The protocol associating constraint-induced movement therapy and bimanual functional training was effective in promoting daily living functioning among children with cerebral palsy.

This study compared the passive stiffness of wrist flexors and the strength of wrist flexors and extensors in three different wrist positions (30 degrees of flexion, neutral, and 30 degrees of extension) between children with cerebral palsy (CP) and typically developing (TD) comparison children. It also examined associations between these characteristics and manual function in children with CP. Eleven children with spastic hemiplegic CP (six females, five males; mean age 8y 5mo [SD 1y 8mo], range 6-11y) and 11 TD children, matched for age and sex, took part in this study. Passive stiffness of muscles was measured as the torque/angle relation during passive motion. Isometric strength tests were performed and the time needed to complete three tasks based on the Jebsen-Taylor Hand Function Test was recorded. Flexor stiffness was higher in the group with CP. Strength of flexors and extensors in the group with CP was lower with the wrist extended. No difference among test positions was found in the TD group. Moderate correlations were observed between manual function and variables related to strength and stiffness of wrist muscles in the group with CP. Children with CP showed muscle alterations coherent with the use of the wrist in flexion. Intervention on these characteristics could have a positive impact on manual function.

Both individuals demonstrated gains in all parameters over initial baseline and subsequent phases, with performance increases ranging from 26% to 233% when first and last assessments were compared. Significantly superior effects of treadmill training over baseline conditions on cadence were detected (P<0.05). Gains in walking speed were not significantly better during intervention, but intervention withdrawal produced deceleration of performance gains. Gains in Timed Up and Go, step length and balance were not consistent and were possibly caused by a learning effect of the association between repeated testing and treadmill training. Rivermead Visual Gait Assessment gains reached significance only for subject 2 (P<0.05), probably because of increased variability of performance of subject 1. Results suggest that the association between repeated testing and treadmill training might have been responsible for the observed gains in the two ataxic patients.

Nine children with spastic hemiplegic cerebral palsy underwent 24 sessions of wrist muscles strengthening in the extended wrist range aided by electrostimulation. Isometric strength of flexors and extensors was registered in three wrist positions (30 degrees of flexion, neutral, and 30 degrees of extension) to infer on angle-torque curves. Passive stiffness of wrist flexors and wrist flexion angle during manual tasks and hand function were also documented. Significant strength gains were observed at 30 degrees of wrist extension for flexors (p= 0.029) and extensors (p= 0.024). No gains were observed at 30 degrees of flexion. The difference in extensor strength between the three test positions changed after intervention (p< 0.034), suggesting a shift in the angle-torque curve. No changes were observed in passive stiffness (p= 0.506), wrist angle (p< 0.586), or hand function (p= 0.525). Strength training in specific joint ranges may alter angle-torque relationships. For functional gains to be observed, however, a more aggressive intervention and contextualized task training would probably be needed.

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© Revista Brasileira de FisioterapiaCorrelation between a functional performance questionnaire and physical capability tests among patients with low back pain Correlação entre um questionário de desempenho funcional e testes de capacidade física em pacientes com lombalgia Ocarino JM 1,2 , Gonçalves GGP 2 , Vaz DV 2 , Cabral AAV 3 , Porto JV 3 , Silva MT 3 AbstractContextualization: Low back pain is a set of painful manifestations that may cause limitations to several aspects of an individual's life. The model of the International Classification of Functioning, Disability and Health (ICF) proposed by the World Health Organization provides a structure for understanding the functioning and disability associated with health conditions, thus enabling significant descriptions of an individual's health. The ICF uses the terms "capacity" and "performance" to refer to different aspects of function and to differentiate between patients' functional status. In clinical practice, it is necessary to determine whether there is any association between these different aspects. Objectives: To analyze the correlation between the Roland Morris functional performance questionnaire and physical capacity tests (sit-to-stand and 50-foot walk) among patients with low back pain. Methods: Thirty patients of mean age 43.16 years, with a diagnosis of low back pain, were assessed using the Roland Morris questionnaire and the capacity tests. Results: Analysis using Pearson's correlation showed a significant but weak correlation between the Roland Morris score and the sit-to-stand test (r=0.38; p=0.0388). No significant correlation was observed between the questionnaire score and the 50-foot walk test (r=0.24; p=0.1862). Conclusion:The results indicate the need to use instruments that evaluate both aspects of function (capacity and performance) among patients with low back pain, so that a more complete functional profile of such individuals can be defined. Palavras-chave: lombalgia; Classificação Internacional de Funcionalidade; incapacidade e saúde; função.

In cart-pole balancing, one moves a cart in 1 dimension so as to balance an attached inverted pendulum. We approached perception-action and learning in this task from an ecological perspective. This entailed identifying a space of informational variables that balancers use as they perform the task and demonstrating that they improve by traversing the space to the loci of more useful variables. We presented a novel information space-including fractional derivatives of pendulum angle (e.g., halfway between angle and angular velocity)-as possible information for balancing. Fourteen college students tried to meet a criterion of balancing the pole for 30 s on 3 of 5 successive trials, up to a maximum of 150 attempts. Loci in the fractional derivative space predicted the time series of force production well. Systematic differences were seen in loci as a function of success, and systematic changes in locus were seen with learning. The fractional derivatives were shown to predict pole angles a short time interval into the future, allowing balancers to prospectively control the action and thereby nullify visuomotor delay. In addition to loci in the information space, we analyzed loci in a calibration space, reflecting the gain relating force to information.

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