Objective: Studies that assessed motor performance comparing healthy adults and old, shown agerelated differences in several parameters. It is not known whether these differences remain evident when people are under stroke condition. Our aim was to describe clinical and functional characteristics and to compare a dual task performance between older and younger post stroke individuals. Methods: We evaluated hemiparetic patients with independent gait between August/2011 and August/2012. The following scales/tests were applied: NIH Stroke Scale (NIHSS), Modified Barthel Index (mBI), Timed Up and Go Test (TUG) and TUG with cognitive task (TUGcog). X2, Fisher tests or Mann Whitney U test were used when appropriated. Results: Amongst 92 participants 54.3% were adults and 45.7% were elder adults. Adults and elder adults presented similar characteristics, although statistical difference was observed at instruction level (P = .01), hypertension (P= .02), verbal fluency (P < .01) and delta time for TUGcog (P < .01). Conclusion: Individuals post stroke in this study presented slightly clinical and functional differences, but it was possible to observe that older need more time to perform multitasking. Probably, age alone is not an important factor in differentiating independent stroke patients. However, postural instability, in elderly patients, should be evaluated more carefully taking into account the attentional demands, since dual task is used in many activities of daily life.
INTRODUCTION: Individuals with human T-cell lymphotropic virus 1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) experience sensorimotor alterations, which can affect functional performance. Virtual reality (VR) videogaming is a therapeutic option, though there is scarce evidence for its use in this population. We aimed to investigate the therapeutic effects of a VR video game on functional mobility, balance, and gait speed in individuals with HAM/TSP. METHODS: We conducted a blinded, crossover clinical trial comprising 29 individuals with HAM/TSP and randomized them into two groups: (1) early therapy: rehabilitative protocol started immediately after the initial evaluation and (2) late therapy: rehabilitative protocol started 10 weeks later. We assessed all participants for balance using the Berg Balance Scale (BBS) scores, functional mobility using the Timed Up and Go (TUG) test, and gait speed using video camera and CvMob software. Differences were considered significant if p <0.05. RESULTS: The early therapy group individuals presented with higher BBS scores ( p =0.415), less TUG times ( p =0.290), and greater gait speed ( p =0.296) than the late therapy group individuals. CONCLUSIONS: VR videogaming is a useful option for rehabilitative therapy in individuals with HAM/TSP; it positively affects balance, functional mobility, and gait speed.
INTRODUÇÃO: Devido ao contexto pandêmico foi necessário reinventar nossa prática profissional e inserir as modalidades de teleconsulta, teleconsultoria e telemonitoramento ao atendimento fisioterapêutico. Comunicação estabelecida por aplicativo de mensagem, com o envio de vídeos ou cartilhas de exercícios, e atividades síncronas com as orientações de exercícios no ambiente domiciliar, assegurando proteger a comunidade da propagação do vírus, facilitando o distanciamento físico e social preconizado no momento. OBJETIVO: Relatar a experiência da teleconsulta e telemonitoramento do ponto de vista de fisioterapeutas docentes de estágio supervisionado em um ambulatório docente assistencial. METODOLOGIA: Trata-se de um relato de experiência docente-assistencial, interdisciplinar, a qual ocorreu no período de agosto a dezembro de 2020, instituídas no componente curricular Estágio Supervisionado Ambulatorial e Estágio em Gestão, do curso de Fisioterapia da Escola Bahiana de Medicina e Saúde Pública (EBMSP), em Salvador, Bahia. Realizou-se a teleconsulta e telemonitoramento através do número de telefone celular cadastrado no aplicativo ®WhatsApp LLC, com atendimento online e duração de 50 minutos. RELATO DE EXPERIÊNCIA: O corpo docente foi instigado a motivar a turma a enfrentar novos desafios, como: dispensar a aplicação da técnica fisioterapêutica com suas mãos em prol da promoção da educação em saúde e priorizar o desenvolvimento do autocuidado no paciente a partir das orientações à distância. Apesar das frustrações geradas pelas mudanças da modalidade de atendimento, os discentes passaram a vislumbrar a abertura de espaço interno para novas experiências como estímulos positivos enfrentado durante o estágio. Dessa forma, observou-se que mesmo com os desafios foi possível estabelecer e entender que algumas práticas vieram para ficar nos casos em que melhor se aplicam.
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