ABSTRACT
BACKGROUND: Upper limb (UL) impairment is the most common disabling deficit following a stroke. Previous studies have suggested that transcranial direct current stimulation (tDCS) enhances the effect of conventional therapies. OBJECTIVE: This pilot double-blind randomized control trial aimed to determine whether or not tDCS, combined with Wii virtual reality therapy (VRT), would be superior to Wii therapy alone in improving upper limb function and quality of life in chronic stroke individuals. METHODS: Twenty participants were randomly assigned either to an experimental group that received VRT and tDCS, or a control group that received VRT and sham tDCS. The therapy was delivered over 15 sessions with 13 minutes of active or sham anodal tDCS, and one hour of virtual reality therapy. The outcomes included were determined using the Fugl-Meyer scale, the Wolf motor function test, the modified Ashworth scale (MAS), grip strength, and the stroke specific quality of life scale (SSQOL). Minimal clinically important differences (MCID) were observed when assessing outcome data. RESULTS: Both groups demonstrated gains in all evaluated areas, except for the SSQOL-UL domain. Differences between groups were only observed in wrist spasticity levels in the experimental group, where more than 50% of the participants achieved the MCID. CONCLUSIONS: These findings support that tDCS, combined with VRT therapy, should be investigated and clarified further.
Subject(s)
Electric Stimulation Therapy , Stroke Rehabilitation , Upper Extremity , Virtual Reality Exposure Therapy , Activities of Daily Living , Aged , Combined Modality Therapy/methods , Double-Blind Method , Female , Humans , Male , Middle Aged , Muscle Spasticity/rehabilitation , Pilot Projects , Quality of Life , Recovery of Function/physiology , Treatment OutcomeABSTRACT
The nutritional status and some risk factors in 894 school children (ages 6 to 12) in the State of Pernambuco, Brazil, were analyzed based on the data collected by the Second State Research on Nourishment, Health and Nutrition carried out in 1997. The cutoff point used in the nutritional evaluation was the limit referring to -2 score-Z, being the NCHS the reference standard. The prevalence of stunting in the state was of 16.9%. Rural areas were more affected, reaching 27.1%. Bivariate analysis showed that the low socioeconomic level of the children and their families is associated with the occurrence of stunting. The logistic regression model pointed the variables: residence location, gender, access to treated potable water, low education, and per-capita income as the main determinants in stunting. The conjunct analysis of all the factors that explain the malnutrition found among the school children studied showed that the probability of a school-aged child to present height deficit varied from 1.5 to 60.3% depending on the risk factors taken into account, therefore showing different epidemiological "scenarios." The study also concluded that in the State of Pernambuco the height deficit constitutes a public health problem especially for school children in rural areas, showing two very different epidemiologic realities between urban and rural areas.
Subject(s)
Growth Disorders/epidemiology , Brazil/epidemiology , Child , Child Nutrition Disorders/epidemiology , Epidemiologic Methods , Female , Humans , Male , Socioeconomic FactorsABSTRACT
O presente estudo objetivou avaliar a prevalência da dor na coluna vertebral em profissionais fisioterapeutas que trabalham em serviços públicos e privados na cidade do Recife e a influência de possíveis fatores de risco. A amostra do tipo probabilística (aleatória sistemática) foi constituída de 128 profissionais fisioterapeutas. Os dados foram coletados por meio de um formulário próprio, contendo informaçöes referentes ao profissional, antecedentes familiares e seu trabalho. Para análise estatística dos resultados foi empregado o teste do Qui-quadrado de associaçäo de Pearson. Em tabelas 2x2 com correçäo de Yates e, quando necessário, o teste de Fisher, para os quais foi considerado um nível crítico de 95 por cento de confiaça em todos os cálculos, utilizando-se o "software" Epi-Info. Os resultados mostraram uma prevalência de 75 por cento de dor na coluna vertebral na amostra estudada, com a maior queixa sendo evidenciada na regiäo lombar (27,1 por cento). A faixa etária mais acometida foi a que vai dos 20 a menos de 30 anos.As variáveis sexo, idade, tempo que exerce a profissäo, jornada de trabalho e área de atuaçäo näo se mostraram discriminantes para a dor na coluna vertebral dos profissionais estudados. Dentre os sintomas associados, o formigamento foi o único que mostrou associaçäo com a ocorrência de dor na coluna vertebral
