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Strength training improves fall-related gait kinematics in the elderly: a randomized controlled trial

Persch, Leslie N.; Ugrinowitsch, Carlos; Pereira, Gleber; Rodacki, Andre L. F.
Fonte: ELSEVIER SCI LTD Publicador: ELSEVIER SCI LTD
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.38%
Background: Falls are one of the greatest concerns among the elderly. Among a number of strategies proposed to reduce the risk of falls, improving muscle strength has been applied as a successful preventive strategy. Although it has been suggested as a relevant strategy, no studies have analyzed how muscle strength improvements affect the gait pattern. The aim of this study was to determine the effects of a lower limb strength training program on gait kinematics parameters associated with the risk of falls in elderly women. Methods: Twenty seven elderly women were assigned in a balance and randomized order into an experimental (n = 14: age = 61.1 (4.3) years, BMI = 26.4 (2.8) kg m(-2)) and a control (n = 13; age = 61.6 (6.6) years; BMI = 25.9 (3.0) kg m(-2)) group. The EG performed lower limb strength training during 12 weeks (3 days per week), being training load increased weekly. Findings: Primary outcomes were gait kinematics parameters and maximum voluntary isometric contractions at pre- and post-training period. Secondary outcomes were training load improvement weekly and one repetition maximum every two weeks. The I maximal repetition increment ranged from 32% to 97% and was the best predictor of changes in gait parameters (spatial...

Efeitos de um treino em ambiente virtual sobre o desempenho da marcha e funções cognitivas em idosos saudáveis; Effects of a training in virtual environment about gait performance and cognitive functions in healthy elderly

Lobo, Alexandra Modenesi
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 17/05/2013 PT
Relevância na Pesquisa
36.42%
O objetivo do presente estudo foi comparar os efeitos de dois tipos de programas de treinamento do equilíbrio e marcha, um baseado no Nintendo Wii Fit® e o outro baseado em exercícios convencionais sem a utilização do videogame, na eficiência da marcha, funções cognitivas e funcionalidade de idosos saudáveis. Trata-se de um ensaio clínico, cego e randomizado realizado no Departamento de Fonoaudiologia, Fisioterapia e Terapia Ocupacional no Laboratório de Aprendizagem Sensório-Motora (LASM) da Universidade de São Paulo. Participaram do estudo 32 idosos saudáveis que foram randomizados em grupo experimental (n=16) e grupo controle (n=16). Ambos os grupos realizaram 14 sessões individuais de treinamento, duas vezes na semana por sete semanas. As sessões eram divididas em duas partes: a primeira parte era composta de 30 minutos de exercícios globais que incluíam alongamento e fortalecimento muscular além de mobilidade axial; a segunda parte era composta de 30 minutos de exercícios de equilíbrio e marcha. O grupo experimental realizou os exercícios de equilíbrio e marcha por meio de 10 jogos do vídeogame Nintendo Wii Fit®, que promoviam a estimulação cognitiva e motora por meio da realimentação visual e auditiva. Já o grupo controle realizou os exercícios sem nenhuma estimulação cognitiva associada. As principais medidas do estudo foram: (1) Functional Gait Assessment (FGA); (2) Montreal Cognitive Assessment (MoCA); (3) Índice do Andar Dinâmico (IAD); (4) Falls Efficacy Scale (FES-I); (5) Teste da marcha de 30 segundos em condição de simples tarefa e dupla tarefa. A análise estatística foi realizada por meio da ANOVA de medidas repetidas e pós hoc teste de Tukey para a verificação de possíveis diferenças entre grupos e avaliações...

Stretching Exercise Program Improves Gait in the Elderly

Cristopoliski, Fabiano; Barela, Jose Angelo; Leite, Neiva; Fowler, Neil E.; Felix Rodacki, Andre L.
Fonte: Karger Publicador: Karger
Tipo: Artigo de Revista Científica Formato: 614-620
ENG
Relevância na Pesquisa
36.35%
Background: Ageing is characterized by a number of physical changes that contribute to a decline in the ability to perform daily tasks. Stretching has been proposed to reduce hip flexion contracture and increase hip and pelvis range of motion, thus improving gait performance. Objective: The purpose of this study was to determine whether a supervised stretching program designed to improve the range of motion of the lower limbs alters gait kinematics in older adults. Methods: Twenty healthy older adult women (65.9 +/- 4.2 years old and BMI 24.9 +/- 3.5) were divided into 2 groups. The experimental group undertook 12 sessions of stretching exercises, whereas the control group did not engage in any physical activity. Gait performance was assessed at the beginning of the experiment and after the 4-week intervention period. Results: Those in the experimental group showed increased step length, higher velocity and reduced double support time after training. In addition, participants involved in the stretching program showed greater anterior and lateral pelvis tilt and also greater rotation (p < 0.05). Conclusions: Based on our results, we can suggest that a supervised stretching program is effective to alter a number of gait variables. Moreover...

Effect of treadmill gait on bone markers and bone mineral density of quadriplegic subjects

Carvalho,D.C.L.; Garlipp,C.R.; Bottini,P.V.; Afaz,S.H.; Moda,M.A.; Cliquet Jr.,A.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2006 EN
Relevância na Pesquisa
36.4%
Quadriplegic subjects present extensive muscle mass paralysis which is responsible for the dramatic decrease in bone mass, increasing the risk of bone fractures. There has been much effort to find an efficient treatment to prevent or reverse this significant bone loss. We used 21 male subjects, mean age 31.95 ± 8.01 years, with chronic quadriplegia, between C4 and C8, to evaluate the effect of treadmill gait training using neuromuscular electrical stimulation, with 30-50% weight relief, on bone mass, comparing individual dual-energy X-ray absorptiometry responses and biochemical markers of bone metabolism. Subjects were divided into gait (N = 11) and control (N = 10) groups. The gait group underwent gait training for 6 months, twice a week, for 20 min, while the control group did not perform gait. Bone mineral density (BMD) of lumbar spine, femoral neck, trochanteric area, and total femur, and biochemical markers (osteocalcin, bone alkaline phosphatase, pyridinoline, and deoxypyridinoline) were measured at the beginning of the study and 6 months later. In the gait group, 81.8% of the subjects presented a significant increase in bone formation and 66.7% also presented a significant decrease of bone resorption markers, whereas 30% of the controls did not present any change in markers and 20% presented an increase in bone formation. Marker results did not always agree with BMD data. Indeed...

Influence of a physical training program on muscle strength, balance and gait velocity among women with osteoporosis

Aveiro,MC; Granito,RN; Navega,MT; Driusso,P; Oishi,J
Fonte: Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia Publicador: Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2006 EN
Relevância na Pesquisa
36.44%
OBJECTIVES: The trend towards increased life expectancy will certainly lead to increases in morbidity and mortality relating to osteoporosis. Because of the lack of well defined protocols on the intensity and frequency of easily performed physical exercises for Brazilian women, this study proposed to analyze the effects of a training program for ankle muscle strength, balance performance and gait velocity among women with a densitometric diagnosis of osteoporosis. METHODS: Twelve female volunteers (age 68.7 ± 2.7 years) underwent physical evaluation and subsequent reevaluation after twelve weeks. The physical activity program was guided by a physical therapist, who conducted 60-minute sessions, three times a week for twelve weeks. Each training session included some stretching exercises, strengthening exercises for the ankle dorsiflexor and plantar-flexor muscles, with 50% of 10-repetition maximum (10-RM), and balance training. RESULTS: The variables analyzed regarding balance index, gait velocity and muscle strength presented significant improvement (p < 0.05), as shown by the Wilcoxon non-parametric test. CONCLUSION: After the 12-week exercise program, the participants presented benefits in terms of their fitness. The results demonstrate that the training had a role in improving the condition of this group of patients...

Effects of adding load to the gait of children with cerebral palsy: a three-case report

Simão,Camila Rocha; Galvão,Élida Rayanne Viana Pinheiro; Fonseca,Débora Oliveira da Silveira; Bezerra,Dayse Aleixo; Andrade,Amanda Capistrano de; Lindquist,Ana Raquel Rodrigues
Fonte: Universidade de São Paulo Publicador: Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2014 EN
Relevância na Pesquisa
36.33%
Our purpose in this study was to analyze the immediate effects of locomotor gait training with different loads on a treadmill on the kinematic parameters of gait in children with Spastic Hemiparetic Cerebral Palsy (SHCP), as well as investigating which load prompted the most adequate motor responses to promote the propulsion of the Paretic Lower Limb (PLL). This case report included 3 children of both sexes, aged 8-12 years. The children walked on the treadmill with loads on their ankles that corresponded to 40, 50 and 60% of the weight of the Lower Limb (LL), on 3 different non-consecutive days. The kinematic parameters were assessed during the pre-training phase (PTPH) and immediately after training (PHI). The spatiotemporal variables did not change immediately after gait training with the aforementioned loads. On the other hand, we observed wider joint angles in the hip and knee during the swing phase immediately after training, especially with a load of 60% of the weight of the lower limb. These findings indicate that the 60% load is the most appropriate to prompt immediate changes in the joint kinematics of the PLL. These alterations can be important in improving propulsion during the swing phase of gait in children with SHCP.

Dynamic Principles of Gait and Their Clinical Implications

Kuo, Arthur D.; Donelan, J. Maxwell
Fonte: American Physical Therapy Association Publicador: American Physical Therapy Association
Tipo: Artigo de Revista Científica
Publicado em /02/2010 EN
Relevância na Pesquisa
36.41%
A healthy gait pattern depends on an array of biomechanical features, orchestrated by the central nervous system for economy and stability. Injuries and other pathologies can alter these features and result in substantial gait deficits, often with detrimental consequences for energy expenditure and balance. An understanding of the role of biomechanics in the generation of healthy gait, therefore, can provide insight into these deficits. This article examines the basic principles of gait from the standpoint of dynamic walking, an approach that combines an inverted pendulum model of the stance leg with a pendulum model of the swing leg and its impact with the ground. The heel-strike at the end of each step has dynamic effects that can contribute to a periodic gait and its passive stability. Biomechanics, therefore, can account for much of the gait pattern, with additional motor inputs that are important for improving economy and stability. The dynamic walking approach can predict the consequences of disruptions to normal biomechanics, and the associated observations can help explain some aspects of impaired gait. This article reviews the basic principles of dynamic walking and the associated experimental evidence for healthy gait and then considers how the principles may be applied to clinical gait pathologies.

Dalfampridine: Review of its Efficacy in Improving Gait in Patients with Multiple Sclerosis

Sahraian, M.A.; Maghzi, A.H.; Etemadifar, M.; Minagar, A.
Fonte: Libertas Academica Publicador: Libertas Academica
Tipo: Artigo de Revista Científica
Publicado em 16/05/2011 EN
Relevância na Pesquisa
36.09%
Multiple sclerosis (MS) is a progressive immune-mediated neurodegenerative disease of human central nervous system (CNS), which causes irreversible disability in young adults. The cause and cure for MS remain unknown. Pathophysiology of MS includes two arms: inflammatory demyelination and neurodegeneration. The inflammatory demyelination of MS which is mainly promoted by a massive activation of the immune system against putative CNS antigen(s) leads to loss of oligodendrocyte/myelin complex which slows down or halts impulse conduction in denuded axons. Practically, loss of myelin significantly reduces signal conduction along the demyelinated axons through alterations in the distribution of axonal ion channels. Dalfampridine (4-aminopyridine or 4-AP) is an oral potassium channel blocker, which was recently approved by FDA for symptomatic treatment of MS. Dalfampridine, which acts at the central and peripheral nervous systems, enhances conduction in demyelinated axons and improves walking ability of MS patients. A number of clinical trials have evaluated the safety and efficacy of fampridine in MS patients with the degree of gait improvement as the main outcome. The objective of this manuscript is to provide an overview of the pharmacology...

An 8-week Aquatic Exercise Program is Effective at Improving Gait Stability of the Elderly

Lim, Hee Sung; Roh, Su Yeon; Yoon, Sukhoon
Fonte: The Society of Physical Therapy Science Publicador: The Society of Physical Therapy Science
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.33%
[Purpose] The purpose of this study was to investigate the effect of 8 weeks aquatic exercise on the gait stability of the elderly using dynamic factors: center of mass (COM), velocity of center of mass (COMV), and center of pressure (COP). [Subjects] Eleven elderly participants (age: 77.18 ± 4.96 yrs, height: 149.48 ± 3.61 cm, body mass: 56.94 ± 6.62 kg, and leg length: 82.36 ± 2.98 cm), participated in this study. [Methods] To identify the 8-week aquatic training effect, 3-D motion analysis with 7 infrared cameras and one force plate, was performed. [Results] For the COM-COP inclination angles, significantly decreased medial inclination angles were shown in both the posterior and anterior swing phases. For the COMV-COP inclination angles, decreased medial inclination angles were shown in both the posterior and anterior swing phases, but significant difference was found only in the posterior phase. [Conclusion] The results suggest that 8 weeks aquatic exercise is effective at improving the gait stability of the elderly. Further studies should extend the training period to gain statistically significant results for the effect of aquatic exercise in the anterior-posterior direction.

The Effect of Mirror Therapy Integrating Functional Electrical Stimulation on the Gait of Stroke Patients

Ji, Sang-Goo; Cha, Hyun-Gyu; Kim, Myoung-Kwon; Lee, Chang-Ryeol
Fonte: The Society of Physical Therapy Science Publicador: The Society of Physical Therapy Science
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.3%
[Purpose] The aim of the present study was to examine whether mirror therapy in conjunction with FES in stroke patients can improve gait ability. [Subjects] This study was conducted with 30 subjects who were diagnosed with hemiparesis due to stroke. [Methods] Experimental group I contained 10 subjects who received mirror therapy in conjunction with functional electrical stimulation, experimental group II contained 10 subjects who received mirror therapy, and the control group contained 10 subjects who received a sham therapy. A gait analysis was performed using a three-dimensional motion capture system, which was a real-time tracking device that delivers data in an infrared mode via reflective markers using six cameras. [Results] The results showed a significant difference in gait velocity between groups after the experiment, and post hoc analysis revealed significant differences between experimental group I and the control group and between experimental group II and the control group, respectively. There were also significant differences in step length and stride length between the groups after the experiment, and post hoc analysis revealed significant differences between experimental group I and control group. [Conclusion] The present study showed that mirror therapy in conjunction with FES is more effective for improving gait ability than mirror therapy alone.

Effects of communal exercise with visual and auditory feedback provided by a smart application on gait ability and fear of falling in Parkinson’s disease patients

Park, Yun-Jin
Fonte: Korean Society of Exercise Rehabilitation Publicador: Korean Society of Exercise Rehabilitation
Tipo: Artigo de Revista Científica
Publicado em 31/10/2014 EN
Relevância na Pesquisa
36.25%
Parkinson’s disease is a chronically developing neurodegenerative disease showing typical motor symptoms of the following triad: resting tremor, freezing of gait, and bradykinesia-hypokinesia. In the present study, we investigated the effects of a communal exercise program, using the visual and auditory feedback provided by a smart application, to assess gait ability, fear of falling, and fall efficacy in Parkinson’s disease patients. Subjects consisted of 29 Parkinson’s disease patients who were non-demented individuals. The subjects were randomly divided into three groups: the control group (n= 9, CG), the communal exercise group using the smart application (n= 10, CCEG), and the individual exercise group using the smart application (n= 10, ICEG). The communal exercise program consisted of a warm up (10 min) followed by communal exercise using the smart application (40 min), and a cool down (10 min) for 3 days per week over 10 weeks. The results presented here show that velocity and cadence were significantly increased among groups. Step and stride length were significantly increased among times. Fear of falling and fall efficacy were significantly different among groups and times. In particular, fear of falling was lower and fall efficacy was higher in the CCEG than in the ICEG and CG. These findings indicate that 10 weeks of the communal exercise program using the smart application can be effective in improving gait ability...

Improvement of gait ability with a short-term intensive gait rehabilitation program using body weight support treadmill training in community dwelling chronic poststroke survivors

Takao, Toshifumi; Tanaka, Naoki; Iizuka, Noboru; Saitou, Hideyuki; Tamaoka, Akira; Yanagi, Hisako
Fonte: The Society of Physical Therapy Science Publicador: The Society of Physical Therapy Science
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.35%
[Purpose] Most previous studies have shown that body weight support treadmill training (BWSTT) can improve gait speed poststroke patients. The purpose of this study was to evaluate effectiveness of a short-term intensive program using BWSTT among community dwelling poststroke survivors. [Subjects] Eighteen subjects participated in this study. The treatment group was composed of 10 subjects (2 women; 8 men; mean age, 59.1 ± 12.5 years; time since stroke onset, 35.3 ± 33.2 months), whereas the control group was made up of 8 subjects (3 women; 5 men; mean age, 59.8 ± 6.3 years; time since stroke onset, 39.3 ± 27.3 months). [Methods] The treatment group received BWSTT 3 times a week for 4 weeks (a total of 12 times), with each session lasting 20 minutes. The main outcome measures were maximum gait speed on a flat floor, cadence, and step length. [Results] No differences were observed in the baseline clinical data between the 2 groups. The gait speed in the treatment group was significantly improved compared with that in the control by 2-way ANOVA, while the other parameters showed no significant interaction. [Conclusion] These results suggested that short-term intensive gait rehabilitation using BWSTT was useful for improving gait ability among community dwelling poststroke subjects.

Effect of the class and individual applications of task-oriented circuit training on gait ability in patients with chronic stroke

Song, Hyun Seung; Kim, Jin Young; Park, Seong Doo
Fonte: The Society of Physical Therapy Science Publicador: The Society of Physical Therapy Science
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.33%
[Purpose] This study aimed to determine differences in gait abilities by comparing class-based task-oriented circuit training (CTCT) and individual-based task-oriented circuit training (ITCT). [Subjects and Methods] The subjects were 30 patients who were diagnosed with hemiplegia due to stroke more than six months previously. They were divided into Group I (n=10), which received conventional physiotherapy, Group II (n=10), which received conventional physiotherapy and ITCT, and Group III (n=10), which received conventional physiotherapy and CTCT. To determine the qualitative aspect of gait ability, a GAITRite (CIR Systems Inc., Sparta NJ, USA) was employed, while a two-minute walking test (2MWT) was conducted to determine the quantitative aspect. [Results] The gait ability showed significant differences in velocity, cadence, and 2MWT between groups in the significance test. As a result, the Bonferroni post test showed that gait velocity was significantly different between Groups I and II and between Groups I and III, while cadence showed a significant difference between Groups I and III. In the 2MWT, Groups I and II and Groups I and III also showed significant differences. [Conclusion] Both the individual and class applications task-oriented circuit training were effective for improving gait ability. This result indicates that CTCT can improve the physical ability of stroke patients as much as ITCT.

Effect of paralyzed side soleus muscle pressure on the gait of stroke patients as measured by a three-dimensional motion analysis system

Miura, Nodoka; Katsuhira, Junji; Kurosawa, Kazuo
Fonte: The Society of Physical Therapy Science Publicador: The Society of Physical Therapy Science
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.09%
[Purpose] The purpose of this study was to examine the effects of muscle belly compression by a supporter on the paralyzed side soleus muscle of patients with cerebrovascular disability, and to determine the intensity of compression that is effective for improving gait. [Subjects] Eleven patients with chronic cerebral vascular disorder. [Methods] Before setting the supporter, standing posture and 6 m free walking were measured 3 times with the three-dimensional motion analysis system, VICON. Then, supporters were placed on the center of the lower leg of the hemiplegic side of the subjects and inflated to 30 or 50 mmHg. Three minutes after wearing the supporters, the subjects walked again for 3 times. The data measured with VICON were processed using Visial3D.V4, and the angles of the ankle, steps of the hemiplegic and non-hemiplegic sides, walking speed, walk rate and cadence were calculated. [Results] Compared to without a supporter, a supporter with 30 mmHg pressure showed a significant reduction in the angle of the knee at Initial Contact (IC), and a significant increase in the power of the knee extension at Loading Response (LR). [Conclusion] The results reveal a supporter with that of the subjects during pressure over 30 mmHg applied for 3 minutes improved the knee angle power and hemiplegia walking.

Effects of a multifactorial fall prevention program on balance, gait, and fear of falling in post-stroke inpatients

Jung, Younuk; Lee, Kyeongbong; Shin, Seonhae; Lee, Wanhee
Fonte: The Society of Physical Therapy Science Publicador: The Society of Physical Therapy Science
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.39%
[Purpose] This study investigated the effects of a multifactorial fall prevention program on balance, gait, and fear of falling in stroke patients. [Subjects] Twenty-five stroke patients were divided randomly into multifactorial fall prevention program group (n=15) and control treadmill group (n=10). [Methods] All interventions were applied for 30 min, five times per week, for five weeks. The fall prevention program included interventions based on the “Step Up to Stop Falls” initiative and educational interventions based on the Department of Health guidelines. For those in the treadmill group, the speed was increased gradually. The Korean falls efficacy scale and Korean activities-specific balance confidence scale were used to assess fear of falling. To assess balance and walking ability, the Korean performance-oriented mobility assessment scale and the 10-m and 6-minute walk tests were used. [Results] The fall prevention program interventions were found to be very effective at improving gait, balance, and fear of falling compared with the treadmill intervention and therefore seem appropriate for stroke patients. [Conclusion] A multifactorial fall prevention program is effective at improving balance, gait ability, and fear of falling. It is a more specific and broad intervention for reducing falls among inpatients in facilities and hospitals.

Efeitos do treinamento de dupla tarefa no controle do equilíbrio dinâmico e estático de idosas pré-frágeis: um estudo piloto

Ribeiro, Viviane Silva
Fonte: Universidade Federal do Rio Grande do Norte; BR; UFRN; Programa de Pós-Graduação em Fisioterapia; Movimento e Saúde Publicador: Universidade Federal do Rio Grande do Norte; BR; UFRN; Programa de Pós-Graduação em Fisioterapia; Movimento e Saúde
Tipo: Dissertação Formato: application/pdf
POR
Relevância na Pesquisa
36.19%
The increasing world population of older individuals has become a subject of growing research for prevention and reversibility of the frailty because it is a major risk factor for the occurrence of falls, especially when it involves everyday situations of dual task. Some rehabilitation programs have already used the methods of dual-task with general exercises for improving gait and postural control, but has been reported that these interventions have little specificity with limited success to improve certain aspects of static and dynamic position during the performance of functional tasks. This study aimed to verify the measures of postural control in a group of elderly women with fragility phenotype after physical therapy intervention program based on dual-task treadmill training. We selected six pre-frail elderly subjects, with a minimum age of 65, female, living in the community and randomly assigned to two groups. The survey was conducted twice a week for 45 minutes, for four weeks. The simple task intervention consisted only in training on a treadmill and the dual task consisted of in treadmill training associated with visual stimuli. The assessments were made with the use of the Berg Balance Scale (BBS) and the Balance Master® computerized posturography...

Influencia de la movilización rítmica del plexo sacro sin componentes adicionales en la marcha de pacientes neurológicos; Influence of the rhythmical mobilization of the sacral plexus, without additional components, on the gait of neurological patients

Río Fernández, Patricia Roxana del
Fonte: Universidade de Cantabria Publicador: Universidade de Cantabria
Tipo: Trabalho de Conclusão de Curso
SPA
Relevância na Pesquisa
36.3%
RESUMEN: Introducción: En la actualidad la incidencia de la patología neurológica está adquiriendo mayor importancia en el mundo de la investigación, debido a la gran repercusión económica en el sistema socio sanitario. Esto ha llevado a un grado más alto de especialización en campo de la fisioterapia neurológica a la hora de mejorar los niveles de actividad y performance. Objetivos: Analizar mediante test y escalas las alteraciones de la marcha en pacientes con daño cerebral adquirido y clínica de hemiparesia, que han sido tratados con una técnica de movilización rítmica de una parte del plexo sacro en comparación con un tratamiento de fisioterapia convencional, y sin la realización de movilización del sistema nervioso. Material y Métodos: Se plantea un ensayo clínico aleatorio. A un grupo se les aplicó la movilización rítmica del plexo sacro, y al otro se realizó técnicas de relajación de la musculatura hipertónica del miembro afecto a través de inhibición y estiramientos pasivos. Antes y después del tratamiento se realizó en ambos una valoración analítica para evidenciar diferencias entre tratamientos, y para observar si habíamos incidido en el sistema nervioso obteniendo como resultado las mejoras en la velocidad de la marcha. Resultados: Mediante el programa estadístico PSPP se observa que la movilización rítmica del plexo sacro no es más efectiva para mejorar la marcha que el trabajo del miembro inferior con fisioterapia convencional. Sin embargo se observan mejores resultados en el grupo experimental que en el grupo control. Discusión: Este estudio ha intentado objetivar la utilidad de una herramienta más dentro del razonamiento clínico en la fisioterapia neurológica. Por lo que podemos considerarlo como una puerta abierta para futuros trabajos en esta dirección.; ABSTRACT: Introduction: Incidence of neurological disease is gaining importance as research topic due to its big economic impact on the healthcare system. This has led to a higher level of specialization in the field of neurological physiotherapy in order to improve levels of activity and performance. Objectives: To analyze using scales and test gait disorders in patients with acquired brain injury and hemiparesy who have been treated with a technique of rhythmical movement of part of the sacral plexus...

Temporal variability of gait in Parkinson disease: effectsof a rehabilitation programme based on rhythmic sound cuesTemporal variability of gait in Parkinson disease: effectsof a rehabilitation programme based on rhythmic sound cues

Fernández del Olmo, M.; Cudeiro Mazaira, Francisco Javier
Fonte: Elsevier Publicador: Elsevier
Tipo: Dissertação de Mestrado
ENG
Relevância na Pesquisa
46.4%
[Abstract] It has been suggested that sequential movements in patients with Parkinson's disease (PD) might be improved by the effects of external rhythmic cues. We studied spatiotemporal gait parameters and temporal gait variability in patients with PD and control subjects under different walking conditions in order to investigate whether rhythmic auditory cues could improve temporal variability. A total of 30 subjects were recruited, comprising 15 patients with idiopathic PD and 15 control subjects with no history of neurological disorder. As an indicator for temporal stability, we used the coefficient of variability (CV=standard deviation/mean×100) of recorded intervals between two consecutive steps (gait variability). After control values were obtained, subjects underwent a Physical Rehabilitation Programme (PRP) consisting of a variety of motor tasks performed in combination with rhythmic sounds with different cadences. Sessions lasted 1 h/day, five times a week for a period of four consecutive weeks. At the end of the PRP subjects were evaluated again. Following completion of the programme the patients' coefficients of variability improved significantly for the preferred gait (gait: t=2.950, p=0.011) but were not significantly different from those obtained in control subjects (gait: t=3.873...

Interactive Rhythmic Auditory Stimulation Reinstates Natural 1/f Timing in Gait of Parkinson's Patients

Hove, Michael J.; Suzuki, Kazuki; Uchitomi, Hirotaka; Orimo, Satoshi; Miyake, Yoshihiro
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 02/03/2012 EN
Relevância na Pesquisa
36.38%
Parkinson's disease (PD) and basal ganglia dysfunction impair movement timing, which leads to gait instability and falls. Parkinsonian gait consists of random, disconnected stride times—rather than the 1/f structure observed in healthy gait—and this randomness of stride times (low fractal scaling) predicts falling. Walking with fixed-tempo Rhythmic Auditory Stimulation (RAS) can improve many aspects of gait timing; however, it lowers fractal scaling (away from healthy 1/f structure) and requires attention. Here we show that interactive rhythmic auditory stimulation reestablishes healthy gait dynamics in PD patients. In the experiment, PD patients and healthy participants walked with a) no auditory stimulation, b) fixed-tempo RAS, and c) interactive rhythmic auditory stimulation. The interactive system used foot sensors and nonlinear oscillators to track and mutually entrain with the human's step timing. Patients consistently synchronized with the interactive system, their fractal scaling returned to levels of healthy participants, and their gait felt more stable to them. Patients and healthy participants rarely synchronized with fixed-tempo RAS, and when they did synchronize their fractal scaling declined from healthy 1/f levels. Five minutes after removing the interactive rhythmic stimulation...

Wii-Fit for Improving Gait and Balance in an Assisted Living Facility: A Pilot Study

Padala, Kalpana P.; Padala, Prasad R.; Malloy, Timothy R.; Geske, Jenenne A.; Dubbert, Patricia M.; Dennis, Richard A.; Garner, Kimberly K.; Bopp, Melinda M.; Burke, William J.; Sullivan, Dennis H.
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.19%
Objectives. To determine the effects on balance and gait of a Wii-Fit program compared to a walking program in subjects with mild Alzheimer's dementia (AD). Methods. A prospective randomized (1 : 1) pilot study with two intervention arms was conducted in an assisted living facility with twenty-two mild AD subjects. In both groups the intervention occurred under supervision for 30 minutes daily, five times a week for eight weeks. Repeated measures ANOVA and paired t-tests were used to analyze changes. Results. Both groups showed improvement in Berg Balance Scale (BBS), Tinetti Test (TT) and Timed Up and Go (TUG) over 8 weeks. However, there was no statistically significant difference between the groups over time. Intragroup analysis in the Wii-Fit group showed significant improvement on BBS (P = 0.003), and TT (P = 0.013). The walking group showed a trend towards improvement on BBS (P = 0.06) and TUG (P = 0.07) and significant improvement in TT (P = 0.06). Conclusion. This pilot study demonstrates the safety and efficacy of Wii-Fit in an assisted living facility in subjects with mild AD. Use of Wii-Fit resulted in significant improvements in balance and gait comparable to those in the robust monitored walking program. These results need to be confirmed in a larger...