Repetitive transcranial magnetic stimulation (rTMS) over motor cortex and trans-spinal direct current stimulation (tsDCS) modulate corticospinal circuits in healthy and injured subjects. However, their associated effects with physical exercise is still not defined. This study aimed to investigate the effect of three different settings of rTMS and tsDCS combined with treadmill exercise on spinal cord and cortical excitability of healthy subjects. We performed a triple blind, randomized, sham-controlled crossover study with 12 healthy volunteers who underwent single sessions of rTMS (1Hz, 20Hz and Sham) and tsDCS (anodal, cathodal and Sham) associated with 20 minutes of treadmill walking. Cortical excitability was assessed by motor evoked potential (MEP) and spinal cord excitability by the Hoffmann reflex (Hr), nociceptive flexion reflex (NFR) and homosynaptic depression (HD). All measures were assessed before, immediately, 30 and 60 minutes after the experimental procedures. Our results demonstrated that anodal tsDCS/treadmill exercise reduced MEP’s amplitude and NFR’s area compared to sham condition, conversely, cathodal tsDCS/treadmill exercise increased NFR’s area. High-frequency rTMS increased MEP’s amplitude and NFR’s area compared to sham condition. Anodal tsDCS/treadmill exercise and 20Hz rTMS/treadmill exercise reduced Hr amplitude up to 30 minutes after stimulation offset and no changes were observed in HD measures. We demonstrated that tsDCS and rTMS combined with treadmill exercise modulated cortical and spinal cord excitability through different mechanisms. tsDCS modulated spinal reflexes in a polarity-dependent way acting at local spinal circuits while rTMS probably promoted changes in the presynaptic inhibition of spinal motoneurons. In addition, the association of two neuromodulatory techniques induced long-lasting changes.

AIMS proved very capable of detecting delayed gross motor development in preterm infants when compared with the Bayley-III/GM. The 10th percentile of AIMS provided the best combination of indicators, with greater specificity.

Given the evidence, the research supporting the ability of Alberta Infant Motor Scale to diagnose delayed motor development in preterm infants presents limitations. Further studies are suggested in order to avoid the above-mentioned biases to assess the Alberta Infant Motor Scale accuracy in preterm babies.

tsDCS did not affect the Hoffmann reflex, as shown in six studies. However, these findings come from studies with selection, performance and detection bias, and further research is needed to examine the effect of this intervention.

Introdução: os efeitos do treinamento cardiovascular são potencializados quando realizados na piscina terapêutica devido às propriedades físicas da água. Objetivo: avaliar os efeitos de um protocolo de hidroterapia na qualidade de vida e no condicionamento cardiovascular de pacientes pós-AVE. Métodos: dez pacientes foram divididos nos grupos: controle (exposto ao protocolo de exercícios no solo) e experimental (submetidos a 10 sessões de hidroterapia). As medidas para frequência cardíaca e respiratória, o número de voltas, saturação de oxigênio durante o teste de caminhada de seis minutos e qualidade de vida segundo a escala EQVE-AVE, foram avaliadas antes e após o programa de atividades. Resultados: houve um aumento expressivo da quantidade de voltas [12,80 ± 2,78 (p=0,01) ] em ambos os grupos e dos escores para a qualidade de vida [196,20±42,92 (p=0,046) ] apenas no grupo experimental em relação a condição inicial. Conclusão: o protocolo de hidroterapia promoveu os mesmos efeitos do treinamento no solo sobre o condicionamento cardiovascular, no entanto, foi capaz de promover um aumento dos escores para qualidade de vida.

Objectives: We aimed to assess the symptom burden and health related quality of life in patients with idiopathic lung fibrosis. MethOds: Patients have been consecutively enrolled in an ongoing prospective non-interventional registry in Germany, investigating clinical characteristics, clinical management practices and quality of life. IPF diagnoses were in agreement with the international IPF guideline published in 2011. Clinical parameters and treatment practice were recorded by the physician. Patients filled out the EQ-5D-5L, St George's Respiratory Questionnaire (SGRQ), WHO-5 and the UCSD shortness of breath (SOB) scale. The time trade off (TTO) score was calculated for the EQ-5D. Results: To date (04 June 2014), 421 patients with IPF have been enrolled in the registry (mean age 68.6±9.5; 77% male). The mean six-minute walk distance was 271±200, mean % of predicted forced vital capacity was 72±20 and the mean % predicted DLCO was 35±16. Patients were treated with oral steroids (22.1%, as monotherapy in 7.1%); N-acetylcysteine (34.8%), pirfenidone (47.2%), and long-term O2 therapy (34.4%). The physician rated the disease in 35.6% as stable, in 31.1% as slowly progressing and in 11.9% as rapidly progressing. One in four patients described their current state of health as at least good, and every fifth as poor. The mean EQ-5D TTO score was 0.8±0.2. 45% of the patients showed depressive symptoms based on the WHO-5. The mean SGRQ sum score was 47.7±20.1 describing difficulties with breathing in the previous 3 months. Higher EQ-5D TTO scores were significantly associated with a lower number of comorbid diseases (r= -0.31), higher 6-minute walk distance (r= 0.20), higher FVC % pred (r= 0.27), less depression (r= 0.66) and lower SGRQ scores (r= -0.72). cOnclusiOns: The IPF patients in this large registry had a more severe disease, a higher symptom burden and more compromised quality of life compared to recent randomised controlled trials.Objectives: The Nighttime Symptoms of COPD Instrument (NiSCI) and Early Morning Symptoms of COPD Instrument (EMSCI) were developed to support treatment benefit endpoints in global clinical trials. Translations that were conceptually equivalent to the English source version and easily understood by the target country populations were required. The purpose of this study was to translate and assess conceptual equivalence of the NiSCI and EMSCI for use in 14 countriesand United Kingdom. MethOds: The NiSCI and EMSCI were translated following ISPOR guidelines for linguistic validation of PRO measures (Wild et al., 2005) using the universal approach discussed in the second Task Force Report (Wild et al., 2009). The universal English, Spanish and French versions were previously translated (Eremenco et al., 2012). For the remaining languages, two forward translations by native translators, reconciliation of the forwards, one back-translation by an English-speaker fluent in the target language, and final reconciliation by a native speaking language coordinator were conducted for both measures. ...

RESUMOIntrodução: Síndrome de Chacort-Marie-Tooth é uma neuropatia hereditária com diferentes características genéticas e sinais clássicos bem descritos na literatura. Enquanto tratamento, o Ácido Ascórbico vem sendo testado visando promover a mielinização. O prognóstico depende da clínica apresentada, onde portadores desenvolvem compensações biomecânicas acarretando diminuição na velocidade de execução dos atos motores. Objetivo: Identificar intervenções atualmente utilizadas pela fisioterapia em crianças com Síndrome de Chacort-Marie-Tooth. Métodos: Revisão integrativa realizada nas bases de dados Scielo, Lilacs, Pubmed/Medline e Bireme. Na busca por descritores obteve-se 318 artigos. Realizou-se o fluxograma segundo PRISMA obtendo-se 96 artigos destes, 18 atenderam aos objetivos. Resultados: Os dados foram descritos e tabelados para a caracterização dos estudos, das crianças acometidas, dos instrumentos de diagnóstico e avaliação fisioterapêutica, bem como, dos protocolos de tratamento. A maioria dos estudos encontrados foi revisão de literatura e estudos de casos. As repercussões clínicas achadas relacionam-se às alterações biomecânicas nos membros inferiores, principalmente pés, com progressão gradual para outros segmentos. O diagnóstico foi dado mais frequentemente através da eletroneuromiografia. Identificou-se uma variedade de instrumentos avaliativos. Discussão: Ao se falar em aspectos atuais nas disfunções sensóriomotoras, poucas inovações são descritas. A necessidade de atenção nas identificações dos casos é destacada de forma a possibilitar a inserção dos portadores em atividades de caráter preventivo e no âmbito social. Conclusão: A fisioterapia convencional se mantém relevante como tratamento e das inovações identificadas, a gameterapia traz novas perspectivas funcionais. Destaca-se a utilização dos diversos testes e escalas conceituados, uma vez que possibilita a fisioterapia baseada em evidência.Palavras chave: Doença de Charcot-Marie-Tooth; Fisioterapia; Atividade Motora. ABSTRACTIntroduction: Chacort-Marie-Tooth syndrome is a hereditary neuropathy with different genetic characteristics and classic signs well described in the literature. As the treatment, Ascorbic Acid has been tested in order to promote myelination. The prognosis depends on the clinical presentation, where the patients develop biomechanical compensations causing a decrease in the speed of execution of the motor acts. Objective: To identify interventions currently used by physical therapy in children with Chacort-Marie-Tooth Syndrome. Methods: Integrative review performed in the databases Scielo, Lilacs, Pubmed / Medline and Bireme. The search for descriptors yielded 318 articles. The flowchart according to PRISMA was obtained, obtaining 96 articles of these, 18 met the objectives. Results: The data were described and tabulated for the characterization of the studies, the children affected, the diagnostic instruments and physiotherapeutic evaluation, as well as the treatment protocols. Most of the studies found were the literatur...

It is a crossover, double-blind, sham-controlled, pseudorandomized, and counterbalanced study at the Laboratory of Applied Neuroscience (LANA) of the Federal University of Pernambuco (UFPE).We performed a double-blind, randomized, sham-controlled crossover study with 12 healthy volunteers who underwent single sessions of rTMS (1Hz, 20Hz and Sham) and tsDCS (anodal, cathodal and Sham) associated with 20 minutes of treadmill walking. Cortical excitability was assessed by motor evoked potential (MEP) and spinal cord excitability by the Hoffmann reflex (Hr), nociceptive flexion reflex (NFR) and homosynaptic depression (HD). All measures were assessed before, immediately, 30 and 60 minutes after the experimental procedures.