Robot-Assisted Therapy (RT) is an innovative approach to neurological rehabilitation that uses intensive, repetitive, interactive, and individualized practice. This systematic review aimed to investigate the effectiveness of RT on the body function and structure of people with upper limb impairments (PROSPERO registration: CRD42017054982). A search strategy conducted on seven databases identified randomized controlled studies. Methodological quality was assessed using the PEDro scale. When possible, the data were pooled, the strength of evidence was assessed using the GRADE system, and the effect sizes were assessed using Cohen coefficient. Subgroup analyses investigated the impact on the estimated effects of the following parameters: methodological quality; portion of the assessed upper limb; duration of stroke; and intervention dose and duration. Thirty-eight studies involving 1174 participants were included. Pooled estimates revealed small effects of RT on motor control and medium effects on strength compared with other intervention (OI) at a short-term follow-up. Standardized differences in means were as follows: 0.3 (95% CI 0.1 to 0.4) and 0.5 (95% CI 0.2 to 0.8). Effects at other time points and on other investigated outcomes related to body function and structure were not found (p>0.05). The strength of the current evidence was usually low quality. Subgroup analyses suggested that the methodological quality, and duration and dose of RT may influence the estimated effects. In conclusion, RT has small effects on motor control and medium effects on strength in people with limited upper limb function. Poor methodological quality, and lower treatment dose and duration may impact negatively the estimated effects.

The assessment of motor abilities is important to identify atypical development, to measure progress obtained with intervention, and for research. Motor assessment usually is based on the use of standardized tests, on which children are expected to perform specific tasks that are deemed common. As the majority of the motor development tests were created by researchers from European and North American countries, concepts from these cultures are embedded in the tasks, materials, and format of the instruments. This raises the question as to whether these instruments can be used internationally, with the perhaps misguided assumption that motor skill development is the same across different countries. Is it necessary to adapt standardized motor ability tests for cross-cultural use? This paper discusses the relationship between culture and motor development and points out some aspects that should be considered to make our assessment of motor ability more relevant cross-culturally.

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Neste estudo analisamos a implementação da política de cotas para pessoas com deficiência na Universidade Federal de Minas Gerais. O objetivo geral foi identificar o perfil dos estudantes que ingressaram através do sistema de cotas, por meio da análise de características como o tipo de deficiência, a área de estudos escolhida, a idade, o sexo, entre outros. A fundamentação para a realização da pesquisa permeia a compreensão in loco do estabelecimento da Política de cotas. Dentre os diversos aspectos identificados, foi possível notar que os alunos são formados pela maioria de homens, com deficiência física e a maior parte escolheu cursos da área da saúde. Esses resultados, em linhas gerais, embasaram a conclusão da necessidade de ampliação das discussões e reflexões acerca das demandas de acessibilidade que as instituições federais podem apresentar nos próximos anos.

Resumo: O objetivo deste estudo foi analisar o efeito do uso de órtese de imobilização do punho, confeccionada com diferentes materiais, na função manual e na força de preensão. Métodos: Vinte e seis adultos, com média de idade de 26 anos foram submetidos ao Teste Funcional da Mão de Jebsen Taylor e ao Teste de Força de Preensão (Dinamômetro Jamar ® ), em três condições: com a mão livre, com o uso de órtese de compósito e com a órtese de termomoldável. Os testes foram realizados apenas com a mão dominante. Utilizou-se, para comparação, a média de três medidas da força de preensão e do tempo gasto para a realização dos subtestes. Os resultados obtidos nas três condições foram comparados e analisados utilizando-se o teste estatístico de Wilcoxon. Detectou-se redução da força de preensão com o uso de órtese. Foram encontradas diferenças significativas quando comparadas a força de preensão na condição livre e com o uso de quaisquer das órteses. Não foram encontradas diferenças significativas quando comparadas a força de preensão com o uso dos dois tipos de órtese. Observou-se uma redução do tempo gasto para a realização das tarefas com o uso das órteses. A órtese de imobilização do punho em extensão tem influência na força de preensão manual e na função manual, porém sem implicar na impossibilidade de sua execução. Palavras-chave: Órteses, Função Manual, Punho, Força de Preensão. Effect of wrist orthosis on hand functionAbstract: The aim of this paper is to investigate the effect of orthosis on the forearm muscle activation. Twenty-six adults, with average age of 26, performed the Jebsen Taylor Test. The volunteers also performed the grip strength test under three conditions: free hand (without orthosis), wearing a composite orthosis, and wearing a thermoplastic orthosis. Only the dominant hand was studied. The mean of three measures of grip strength and the time spent to perform the tests were used to compare the results. Statistical analysis was carried out using the Wilcoxon Test. There was a decrease in grip strength with the use of orthosis. Significant differences were noticed when the volunteers were tested with and without orthosis. No significant differences were observed when data from the two orthosis were compared. A decrease in time to perform the tasks during the Jebsen Taylor Test was noticed with the use of orthosis. Wrist extension orthosis interferes on grip strength and manual function, but it does not restrain its execution.

Background. Previous studies have suggested that robot-assisted therapy (RT) is effective in treating impairment and that it may also improve individuals’ participation. Objective. To investigate the effect of RT on the participation of individuals with limited upper limb functioning (PROSPERO: CRD42019133880). Data Sources: PEDro, Embase, MEDLINE, CINAHL, Cochrane, AMED, and Compendex. Inclusion Criteria. We selected randomized or quasirandomized controlled studies comparing the effects of RT with minimal or other interventions on participation of individuals with limited upper limb functioning. Data Extraction and Synthesis. Methodological quality of the included studies was assessed using the 0-10 PEDro scale, and effect estimates were reported using standardized mean differences (SMDs) with 95% confidence intervals (CIs), and the certainty of the current evidence was assessed using the GRADE. Results. Twelve randomized controlled studies involving 845 participants were included. The estimates of medium effects between RT and minimal intervention (MI) at a short-term follow-up were pooled, but there are no short-term effects between RT and OI. Standardized differences in means were as follows: 0.6 (95% CI 0.1 to 1.2) and 0.2 (95% CI -0.0 to 0.4). There were also no effects of additional RT in the short- or medium-term follow-up periods. Standardized differences in means were as follows: -0.6 (95% CI -1.1 to -0.1) and 0.2 (95% CI -0.3 to 0.8). The methodological quality of the included studies potentially compromised the effect estimates of RT. The existing evidence was very low-quality with many confounding variables between studies. Conclusions. For patients with upper limb neurological dysfunction, low-quality evidence supports RT over MI in terms of improving individual participation in the short term. The existing low- to very low-quality evidence does not support RT over OI in either the short- or medium-term follow-up periods with respect to community participation.

The Assessment of Motor Coordination andDexterity -ACOORDEM is a standardized motor assessment for Brazilian children aged 4-8 years. This study aimed to investigate the validity and reliability of the test for 4-yearold children. Eighty children of 4 years old, divided into equal groups by sex and school type (public or private), were evaluated. Parents and teachers also answered the questionnaires. The retest was applied to 10 participants. Few items showed a statistically significant difference associated with sex and school type. The test-retest reliability presented good indexes. ACOORDEM is suitable for the motor assessment of 4-year-old children; however, some items need to be revised or discarded to improve the instrument reliability and reduce the administration time.

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