Objectives: (1) To assess the effects of a conventional, delayed physiotherapy protocol used by Ischemic Stroke (IS) and Hemorrhagic Stroke (HS) post-stroke patients, in their electromyographic activation patterns during hemiparetic gait; and (2) to study whether this protocol may improve the functional abilities in this population. Methods: This is an observational, descriptive, and analytical quasi-experimental trial. Forty patients with unilateral IS ([Formula: see text]) and HS ([Formula: see text]) stroke were recruited; the stroke involved the motor cortex or sub-cortical areas, and the patients were able to walk independently. Interventions with standard protocols of physiotherapy were carried out. Evaluations (clinical and gait assessment) were performed at the time of admission and at the end of the protocol. Outcome measures include Stroke Impact Scale, Timed Up and Go Test, and gait electromyographic evaluation. Results: Only IS patients (with an average of [Formula: see text] months delayed access to physiotherapy rehabilitation) had improvements in Timed Up and Go Test (change in [Formula: see text][Formula: see text]seg [Formula: see text]) and presented an anticipation of the onset in Upper leg muscles after the intervention. BF ([Formula: see text]), ST ([Formula: see text]), and RF ([Formula: see text]), started their recruitment (onset) earlier at the swing phase of the gait cycle, which is more similar to the normal pattern (grey shadow). IS and HS ([Formula: see text] months since last stroke) patients presented higher electromyographic activation, after physiotherapy, of the posterior leg muscles (gastrocnemius, semitendinosus and biceps femoris) during stance phase ([Formula: see text]). Conclusion: IS patients had improvements after delayed conventional physiotherapy. For HS limited response to intervention was observed.

Background. Since patient’s prognosis after stroke depends on its severity, brain location, and type early intervention is strongly recommended. Objective. We aimed to determine whether it is still possible to improve balance in chronic patients, who suffered Intracerebral Hemorrhagic Strokes (ICHS) or Ischemic Strokes (IS), after later intervention. Methods. 34 patients who had unilateral ICHS or IS and involved the motor cortex or sub-cortical areas took part in the study. The patients underwent clinical balance evaluation (using the Berg Balance Scale) and posturographic assessment (with a capacitive pressure platform) at the time of admission to the physiotherapy and at the end of the study. The physiotherapy intervention consisted of 20 sessions of 60 minutes carried out 3 times per week, following standard protocols: stretching; passive range of motion (ROM); active assistive ROM; active ROM; resistance training; coordination and balance activities while sitting and standing, and Large-muscle activities such as walking, treadmill, stationary cycle, combined arm-leg ergometry, arm ergometry, seated stepper and circuit training. Results. In the posturographic assessment, the IS group had significant lower amplitude of center of pressure (COP) anteroposterior displacement, after physical therapy intervention. Also, the 95% confidence ellipse area of the COP and the total COP displacement showed significant interaction between the subtype of stroke and the assessment period, meaning the IS group improved their balance after treatment on the contrary of ICHS. The structural analysis of the COP reinforced these results. On the other hand, no difference was observed in the clinical scale, between the assessment periods, for any subtype of stroke. Conclusion. Only IS patients have shown balance improvements after conventional intervention. COP measurements are more sensible to assess balance in chronic patients than Berg Balance Scale.

We investigated the impact of visual impairment on balance control. We measured the center of pressure (COP) between the two feet and plantar surface pressures on each foot in 18 normal-sighted participants and compared their data with measures from 18 legally blind participants, either acquired or congenital. Pressures were measured in open- and closed-eye conditions using a baropodometric resistive plate. In the eyes-open condition, there were no differences between the sighted and legally blind groups in COP displacement. However, participants with visual loss had significantly increased pressures in two metatarsal regions (M1 and M2 zones) of the plantar surface in both viewing conditions (p < 0.05). The differences in pressure measures between the normally sighted and legally blind groups could be attributed mainly to the subgroup of subjects with acquired impairment. Our findings suggest that subjects with visual impairment present increased metatarsal pressures (i.e. forefoot), not yet associated to anterior displacement of COP or impaired balance control.

SummaryStudy aim: To determine whether a physiotherapy protocol improves the electromyographic activation (EA) during the hemiparetic gait in patients with delayed access to rehabilitation. Material and methods: 40 post-stroke patients underwent clinical evaluation and gait assessment at the time of admission and at the end of treatment. Results: The anterior leg muscles tibialis anterior and rectus femoris had earlier onset (p = 0.0001). Conclusion: Electromyographic findings showed altered patterns during the hemiparetic gait cycle, even in patients with delayed access to treatment.

OBJETIVO: Identificar a sobrecarga física, emocional e social dos cuidadores informais de crianças com paralisia cerebral (PC) atendidos no ambulatório da Faculdade de Fisioterapia e Terapia Ocupacional (FFTO) da Universidade Federal do Pará (UFPA).MÉTODOS: Trata-se de um estudo descritivo e transversal com cuidadores de crianças com o diagnóstico clínico de PC, atendidas no setor de fisioterapia da FFTO-UFPA. Para a coleta de dados utilizou-se o questionário de Avaliação da Sobrecarga do Cuidador Informal (QASCI) e um formulário com identificação e dados sociodemográficos dos cuidadores. Os dados coletados foram transcritos para um banco de dados no programa Excel®. No intuito de descrever os achados, foi utilizada a estatística descritiva (média, desvio padrão, percentual).RESULTADOS: A amostra foi composta por seis mães com média de idade de 30,6+4,6 anos. As subdimensões Implicações na vida pessoal (40,9%), Suporte familiar (29,1%) e Sobrecarga financeira (29%) foram as categorias que obtiveram maior escore no questionário QASCI dentre os cuidadores participantes, sendo classificadas com nível moderado.CONCLUSÕES: O aumento da sobrecarga das cuidadoras foi identificado em subcategorias relacionadas ao maior desgaste físico da cuidadora, da falta de uma rede de apoio familiar e do aumento do impacto financeiro na renda familiar. Esses fatores podem comprometer a participação da cuidadora em atividades sociais que não estejam diretamente relacionados ao cuidado da criança. Os fatores emocionais, neste estudo, não foram relacionados ao aumento da sobrecarga das cuidadoras.