financed by the FEDER, within the PT2020 Partnership Agreement; the Project MultiBiorefinery (POCI-01-0145-FEDER-016403); the Project FoSynBio (POCI-01-0145-FEDER-029549) and Lignozymes (POCI-01-0145FEDER-029773). The authors also acknowledge BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020 - Programa Operacional Regional do Norte., info:eu-repo/semantics/publishedVersion

Background: Handgrip strength is currently considered a predictor of overall muscle strength and functional capacity. Therefore, it is important to find reliable and affordable instruments for this analysis, such as the modified sphygmomanometer test (MST). Objectives: To assess the concurrent criterion validity of the MST, to compare the MST with the Jamar dynamometer, and to analyze the reproducibility (i.e. reliability and agreement) of the MST in individuals with Parkinson's disease (PD). Method: The authors recruited 50 subjects, 24 with PD (65.5±6.2 years of age) and 26 healthy elderly subjects (63.4±7.2 years of age). The handgrip strength was measured using the Jamar dynamometer and modified sphygmomanometer. The concurrent criterion validity was analyzed using Pearson's correlation coefficient and a simple linear regression test. The reproducibility of the MST was evaluated with the coefficient of intra-class correlation (ICC 2,1 ), the standard error of measurement (SEM), the minimal detectable change (MDC), and the Bland-Altman plot. For all of the analyses, α≤0.05 was considered a risk. Results: There was a significant correlation of moderate magnitude (r≥0.45) between the MST and the Jamar dynamometer. The MST had excellent reliability (ICC 2,1 ≥0.7). The SEM and the MDC were adequate; however, the Bland-Altman plot indicated an unsatisfactory interrater agreement. Conclusions: The MST exhibited adequate validity and excellent reliability and is, therefore, suitable for monitoring the handgrip strength in PD. However, if the goal is to compare the measurements between examiners, the authors recommend that the data be interpreted with caution.

[Purpose] The aim of the present study was to analyze the psychometric properties of the Stroke Specific Quality of Life (SS-QOL) scale for the assessment of social participation following a stroke. [Methods] A preliminary analysis was performed of the SS-QOL items that address the participation category. For this, the scoring patterns of the answers of individuals and internal consistence were determined using the Rasch model. Reliability was assessed by intraclass correlation coefficients (ICC). [Results] The reliability coefficients analyzed by the Rasch model were 0.91 for the items and 0.87 for the patients. The separation index was 3.19 for the items and 2.58 for the patients. The findings indicate that the items separated the patients into three levels of participation: low, medium, and high. Among the 26 items addressing participation, three did not fit the model. All items showed adequate reliability (ICC ≥ 0.60). [Conclusion] The Rasch analysis detected three items with erratic behavior; however, the erratic patterns of these items may be explained by individual peculiarities among the patients. These items should be monitored to determine if the problems found in the present study persist. If so, the items should also be revised or possibly even eliminated.

Resumo: Introdução: Devido à inadequada resposta aos corticóides inalatórios, os pacientes com asma de difícil controlo (ADC) são submetidos a corticóides orais ou uso de omalizumabe. Embora sejam necessários para o tratamento desses pacientes, há uma relação significativa entre o uso de esteróides e fraqueza muscular periférica e respiratória, resultando em implicações como a perda da qualidade de vida e função pulmonar comprometida. No entanto, não se sabe se estes pacientes sofrem alterações neurofisiológicas devido ao efeito da droga. Objetivo: Investigar as características neurofisiológicas e funcionais de pacientes com ADC, para melhor compreensão da doença. Método: Foi realizado um estudo transversal em 3 grupos de pacientes: ADCC (que fazem uso de corticóide por via oral); ADCO (que fazem uso do Omalizumab) e GC (controlo saudável da mesma idade). A avaliação foi composta pela prova da marcha dos 6 minutos, teste senta-levanta, equilíbrio estático com a plataforma de pressão, reflexos monossimpáticos (patelar e aquileu) e a força do quadríceps do membro inferior dominante. Resultados: Embora os resultados em relação aos aspetos neurofisiológicos mostrem não haver diferença estatisticamente significativa entre os grupos controlo e com ADC, deve ser observado que o grupo com ADC, apresentou importante redução da capacidade funcional, quando comparado ao grupo controlo (diminuição da força muscular (p

OBJETIVO: Identificar categorias do componente de participação da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) que já foram sistematicamente relacionadas aos instrumentos de Qualidade de Vida Relacionada à Saúde (QVRS) comumente utilizados em indivíduos acometidos pelo acidente vascular encefálico (AVE) - Nottingham Health Profile (NHP), Short-Form Health Survey (SF-36) e Stroke Specific Quality of Life (SS-QOL) - e sugerir a utilização dos mesmos para avaliar e/ou caracterizar tal componente nessa população. MÉTODOS: Por meio de busca nas bases de dados Medline, SciELO e Lilacs, foi realizado levantamento dos estudos que associavam os conceitos mensurados pelos itens do NHP, SF-36 e SS-QOL com os componentes e categorias da CIF. RESULTADOS: Dos 24 estudos identificados, quatro atenderam aos critérios estabelecidos: dois avaliaram os três instrumentos de QVRS, um avaliou o NHP e SF-36, e outro apenas o SS-QOL. Para cada instrumento, foram encontrados três estudos que associaram seus conceitos até, no mínimo, o segundo nível de hierarquia das categorias da CIF. Considerando os resultados concordantes entre os três estudos que avaliaram o mesmo instrumento, nove categorias de participação foram associadas ao NHP, sete ao SF-36 e 15 ao SS-QOL, sendo que apenas uma foi específica para o NHP, uma para o SF-36, e sete para o SS-QOL. CONCLUSÕES: Para a avaliação da participação de indivíduos acometidos pelo AVE segundo a estrutura da CIF, o SS-QOL pareceu ser o instrumento mais adequado, pois, além de avaliar o maior número de categorias, também avalia o maior número de categorias distintas quando comparado aos outros dois instrumentos de QVRS, que acrescentam apenas uma categoria àquelas mensuradas pelo SS-QOL.OBJECTIVE: To identify the categories of the participation component of the International Classification of Functionality, Incapacity, and Health (ICF) which are currently related to Health-related Quality of Life (HRQOL) instruments commonly used in cerebrovascular accident (CVA) victims-Nottingham Health Profile (NHP), Short-Form Health Survey (SF-36), and Stroke Specific Quality of Life (SS-QOL)-and suggest the utilization of these instruments to assess and/or characterize that component in that population. METHODS: Through searches in the Medline, SciELO, and Lilacs databases, a compilation of studies which associated the concepts measured by the NHP, SF-36, and SS-QOL items with the ICF components and categories, was carried out. RESULTS: Of the 24 identified studies, four met the established criteria: two assessed the three HRQOL instruments, one assessed the NHP and SF-36, and the other just the SS-QOL. For each instrument, three studies were found which associated their concepts up to, at least, the second hierarchical level of the ICF categories. Considering the results that were in agreement between the three studies that assessed the same instrument, nine participation categories were associated with the NHP, seven with the SF-36, and 15 with the SS-QOL, although just one was specific to the NHP, one to the SF-36, and seven to the SS-QOL. CONCLUSIONS: To assess the participation of CVA victims based upon the ICF framework, the SS-QOL appeared to be the most suitable instrument in that, in addition to assessing the greatest number of categories, it also assesses the greatest number of distinct categories, when compared to the other two HRQOL instruments, which added just one category to those measured by SS-QOL.

It has been already shown that delivering tDCS that are spaced by an interval alters its impact on motor plasticity. These effects can be explained, based on metaplasticity in which a previous modification of activity in a neuronal network can change the effects of subsequent interventions in the same network. But to date there is limited data assessing metaplasticity effects in cognitive functioning., This work was supported by the Portuguese Foundation for Science and Technology (FCT) with two individual grants (SFRH/BPD/86041/2012 and SFRH/BPD/86027/2012).

A stroke may leave neurological, motor and sensory sequelae, interfering with the function of movements and culminating in gait and balance changes. Therefore, it is necessary to demonstrate the efficacy of eight-point binding, a low-cost technique that functions to provide proprioceptive information and promote the biomechanical alignment of the ankle, acting against mechanisms that lead to equinovarus foot. This study aims to determine the immediate effect of eight-point binding as a physical therapy resource for the rehabilitation of function performance after a stroke. To this end, 22 patients who were able to walk alone without an orthosis were evaluated, and performed the Timed Up and Go (TUG) functional mobility test, a gait speed assessment and the Berg Balance Scale, with and without the eight-point binding in the paretic lower limb. When comparing the results after the eight-point binding, it was possible to observe a statistically significant difference (p