Realidade virtual na função motora de membros inferiores pós-acidente vascular encefálico

O Acidente Vascular Encefálico (AVE) pode gerar importantes alterações motoras, de tônus e sensitivas. A realidade virtual (RV), voltada para reabilitação, pode trazer benefícios em relação à aptidão física, atividades motoras e de equilíbrio. Objetivo: Investigar o efeito da terapia por RV no equilíbrio estático e dinâmico, descarga de peso no membro inferior afetado, tônus e recrutamento muscular, independência funcional e função sensório-motora de indivíduos pós-AVE. Métodos: Trata-se de estudo clínico, quasi-experimental e prospectivo em 6 indivíduos com diagnóstico de AVE. Antes e após intervenção com Nintendo Wii Fit Plus os indivíduos foram avaliados pela Escala de Equilíbrio de Berg, Timed “Up and Go”, Índice do Andar Dinâmico; Teste de Marcha (TM); Escala Modificada de Ashworth (EMA); Eletromiografia; Índice de Barthel e Escala Fugl Meyer (EFM). Para análise estatística utilizou-se o teste Kolmogorov-Smirnov, teste t e Wilcoxon. Foi adotado P 80%. Resultados: No TM inicial da 1ª e 15ª sessão (p = 0,03; d = 1,96; P = 96%), EMA dos músculos extensores de quadril (p = 0,04; d = 3,77; P 99%) e joelho (p = 0,04; d = 3,23; P = 99%) e flexores plantares (p = 0,01; d = 3,18; P = 99%) e EFM nas dimensões coordenação/velocidade (p = 0,02; d = 6,74; P = 100%) e sensibilidade (p = 0,01), foram observados resultados significativos com grande efeito e Power > 90%. Nos demais instrumentos não foram encontrados valores significativos. Conclusão: O programa de reabilitação, por RV, foi eficaz na melhora da descarga de peso no membro inferior afetado, tônus muscular e função sensório-motora nos indivíduos do estudoStrokes can generate significant motor, tonic and sensitive changes. Virtual reality (RV), focused on rehabilitation, can bring several benefits such as improvements on physical fitness, motor skills and balance. Objective: To assess the effects of the RV intervention to the static and dynamic balance, weight load on the affected limb, tone and muscle recruitment, functional independence and sensorimotor function in post-stroke individuals. Methods: Quasi-experimental and prospective clinical study with 6 subjects with diagnosis of stroke. Before and after the intervention with Nintendo Wii Fit Plus, the subjects were assessed by the Berg Balance Scale, Timed “Up and Go” and Dynamic Floor Index; Gait Test (GT); Modified Ashworth Scale (MAS); Electromyography; Barthel Index and Fugl-Meyer Scale (FMS). The Statistical analysis used Kolmogorov-Smirnov test, t test and Wilcoxon. Results: The 1st and 15th session evaluations have shown that GT (p = 0.03, d = 1.96, P = 96%), MAS for hip extensor muscles (p = 0.04; d = 3.77; P = 99%), knee extensors (p = 0.04; d = 3.23; P = 99%), plantar flexors (p = 0.01; d = 3.18; P = 99%), FMS in coordination/velocity dimensions (p = 0.02; d = 6.74; P = 100%) and sensitivity (p = 0.01) presented significant results, large effect size and power above 90%. Significant values were not found to the other evaluations. Conclusion: The RV rehabilitation program was effective and improved the weight-load in affected limb, muscle tone and sensorimotor function of the subject

Participation of Potential Transient Receptors in the Antinociceptive Effect of Pharmacopuncture

Background : Despite the widespread clinical use of acupuncture in painful situations, the use of this treatment should be further clarified. Nociception is mediated by the activation of nociceptors, such as transient receptor potentials (TRPs). The family of TRPs includes TRPV1, TRPM8, and TRPA1, which can be stimulated by substances such as capsaicin, menthol, and methyl salicylate, respectively. Objectives: This study aimed to investigate the role of TRPs in antinociception via the administration of agonists of these receptors in the Zusanli acupoint (ST36) in models of inflammatory, acute, and neuropathic pain. Methods : Male Wistar rats were used for this experiment. All rats received a subcutaneous injection of TRP agonists (capsaicin, menthol, or methyl salicylate) in ST36; saline was injected as control. Nociception was evaluated using the electronic mechanical threshold test and tail-flick test before the administration of complete Freund’s adjunct or chronic constriction injury of the sciatic nerve and after the administration of TRP agonists. Results : Nociception was found to be attenuated after treatment with TRP agonists. The administration of different doses (0.03, 0.3, and 3.0 μg/20 μL) of capsaicin, menthol, and methyl salicylate in the different pain models (neuropathic, inflammatory, and nociceptive) induced antinociception in most of the evaluated time points. Conclusion : Based on the findings, we suggest that the activation of TRPV1, TRPM8, and TRPA1 receptors results in the antinociceptive effect of the stimulation of the ST36 acupoint. Thus, TRP receptors may present a new therapeutic opportunity for the control of inflammatory and neuropathic pain

The combined effect of acupuncture and Tanacetum parthenium on quality of life in women with headache: randomised study

Background The aim of the present study was to investigate the efficacy and tolerability of acupuncture (AC), Tanacetum (TAN) or combined treatment on quality of life in women with chronic migraine (CM). Methods A total of 69 women volunteers were randomly divided into 3 groups: AC, acupuncture administered in 20 sessions over 10 weeks (n=22); TAN, at 150 mg/day (n=23); and AC+TAN (n=23). The primary outcome was Short-Form 36 (SF-36) quality of life assessment score. Secondary outcomes included the Migraine Disability Assessment (MIDAS) and visual analogue scale (VAS) score experienced after randomisation. Results AC+TAN was statistically significantly more effective than AC or TAN alone in overall health-related quality of life (SF-36; p<0.05), on MIDAS score (-35.1 (10.6) AC vs -24.8 (11.7) TAN vs -42.5 (9.8) AC+TAN; p<0.05) and in reducing the mean score of pain on VAS (-5.6 (2.4) AC vs -3.7 (2.1) TAN vs -6.4 (3.1) AC+TAN; p<0.05). Conclusions The present work shows an improvement of the quality of life and better analgesic effect of acupuncture combined with TAN treatment on migraine pain in women when compared with acupuncture or TAN alone

Papel da educação após o medo pandêmico do COVID-19: uma perspectiva multidisciplinar e científica

In response to the outbreak of the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), pathogen of the new coronavirus disease (COVID-19), several sectors and social activities have been affected, including education. At first, it is explained that educators and students can feel fragile during and after the SARS-CoV-2 outbreak. Subsequently, it is discussed that their relationship ought to be carefully established given the triggering of psychological and neuropsychiatric effects arising from neural coding and plasticity processes, which result in the formation of positive and negative memories in the short to long term. Finally, it is pointed out that the SARS-CoV-2 pandemic generates a need for adequacy and adaptation for the significant attention to students during the re-starting of studies, given that possible disorders of sensory modulation and involvement of limbic brain areas triggered in situations of risk of death, potential or real threat, can happen. It is assumed that at times of the SARS-CoV-2 pandemic, in addition to preserving life, one of the challenges is the behavioural (re)organisation, which includes habits from the educational context that need to contemplate a scientific perspective, seeking to transform the consequences of the pandemic fear on opportunities to reinforcement of familiar links. In the context of modern rationality, the SARS-CoV-2 pandemic is also a period to think about the relationship between scientific knowledge and common sense. With this logic, neurosciences can develop a new format for the teaching-learning process, so that educators and students experiencing the pandemic threatening do not manifest psychological distress and secondary consequences. Therefore, education can be considered a central space in decision-making in the face of SARS-CoV-2 pandemic. In this sense, the urgency of a multidisciplinary strategies development is highlighted, connecting the synergy between neurosciences and education after the COVID-19 pandemic

Effect of Systemic and Auricular Acupuncture with a 2/100 Hz Frequency and Nogier Frequency in Fibromyalgia: a Randomized Clinical Trial, Pilot Study

Background : Fibromyalgia is a syndrome of chronic, generalized muscular pain, accompanied by sleep disturbances, fatigue and cardic autonomic dysfunction that will affect the quality of life. There is currently no gold standard treatment. There are limitations of studies with electroacupuncture in auricular acupuncture. Objectives: We evaluate the effects of systemic electroacupuncture (EA) with frequencies of 2/100 Hz associated of auricular acupuncture with a Nogier frequency (2.28, 4.56 and 9.12 Hz) for pain intensity, heart rate variability (HRV), and quality of life in fibromyalgia. Methods : Randomized clinical trial, a pilot study. Eighteen volunteers were randomized into a control group (CG, n = 9) and an experimental group (EG, n = 9). Six systemic EA sessions systemic and auricular were applied in the EG for 20 min, twice a week, for six weeks consecutive. The Numerical Pain Assessment Scale (NPRS), 2010 diagnostic criteria of the American College of Rheumatology (FDC 2010), Fibromyalgia Impact Questionnaire (FIQ) and analysis of HRV were the instruments used. The independent t-test compared to the groups was applied. Results : There was no statistically significant difference for the primary outcome for NPRS (p > 0.05). In the secondary outcome there was a significant difference in the total score and in some FIQ domains (p = 0.008) and some variables such as pain (p = 0.02) and anxiety (p = 0.006). There was no significant difference for the FDC 2010 and HRV variables (p > 0.05). Conclusion : 2/100 Hz systemic EA associated with the Nogier frequency positively influenced some quality of life variables; however, pain intensity, diagnostic criteria, and HRV variables did not change

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc