No abstract

Neuropathic pain after brachial plexus injury (NPBPI) is a highly disabling clinical condition and is increasingly prevalent due to increased motorcycle accidents. Currently, no randomized controlled trials have evaluated the effectiveness of non-invasive brain stimulation techniques such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS) in patients suffering from NPBPI. In this study, we directly compare the efficacy of 10-Hz rTMS and anodal 2 mA tDCS techniques applied over the motor cortex (5 daily consecutive sessions) in 20 patients with NPBPI, allocated into 2 parallel groups (active or sham). The order of the sessions was randomised for each of these treatment groups according to a crossover design and separated by a 30-day interval. Scores for “continuous” and “paroxysmal” pain (primary outcome) were tabulated after the last stimulation day and 30 days after. Secondary outcomes included the improvement in multidimensional aspects of pain, anxiety state and quality of life from a qualitative and quantitative approach. Active rTMS and tDCS were both superior to sham in reducing continuous (p < 0.001) and paroxysmal (p = 0.002; p = 0.02) pain as well as in multidimensional aspects of pain (p = 0.001; p = 0.002) and anxiety state (p =  < 0.001; p = 0.005). Our results suggest rTMS and tDCS are able to treat NPBPI with little distinction in pain and anxiety state, which may promote the use of tDCS in brachial plexus injury pain management, as it constitutes an easier and more available technique.Clinical Trial Registration: http://www.ensaiosclinicos.gov.br/, RBR-5xnjbc – Sep 3, 2018.

Despite advances in the treatment of Alzheimer’s disease (AD), there is currently no prospect of a cure, and evidence shows that multifactorial interventions can benefit patients. A promising therapeutic alternative is the use of transcranial direct current stimulation (tDCS) simultaneously with cognitive intervention. The combination of these non-pharmacological techniques is apparently a safe and accessible approach. This study protocol aims to compare the efficacy of tDCS and cognitive intervention in a double-blind, randomized and factorial clinical trial. One hundred participants diagnosed with mild-stage AD will be randomized to receive both tDCS and cognitive intervention, tDCS, cognitive intervention, or placebo. The treatment will last 8 weeks, with a 12-month follow-up. The primary outcome will be the improvement of global cognitive functions, evaluated by the AD Assessment Scale, cognitive subscale (ADAS-Cog). The secondary outcomes will include measures of functional, affective, and behavioral components, as well as a neurophysiological marker (Brain-derived neurotrophic factor, BDNF). This study will enable us to assess, both in the short and long term, whether tDCS is more effective than the placebo and to examine the effects of combined therapy (tDCS and cognitive intervention) and isolated treatments (tDCS vs. cognitive intervention) on patients with AD.Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02772185—May 5, 2016.

Introduction: The intensity of symptomatic symptoms during the menopause period can directly affect the quality of life of women and physical activity in this phase offers several benefits. Hydrotherapy programs in this population have received little attention and there is a need to establish a protocol for immersion in water. Objective: to analyze the benefits of an aquatic therapeutic exercise program under physical, emotional, psychological and quality of life aspects. Methods: This is a quasi-experimental, comparative, longitudinal study. Menopausal women aged between 45 and 70 years attended at the service at Clinical School of Physiotherapy at the Federal University of Paraíba were included in the study. The hydrotherapy protocol was applied for 90 minutes, twice a week for 9 months. Data collection took place through an initial and final evaluation, using the following instruments: Form with sociodemographic and clinical data; the Kupperman Index; Geriatric Depression Scale and the questionnaire Quality of Life Profile for Chronic Patients (PECVEC). Results: With regard to menopausal symptoms, a significant difference was observed (p=0,008). As for the symptoms of depression, no significant changes were observed (p=0,308). Regarding quality of life, we observed an increase in the score, with a significant difference (p=0,008). Conclusion: The applied hydrotherapy protocol provided an improvement in menopausal symptoms, providing physical and functional benefits, in addition to helping to improve the emotional state and quality of life of women.