Treinamento de classe em circuito em água versus terra em pacientes pós-acidente vascular cerebral: um protocolo para um estudo controlado randomizado

[Abstract] INTRODUCTION: A high percentage of poststroke patients have permanent aftermaths despite conventional rehabilitation. Circuit class training offers an efficient way to achieve structured practice of task-related activities during stroke rehabilitation. Aquatic therapy is another therapeutic approach that offers a great variety of options to be a highly dynamic environment, which helps to improving functionality and recover quality of life and independence in people with disabilities. OBJECTIVE: To determine the effectiveness of a circuit class training in water versus land in post-stroke patients. METHODS: Forty participants will be randomized in two groups: aquatic circuit class training (ACCT) and land circuit class training (LCCT). In both groups, the intervention will be a 7-week class therapy, 3-times weekly, giving a total of 20 sessions, 60 minutes each. Blinded assessors will conduct assessments, using standardized tools: baseline, post-intervention, and 20 days follow-up for the effectiveness of the therapy in terms of gait, balance and upper limb motor function. RESULTS/CONCLUSION: This trial will examine the immediate and medium term effect of an ACCT program as compared to a LCCT program in people with stroke. It has the potential to identify interventions that may improve rehabilitation of these patients. Both CCT programs are based in International Classification of Function, Disability and Health model with activities aimed at impairment, activity and participation levels.[Resumo] INTRODUÇÃO: Uma alta porcentagem de pacientes pós-AVC tem consequências permanentes, apesar da reabilitação convencional. O treinamento em circuito oferece uma maneira eficiente de realizar a prática estruturada de atividades relacionadas à tarefa durante a reabilitação do AVC. A terapia aquática é outra abordagem terapêutica que oferece uma grande variedade de opções para ser um ambiente altamente dinâmico, o que ajuda a melhorar a funcionalidade e recuperar a qualidade de vida e a independência das pessoas com deficiência. OBJETIVO: Determinar os efeitos de um treinamento de classe em circuito em água versus terra em pacientes pós-AVC. MÉTODOS: Quarenta participantes serão randomizados em dois grupos: treinamento de classe em circuito aquático (ACCT) e treinamento em circuito de terra (LCCT). Em ambos os grupos, a intervenção será uma terapia de 7 semanas, 3 vezes por semana, dando um total de 20 sessões, 60 minutos cada uma. Os avaliadores cegos conduzirão avaliações, utilizando ferramentas padronizadas: linha de base, pós-intervenção e 20 dias de acompanhamento para a eficácia da terapia em termos de marcha, equilíbrio e função motora do membro superior. RESULTADOS / CONCLUSÃO: Este estudo examinará o efeito imediato e de médio prazo de um programa ACCT em comparação com um programa LCCT em pessoas com AVC. Tem o potencial de identificar intervenções que possam melhorar a reabilitação desses pacientes. Ambos os programas do CCT são baseados no modelo da Classificação Internacional de Função, Incapacidade e Saúde, com atividades voltadas para os níveis de deficiência, atividade e participação

IV Foro Internacional de Ganadería Sustentable: conectividad ecosistémica y articulación territorial hacia la Agenda 2030

En este espacio plural de análisis y reflexiones, buscamos articular conceptos y posibilidades para los territorios de montaña del centro de México, dando importancia a medios de vida vinculados a la ganadería y su interacción ecosistémica, fundamentado en innovaciones, casos de éxito e iniciativas emblemáticas nacionales e internacionales. La socialización de experiencias es uno de los pilares para transitar hacia la sostenibilidad de los sistemas productivos ganaderos: compartir logros e iniciativas, crear sinergias e identificar vulnerabilidades desde distintos enfoques.GIZ, Agencia de Cooperación Aleman

La renovación de la palabra en el bicentenario de la Argentina : los colores de la mirada lingüística

El libro reúne trabajos en los que se exponen resultados de investigaciones presentadas por investigadores de Argentina, Chile, Brasil, España, Italia y Alemania en el XII Congreso de la Sociedad Argentina de Lingüística (SAL), Bicentenario: la renovación de la palabra, realizado en Mendoza, Argentina, entre el 6 y el 9 de abril de 2010. Las temáticas abordadas en los 167 capítulos muestran las grandes líneas de investigación que se desarrollan fundamentalmente en nuestro país, pero también en los otros países mencionados arriba, y señalan además las áreas que recién se inician, con poca tradición en nuestro país y que deberían fomentarse. Los trabajos aquí publicados se enmarcan dentro de las siguientes disciplinas y/o campos de investigación: Fonología, Sintaxis, Semántica y Pragmática, Lingüística Cognitiva, Análisis del Discurso, Psicolingüística, Adquisición de la Lengua, Sociolingüística y Dialectología, Didáctica de la lengua, Lingüística Aplicada, Lingüística Computacional, Historia de la Lengua y la Lingüística, Lenguas Aborígenes, Filosofía del Lenguaje, Lexicología y Terminología

An Observational Study Comparing Fibromyalgia and Chronic Low Back Pain in Somatosensory Sensitivity, Motor Function and Balance

Fibromyalgia (FM) and chronic low back pain (CLBP) have shared pathophysiology and have a considerable impact on patients’ daily activities and quality of life. The main objective of this study was to compare pain impact, somatosensory sensitivity, motor functionality, and balance among 60 patients with FM, 60 patients with CLBP, and 60 pain-free controls aged between 30 and 65 years. It is essential to know the possible differences existing in symptomatology of two of the major chronic pain processes that most affect the population, such as FM and CLBP. The fact of establishing possible differences in sensory thresholds, motor function, and proprioceptive measures among patients with FM and CLBP could bring us closer to a greater knowledge of the chronic pain process. Through an observational study, a comparison was made between the three groups (FM, CLBP, and pain-free controls) evaluating functional performance, postural balance, kinematic gait parameters, strength, depression, fatigue, and sensitivity to pain and vibration. Patients with chronic pain showed worse somatosensory sensitivity (p < 0.001) and motor function (p < 0.001) than pain-free controls. Moreover, patients with FM showed greater pain impact (p < 0.001) and bigger somatosensory (p < 0.001) and motor deficiencies (p < 0.001) than patients with CLBP. Further research should explore the possible reasons for the greater deterioration in patients with FM in comparison with other chronic pain conditions. Our results, showing the multiple areas susceptible of deterioration, make it necessary to adopt interdisciplinary interventions focused both on physical and emotional dysfunction

Differences in Postural Balance, Pain Sensitivity and Depression between Individuals with Acute and Chronic Back Pain

To compare differences in postural balance, pain and depression in patients with chronic and acute low back pain, twenty patients with chronic and twenty patients with acute low back pain from the Edward Francis Small Hospital (Banjul, Gambia), as well as 20 age-matched healthy controls participated in the study. A modified Romberg test was used to assess postural balance during one minute with closed eyes. Body sway in the anteroposterior and mediolateral axes was video-recorded during test performance and further analyzed with an open source software for movement analyses (CvMob). Pain sensitivity was assessed by means of pressure pain thresholds and depression by a self-report questionnaire (PHQ-9). As results, patients with chronic low back pain displayed higher body sway in the anteroposterior and mediolateral axes, as well as faster body sway than patients with acute low back pain and healthy controls. Nevertheless, group differences disappeared when depression was introduced as a covariate, indicating a major role of depression in postural balance deficits of patients with pain disorders. As conclusions, the assessment of postural balance and depression should be implemented in the clinical routine for the design of tailored interventions in pain conditions

A Comparison of the Effect of Two Types of Whole Body Vibration Platforms on Fibromyalgia. A Randomized Controlled Trial

Whole body vibration has been proven to improve the health status of patients with fibromyalgia, providing an activation of the neuromuscular spindles, which are responsible for muscle contraction. The present study aimed to compare the effectiveness of two types of whole body vibrating platforms (vertical and rotational) during a 12-week training program. Sixty fibromyalgia patients (90% were women) were randomly assigned to one of the following groups: group A (n = 20), who performed the vibration training with a vertical platform; group B (n = 20), who did rotational platform training; or a control group C (n = 20), who did not do any training. Sensitivity measures (pressure pain and vibration thresholds), quality of life (Quality of Life Index), motor function tasks (Berg Scale, six-minute walking test, isometric back muscle strength), and static and dynamic balance (Romberg test and gait analysis) were assessed before, immediately after, and three months after the therapy program. Although both types of vibration appeared to have beneficial effects with respect to the control group, the training was more effective with the rotational than with vertical platform in some parameters, such as vibration thresholds (p < 0.001), motor function tasks (p < 0.001), mediolateral sway (p < 0.001), and gait speed (p < 0.05). Nevertheless, improvements disappeared in the follow-up in both types of vibration. Our study points out greater benefits with the use of rotational rather than vertical whole body vibration. The use of the rotational modality is recommended in the standard therapy program for patients with fibromyalgia. Due to the fact that the positive effects of both types of vibration disappeared during the follow-up, continuous or intermittent use is recommended