Introduction: Hemiparesis post-stroke usually results in locomotor limitations. As conventional rehabilitation is monotonous, the Serious Games (SG) represents an excellent treatment strategy, allowing to perform physical training in an interesting and enjoyable way. Objective: To evaluate the effects of an exercise program using the SG developed for hemiparetic stroke patients’ locomotor rehabilitation. Method: Non-Randomized Controlled Clinical Trial. Twenty-four hemiparetic stroke patients with subacute or chronic stroke (twelve men), mean age of 57.8 ± 10.4 years (injury time of 16.8 ± 19.6 months) participated in the study. The experimental group (n = 16) participated in an exercise program with the SG for lower limb rehabilitation. The control group (n = 8) received conventional treatment (kinesiotherapy). The intervention consisted of sessions twice a week for ten weeks. The following parameters were assessed: muscle strength (dynamometry), spasticity (Modified Ashworth Scale), functional mobility (Timed Up and Go Test - TUGT), and the gait speed (GS). Results: Both groups showed improvements, but the experimental group was better in all the studied variables, the muscular strength of the lower limb paresis and of the quadriceps femoris (p = 0.002; d = 0.7); and for the hamstrings (p < 0.001; d = 1.3), TUGT (p < 0.001; d = 0.4), and GS (p = 0.001; d = 0.4). Conclusion: The exercise program with the SG was useful for the patients treated in this study. The results showed a superiority of the SG regarding the conventional treatment in all the controlled variables. This was probably because of the greater repeatability of the exercises and the increased attention and motivation.
Objetivo. O objetivo desta revisão de literatura foi levantar e discutir estudos sobre a contribuição visual para o controle postural, aspecto este, notoriamente necessário para o controle motor como um todo. Método. Foram revisados livros e artigos indexados nas bases de dados Scielo, Lilacs, PubMed Central, Medscape Neurology, publicados de 1987 a 2009, em inglês e português. Resultados. Revisaram-se os aspectos mais relevantes sobre a visão como um sistema sensorial especial; a sua relação com os sistemas somatossensorial e vestibular; os centros neurais integradores e as vias descendentes para o controle postural. Em seguida, foram abordados aspectos quanto à contribuição visual para o sistema de controle postural ao longo do desenvolvimento, pesquisas sobre o controle postural em cegos e em pacientes com distúrbios neurológicos. Conclusão. Embora a Teoria Ecológica proposta por James Gibson ainda considerada nova no campo da fisioterapia, os achados teóricos e de pesquisa poderão, com o tempo, avançar o suficiente para explicar como o sistema musculoesquelético é utilizado para restringir e organizar habilidades funcionais.
Introduction:The Stroke is a neurologic disturbs that leads to a serious impact to the functionality and the quality of life of the survivors. It is necessary to develop new tools with rehabilitation objectives, where the Virtual Reality (VR) is introduced as a useful therapeutic resource to the motor recovery, in an attractive and efficient way, restoring functions through adapted games. Objective: Analyzing the therapeutic effects of the Virtual Reality (Serious Game) in the recovery of the upper limb in hemiparetic Stroke patients. Methods: Quasi-experimental research type time series, there are three pre and three post-tests already accomplished around 20 VR sessions. In the assessments the following measurement instruments were used: Fugl-Meyer Scale -session of the upper limb (FMS -UL); Range of Motion (ROM) for flexion and abduction shoulder; Box and Block Test (BBT); Nine Holes and Peg Test (9HPT); the Nottingham Health Profile (NHP); and the Modified Ashworth Scale (MAS). Results: Significant gains were observed in the FMS-UL tests, with
As quedas representam um motivo de preocupação para idosos, pois podem acarretar incapacidade física e perda da independência. Idosos institucionalizados são na grande maioria fragilizados, podendo desta forma, aumentar a suscetibilidade à quedas. Estudos sobre as quedas tornam-se necessários a fim de se buscar meios mais efetivos para minimizar sua incidência. O objetivo da pesquisa foi avaliar a propensão à quedas em idosos institucionalizados e não-institucionalizados, através do nível de mobilidade funcional. Utilizou-se o teste “Timed Up & Go” para avaliar o nível de mobilidade funcional de 53 idosos institucionalizados e 53 não institucionalizados. Quanto maior o tempo de realização, em segundos (s), maior o risco de quedas. Os dados coletados foram analisados estatisticamente, obtendo-se as médias e desvio padrão de ambos os grupos. Aplicou-se o teste t (Student) para avaliar a significância dos dados. O grupo dos idosos nãoinstitucionalizados obteve uma média de 8,84 segundos, e o grupo dos idosos institucionalizados 20,09 segundos. No grupo de idosos institucionalizados 65,38% realizaram o teste em menos de 20s, 23,08% entre 20 e 29s e 11,54% em tempo superior a 30s. No grupo dos idosos não institucionalizados, 100% dos indivíduos obtiveram um desempenho de menos de 20s. Uma proporção significativa do grupo de idosos institucionalizados, que apresentou médio e alto risco de quedas. Medidas preventivas fazem-se necessárias para reduzir a exposição destes idosos aos fatores de risco.Palavras-chave: Idosos, quedas, institucionalização.
Objective: To analyze postural control in acquired and congenitally blind adults. Methods: A total of 40 visually impaired adults participated in the research, divided into 2 groups, 20 with acquired blindness and 20 with congenital blindness − 21 males and 19 females, mean age 35.8 ± 10.8. The Brazilian version of Berg Balance Scale and the motor domain of functional independence measure were utilized. Results: On Berg Balance Scale the mean for acquired blindness was 54.0 ± 2.4 and 54.4 ± 2.5 for congenitally blind subjects; on functional independence measure the mean for acquired blind group was 87.1 ± 4.8 and 87.3 ± 2.3 for congenitally blind group. Conclusion: Based upon the scale used the results suggest the ability to control posture can be developed by compensatory mechanisms and it is not affected by visual loss in congenitally and acquired blindness.
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