Impacto de programa fisioterapêutico no desempenho funcional da criança com doença de Charcot-Marie-Tooth tipo 2: estudo de caso

This case study aimed at verifying the influence of a physical therapy program on the functional performance of a child with diagnosis of Charcot-Marie-Tooth) disease type 2. The 6 year-old male child presented low and upper limbs affected at both motor and sensitive levels. Before and after the program, the subject was assessed by means of the Pediatric Evaluation Disability Inventory (PEDI), designed for children between 6 months through 7.5 years old. PEDI is divided into three parts – functional skills (involving selfcare, mobility and social function), caregiver assistance, and environment modification – and only the first part was used in this study. Drawing on the difficulties detected at the first evaluation, a physical therapy program was designed, based on the neurodevelopmental concept. The program lasted two months, with two 50-minute sessions per week (a total of 15 sessions). At the post-program evaluation, self-care score raised from 20.8 to 26.7, and mobility scare, from 40 to 54,9, specially in transference and going up and downstairs skills. Thus, the therapy program was effective in improving the subject's functional performance.O estudo visou verificar a influência de um programa fisioterapêutico nodesempenho funcional de uma criança com diagnóstico de Charcot-Marie-Tooth tipo 2. O participante (sexo masculino, 6 anos) apresentava comprometimento motor e sensitivo em membros superiores e inferiores. Antes e após o programa, o participante foi avaliado pelo Pediatric Evaluation Disability Inventory (PEDI), questionário que avalia o desempenho funcional de crianças na faixa de 6 meses a 7 anos e meio. O PEDI divide-se em três partes: habilidades funcionais (envolvendoautocuidado, mobilidade e função social), assistência do cuidador e modificações do ambiente; este estudo limitou-se à parte de habilidades funcionais. A partir das dificuldades detectadas na avaliação inicial, elaborou-se um programa de intervenção fisioterapêutica com base no conceito neuroevolutivo Bobath. O programa foi aplicado por 2 meses, sendo realizadas 2 sessões semanais de 50 minutos cada, totalizando 15 sessões. Na avaliação após a aplicação do programa, aumentou o escore normativo no PEDI, nas áreas de autocuidado (de 20,8 para 26,7) e mobilidade (de 40 para 54,9), especialmente nas habilidades de transferência, subir e descer escadas. Portanto, o programa de intervenção fisioterapêutica mostrou-se eficaz, promovendo melhora no desempenho funcional da criança

The effects of a progressive loading exercise program on femoral physical properties and strength of osteopenic rats

Background: Many studies have shown that physical exercises are able to stimulate bone formation and increase bone mass, constituting a therapeutic modality to treat bone loss due to osteoporosis. However, some points about the intensity, duration and frequency of the exercises remain confusing and contradictory. Thus, the aim of this study was to determine the effects of a progressive loading exercise program on femur of osteopenic rats. To induce osteopenia we used the animal model of ovariectomy (OVX). Forty animals was studied and divided into 4 groups: sham-operated sedentary (SS); ovariectomy-sedentary (OS); sham-operated training (ST) and ovariectomy training (OT). The trained groups performed jumps into water: 4 series of 10 jumps each, with an overload of 50% to 80% of the animal's body weight, during 8 weeks. Femora were submitted to a physical properties evaluation, a biomechanical test, calcium and phosphorus content measurement and a morphometric histological evaluation. Results: osteopenic animals showed a decrease of bone strength and lower values of bone weights, bone density and calcium content. The exercised osteopenic rats showed higher values of geometrical, physical properties, bone strength and calcium content compared to controls. The results of the present study indicate that the progressive loading exercise program had stimulatory effects on femora of osteopenic rats. It seems that the intensity and duration of the protocol used produced bone structural adaptations, which contributed to reverse bone loss due to ovariectomy