RESUMEN
Objective:To observe and analyze the clinical effect of combining motor imagery training (MIT) with transcranial direct current stimulation (tDCS) for improving the upper limb functioning of hemiplegic stroke survivors.Methods:Ninety stroke survivors with hemiplegia were randomly divided into a conventional group (treated with tDCS) and a combination group (treated with MIT combined with tDCS), each of 45. The conventional group received 20min of tDCS using the IS200 intelligent electrical stimulator once daily, 6 times/week, for 4 weeks. The combination group received 40min of motor imagery training right after the tDCS treatment. Before and after the treatment, upper limb motor functioning was evaluated using the Fugl-Meyer assessment for the upper extremities (FMA-UE) and the Hong Kong version of a functional test for the hemiplegic upper extremity (FTHUE-HK). Surface electromyographs were recorded from the anterior deltoid and the triceps brachii muscles during maximum active shoulder flexion and elbow extension. The muscle strength of the affected limb was evaluated using the root mean square values of the integrated electromyograms (IEMGs).Results:There were no significant differences between the groups before the treatment. Afterward, significant improvement was observed in the average FMA-UE scores, FTHUE-HK scores, surface EMG indexes and iEMG values in both groups. The improvement in the combination group was significantly greater than in the conventional group.Conclusion:Combining MIT with tDCS can better improve upper limb motor functioning and muscle strength after a stroke survivors than tDCS alone.
RESUMEN
Abstract The aim is to analyze upper limb functioning and disability, and its association with health-related quality of life among artisanal fisherwomen from Bahia, Brazil. Cross-sectional epidemiological study was conducted with a sample of 209 fisherwomen. Structured questionnaires were used for socio-demographic and comorbidity information, as well as the instruments Disabilities of the Arm, Shoulder and Hand (DASH) and Short-Form Healthy Survey (SF-36) respectively, to evaluate the upper limbs and health-related quality of life. The results demonstrated that the presence of musculoskeletal disorders in the upper limbs directly affects the values of the DASH instrument and the SF-36v01 questionnaire scores, while also generating a negative correlation between the DASH and SF-36v01. The varying functioning abilities, pain and social aspects negatively affect upper limb function, and the daily activities and work of fisherwomen. The presence of chronic disease and the absence of intervention and rehabilitation for these professionals, that could produces, in a long-term, cases of disability.
Resumo O objetivo foi analisar a incapacidade e a funcionalidade de membros superiores e verificar sua associação com a qualidade de vida relacionada com a saúde de pescadoras artesanais da Bahia, Brasil. Estudo epidemiológico, de corte transversal, envolvendo uma amostra de 209 pescadoras artesanais. Foram utilizados questionários estruturados para informações sociodemográficas e comorbidades e os instrumentos Disabilities of the Arm, Shoulder and Hand (DASH) e Medical Outcomes Study 36-Item Short-Form Healthy Survey (SF-36), para, respectivamente, avaliação dos membros superiores e qualidade de vida relacionada com a saúde. Os resultados encontrados demonstram que a presença de distúrbios musculoesqueléticos (DME) em membros superiores afeta diretamente os valores do instrumento DASH e os escores do SF-36v01, bem como a correlação negativa encontrada entre o DASH e os domínios do SF-36v01. As variáveis capacidade funcional, dor e aspectos sociais afetam negativamente a funcionalidade de membros superiores e as atividades do cotidiano e do trabalho de pescadoras artesanais. A presença de doença crônica e a ausência de intervenção e reabilitação desses profissionais geram, a longo prazo, casos de incapacidade.