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ABSTRACT:Stroke can bring limitations to functional task performance, thus reducing patients' independence and quality of life. The purpose of this study was to draw the epidemiological profile of hemiparetic, stroke survivors in the city of Diamantina, MG, and to foster a joint program of action by the university and local public health service, in order to attend to these subjects. From 82 subjects registered at the Health Family Strategy units (HFS), 51 were contacted and interviewed, by using a semi-structured questionnaire. Their mean age was 67.8 years old, and time since onset of stroke, 6.7 years; 50% were illiterate and 41.2% lived on one monthly minimum wage. Reported risk factors prior to the stroke were unhealthy diet, physical inactivity, alcoholism, smoking, and family history of stroke (father or mother). At the time of the study 78.73% had high blood pressure and 35.29% had never undergone physiotherapy treatment after the stroke episode. Hence, inclusion of physical therapists in HFS, changes in subjects' lifestyle, and improvement or changes in local health policies are imperative.

Introdução: A realidade virtual (RV) pode ser uma ferramenta terapêutica utilizada no campo da neurorreabilitação. É considerada uma atividade lúdica que fornece feedback visual e auditivo, facilitando a adesão dos pacientes ao tratamento. Objetivo: Realizar uma revisão de literatura a respeito da influência da RV na reabilitação de pacientes com doença de Parkinson. Método: Utilizamos como base de dados os sistemas virtuais das bibliotecas Medline, PEDro, Lilacs, Scielo e Pubmed, a partir dos seguintes descritores: Doença de Parkinson e Realidade Virtual; Doença de Parkinson e Wii e seus equivalentes em espanhol e inglês para obtenção dos artigos. Foi utilizada a escala PEDro para fins de pontuação metodológica dos artigos analisados. Resultados: A partir de 50 artigos obtidos após a aplicação dos critérios de inclusão e exclusão, foram obtidos 16 artigos para análise. De acordo com a escala PEDro a maioria dos artigos teve baixa pontuação. Os resultados sugerem que a RV apresenta resultados positivos nas variáveis velocidade e tempo de movimento, equilíbrio, marcha, controle postural e funcionalidade de membros superiores. A atividade lúdica oferecida pela RV e a contribuição dos feedbacks visual e auditivo oferecido por este tipo de intervenção podem ser o grande potencial desta nova ferramenta. Conclusão: A RV é útil na potencialização do controle motor, na funcionalidade, na capacidade cognitiva e no equilíbrio, mas ainda precisa de estudos com melhor qualidade metodológica para confirmação dos resultados da RV na doença de Parkinson.

Background: Self-reported clinical worsening by people with Parkinson's disease (PD) during social distancing may be aggravated in Brazil, where the e/tele-health system is precarious.Objectives: This study aims to investigate self-reported changes in motor and non-motor aspects during social distancing in people with PD living in Brazil and to investigate the factors that might explain these changes.Methods: In this multicenter cross-sectional trial, 478 people with a diagnosis of idiopathic PD (mean age = 67, SD = 9.5; 167 female) were recruited from 14 centers distributed throughout the five geographical regions of Brazil. The evaluators from each center applied a questionnaire by telephone, which included questions (previous and current period of social distancing) about the motor and non-motor experiences of daily living, quality of life, daily routine, and physical activity volume.Results: Self-reported clinical worsening in non-motor and motor aspects of daily life experiences (Movement Disorder Society-Unified PD Rating Scale—parts IB and II—emotional and mental health, and fear of falling) and in the quality of life was observed. Only 31% of the participants reported a guided home-based physical activity with distance supervision. Perceived changes in the quality of life, freezing of gait, decreased physical activity volume, daily routine, and fear of falling explained the self-reported clinical worsening (P < 0.05).Conclusions: Self-reported clinical worsening in people with PD living in Brazil during social distancing can also be aggravated by the precarious e/tele-health system, as perception of decreased physical activity volume and impoverishment in daily routine were some of the explanatory factors. Considering the multifaceted worsening, the implementation of a remote multi-professional support for these people is urgent.

Dysregulation of tissue renin-angiotensin system (RAS) is involved in oxidative and inflammatory processes observed in major aging-related diseases, including neurodegenerative diseases such as Parkinson's disease (PD). Physical exercise has beneficial effects against aging-related changes, dopaminergic neuron vulnerability, and PD progression. The present study indicates that sedentary aged rats have an increase in activity of the nigral angiotensin (Ang) II/Ang type 1 receptor (AT1) axis (ie, the pro-oxidative pro-inflammatory arm), and a decrease in the activity of the RAS protective arm (ie, Ang II/AT2 and Ang 1-7/Mas receptor axis) in comparison with young rats. In addition, sedentary aged rats showed a decrease in levels of nigral IGF-1, SIRT1, SIRT3, and VEGF. Treadmill running induced a significant increase in levels of IGF-1, SIRT1, SIRT3, and VEGF, as well as an increase in expression of the protective Ang 1-7/Mas axis and inhibition of the Ang II/AT1 axis. The exercise-induced increase in IGF-1 and sirtuins may mediate the effects of exercise on the nigral RAS. However, exercise may induce the increase in VEGF and modulation of RAS activity by different pathways. Exercise, via RAS, contributes to inhibition of the pro-oxidative and proinflammatory state that increase dopaminergic neuron vulnerability and risk of PD with aging.

Aims (1) To evaluate mental health symptoms in people with Parkinson's (PwP) in self-isolation, before and during the in Brazil;(2) to explore associations between mental health and physical activity levels. Methods An observational cross-sectional survey using retrospective data. PwP from the Brazilian territory, both sexes, no age limit, in self-isolation due to COVID-19 pandemic, were invited to complete an online self-administered and validated questionnaire. Demographic data (sex, age, Brazilian state they lived in, levels of education, and household income), days in self-isolation, time of diagnosis, and symptoms that bothered most were reported. Self-reported levels of physical activity and mental health symptoms (depression, anxiety, fear, and thoughts of death), before and during the COVID-19 pandemic, were assessed. ResultsThe participants were 156 individuals with PD (64 ± 11 years), from both sexes (50% women; 50% men), resident in the 5 Brazilian regions. There was a worse on mental health symptoms over the time: anxiety [effect size = − 0.52; 95% CI (− 0.70; − 0.28); p < .001], fear [effect size = − 0.58; 95% CI (− 0.76; − 0.34); p < .001], and thoughts of death [effect size = − 0.43; 95% CI (− 072;-0.02); p = .001]. A lower physical activity level during the pandemic is related to increased probability of thoughts of death [crude OR = 1.84; 95% CI (0.98; 3.46); p = 0.05; adjusted OR = 2.98; 95% CI (− 0.01; 2.19); p = 0.05]. Anxiety, fear and depression were not associated with physical activity levels. Conclusions Anxiety, fear and thoughts of death worsened during the COVID-19 pandemic in comparison with the period before COVID-19. Lower physical activity level during the pandemic was related to an increased probability of thoughts of death.

Wallerian degeneration is a very well described phenomenon in the vertebrate nervous system. In arthropods, and especially in crustaceans, nerve fiber degeneration has not been described extensively. In addition, literature shows that the events do not follow the same patterns as in vertebrates. In this study we report, by qualitative and quantitative ultrastructural analyses, the features and time course of the protocerebral tract degeneration following extirpation of the optic stalk. No remarkable changes were observed seven days after lesion. After 28 days the protocerebral tracts presented apparently preserved small and large diameter axons and some degenerating medium axons, with irregular contours and empty-looking aspect of the axoplasm. Forty days after the ablation of the optic stalks, both small (type I) and medium (type II and III) axons revealed signs of partial or total degeneration, but large nerve fibers (type IV) were still intact. After 45 days, the tract showed signs of advanced stage of degeneration and, apart from large axons, normal-looking fibers were almost absent. At these 3 last time points, degenerating axons displayed different electron densities and aspects, probably correlating to different onset times of the process. In addition, cells with granules in their cytoplasm, possibly hemocytes, were quite distinct, especially at 40 and 45 days after axotomy. These cells might share with glial cells the function of phagocytosis of cellular debris during the protocerebral tract degeneration. Quantitative analysis showed that the number of degenerating fibers increased significantly from 28 to 40 days after lesion, whereas the number of normal fibers decreased accordingly. Measurements of cross-sectional areas of normal and degenerating axons showed that types II and III (medium) start to degenerate before type I (small). Type IV (large) axons do not degenerate, even after 40 days. Therefore, we can conclude that degeneration in these afferent fibers starts late after axotomy, but proceeds at a faster rate afterwards until the complete degeneration of small and medium axons.

ResumoIntrodução: O Setor Litoral da Universidade Federal do Paraná (UFPR), com seu Projeto Político-Pedagógico (PPP) inovador, baseado na Teoria da Complexidade, está finalizando o processo de implantação de sua primeira turma de Fisioterapia. Objetivos: Comentar algumas das bases teóricas que sustentam tal projeto pedagógico, apresentando a experiência da construção coletiva de um PPP pautado em três eixos curriculares. Metodologia: De caráter qualitativo e de cunho teórico-reflexivo. Resultados: A construção do PPP resultou numa organização curricular em três eixos: Fundamentos Teórico-Práticos (FTP), Projetos de Aprendizagem (PA) e Interações Culturais e Humanísticas (ICH). Os FTP (aproximadamente 60% do currículo) compreendem módulos temá-ticos elaborados por equipe interdisciplinar de professores, contextualizados com a realidade do mundo do trabalho, aproximando-se dos princípios do Sistema Único de Saúde (SUS) e atendendo às Diretrizes Curriculares Nacionais (DCN). Nos PA, o estudante desenvolve projetos mediados por Fisioter Mov. 2010 abr/jun;23(2):331-40Signorelli MC, Israel VL, Gomes ARS, Motter AA, Takeda SYM, Corrêa CL. 332 docentes, que envolvem necessariamente a tríade "ensino-pesquisa-extensão". Esses são imbricados à realidade do litoral paranaense, extensiva e/ou ampliada para outras comunidades. Já as ICH (20% do currículo) são espaços para a vivência de um diferencial na gênese do fisioterapeuta: uma formação pautada na complexidade do ser humano e na integração deste com o meio, pois são realizadas em conjunto com outros cursos e comunidade. Considerações finais: Nessa trajetória, os estudantes que se desenvolvem pela UFPR já demonstram características diferenciadas, resultantes de práxis generalista, humanista, crítica e reflexiva, como preconizam as DCN. Esperamos que essa vivência proporcione articulação de saberes e práticas, formando profissionais qualificados, cidadãos conscientes e sensibilizados para a coletividade. Palavras