Efectos de un programa de clase en circuito en agua versus un programa de clase en circuito en suelo en personas que sufrieron un accidente cerebrovascular

Programa Oficial de Doutoramento en Saúde, Discapacidade e Dependencia. 560V01[Resumen] INTRODUCCIÓN: La evidencia científica actual apoya el uso de la terapia orientada a la tarea y de la terapia acuática como formas de tratamiento en la neurorrehabilitación de personas que han sufrido un accidente cerebrovascular. MÉTODOS: Se realizó un ensayo clínico controlado aleatorizado para comprobar los efectos de un programa de terapia de clase en circuito en agua versus un programa de circuito en suelo en personas que sufrieron un accidente cerebrovascular. Los métodos de evaluación utilizados fueron: Software de análisis de movimiento CvMob, Test de 10 Metros Marcha, Test de 2 Minutos Marcha, Escala de Equilibrio de Berg, Test de Alcance Funcional, Test Timed Up & Go, Cuestionario de Self-Efficacy en ACV, Escala de confianza en el equilibrio en actividades específicas, Evaluación Fugl-Meyer y Box and Block Test. RESULTADOS: Ambas terapias han demostrado ser efectivas en los parámetros evaluados: marcha, equilibrio y función del miembro superior. Hubo diferencias significativas entre los grupos en la escala de equilibrio de Berg después de la terapia, a favor del grupo de agua. CONCLUSIONES: Se recomienda el uso de la terapia de clase en circuito en agua o en suelo como forma de tratamiento en personas que han sufrido un accidente cerebrovascular.[Resumo] INTRODUCIÓN: A evidencia científica actual soporta o uso de terapia orientada a tarefas e da terapia acuática como formas de tratamento en neurorrehabilitación de persoas que sufriron un accidente vascular cerebral. MÉTODOS: Realizouse un ensaio clínico controlado aleatorizado co fin de comprobar os efectos de un programa de terapia de clase en circuito en auga versus un programa de terapia de clase en circuito no solo en persoas que sufriron un accidente vascular cerebral. Os métodos de avaliación utilizados foron: Software de análise de movemento CvMob, Test de 10 Metros Marcha, Test de 2 Minutos Marcha, Escala de Equilibrio de Berg, Test de Alcance Funcional, Test Timed Up & Go, Cuestionario de Self-Efficacy, Escala de confianza no equilibrio en actividades específicas, Evaluación Fugl-Meyer e Box and Block Test. RESULTADOS: Ambos tratamentos demostraron ser eficaces nos parámetros avaliados: marcha, equilibrio e función do membro superior. Houbo diferenzas significativas entre os grupos na escala de equilibrio de Berg despois da terapia, con mellorías no grupo de auga. CONCLUSIÓNS: Recoméndase o uso da terapia de clase en circuito en auga ou en solo como tratamento para persoas que sufriron un accidente vascular cerebral.[Abstract] INTRODUCTION: Current scientific evidence supports the use of task-oriented therapy and aquatic therapy as treatment modalities in neurorehabilitation of people who have suffered a stroke. METHODS: A randomized controlled trial was conducted to test the effects of a circuit class therapy in water versus circuit class therapy on land in people who suffered a stroke. Assessments methods were: CvMob motion analysis software, 10 Meter Walk Test, 2 Minute Walk Test, Berg Balance Scale, Fugl-Meyer Assessment, Functional Reach Test, Timed Up & Go test, Stroke Self-Efficacy Questionnaire, Activities-Specific Balance Confidence Scale and Box and Block Test. RESULTS: Both therapies have been effective in the parameters evaluated: gait, balance and upper limb function. There were significant differences between groups on the Berg balance scale after therapy, with water group improvements. CONCLUSIONS: The use of circuit class therapy in water or land is recommended to treat people who have suffered a stroke

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

Transcultural adaptation and validation of a French version of the University of California, Los Angeles geriatrics attitudes scale (UCLA-GAS-F)

Background : In the context of demographic aging, active aging must be encouraged. In addition, the increase in life expectancy requires specific care for the elderly. Therefore, it is important to ensure appropriate training and education to caregivers. Educational institutions put value in positively influencing the attitudes and behaviours towards elderly people in order to ensure the quality of patient care in the future. Questionnaires are often used to assess attitudes. Among them, the University of California, Los Angeles Geriatrics Attitudes Scale (UCLA-GAS) was developed to assess attitudes towards older people and caring for older patients. This scale has been used to evaluate attitude of healthcare professionals and students including undergraduate physiotherapy students. To our knowledge, there is no scale that assesses the same concept in French. Therefore, this study aimed to translate and adapt the UCLA-GAS into French and to test its psychometric properties. Methods : We conducted this study in two phases. First, we translated and adapted the UCLA-GAS from English into French following the five recommended stages of cross-cultural adaptation. Second, we validated the French version of the scale with undergraduate physiotherapy students. One hundred nineteen students participated from the first to the third academic years. We estimated reliability and validity of the scale. We performed correlation analyses between the French version of the UCLA-GAS (UCLA-GAS-F) with the Aging Stereotypes and Exercise Scale (ASES) and the Attitudes to Aging Questionnaire (AAQ). Results : The scale was translated and adapted into French. Results of the validation phase showed that the UCLA-GAS-F had high test-retest reliability (ICC 0.83, 95%CI 0.74–0.89), but internal consistency below 0.7 (Cronbach’s alpha 0.49 to 0.57). The scale showed no ceiling or floor effect. As expected, the French version showed a weak correlation to the ASES (r = 0.28, p = .003) and to the AAQ (r = 0.32, p = .001). Conclusions : Despite low internal consistency, the French version of the UCLA-GAS showed appropriate psychometric properties. Further validation should include healthcare professionals and other healthcare students

Transcultural adaptation and validation of a French version of the University of California, Los Angeles geriatrics attitudes scale (UCLA-GAS-F)

Background : In the context of demographic aging, active aging must be encouraged. In addition, the increase in life expectancy requires specific care for the elderly. Therefore, it is important to ensure appropriate training and education to caregivers. Educational institutions put value in positively influencing the attitudes and behaviours towards elderly people in order to ensure the quality of patient care in the future. Questionnaires are often used to assess attitudes. Among them, the University of California, Los Angeles Geriatrics Attitudes Scale (UCLA-GAS) was developed to assess attitudes towards older people and caring for older patients. This scale has been used to evaluate attitude of healthcare professionals and students including undergraduate physiotherapy students. To our knowledge, there is no scale that assesses the same concept in French. Therefore, this study aimed to translate and adapt the UCLA-GAS into French and to test its psychometric properties. Methods : We conducted this study in two phases. First, we translated and adapted the UCLA-GAS from English into French following the five recommended stages of cross-cultural adaptation. Second, we validated the French version of the scale with undergraduate physiotherapy students. One hundred nineteen students participated from the first to the third academic years. We estimated reliability and validity of the scale. We performed correlation analyses between the French version of the UCLA-GAS (UCLA-GAS-F) with the Aging Stereotypes and Exercise Scale (ASES) and the Attitudes to Aging Questionnaire (AAQ). Results : The scale was translated and adapted into French. Results of the validation phase showed that the UCLA-GAS-F had high test-retest reliability (ICC 0.83, 95%CI 0.74–0.89), but internal consistency below 0.7 (Cronbach’s alpha 0.49 to 0.57). The scale showed no ceiling or floor effect. As expected, the French version showed a weak correlation to the ASES (r = 0.28, p = .003) and to the AAQ (r = 0.32, p = .001). Conclusions : Despite low internal consistency, the French version of the UCLA-GAS showed appropriate psychometric properties. Further validation should include healthcare professionals and other healthcare students

Effectiveness of Aquatic Therapy vs Land-based Therapy for Balance and Pain in Women with Fibromyalgia: a study protocol for a randomised controlled trial

Abstract Background Fibromyalgia is a disease with an increasing incidence. It impairs the quality of life of patients and decreases their functional capacity. Aquatic therapy has already been used for managing the symptoms of this syndrome. However, aquatic therapy has only recently been introduced as a treatment modality for improving proprioception in fibromyalgia. The main objective of this study is to determine the effectiveness of two physiotherapy protocols, one in and one out of water, for improving balance and decreasing pain in women with fibromyalgia. Methods/Design The study protocol will be a single-blind randomised controlled trial. Forty women diagnosed with fibromyalgia will be randomly assigned into 2 groups: Aquatic Therapy (n = 20) or Land-based Therapy (n = 20). Both interventions include 60-min therapy sessions, structured into 4 sections: Warm-up, Proprioceptive Exercises, Stretching and Relaxation. These sessions will be carried out 3 times a week for 3 months. Primary outcomes are balance (static and dynamic) and pain (intensity and threshold). Secondary outcomes include functional balance, quality of life, quality of sleep, fatigue, self-confidence in balance and physical ability. Outcome measures will be evaluated at baseline, at the end of the 3-month intervention period, and 6-weeks post-treatment. Statistical analysis will be carried out using the SPSS 21.0 program for Windows and a significance level of p ≤ 0.05 will be used for all tests. Discussion This study protocol details two physiotherapy interventions in women with fibromyalgia to improve balance and decrease pain: aquatic therapy and land-based therapy. In current literature there is a lack of methodological rigour and a limited number of studies that describe physiotherapy protocols to manage fibromyalgia symptoms. High-quality scientific works are required to highlight physiotherapy as one of the most recommended treatment options for this syndrome. Trial registration Date of publication in ClinicalTrials.gov: 18/02/2016. ClinicalTrials.gov Identifier: NCT02695875