A Comparative Study of Conventional Physiotherapy versus Robot-Assisted Gait Training Associated to Physiotherapy in Individuals with Ataxia after Stroke

Objectives. To assess the influence of RAGT on balance, coordination, and functional independence in activities of daily living of chronic stroke survivors with ataxia at least one year of injury. Methods. It was a randomized controlled trial. The patients were allocated to either therapist-assisted gait training (TAGT) or robotic-assisted gait training (RAGT). Both groups received 3 weekly sessions of physiotherapy with an estimated duration of 60 minutes each and prescribed home exercises. The following outcome measures were evaluated prior to and after the completion of the 5-month protocol treatment: BBS, TUG test, FIM, and SARA. For intragroup comparisons, the Wilcoxon test was used, and the Mann-Whitney test was used for between-group comparison. Results. Nineteen stroke survivors with ataxia sequel after one year of injury were recruited. Both groups showed statistically significant improvement (P < 0 05) in balance, functional independencein, and general ataxia symptoms. There were no statistically significant differences (P < 0 05) for between-group comparisons both at baseline and after completion of the protocol. Conclusions. Chronic stroke patients with ataxia had significant improvements in balance and independence in activities of daily living after RAGT along with conventional therapy and home exercises. This trial was registered with trial registration number 39862414.6.0000.5505.Univ Fed Sao Paulo UNIFESP, Physiol Dept, Sao Paulo, SP, BrazilAACD, Physiotherapy Dept, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Physiol Dept, Sao Paulo, SP, BrazilWeb of Scienc

Measurement properties of the Brazilian Portuguese version of the Lower-Extremity Motor Activity Log for chronic hemiparetic poststroke patients

Background Stroke is among the three leading causes of disability around the world, and it results in immediate difficulty in mobility and gait. There is a lack of instruments to evaluate what daily life is like for these individuals using their lower limbs in real-life environments (outside of the clinical environment). Objective To perform the translation and cultural adaptation to Brazilian Portuguese of the Lower-Extremity Motor Activity Log (LE-MAL) and test its measurement properties in chronic poststroke individuals. Methods The LE-MAL was translated into Brazilian Portuguese and adapted to the Brazilian culture. The comprehension and relevance of the final version were analyzed by a committee of specialists. The reliability, validity, and responsiveness of the LE-MAL/Brazil to detect changes after lower extremity constraint-induced movement therapy (LE-CIMT) and an intensive conventional therapy were tested. Results The LE-MAL/Brazil showed excellent inter- and intrarater reliability, with an intraclass correlation coefficient and Cronbach alpha > 0.70, as well as standard error of measurement and smallest detectable change < 10% of the total instrument score when applied by the same evaluators. Conclusion The responsiveness of the LE-MAL/Brazil to detect changes showed better results after LE-CIMT than after the intensive conventional therapy, with most of the correlations > 0.50

Visions for nature and nature’s contributions to people for the 21st century : Report from an IPBES visioning workshop held on 4-8 September 2017 in Auckland, New Zealand

Existing scenarios of biodiversity and ecosystem services (BES) have important limitations and gaps that constrain their usefulness for the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES). Specifically, they fail to incorporate policy objectives related to nature conservation and social-ecological feedbacks, they do not address the linkages between biodiversity and ecosystem services, and they are typically relevant at only a particular spatial scale. In addition, nature and its benefits are treated as the consequence of human decisions, but are not at the centre of the analysis. To address these issues, the IPBES Scenarios and Models Expert Group initiated the development of a set of Multiscale Scenarios for Nature Futures based on positive visions for human relationships with nature.The first step of this process was a visioning workshop with stakeholders and experts on 4-8 September 2017 in Auckland, New Zealand. A total of 73 participants from inter-governmental organisations, national government organisations, non-governmental organisations, academia and the private sector, from 31 countries, and with a range of sectoral expertise on biodiversity topics, from urban development to agriculture to fisheries, worked together in a visioning exercise. This report documents the results from this visioning workshop to inform further stakeholder consultation and the development of the associated multiscale scenarios by modelers and experts. This creative visioning exercise was carried out in four steps based on a suite of participatory methods that were used to develop visions of alternative futures. First the participants identified important themes to develop the visions. Next, thematic groups identified the main trends for BES in each theme and a set of “Seeds” of emerging initiatives leading to positive futures for our relationship with nature. Implications of what would happen across a range of sectors were identified for each seed. Then a pathway analysis of how the current regime in each theme may be transformed into the future desirable regime was carriedout. Narratives were then built for the visions emerging from each group. Finally, commonalities of visions across the groups were identified, and the regional relevance of each vision for different parts of the world was assessed

Visions for nature and nature’s contributions to people for the 21st century : Report from an IPBES visioning workshop held on 4-8 September 2017 in Auckland, New Zealand

Existing scenarios of biodiversity and ecosystem services (BES) have important limitations and gaps that constrain their usefulness for the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES). Specifically, they fail to incorporate policy objectives related to nature conservation and social-ecological feedbacks, they do not address the linkages between biodiversity and ecosystem services, and they are typically relevant at only a particular spatial scale. In addition, nature and its benefits are treated as the consequence of human decisions, but are not at the centre of the analysis. To address these issues, the IPBES Scenarios and Models Expert Group initiated the development of a set of Multiscale Scenarios for Nature Futures based on positive visions for human relationships with nature.The first step of this process was a visioning workshop with stakeholders and experts on 4-8 September 2017 in Auckland, New Zealand. A total of 73 participants from inter-governmental organisations, national government organisations, non-governmental organisations, academia and the private sector, from 31 countries, and with a range of sectoral expertise on biodiversity topics, from urban development to agriculture to fisheries, worked together in a visioning exercise. This report documents the results from this visioning workshop to inform further stakeholder consultation and the development of the associated multiscale scenarios by modelers and experts. This creative visioning exercise was carried out in four steps based on a suite of participatory methods that were used to develop visions of alternative futures. First the participants identified important themes to develop the visions. Next, thematic groups identified the main trends for BES in each theme and a set of “Seeds” of emerging initiatives leading to positive futures for our relationship with nature. Implications of what would happen across a range of sectors were identified for each seed. Then a pathway analysis of how the current regime in each theme may be transformed into the future desirable regime was carriedout. Narratives were then built for the visions emerging from each group. Finally, commonalities of visions across the groups were identified, and the regional relevance of each vision for different parts of the world was assessed