[Purpose] The aim of the present study was to investigate the effect of balance training with visual biofeedback on balance, body symmetry, and function among individuals with hemiplegia following a stroke. [Subjects and Methods] The present study was performed using a randomized controlled clinical trial with a blinded evaluator. The subjects were twenty adults with hemiplegia following a stroke. The experimental group performed balance training with visual biofeedback using Wii Fit® together with conventional physical therapy. The control group underwent conventional physical therapy alone. The intervention lasted five weeks, with two sessions per week. Body symmetry (baropodometry), static balance (stabilometry), functional balance (Berg Balance Scale), functional mobility (Timed Up and Go test), and independence in activities of daily living (Functional Independence Measure) were assessed before and after the intervention. [Results] No statistically significant differences were found between the experimental and control groups. In the intragroup analysis, both groups demonstrated a significant improvement in all variables studied. [Conclusion] The physical therapy program combined with balance training involving visual biofeedback (Wii Fit®) led to an improvement in body symmetry, balance, and function among stroke victims. However, the improvement was similar to that achieved with conventional physical therapy alone.
OBJETIVO: A hemiparesia é um comprometimento parcial do hemicorpo que altera o equilíbrio, sendo este essencial para as atividades funcionais. OBJETIVO: Avaliar o equilíbrio em pacientes hemiparéticos submetidos ao treino de equilíbrio com o programa Wii Fit, que atuou como um recurso de biofeedback visual. MÉTODO: Foram selecionados 12 pacientes hemiparéticos pós AVE, 5 do sexo masculino e 7 do sexo feminino, com idade média de 58 ± 12,57 anos, divididos aleatoriamente em dois grupos. Um deles realizou a fisioterapia convencional (GC) pelo período de uma hora, o outro realizou por trinta minutos e mais trinta minutos de treino de equilíbrio com auxílio do Wii Fit (GW), duas vezes por semana durante cinco semanas, completando dez sessões. O equilíbrio foi avaliado antes e após as intervenções, por meio da aplicação da Escala de Equilíbrio de Berg (EEB) e pela estabilometria, que mensura a oscilação do centro de pressão (COP), nos eixos ântero-posterior (AP) e médio-lateral (ML), por uma plataforma de pressão em duas condições: de olhos abertos (OA) e olhos fechados (OF). RESULTADOS: De acordo com a EEB, os pacientes, tanto do GC quanto o do GW, obtiveram maior controle do equilíbrio estático e dinâmico. Na avaliação do COP no eixo ML, os indivíduos do GC e do GW tiveram diminuição na oscilação ML após a intervenção proposta para cada grupo, nas condições de OA e OF. No eixo AP do COP, o GC não teve diminuição na oscilação AP de OA e OF, e o GW apresentou diminuição na oscilação AP de OA e OF. CONLUSÃO: O presente estudo demonstra que a fisioterapia associada ao treino de equilíbrio com o Wii Fit apresenta resultados significantes na reabilitação dos indivíduos hemiparéticos, obtendo, assim, mais um recurso terapêutico na fisioterapia.
Cerebral palsy (CP) is a term used to classify individuals with nonprogressive lesions of the immature brain and consequent movement difficulty and postural instability. 1 CP is the most prevalent cause of chronic motor function impairment. 2 Patients with CP are categorized by movement disorder type, which may be spastic, dyskinetic (dystonia or choreoathetosis), or ataxic. The degree of functional impairment varies, depending on a combination of type, topography of motor dysfunction, and severity. 2 Although clinical changes are not progressive, the health care of individuals with CP should be continuous because their motor function may decline throughout their lives. The average lifetime cost for an individual with CP, including medical, non-medical, and special education expenses, is $1.2 million. 3 Scientific evidence of interventions for maintaining physical function and mobility is limited, and the existing studies are usually of low methodological quality. 4 The same is true for treatments for muscle tone changes in dystonia of adults with CP. 5 This implies a gap in the literature on the natural history of the disease as well as the quality and cost-effectiveness of the interventions, 6 especially in the adult population. 7Spastic CP is the most prevalent and widely studied type. 8 However, dyskinetic CP (DCP) also has a high prevalence (15%-20%) 9in the total population with the disease, affecting one in 500 newborns and 17 million people worldwide. 6 DCP is less well studied Aim: The aim of this study was to characterize upper-limb motor function during a comparative analysis of electromyographic and upper limb movement analysis during drinking between healthy adults and individuals with DCP. Method: Fifteen healthy individuals (CG) and fifteen individuals with DCP (DG)participated in the study. Upper limb function was analyzed during drinking and consisted of a task divided into three phases: the going, the adjustment, and the return.Results: Electromyographic analysis revealed a lower activity of the anterior deltoid, posterior deltoid, and biceps brachii muscles in the DG. When comparing the interactions between groups and phases, only biceps brachii shower lower muscle activity during going and adjustment phases. The DG presented a smaller range of motion (ROM) for the shoulder, elbow, forearm and wrist movements. An interaction between groups and phases showed smaller ROM for the flexion and internal rotation of the shoulder, elbow flexion, forearm pronation, and ulnar deviation in the return phase compared to CG. Interpretation:The results may contribute positively to the quantification of the level of motor impairment and may be used as a reference for the development of therapeutic interventions for patients with DCP.
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