Effect Of Virtual Therapy On Upper Limb Motor Rehabilitation Of Children With Hemiparesis [efeito Da Terapia Virtual Na Reabilitação Motora Do Membro Superior De Crianças Hemiparéticas]

Objective. This study aimed to investigate the effect of virtual therapy on the motor ability of hemiparetic children's upper limb. Method. The sample consisted of three hemiparetic children (8.66±2.30 years). The Pediatric Evaluation of Disability of Inventory (PEDI) and Motor Activity Inventory (MAL) were used for initial and final assessments and the number of hits in each game was counted as well. For the treatment, a hardware (video game) was used, Nintendo brand, model Wii Sports software, using the games (tennis, baseball, golf, boxing). During a period of two weeks, the therapy lasted for 1 hour and 10 minutes each day, consecutively. Results. There was statistical difference in two children in the PEDI (p=0,00) and in the MAL, related to the quality of the upper limb's use (p=0,00) where as relation to the frequency of use, there was statistical difference in all three children in all four games had a increase. Conclusion. It was concluded that the use of Virtual Reality can promote functional gain for hemiparetic children's upper limb.214556562Costa, M.C.F., Bezerra, P.P., Oliveira, A.P.R., Impacto da hemiparesia na simetria e na transferência de peso: Repercussões no desempenho funcional (2006) Rev Neurocienc, 14, pp. 10-13Ortega, D.S., O Paciente Neurológico/Neurocirúrgico Pediátrico (2007) Fisioterapia Respiratória Em Pediatria E Neonatologia, pp. 176-195. , Sarmento GJV., Barueri: ManoleGomes, F.L., Fraqueza Muscular (2007) Guias De Medicina, pp. 1857-1871. , Lopes AC, José FF, Lopes Rd., Barueri: ManoleMorais, G.F.S., Nascimento, L.R., Glória, A.E., Salmela, L.F.T., Paiva, C.M.R., Lopes, T.A.T., A influência do fortalecimento muscular no desempenho motor do membro superior parético de indivíduos acometidos por Acidente Vascular Encefálico (2008) Acta Fisiatr, 15, pp. 245-248Nascimento, L.R., Glória, A.E., Habib, E.S., Effects of constraint-induced movement therapy as a rehabilitation strategy for the affected upper limb of children with hemiparesis: Systematic review of the literature (2009) Rev Bras Fisioter, 13, pp. 97-102. , http://dx.doi.org/10.1590/S1413-35552009005000022Gianni, M.A.D.C., Paralisia Cerebral - Aspectos clínicos (2005) Fisioterapia: Aspectos Clínicos E Práticos Da Reabilitação, pp. 13-25. , Moura EW, Silva PAC., 3 ed. São Paulo: Artes MédicasMarinho, A.P.S., Souza, M.A.B., Pimentel, A.M., Desempenho funcional de crianças com paralisia cerebral diparéticas e hemiparéticas (2008) Rev Cien Med Biol, 7, pp. 57-66Carvalho, L.F.A., Affonseca, C.A., Guerra, S.D., Ferreira, A.R., Goulart, E.M.A., Traumatismo Cranioencefálico Grave em Crianças e Adolescentes (2007) Rev Bras Ter Int, 19, pp. 98-106. , http://dx.doi.org/10.1590/S0103-507X2007000100013Junior, A.L., Conduta frente à criança com trauma craniano (2002) J Ped, 78, pp. 40-47Jerônimo, R.A., Lima, S.M.P.F., Tecnologias Computacionais e ambientes virtuais no processo terapêutico de reabilitação (2006) Mundo Saúde, 30, pp. 96-106Kisner, C., Tori, R., Introdução à Realidade Virtual, Realidade misturada e hiperrealidade (2004) Realidade Virtual: Conceitos E Tendências, pp. 3-20. , Kisner C, Tori R, São Paulo: Mania de LivroBroeren, J., (2012) Virtual Rehabilitation: Implications For Persons With Stroke(endereço Na Internet), , http://gupea.ub.gu.se/bitstream/2077/7329/1/PhD_Thesis_Jurgen_Broeren.pdf, Gothenburg, Sweden: Gothenburg University Publications Electronic Archive (GUPEA).(atualizado em 2011assessado em). Disponível emDeuschle, V.P., Cechella, C., O déficit em consciência fonológica e sua relação com a dislexia: Diagnóstico e intervenção (2009) Rev CEFAC, 11, pp. 194-200. , http://dx.doi.org/10.1590/S1516-18462008005000001Silva, M.F.M.C., Kleinhans, A.C.S., Processos cognitivos e plasticidade Cerebral na Síndrome de Down (2006) Rev Bras Ed Esp, 12, pp. 123-138Vasconselos, R.L.D.M., Moura, T.L., Campos, T.F., Lindquist, A.R.R., Guerra, R.O., Avaliação do desempenho funcional de crianças com paralisia cerebral de acordo com os níveis de comprometimento motor (2009) Rev Bras Fisioter, 13, pp. 390-397. , http://dx.doi.org/10.1590/S1413-35552009005000051Fonseca, J.O., Cordani, L.K., Oliveira, M.C., Aplicação do inventário de avaliação pediátrica de incapacidade (PEDI) com crianças portadoras de paralisia cerebral tetraparesia espástica (2005) Rev Ter Ocup USP, 16, pp. 67-74Carlberg, E.B., Vollestad, N.K., Everyday functioning in Young children with cerebral palsy: Functional skills, caregiver assistance, and modifications of the environment (2003) Dev MedChild Neurol, 45, pp. 603-612Uswatte, G., Taub, E., Implications of the Learned Nonuse Formulation for Measuring Rehabilitation Outcomes: Lessons From Constraint-Induced Movement Therapy (2005) Rehabil Psychol, 50, pp. 34-42. , http://dx.doi.org/10.1037/0090-5550.50.1.34Wolf, S.L., Lecraw, D.E., Barton, L.A., Jann, B.B., Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients (1989) Exp Neurol, 104, pp. 125-132. , http://dx.doi.org/10.1016/S0014-4886(89)80005-6Paz, L.P.D.S., (2007) Quantidade E Qualidade Do Uso Da Extremidade Superior Parética Após Acidente Cerebrovascular, , [dissertação]. Campinas: Faculdade de Ciências Médicas da Universidade Estadual de Campinas, UnicampJang, S.H., You, S.H., Hallett, M., Cho, Y.W., Park, C.M., Cho, S.H., Cortical Reorganization and Associated Functional Motor Recovery After Virtual Reality in Patients With Chronic Stroke: An Experimenter-Blind Preliminary Study (2005) Arc Phys Med Rehabi, 86, pp. 2218-2223. , http://dx.doi.org/10.1016/j.apmr.2005.04.015Flynn, S., Copar, S., Ghate, N., Harris, M., Palma, P., Bender, A., Effects of Virtual Reality Immersion In Individuals With Central Nervous System Injury, , http://www.temple.edu/ispr/prev_conferences/proceedings/2007/Flynn,%20et%20al.pdf, (endereço na internet). Philadelphia: Temple University. (atualizado em 2012acessado em 2012), Disponível emReid, D.T., The influence of virtual reality on playfulness in children with cerebral palsy: A pilot study (2004) Occup Ther Inte, 11, pp. 131-144. , http://dx.doi.org/10.1002/oti.202Deutsch, J.E., Borbely, M., Filler, J., Huhn, K., Bowlby, P.G., Use of a Low-Cost, Commercially Available Gaming Console (Wii) for Rehabilitation of an Adolescent With Cerebral Palsy Phys Ther2008, 88, pp. 1196-1207. , http://dx.doi.org/10.2522/ptj.20080062Weiss, P.L., Rand, D., Katz, N., Kizony, R., Video capture virtual reality as a flexible and effective rehabilitation tool (2004) J NeuroEngin Rehabil, 12, pp. 1-12Ferreira, L.R., Silva, A.T., Deamo, R.A.A., (2008) Utilização Da Realidade Virtual Como Recurso Terapêutico: Estudo De Caso, , [dissertação]. Itajubá: Centro Universitario de Itajubá: UniversitasGriffiths, M., The educational benefits of videogames Video games have great positive potential in addition to their entertainment value and there has been considerable success when games are designed to address a specific problem or to teach a certain skill (2002) Edu Health, 20, pp. 47-51You, S.H., Jang, S.H., Kim, Y.H., Cortical reorganization induced by virtual reality therapy in a child with hemiparetic cerebral palsy (2005) Dev Med Child Neurol, 47, pp. 628-635. , http://dx.doi.org/10.1111/j.1469-8749.2005.tb01216.

Comparação cinemática e neuromuscular de um exercício de abdominais no solo e na fitball

O objectivo deste estudo foi comparar a cinemática e a actividade neuromuscular em exercícios de abdominais no solo e na Fitball. Quinze jovens mulheres participaram voluntariamente neste estudo. Cada sujeito efectuou duas vezes, três séries de dez abdominais com um intervalo mínimo de 60 segundos entre cada série. O exercício foi efectuado uma vez no solo e outra na Fitball. Os dados cinemáticos e neuromusculares foram recolhidos ao longo de todo o protocolo. Foi avaliada a actividades neuromuscular do recto femoral, do recto abdominal superior, do recto abdominal inferior e do oblíquo externo. Um electrogoniómetro foi colocado entre a sexta costela e a crista ilíaca (coluna) e outro entre a crista ilíaca e a zona trocantérica (anca) para avaliação cinemática. O período do exercício entre as condições em estudo não foi significativo. O ângulo mínimo da anca e da coluna lombar foram significativamente inferiores durante a execução do exercício no solo do que na Fitball. A actividade neuromuscular foi significativamente superior quando o exercício foi realizado na Fitball do que no solo em todos os grupos musculares. Como conclusão, actividade neuromuscular é superior aquando da exercitação na Fitball do que no solo

Patient safety culture: radiographers’ perception

Research to evaluate radiographers’ perceptions about patient safety culture in Portuguese public and private imaging facilities found that overall perception is positive but the safety culture dimensions rating should guide culture development of safety culture improvement action plans.info:eu-repo/semantics/publishedVersio

Prevalence of diabetes-associated gene variants and its association with blood glucose levels in the Algarve population, Portugal

The global rise in incidence of type 2 (T2D) has been called a pandemic, constituting a major public health concern. Although environmental factors play a substantial role in the etiology of T2D, genetic susceptibility has been established as a key component in T2D risk. Given the absence of studies regarding the prevalence of T2D associated variants in the Portuguese population, our aim was to determine the prevalence of disease-associated variants and determine its relative contribution to this phenotype. For this purpose, we have recruited 221 individuals (93 males and 128 females), between 26-91 years old (mean age 57.1), who were enrolled in the Health Centre of S. Brás de Alportel (Algarve). For each participant, we have measured total glucose levels and collected DNA. In addition, each participant has answered an exhaustive questionnaire including socio-demographic information, health history and lifestyle. We have selected and analysed three of the most significant loci previously reported to be associated with T2D in Caucasian populations (TCF7L2 rs7903146, PARPG rs1801282 and FTO rs9939609) and performed an association analysis between glucose levels in this population and the selected gene variants. The mean total population glucose level was 103.85±35.3 g/dl. We found a significant difference in the mean glucose levels between males (mean = 111.5±51.3 g/dl) and females (mean = 98.4±17.6 g/dl) (Mann-Whitney test P < 0.001). The relative allele frequencies of the genotyped variants have been established. Genotype distribution for all investigated SNPs was in Hardy-Weinberg equilibrium. We found a marginal association between glucose levels and genotypes at the TCF7L2 locus (Mann-Whitney test P = 0.045) in females but not in males, with carriers of the T allele displaying higher levels of blood glucose than homozygous for the A allele. This difference is also observed in males, although not reaching significance. No association was found between glucose levels and the other genotyped variants. These results suggest that the pathophysiology of the disease may be different between males and females, or that environmental factors are influencing this trait in males. We are currently investigating the later hypothesis by increasing our sample size and by analysing lifestyle information provided by the participants in order to evaluate gene-environment interactions influencing glucose levels in the Portuguese population.The pilot study of the Portuguese Component of the European Health Examination Survey (EHES) project has received funding from the European Commission/DG Sanco (Agreement number: 20092301 – EHES JA – EAHC). This study has also received funding from the Portuguese Foundation for Science and Technology (FCT) (Project Reference: PTDC/SAU-ESA/101743/2008)

Prevalence of alpha-1 antitrypsin deficiency and hereditary hemochromatosis gene mutations in Algarve, Portugal

Alpha-1 antitrypsin (AAT) deficiency and hereditary hemochromatosis (HH) are two of the most fatal genetic disorders in adult life, affecting million individuals worldwide. They are often under-diagnosed conditions and diagnosis is only made when the patient is already in the advanced stages of damage. AAT deficiency results from mutations in one highly pleiomorphic gene located on chromosome 14, SERPINA 1, being Z and S mutations the most relevant clinically. These mutations will lead to an AAT deficit that compromises the lungs protection, originating emphysema, chronic bronchitis, asthma or even chronic obstructive pulmonary disease (COPD) and it is also strongly associated with various liver diseases. On the other hand, C282Y and H63D mutations in the HFE gene, located on chromosome 6, are reported to be mostly responsible for the iron accumulation in HH disorder, leading to severe damage in different organs. Disease manifestations include cirrhosis, hepatic fibrosis, diabetes mellitus, arthropathy and hepatocarcinoma. Given the insufficient population-based information about the prevalence of these gene variants in the Portuguese population, the aim of this study was to assess their frequency in a representative sample from São Brás de Alportel, in the South of Portugal. To achieve our goal, we have genotyped a total of 208 adult subjects, including 118 females and 90 males (mean age: 58 years, range: 26-91). Regarding AAT deficiency, we found 4,3% MZ, 0,5% SS and 15,4% MS genotypes. The calculated frequency for the Z allele was 2,2% (95% CI: 0-11,7%) and for the S allele was 8,2% (95% CI: 0-17,4%). About HH, we found 1,4% C282Y/H63D, 2,4% H63D/H63D, 5,8% C282Y/N and 23,6% H63D/N genotypes. Frequencies of C282Y and H63D alleles were 3,6% (95% CI: 0-13%) and 14,9% (95% CI: 6-23,8%), respectively. The observed allele frequencies were in Hardy-Weinberg Equilibrium and no association was found with related diseases likely due to the smaller sample available. Our findings show the highest prevalence of Z allele from SERPINA1 gene found, when compared to other populations. The remaining findings are in agreement with previously published studies. Future studies involving a larger sample size will be necessary to evaluate the penetrance of the studied gene mutations and to assess gene-environment interactions that influence disease risk, contributing to reduce the burden of these diseases which can have a great public health impact.The pilot study of the Portuguese Component of the European Health Examination Survey (EHES) project has received funding from the European Commission/DG Sanco (Agreement number: 20092301 – EHES JA – EAHC). This study has also received funding from the Portuguese Foundation for Science and Technology (FCT) (Project Reference: PTDC/SAU-ESA/101743/2008)

Genetic variation at the CY2C19 gene associated with Metabolic Syndrome susceptibility in a South Portuguese population

Metabolic syndrome (MetS) is a cluster of conditions — increased blood pressure, high blood glucose level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing the risk of heart disease, stroke and diabetes. In Portugal, the MetS prevalence is estimated to be 27,5% with regional variations, being highest in the Alentejo (30,99%) and lowest in the Algarve (24,42%), constituting a public health problem. Although for clinical settings, a binary definition of MetS enabling a yes or no diagnosis is useful, it is clear that dichotomizing a continuous outcome variable reduces the statistical power of the MetS association studies. Therefore, the aim of the present study is to identify genetic risk factors involved in MetS etiology, using a continuous MetS score. To achieve our goal, a principal component analysis was performed to compute a score using the six normalized risk factors for MetS (waist circumference, diastolic and systolic blood pressure, glucose, triglycerides and HDL blood levels), with a higher MetS score indicating a less favorable MetS profile. After calculating this score, an association study was performed using 37 SNPs in candidate genes involved in MetS related diseases. A total of 206 subjects, including 119 women and 87 men (mean age: 56,31± 16,37 years, range: 26-91 years) were included in this analysis. We found 4 SNPs significantly associated with higher MetS scores (rs4244285 (CYP2C19), rs279871 (GABRA2), rs1647 (NPY) and rs1142345(TPMT)). P-values are 4,36x10-4, 1,3x10-2, 1,7x10-2 and 9,76x10-3 respectively. After correcting for multiple testing only rs4244285 (CYP2C19) remains significant (p=0,016). In addition, we have performed a multiple regression analysis considering the CYP2C19 genotype as the independent variable, adjusted for age. The resulting model explains 17% of the MetS score variance. After adding the remaining SNP genotypes that do not survive the multiple testing correction, the same model is able to explain 23,1% of the score. Our findings support the evidence of an association between CYP2C19 rs4244285 gene polymorphism and the MetS score, emphasizing the importance of lipid metabolism, thought cytochrome P450 enzymes, in the MetS etiology. However, further studies will be necessary to replicate these findings in different populations as well as functional studies to clarify the role of this variant in the etiology of MetS.The pilot study of the Portuguese Component of the European Health Examination Survey (EHES) project has received funding from the European Commission/DG Sanco (Agreement number: 20092301 – EHES JA – EAHC). This study has also received funding from the Portuguese Foundation for Science and Technology (FCT) (Project Reference: PTDC/SAU-ESA/101743/2008)

Effects of shoulder compensatory strength training program in rotator cuff strength of young swimmers

INTRODUCTION The purpose of this study was to evaluate de effects of 16 week compensatory strength training program in shoulder strength and respective conventional ratios (concentric ER/IR). METHODS A total of 40 national level male swimmers were assessed and randomly divided in two groups – experimental group (N=20)-(age:14.65±0.67 years old, height:173.48±6.87 cm, body mass:63.15±5.68 kg) and control group (N=20)-(age:14.60±0.60 years old, height: 170.79±6.48 cm, body mass:61.73±4.68 kg). Experimental subjects participated in a 16 week shoulder strength program with Thera-Band® elastic bands (3 times a week). The peak-torque of shoulder internal (IR) and external rotators (ER) was measured in both groups at baseline and after 16 weeks. Concentric action at 60º/s (3 rep) and 180º/s (20 rep) were measured, in a seated position, with the shoulder at 90º of abduction and the elbow flexed to 90º, using an isokinetic dynamometer (Biodex System 3 – Biodex Corp., Shirley, USA). Anova with repeated measures was used to determine significant main effects in shoulder rotators strength and unilateral ER/IR ratios. The level of significance was set at 0.05. RESULTS Significant differences were found in all variables that measure the ER shoulder strength at 60º/s in dominant(DT) (P=0.031) and non-dominant(NDT) shoulder (P=0.001). Meanwhile concentric action at 180º/s, only showed significant differences on DT shoulder (P=0.032). In respect of ER/IR ratio, a compensatory strength training programme induces significant differences in both shoulders at 60º/s (DT: P=0.001; NDT: P=0.001). At 180º/s we just found significant effects on the DT ER/IR ratio (P=0.002). DISCUSSION The results of this study support earlier research [1] that showed that the unilateral shoulder strength ratios increases substantially after a period of a strength training program. Since the ratios describe the quality of muscular balance/imbalance [1], we can conclude that a 16 week compensatory shoulder strength training program using Thera-Band® elastic bands, reduces muscular imbalances in rotator cuff of competitive young swimmers. These results highlight the useful of this kind of compensatory program to prevent shoulder injuries

Facts related to the collection of biological samples in the National Health Examination Survey - Portuguese Component of the European Health Examination Survey

Abstrat disponível em: http://www.ichg2011.org/cgi-bin/showdetail.pl?absno=11013The objective of the National Health Examination Survey (NHES), which corresponds to the Portuguese component of the European Health Examination Survey (EHES), is to collect health data, related risk factors and biological samples of the Portuguese population, using the EHES recommended methodology. These surveys involve an interview, clinical and physical measurements and blood collection. In this context, we herein describe the pilot study performed in S. Brás de Alportel in the Algarve region. For this pilot study, we have recruited 221 individuals (95 males and 126 females), between 25 and 91 years old, who were enrolled in the Health Centre of S. Brás de Alportel (Algarve). For each participant, we have collected 16.5 ml of total blood, in five different Vacutainer® tubes, which was later processed into serum, plasma and DNA. We have performed several biochemical analyses(total cholesterol, LDL,HDL, glucose, tryglicerides, creatinine, ALT, AST, -GT, CRP and iron) and a complete blood count. From the 221 participants in this pilot study, we were able to collect blood to 219 (99.5%). To 185 of these (84.5%) we were able to collect the total amount of blood. The biochemical analyses were performed in all the samples. The total blood count was performed in 103 samples (47%) due to transport constraints. We have also collected DNA from 210 participants (95.9%). We have created a biobank comprising 1847 serum aliquots and 959 plasma aliquots, which have been stored at - 80°C and 210 DNA aliquots which have been stored at 4°C. In conclusion, during this study, we have optimized the logistics and procedures to perform the large scale study for the NHES and EHES. In addition, we have created a biobank comprising detailed questionnaire data, physical and clinical data and biological samples from a representative sample of S. Brás de Alportel in Algarve, Portugal. This biobank will allow us to perform future studies, including the determination of the prevalence of gene variants of public health interest, the characterization of gene-environment interactions in the development of chronic diseases and the genetic structure of the Portuguese population. The success rate, the quality of the data and of the biological samples was high and comparable to similar studies.Fundação para a Ciência e Tecnologia e European Commission/DG Sanc

Soil biochemistry and microbial activity in vineyards under conventional and organic management at Northeast Brazil.

The São Francisco Submedium Valley is located at the Brazilian semiarid region and is an important center for irrigated fruit growing. This region is responsible for 97% of the national exportation of table grapes, including seedless grapes. Based on the fact that orgThe São Francisco Submedium Valley is located at the Brazilian semiarid region and is an important center for irrigated fruit growing. This region is responsible for 97% of the national exportation of table grapes, including seedless grapes. Based on the fact that organic fertilization can improve soil quality, we compared the effects of conventional and organic soil management on microbial activity and mycorrhization of seedless grape crops. We measured glomerospores number, most probable number (MPN) of propagules, richness of arbuscular mycorrhizal fungi (AMF) species, AMF root colonization, EE-BRSP production, carbon microbial biomass (C-MB), microbial respiration, fluorescein diacetate hydrolytic activity (FDA) and metabolic coefficient (qCO2). The organic management led to an increase in all variables with the exception of EE-BRSP and qCO2. Mycorrhizal colonization increased from 4.7% in conventional crops to 15.9% in organic crops. Spore number ranged from 4.1 to 12.4 per 50 g-1 soil in both management systems. The most probable number of AMF propagules increased from 79 cm-3 soil in the conventional system to 110 cm-3 soil in the organic system. Microbial carbon, CO2 emission, and FDA activity were increased by 100 to 200% in the organic crop. Thirteen species of AMF were identified, the majority in the organic cultivation system. Acaulospora excavata, Entrophospora infrequens, Glomus sp.3 and Scutellospora sp. were found only in the organically managed crop. S. gregaria was found only in the conventional crop. Organically managed vineyards increased mycorrhization and general soil microbial activity