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BACKGROUND: SATIS-Stroke questionnaire has been translated and adapted for use in the Brazilian population, however, it is necessary to test the measurement properties in Brazilian population. OBJECTIVE: To test the reliability, agreement, concurrent validity, and diagnostic accuracy of the SATIS-Stroke. METHODS: Chronic stroke survivors were included. The calculations were made using scores in logits (Rasch Model). Reliability was tested using the intraclass correlation coefficient (ICC(2,1)), standard error of measurement (SEM), minimal detectable change (MDC), and Bland-Altman plots. Concurrent validity was analyzed using Spearman's correlation coefficient. For such, the correlation between SATIS-Stroke and Stroke Specific Quality of Life (SS-QOL) questionnaires was determined. Diagnostic accuracy was estimated based on the area under the receiver operating characteristic (ROC) curve with a 95% confidence interval and considering the sensitivity and specificity of SATIS-Stroke in differentiating different types of activity and participation. RESULTS: Eighty stroke survivors were analyzed. Mean age was 57.98±13.85 years and 45.2% had severe impairment. Excellent reliability was found (intra-observer ICC(2,1) = 0.90; 95% CI: 0.84, 0.93; inter-observer ICC(2,1) = 0.89; 95% CI: 0.83, 0.93). The Bland-Altman plot demonstrated satisfactory agreement. In the analysis of concurrent validity, a strong, positive, significant correlation was found between SATIS-Stroke and SS-QOL (r(s) = 0.74; p

Background/aims This study aimed to estimate the discriminatory power of 26 items on the Stroke Specific Quality of Life Scale questionnaire to evaluate the participation component of the International Classification of Functioning, Disability and Health. Methods A prospective study was conducted using accuracy procedures based on the Standards for Reporting Diagnostic Accuracy Studies to evaluate individuals with hemiparesis stemming from a stroke. Discriminatory power was estimated based on the area under the receiver operating characteristic curve with a 95% confidence interval. Two groups were defined for the analysis: community-dwelling and institutionalised individuals. A 5% level of significance (α=0.05) was considered for all analyses. Results The area under the receiver operating characteristic curve was 0.888 (95% confidence interval: 0.794–0.949; P=0.001). Analysis indicated a cut-off point of ≥80 with 73.9% sensitivity and 100% specificity. Conclusions The 26 items of the Stroke Specific Quality of Life questionnaire that evaluate the participation component of the International Classification of Functioning, Disability and Health demonstrate adequate discriminatory power. A cut-off point of ≥80 seems to best discriminate the perception of participation between community-dwelling and institutionalised stroke survivors.

Background SATISPART-Stroke (SATIS-Stroke) is the most complete instrument for the assessment of activity and participation following a stroke. However, its use in a developing country has only been tested through in-person interviews. Objective To determine the validity, reproducibility and viability of the SATIS-Stroke scale administered in two tele-assessment modalities: self-assessment of an electronic form versus videoconference. Methods Methodological study with Brazilian chronic stroke survivors was conducted. Stage I comprised an in-person interview to apply the SATIS-Stroke and a self-assessment by completing an electronic form to respond to the SATIS-Stroke items. Step II occurred 6 to 8 months after Step I, during which SATIS-Stroke was administered again in-person and via videoconference. The order was randomized. Results Ninety-five stroke survivors were recruited, but only 50 answered the electronic form (adherence: 52.6%). Mean scores were higher in the self-administration of electronic form compared to the in-person interview (mean difference = −0.36 ± 0.93; P = 0.009). Adequate reliability was found in the comparison of the in-person and self-assessment of electronic form (ICC2,1 = 0.66; 95%CI: 0.40–0.81). Fifty stroke survivors participated in Step II, during which adequate reliability was found in the comparison of the in-person administration and videoconference (ICC2,1 = 0.55; 95%CI: 0.21–0.74) and a moderate correlation was found between the assessment methods ( r = 0.43; P = 0.02). Discussion Adequate validity and reliability were found in the tele-assessment. Thus, this method is appropriate and viable for use in developing countries. Although reliable, the self-assessment did not have good adherence in the Brazilian population due to internet access problems, lack of familiarity with the digital form and lack of autonomy to answer the questions alone.

To assess the impact of post-stroke depression on the participation component of the International Classification of Functioning, Disability and Health (ICF).Thirty-five stroke survivors with chronic hemiparesis were divided into two groups: those with and without depression. The Geriatric Depression Scale (GDS) was used for the analysis of depressive symptoms. Participation was analysed using the Stroke Specific Quality of Life scale. The Mann-Whitney test was used to compare the participation scores between the two groups. Spearman's correlation coefficients were calculated to determine the strength of the association between the assessment tools. Simple linear regression was used to determine the impact of depression on participation. An alpha risk of 0.05 was considered indicative of statistical significance.The group with depression had low participation scores (p = 0.04). A statistically significant negative correlation of moderate magnitude was found between depression and participation (r = -0.6; p = 0.04). The linear regression model demonstrated that depression is a moderate predictor of participation (r(2) = 0.51; p = 0.001).Depression is a moderate predictor of participation among stroke survivors, explaining 51% of the decline of this aspect. Thus, depression should be diagnosed, monitored and treated to ensure a better prognosis regarding social participation following a stroke. Implications for Rehabilitation Individuals with post-stroke depression experience a lower degree of social participation. Depression explains 51% of the decline in participation following a stroke. The present findings can serve as a basis to assist healthcare professionals involved in the rehabilitation of stroke survivors and can assist in the establishment of adequate treatment plans in stroke rehabilitation.

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.

BACKGROUND: According to the International Classification of Functioning, Disability and Health (ICF), the participation component is considered to be the most complex component characterized in existing instruments that assess quality of life related to health (HRQoL). Questionnaires such as the Nottingham Health Profile (NHP) and the Stroke-Specific Quality of Life (SS-QOL) are currently used to evaluate the participation of individuals in life activities after stroke. However, because participation and HRQoL are different constructs, it is unclear whether these instruments are best suited to this evaluation. OBJECTIVE: To investigate whether the NHP and SS-QOL are suitable instruments for assessing the participation component of ICF. METHOD: A cross-sectional study was conducted in which a sample of 35 individuals completed the SS-QOL and NHP. The study correlated the total score on the questionnaires with the scores on items that evaluate the participation component of the ICF. Both analyses used the Spearman correlation coefficient (r). RESULTS: There was a statistically significant, positive and strong correlation between total score on the SS-QOL and NHP and the score on specific components related to participation (r=0.8, p=0.001 and r=0.9, p=0.001, respectively). CONCLUSIONS: Both the NHP and the SS-QOL show strong correlations between the total score and the score on items that assess the participation categories of the ICF. However, the SS-QOL questionnaire appeared to be the most complete for this assessment because it evaluates more distinct domains and contains the largest number of items related to participation. CONTEXTUALIZAÇÃO: O componente de participação da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) foi apontado como o mais complexo de ser caracterizado a partir de instrumentos já existentes. Atualmente, indica-se o uso de questionários de qualidade de vida relacionada à saúde (QVRS) para avaliação da participação após acidente vascular encefálico (AVE), sendo indicado o Nottingham Health Profile (NHP) e o Stroke Specific Quality of Life (SS-QOL). No entanto, QVRS e participação são construtos distintos, assim, não está claro se esses instrumentos são os mais adequados para essa avaliação. OBJETIVO: Investigar se o NHP e SS-QOL são apropriados para avaliação do componente de participação da CIF. MÉTODO: Estudo transversal com amostra de 35 indivíduos nos quais foram aplicados o SS-QOL e o NHP com intuito de correlacionar o escore total dos questionários com o escore dos itens que avaliam os códigos do componente de participação da CIF utilizando o Coeficiente de Correlação Spearman (r). RESULTADOS: Houve correlação estatisticamente significante, positiva e de forte magnitude entre o escore total do SS-QOL e do NHP com os escores específicos do componente de participação, (r=0,8; p=0,001) e (r=0,9; p=0,001), respectivamente. CONCLUSÕES: Tanto o NHP quanto o SS-QOL apresentaram correlação forte entre o escore total e o escore dos itens que avaliam as categorias de participação da CIF. No entanto, o SS-QOL pareceu ser o questionário mais completo para essa avaliação por avaliar mais domínios distintos e apresentar o maior número de itens relacionados à participação.

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.

Introdução: A dança pode melhorar a qualidade de vida (QV) de pessoas que apresentam algum comprometimento psicomotor, porém, nada foi encontrado sobre a dança sênior para pacientes neurológicos. Objetivo: Avaliar a QV em pacientes hemiparéticos pós-AVE, antes e após terapia com dança sênior. Metodologia: Selecionaram-se oito hemiparéticos e foram aplicados dois questionários de QV, SF-36 e SS-QOL. As sessões de terapia com dança sênior, realizadas na clínica de Fisioterapia da Uninove, tiveram duração de uma hora, duas vezes por semana, totalizando 24 sessões. Ao final, os questionários foram reaplicados. Utilizou-se estatística descritiva para caracterização da amostra, após os dados foram submetidos ao teste de normalidade Kolmogorov-Smirnov e teste Wilcoxon. Estabeleceu-se o nível de significância de 5%. Resultados: Observou-se diferença estatisticamente significante na QV, sendo SF-36 (p=0,05) e SS-QOL (p=0,01). Conclusão: O estudo mostrou resultados positivos, pois houve uma melhora significativa na qualidade de vida dos pacientes que participaram da dança.

Introduction: The main symptoms related to Parkinson’s disease (PD) are: tremors, freezing, bradykinesia and muscle rigidity, which lead to functional decline and difficulties in the execution of activities of daily living (ADL), compromising quality of life (QOL). Objective: To characterize the clinical profile and perception of quality of life (QOL) of patients with PD assisted at Associacao Brasil Parkinson (ABP) and correlate these with disease progression and level of disability. Methods: The clinical and functional evaluation of subjects was performed using the Unified Parkinson’s Disease Rate Scale (UPDRS), a modified version of the Hoehn and Yahr Staging Scale (HY) of disability and Parkinson’s Disease Questionnaire (PDQ-39). Results: There was no significant correlation between disease progression and QOL; however, there was moderate correlation (r=0.5) between disability and QOL, p

Introdução: São necessários treino e parâmetros específicos a fim de evitar a fadiga no treinamento com estimulação elétrica funcional. Objetivo: Verificou-se o aparecimento da fadiga muscular em pacientes, pós AVE, para melhor compreender um parâmetro de estimulação elétrica, a frequência. Métodos: Analisou-se o comportamento da fadiga muscular usando-se a frequência mediana e avaliou-se a contração voluntária máxima isométrica do músculo bíceps braquial hemiparético de 18 indivíduos, em sete momentos. Utilizou-se uma corrente quadrada e bifásica, com t”on” de 10 s., e t”off” de 30 s., e frequência variável de 50 Hz (protocolo 1) e 2.000Hz (protocolo 2). Resultados: Foi observado que não houve diferença estatisticamente significante (p0,05) entre os protocolos 1 e 2; não sendo registrada diferença no período imediatamente pós-terapia. Conclusões: Pelas ferramentas de mensuração utilizadas, eletromiografia e força muscular, não foi possível detectar o aparecimento da fadiga muscular com os dois protocolos de estimulação elétrica funcional utilizados.

Objective This work aims to elucidate by what physical mechanisms and where stimulation occurs in the brain during transcranial magnetic stimulation (TMS), taking into account cortical geometry and tissue heterogeneity. Methods An idealized computer model of TMS was developed, comprising a stimulation coil, a cortical sulcus, and surrounding tissues. The distribution of the induced electric field was computed, and estimates of the relevant parameters were generated to predict the locus and type of neurons stimulated during TMS, assuming three different stimulation mechanisms. Results Tissue heterogeneity strongly affects the spatial distribution of the induced electric field and hence which stimulation mechanism is dominant and where it acts. Stimulation of neurons may occur in the gyrus, in the lip of the gyrus, and in the walls of the sulcus. The stimulated cells can be either pyramidal cells having medium to large caliber axons, or intracortical fibers of medium caliber. Conclusions The results highlight the influence of cortical folding on the action of magnetic and electric fields on cortical tissue. Significance Tissue geometry and heterogeneity in electrical conductivity both must be taken into account to predict accurately stimulation loci and mechanism in TMS.