Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. As a result of the rapid progression and severity of the disease, people with ALS experience loss of functionality and independence. Furthermore, it has already been described presence of autonomic dysfunction. Despite the increasing use of virtual reality (VR) in the treatment of different diseases, the use of virtual reality environment as an intervention program for ALS patients is innovative. The benefits and limitations have not yet been proven. Our objective was to evaluate the autonomic function of individuals with amyotrophic lateral sclerosis throughout the virtual reality task. The analysis of autonomic function was completed before, during, and after the virtual reality task using the upper limbs; also, all steps lasted ten minutes in a sitting position. Heart rate variability (HRV) was taken via the Polar® RS800CX cardiofrequencymeter. The following questionnaire was enforced: Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS) and Fatigue Severity Scale (FSS). Different types of HRV were revealed for the groups, indicating that the ALS group has reduced HRV, with most of the representative indices of the sympathetic nervous system. Besides, the physiological process of reducing parasympathetic activity from rest to VR activity (vagal withdrawal), with reduction in HF (ms2) and an increase in HR from rest to activity, and a further increase throughout recovery, with withdrawal of sympathetic nervous system, occurs just for the control group (CG), with no alterations between rest, activity, and recovery in individuals with ALS. We could conclude that patients with ALS have the reduction of HRV with the sympathetic predominance when equated to the healthy CG. Besides that, the ALS individuals have no capability to adapt the autonomic nervous system when likened to the CG during therapy based on VR and their recovery.
(1) Background: Post-stroke presents motor function deficits, and one interesting possibility for practicing skills is the concept of bilateral transfer. Additionally, there is evidence that the use of virtual reality is beneficial in improving upper limb function. We aimed to evaluate the transfer of motor performance of post-stroke and control groups in two different environments (real and virtual), as well as bilateral transfer, by changing the practice between paretic and non-paretic upper limbs. (2) Methods: We used a coincident timing task with a virtual (Kinect) or a real device (touch screen) in post-stroke and control groups; both groups practiced with bilateral transference. (3) Results: Were included 136 participants, 82 post-stroke and 54 controls. The control group presented better performance during most parts of the protocol; however, it was more evident when compared with the post-stroke paretic upper limb. We found bilateral transference mainly in Practice 2, with the paretic upper limb using the real interface method (touch screen), but only after Practice 1 with the virtual interface (Kinect), using the non-paretic upper limb. (4) Conclusions: The task with the greatest motor and cognitive demand (virtual—Kinect) provided transfer into the real interface, and bilateral transfer was observed in individuals post-stroke. However, this is more strongly observed when the virtual task was performed using the non-paretic upper limb first.
Resumo Introdução O Work Rehabilitation Questionnaire (WORQ) é um instrumento internacional baseado na Classificação Internacional de Funcionalidade, Incapacidade e Saúde para avaliar a capacidade funcional em pessoas com deficiência para o trabalho. Objetivo Realizar adaptação transcultural e análise da confiabilidade para a população brasileira. Métodos A adaptação transcultural consistiu em tradução, síntese das traduções, retrotraduções, análise do comitê de juízes, pré-teste e teste piloto. Os resultados foram obtidos pelo cálculo da taxa de concordância para equivalência semântica, idiomática, experiencial e conceitual. A confiabilidade foi testada por análise de estabilidade, equivalência e consistência interna por meio do cálculo de α-Cronbach e Coeficiente de Correlação Intraclasse (ICC). Resultados Participaram da primeira etapa 05 tradutores, 08 juízes e 14 possíveis usuários no pré-teste. A taxa de concordância foi menor que 90% apenas na equivalência idiomática, resultando em ajustes ortográficos sem alterar o construto do instrumento. A confiabilidade foi testada em 34 trabalhadores com deficiência, idade média de 40,3 (±4,2) anos, ambos os sexos, funcionários de uma instituição de ensino de São Paulo inseridos pela lei de cotas (8.213/91). A Consistência Interna apresentou valores superiores a 80% em todos os domínios e foi maior que 90% para o escore total. Após 15 dias da primeira avaliação, foram sorteados 20 desses participantes para reavaliação. O ICC para estabilidade foi 82,5% (p=0,008) e equivalência foi 95,4% (p<0,001). Conclusão O questionário WORQ foi traduzido e adaptado transculturalmente para o português brasileiro e apresentou confiabilidade para responder aos domínios da CIF. A versão brasileira está disponível na home page do WORQ, no endereço eletrônico http://www.myworq.org/questionnaire_en.php.
ResumoA docência está entre as profissões de maior desgaste em saúde. A transição repentina para o ensino remoto durante a COVID-19 contribuiu para o aumento desses sintomas, gerando danos à qualidade de vida e bem-estar nesta população. Diante disto, o objetivo deste estudo é relatar a experiência do projeto extensionista de Atenção à Saúde do Professor em Ensino Remoto, realizado pelo QualiMack -Programa de Qualidade de Vida e Saúde no Trabalho, do Centro de Ciências Biológicas e da Saúde da Universidade Presbiteriana Mackenzie. Foram realizados encontros remotos baseados em Educação em Saúde, que consistiram em 8 encontros para Grupos de Orientação e 12, para Atividades de Relaxamento; criação e divulgação de peças autoinstrucionais de reforço. Participaram 176 docentes da instituição sede e 113 externos. As estratégias aumentaram o repertório em saúde dos participantes e contribuíram com a capacitação e aprimoramento da equipe no trabalho multidisciplinar e interação com a comunidade.
Introduction The Work Rehabilitation Questionnaire (WORQ) is an international instrument, based on the International Classification of Functioning, Disability and Health (ICF), used to assess the functional capacity of people with work disabilities. Objective To perform a cross-cultural adaptation and a reliability analysis of this instrument for the Brazilian population. Method The cross-cultural adaptation consisted of translation, synthesis of translations, back translations, analysis by the committee of judges, pre-test, and pilot test. The results were obtained by calculating the agreement rate for semantic, idiomatic, experiential, and conceptual equivalence. Reliability was tested by analysis of stability, equivalence, and internal consistency by calculating Cronbach’s Alpha and Intraclass Correlation Coefficient (ICC). Results Five translators, eight judges, and 14 possible users in the pre-test participated in the first stage. The agreement rate was <90% only for idiomatic equivalence, resulting in orthographic adjustments without changing the instrument construct. The reliability was tested on 34 workers with disabilities, with a mean age of 40.3 (±4.2) years, of both sexes, employees of an educational institution in the state of São Paulo, Brazil, hired through the Quotas Law (8,213/91). The internal consistency showed values >80% in all domains and was >90% for the total score. Fifteen days after the first assessment, 20 of these participants were randomly selected for reassessment. The ICC values for stability and equivalence were 82.5% (p=0.008) and 95.4% (p<0.001), respectively. Conclusion The WORQ was translated and cross-culturally adapted to Brazilian Portuguese and reliably responded to the ICF domains. The Brazilian version of the WORQ is available at http://www.myworq.org/questionnaire_en.php.
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