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Corrêa FI, Ledur ÂC, Uehara L, de Andrade ML, Corrêa JCF, Fregni F. Effect of transcranial direct current stimulation combined with pelvic muscle training in women: Randomized, controlled, double-blind, and clinical trial. Neurourol Urodyn 2024; 43:967-976. [PMID: 38426725 DOI: 10.1002/nau.25438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/25/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Pelvic floor muscle training (PFMT) is widely used for pelvic floor muscle (PFM) weakness in women; however, it has no prolonged effects. OBJECTIVE To evaluate the effect of Transcranial Direct Current Stimulation (tDCS) associated with PFMT on PFM contraction, sexual function and quality of life (QoL) in healthy women. STUDY DESIGN 32 nulliparous women, aged 22.7 ± 0.42 years, were randomized into two groups: G1 (active tDCS combined with PFMT) and G2 (sham tDCS combined with PFMT). The treatment was performed three times a week for 4 weeks, totaling 12 sessions. PFM function was assessed using the PERFECT scheme (P = power, E = endurance, R = repetitions, F = rapid contractions, ECT = each timed contraction) and the perineometer (cmH2O). Sexual function was assessed by The Female Sexual Function Index, and QoL by the SF-36 questionnaire. These assessments were performed before and after the 12nd treatment session and after 30-day follow-up. RESULTS There was a significant increase (p = 0.037) in the power of G2 compared to G1; repetitions and fast contraction increased in the G1 group, and the resistance increased in both groups, however, without statistical difference between the groups. ECT increased in the G1 group (p = 0.0). CONCLUSION Active tDCS combined with PFMT did not potentiate the effect of the PFMT to increase the PFM function, QoL, and sexual function in healthy women. However, adjunctive tDCS to PFMT improved the time of contractions, maintaining it during follow-up.
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Affiliation(s)
- Fernanda Ishida Corrêa
- Master's and Doctorate in Rehabilitation Sciences Program, Nove de Julho University, São Paulo, Brazil
| | - Ângela Cristina Ledur
- Master's and Doctorate in Rehabilitation Sciences Program, Nove de Julho University, São Paulo, Brazil
| | - Laura Uehara
- Master's and Doctorate in Rehabilitation Sciences Program, Nove de Julho University, São Paulo, Brazil
| | | | | | - Felipe Fregni
- Harvard Medical School, Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Massachusetts, USA
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de Andrade ML, Silva SM, de Moraes JF, de Jesus SC, Dos Santos Pedro E, Corrêa JCF, Corrêa FI. Predictors of the Social Participation of Adults with Down Syndrome: An Analysis Based on the Biopsychosocial Model of the International Classification of Functioning, Disability, and Health. Am J Phys Med Rehabil 2024; 103:238-244. [PMID: 37752638 DOI: 10.1097/phm.0000000000002341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
OBJECTIVE The aim of the study is to identify the predictors of social participation in Down syndrome adults from the biopsychosocial model of the International Classification of Functioning, Disability, and Health. METHODS An exploratory, analytical, cross-sectional study was conducted with Down syndrome adults. The social participation was assessed using the Life Habits Assessment. The independent variables were determined using the International Classification of Functioning, Disability, and Health biopsychosocial model: body functions were assessed by body mass index, cognition function (Mini-Mental State Examination), and lower limbs muscle strength (Sit-to-Stand Test). Activities were assessed by the 8-Foot Up and Go Test. Environmental factors were assessed by the measure of the quality of the environment, and personal factors were assessed by age, sex, and education level. RESULTS The total Life Habits Assessment score indicates that individuals show moderate restriction in social participation, with major restriction in the education, employment, and responsibilities domains. The 8-Foot Up and Go Test was the best social participation predictor variable, followed by Mini-Mental State Examination, and the Sit-to-Stand Test. Contextual factors were not predictors of participation. CONCLUSIONS It was concluded that individuals with Down syndrome present the most restrictions to social participation in activities that involve social roles. The predictors influencing social participation are functional mobility, cognition, and lower limb muscle strength.
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Affiliation(s)
- Michele Lacerda de Andrade
- From the Doctoral and Master's Rehabilitation Science Programs, Nove de Julho University, São Paulo, Brazil
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Corrêa FI, Kunitake AI, Segheto W, Duarte de Oliveira M, Fregni F, Ferrari Corrêa JC. The effect of transcranial direct current stimulation associated with video game training on the postural balance of older women in the community: A blind, randomized, clinical trial. Physiother Res Int 2024; 29:e2046. [PMID: 37608641 DOI: 10.1002/pri.2046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/03/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Falls are frequent in older adults and can cause trauma, injury, and death. Fall prevention with virtual reality presents good results in improving postural control. Transcranial Direct Current Stimulation (tDCS) has been used with the same aim; however, the combination of the two techniques has still been little studied. PURPOSE To assess whether tDCS can enhance the effect of video game training (VGT) on improving the postural balance of healthy older women. METHOD A blinded, randomized, controlled clinical trial was conducted with 57 older women who were randomized to three balance training groups: Control Group (VGT), Anodal Group (VGT combined with anodic tDCS-atDCS), and Sham Group (VGT combined with sham tDCS-stDCS). Balance training was performed twice a week for four weeks, totalizing eight 20-min sessions using VGT associated with tDCS. Postural balance was assessed pre-and post-training and 30 days after the end of the eight sessions using the Mini-Balance Evaluation Systems Test. RESULTS Compared to pre-intervention the Mini BEST test increased similarly in the three groups in post-intervention (control: pre 23.7 ± 2.8 to post 27.0 ± 2.2; anodal: pre 24.4 ± 1 to post 27.7 ± 0.8 and sham: pre 24.2 ± 1.9 to post 26.5 ± 1.6; p < 0.001) and follow-up (control: pre 23.7 ± 2.8 to follow-up 26.8 ± 2.3; anodal: pre 24.4 ± 1 to follow-up 27.3 ± 1.4 and sham: pre 24.2 ± 1.9 to follow-up 26.8 ± 1.5; p < 0.001). CONCLUSION There was an improvement in the postural balance of the three training groups that were independent of tDCS. DISCUSSION Some studies have shown the positive tDCS effects associated with other tasks to improve balance. However, these results convey the effects of only anodic-tDCS compared to sham-tDCS. Possibly, the effect of VGT surpassed the tDCS effects, promoting a ceiling effect from the combination of these two therapies. However, studies with other therapies combined with tDCS for older adults deserve to be investigated, as well as in frail older people.
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Affiliation(s)
- Fernanda Ishida Corrêa
- Doctoral and Master's Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Andre Issao Kunitake
- Doctoral and Master's Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Wellington Segheto
- Doctoral and Master's Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Max Duarte de Oliveira
- Doctoral and Master's Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Corrêa FI, Carneiro Costa G, Leite Souza P, Marduy A, Parente J, Ferreira da Cruz S, de Souza Cunha M, Beber Freitas M, Correa Alves D, Silva SM, Ferrari Corrêa JC, Fregni F. Additive effect of transcranial direct current stimulation (tDCS) in combination with multicomponent training on elderly physical function capacity: a randomized, triple blind, controlled trial. Physiother Theory Pract 2023; 39:2352-2365. [PMID: 35619246 DOI: 10.1080/09593985.2022.2081638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the additive effect of Transcranial Direct Current Stimulation (tDCS) associated with multi-component training (MT) on the functional capacity (FC) of older adults and to assess whether these effects remain after the end of training. The secondary objectives were to evaluate the locomotion capacity, balance, functional independence, and quality of life and correlate them with functional capacity. METHODOLOGY Twenty-eight older adults were randomized into two groups: experimental (MT associated with active tDCS - a-tDCS) and control (MT associated with sham tDCS - s-tDCS). The FC was measured by the Glittre-ADL test, locomotion capacity by the 6-minute walk test, balance by the BESTest, functional independence by the FIM, and quality of life by the WHQOL. The assessments were performed pre-, post-intervention, and 30-day follow-up. RESULTS There was a significant decrease in the time to the Glittre-ADL test when comparing the a-tDCS and s-tDCS groups after the interventions (139.77 ± 21.62, 205.10 ± 43.02, p < .001) and at the 30-day follow-up (142.74 ± 17.12, 219.55 ± 54.05, p < .001), respectively. There was a moderate correlation between FC and locomotion capacity and balance. CONCLUSIONS The addition of tDCS potentiated the results of MT to impact FC, maintaining the positive results longer. Locomotion and balance influenced the improvement of functional capacity.
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Affiliation(s)
- Fernanda Ishida Corrêa
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Glaucio Carneiro Costa
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Paulo Leite Souza
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Anna Marduy
- Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Joao Parente
- Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Stefany Ferreira da Cruz
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Micaelly de Souza Cunha
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Maik Beber Freitas
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - David Correa Alves
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | - Soraia Micaela Silva
- Doctoral and Master Program in Science of Reabilitation, Nove de Julho University, São Paulo, Brazil
| | | | - Felipe Fregni
- Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
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Boas Fernandes WV, Politti F, Blanco CR, Garcia Lucareli PR, Gomes CAFDP, Corrêa FI, Corrêa JCF. Effect of osteopathic visceral manipulation for individuals with functional constipation and chronic nonspecific low back pain: Randomized controlled trial. J Bodyw Mov Ther 2023; 34:96-103. [PMID: 37301564 DOI: 10.1016/j.jbmt.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 12/14/2022] [Accepted: 04/05/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To investigate the effect of osteopathic visceral manipulation (OVM) on disability and pain intensity in individuals with functional constipation and chronic nonspecific low back pain. METHODS This study is a randomized controlled trial with a blinded assessor. Seventy-six volunteers with functional constipation and chronic nonspecific low back pain were randomized to two groups: OVM and sham OVM. The primary clinical outcome was pain intensity measured using a numeric rating scale (NRS) and disability measured using the Oswestry Disability Index (ODI). The secondary outcomes were electromyographic signals measured during the flexion-extension cycle, the finger-to-floor distance during complete flexion of the trunk and the Fear-Avoidance Beliefs Questionnaire (FABQ). All outcomes were determined after six weeks of treatment as well as three months after randomization. RESULTS The OVM group reported a reduction in pain intensity after six weeks of treatment and at the three-month evaluation (p < .0002) and the sham group reported a reduction in pain intensity after three-month evaluation (p < .007). For the ODI was also found in the OVM group six weeks after the end of treatment (treatment effect = -6.59, 95% CI: -12.01 to -1.17, p = .01) and at the three-month evaluation (treatment effect = -6.02, 95% CI: -11.55 to -0.49, p = .03). Significant differences were also found for paravertebral muscle activity during the dynamic phases (flexion and extension) six-week evaluations. CONCLUSIONS The OVM group demonstrated a reduction in pain intensity and improvement in disability after six-weeks and three-month follow-up while the sham group reduction in pain three-month follow-up.
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Affiliation(s)
- Walkyria Vilas Boas Fernandes
- Postgraduate Program in Rehabilition Sciences, Nove de Julho University, São Paulo, Brazil; Federal University of Mato Grosso, Rondonópolis, Brazil
| | - Fabiano Politti
- Postgraduate Program in Rehabilition Sciences, Nove de Julho University, São Paulo, Brazil
| | | | | | | | - Fernanda Ishida Corrêa
- Postgraduate Program in Rehabilition Sciences, Nove de Julho University, São Paulo, Brazil
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Costa GC, Dal Corso S, Silva SM, Teodosio ADC, Simada Pelosi R, Elício VDC, José A, Dias RR, Ferrari Corrêa JC, Corrêa FI. Validation and reproducibility of the Glittre activities of the daily living test for evaluation of functional capacity after a stroke. Physiother Theory Pract 2023; 39:887-894. [PMID: 35220858 DOI: 10.1080/09593985.2022.2029651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
METHODS Thirty patients with hemiparesis stemming from a stroke and 20 healthy peers were evaluated. Reproducibility was determined using the intraclass correlation coefficient (ICC), standard measurement error (SME), minimum detectable change (MDC), and Bland-Altman analysis. For construct validity, the Glittre ADL test was correlated with the Six-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), and Functional Independence Measure (FIM), and analyzed based on convergent validity and the comparison of known groups (stroke survivors and healthy peers). RESULTS Intra- and inter-observer reliability were excellent (ICC3,1 = 0.98; 0.96, respectively). Intra-observer SME ranged from 0.27 to 0.31 minutes and inter-observer SME was 0.45 minutes. Intra-observer MDC ranged from 1.44 to 1.54 minutes and inter-observer MDC was 1.86 minutes. Strong statistically significant correlations were found between time on the Glittre ADL test and time on the 6MWT (rh = -0.91; p < .001) and TUG test (rh = 0.82; p < .001), whereas a moderate correlation was found with the FIM (rh = -0.47; p < .008). CONCLUSIONS The Glittre ADL test is valid for assessing functional capacity in stroke patients. It demonstrated good convergent and construct validity and excellent intra- and inter-observer reproducibility.
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Affiliation(s)
- Glaucio Carneiro Costa
- Doctoral and Master's Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Simone Dal Corso
- Doctoral and Master's Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Soraia Micaela Silva
- Doctoral and Master's Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | | | - Rosane Simada Pelosi
- Doctoral and Master's Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Virginia Do Carmo Elício
- Doctoral and Master's Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Anderson José
- School of Physiotherapy and Occupational Therapy, Institute of Health Sciences, Federal University of Pará, Belém, Brazil
| | - Raphael Ritti Dias
- Doctoral and Master's Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | | | - Fernanda Ishida Corrêa
- Doctoral and Master's Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
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Pereira GS, Corrêa FI, Santos HMD, Júlio CE, Bazán JAP, Bissoli MEF, Brandão TCP, Thonnard JL, Kossi O, Corrêa JCF, Silva SM. Translation and cross-cultural adaptation of the Brazilian version of the PM-Scale: A specific measure of participation after stroke. Braz J Phys Ther 2023; 27:100497. [PMID: 37001362 PMCID: PMC10073988 DOI: 10.1016/j.bjpt.2023.100497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/20/2021] [Accepted: 02/22/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND The PM-Scale was developed specifically to assess participation in individuals after stroke based on the concepts contained in the International Classification of Functioning, Disability and Health. However, this measure is only available in English and French. OBJECTIVE To translate and cross-culturally adapt the PM-Scale to Brazilian Portuguese, followed by the validation and testing of reliability of the translated version. METHODS The translation process followed standard guidelines. Preliminary test-retest reliability was determined using the intraclass correlation coefficient (ICC2,1). The Rasch model was employed to analyse the validity, unidimensionality, invariance, and internal consistency of the Brazilian version of the PM-Scale. RESULTS The final translated version of the PM-Scale presented appropriate semantic, idiomatic, cultural, and conceptual equivalence. The preliminary analysis revealed excellent intra-observer and inter-observer reliability (ICC2,1 = 0.91; 95%CI: 0.83, 0.95 and ICC2,1 = 0.81; 95%CI: 0.64, 0.89, respectively). The analysis of the Rasch model revealed only one erratic item. An excellent overall fit was found for items (mean ± SD = 0.01 ± 1.02) and adequate fit was found for persons (mean ± SD = 1.16 ± 0.88). Internal consistency was considered adequate (person separation index = 1.77, reliability = 0.76). No significant invariance was found with regards to the personal characteristics of the sample (p > 0.05). CONCLUSION The Brazilian version of the PM-Scale is a valid, unidimensional, linear, reliable scale for measuring participation in stroke survivors and can be administered in less than five minutes.
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Affiliation(s)
- Gabriela Santos Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Fernanda Ishida Corrêa
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Heyriane Martins Dos Santos
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Cíntia Elord Júlio
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | | | | | | | - Jean-Louis Thonnard
- Institute of Neuroscience, Universiteit Catholique de Louvain, Brussels, Belgium
| | - Oyéné Kossi
- ENATSE, Ecole Nationale de Santé Publique et d'Epidemiologie, Université de Parakou, Parakou, Benin; Unit of Neurology and Neurorehabilitation, University Hospital of Parakou, Parakou, Benin
| | - João Carlos Ferrari Corrêa
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil.
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Uehara L, Corrêa JCF, Ritti R, Leite P, de Faria DRG, Pacheco-Barrios K, Castelo-Branco L, Fregni F, Corrêa FI. Transcutaneous auricular vagus nerve stimulation effects on inflammatory markers and clinical evolution of patients with COVID-19: a pilot randomized clinical trial. Expert Rev Med Devices 2022; 19:915-920. [DOI: 10.1080/17434440.2022.2154147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Laura Uehara
- Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | | | - Raphael Ritti
- Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Paulo Leite
- Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | | | - Kevin Pacheco-Barrios
- Harvard Medical School, Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Mass, USA
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Luis Castelo-Branco
- Harvard Medical School, Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Mass, USA
| | - Felipe Fregni
- Harvard Medical School, Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, Mass, USA
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Corrêa FI, Souza PHL, Uehara L, Ritti-Dias RM, Oliveira da Silva G, Segheto W, Pacheco-Barrios K, Fregni F, Corrêa JCF. Transcutaneous Auricular Vagus Nerve Stimulation Improves Inflammation but Does Not Interfere with Cardiac Modulation and Clinical Symptoms of Individuals with COVID-19: A Randomized Clinical Trial. Life (Basel) 2022; 12:life12101644. [PMID: 36295080 PMCID: PMC9604701 DOI: 10.3390/life12101644] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/12/2022] [Accepted: 10/15/2022] [Indexed: 11/16/2022] Open
Abstract
Transcranial auricular vagus nerve stimulation (taVNS) has shown effectiveness in reducing inflammation and depression. Thus, this study evaluated its effect on inflammation, cardiac autonomic modulation, and clinical symptoms in individuals affected by COVID-19. Methods: There were 52 randomized participants hospitalized with COVID-19 diagnosis who were to receive active (a-taVNS) or sham taVNS (s-taVNS) for 90 min twice a day for seven consecutive days. Interleukin 6 (IL-6), 10 (IL-10), cortisol, C-reactive protein (CRP), heart rate variability (HRV), and clinical symptoms were assessed before and after seven days of treatment. There were also seven- and fourteen-day follow-ups for clinical symptoms, including anxiety and depression levels, as well as a six-month follow-up for memory and attention levels. Results: There was significant reduction in CRP −23.9%, (95% CI −46.3 to −1.4) and IL-6 −37.7%, (95% CI −57.6 to −17.7) for the a-taVNS group. There were no changes in IL-10, cortisol levels, or in HRV results (p > 0.05) in both groups. There were no changes regarding clinical symptoms, except for a significant decrease in depression level (−2.85, 95% CI −5.44 to −0.27) in the a-taVNS group. Conclusion: taVNS showed effects on CRP, IL-6, and depression levels; however, it did not affect other clinical symptoms.
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Affiliation(s)
- Fernanda Ishida Corrêa
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
- Correspondence: ; Tel.: +55-11-973440380
| | - Paulo Henrique Leite Souza
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Laura Uehara
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Raphael Mendes Ritti-Dias
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Gustavo Oliveira da Silva
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Wellington Segheto
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Unidad de Investigación para la Generación y Síntesede Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15024, Peru
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - João Carlos Ferrari Corrêa
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
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Uehara L, Corrêa JCF, Leite PHS, Ritti-Dias RM, Fregni F, Corrêa FI. Effects of transcutaneous auricular vagus nerve stimulation on inflammation, cardiac autonomic modulation, and clinical evolution of patients with COVID-19: protocol for a clinical, controlled, randomized, and blind trial. Fisioter Pesqui 2022. [DOI: 10.1590/1809-2950/22007429042022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
ABSTRACT This study aims to evaluate the effect of transcutaneous auricular vagus nerve stimulation (taVNS) on inflammation, cardiac autonomic modulation, and clinical evolution of patients with COVID-19. This is a clinical, sham-controlled, randomized, and blind trial, in which 52 hospitalized individuals diagnosed with COVID-19 will participate. They will be randomized into: experimental group (usual medical treatment associated with active taVNS) and control group (usual medical treatment associated with sham taVNS). The taVNS will be performed by a neuromuscular electric stimulator (Dualpex model 071 of Quark Medical Products), with the stimulation electrode positioned on the left tragus, with alternating current, at a 30Hz frequency with 50% variation. Intensity will be adjusted to the patient’s sensory threshold, with 90-minutes-long stimulation sessions, happening twice per day for seven consecutive days, totaling 14 sessions. Interleukin-6 (IL-6) and interleukin-10 (IL-10), cortisol and C-reactive protein (CRP), blood pressure, heart rate variability (HRV) by low frequency (LF), high frequency (HF) and low and high frequency ratio (LF/HF) parameters will be evaluated before and after the intervention, as well as patients’ clinical evolution-including anxiety and depression levels-whose data will be obtained through medical records and questionnaires. A follow-up will also be performed seven and 14 days after the end of the interventions to verify the clinical evolution, including anxiety and depression levels. Memory and attention levels will be evaluated for six months.
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Affiliation(s)
| | | | | | | | - Felipe Fregni
- Harvard T.H. Chan School of Public Health, Estados Unidos
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Uehara L, Corrêa JCF, Leite PHS, Ritti-Dias RM, Fregni F, Corrêa FI. Efeito da estimulação elétrica transcutânea do nervo vago na inflamação, modulação autonômica cardíaca e evolução clínica dos pacientes com COVID-19: estudo de protocolo para um ensaio clínico, controlado, randomizado e cego. Fisioter Pesqui 2022. [DOI: 10.1590/1809-2950/22007429042022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
RESUMO O objetivo deste estudo é avaliar o efeito da estimulação elétrica transcutânea do nervo vago (EETNV) na inflamação, modulação autonômica cardíaca e evolução clínica dos pacientes com COVID-19. Trata-se de um ensaio clínico, controlado por sham, randomizado e cego, no qual participarão 52 indivíduos hospitalizados com diagnóstico de COVID-19, que serão randomizados em dois grupos de tratamento: grupo experimental (tratamento médico usual associado à EETNV ativa) ou grupo-controle (tratamento médico usual associado à EETNV sham). A EETNV será realizada por meio de um estimulador elétrico neuromuscular (modelo Dualpex 071 da Quark Medical Products), com o eletrodo de estimulação posicionado sobre o tragus esquerdo, com corrente alternada, frequência de 30Hz e variação de 50%, intensidade ajustada para o limiar sensorial do paciente, com duração de 90 minutos cada sessão de estimulação, duas vezes ao dia, durante sete dias consecutivos, totalizando 14 sessões. Serão avaliados pré e pós-intervenção o nível de interleucina-6 (IL-6) e interleucina-10 (IL-10), cortisol e proteína C reativa (PCR), pressão arterial, variabilidade da frequência cardíaca pelos parâmetros de baixa frequência (BF), alta frequência (AF) e pela razão da baixa e alta frequência (BF/AF), além de evolução clínica dos pacientes, incluindo o nível de ansiedade e depressão, cujos dados serão obtidos por meio de prontuários e questionários. Será realizado também um acompanhamento 7 e 14 dias após o término das intervenções para verificar a evolução clínica, incluindo nível de ansiedade e depressão, e durante seis meses serão avaliadas memória e atenção.
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Affiliation(s)
| | | | | | | | - Felipe Fregni
- Harvard T.H. Chan School of Public Health, Estados Unidos
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Pereira GS, Corrêa FI, Júlio CE, Thonnard JL, Bouffioulx E, Corrêa JCF, Silva SM. Clinimetric properties of the SATIS-Stroke questionnaire in the Brazilian population: A satisfaction assessment measure addressing activities and participation after a stroke. Braz J Phys Ther 2021; 25:719-726. [PMID: 34030951 PMCID: PMC8721075 DOI: 10.1016/j.bjpt.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 03/11/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND SATIS-Stroke questionnaire has been translated and adapted for use in the Brazilian population, however, it is necessary to test the measurement properties in Brazilian population. OBJECTIVE To test the reliability, agreement, concurrent validity, and diagnostic accuracy of the SATIS-Stroke. METHODS Chronic stroke survivors were included. The calculations were made using scores in logits (Rasch Model). Reliability was tested using the intraclass correlation coefficient (ICC2,1), standard error of measurement (SEM), minimal detectable change (MDC), and Bland-Altman plots. Concurrent validity was analyzed using Spearman's correlation coefficient. For such, the correlation between SATIS-Stroke and Stroke Specific Quality of Life (SS-QOL) questionnaires was determined. Diagnostic accuracy was estimated based on the area under the receiver operating characteristic (ROC) curve with a 95% confidence interval and considering the sensitivity and specificity of SATIS-Stroke in differentiating different types of activity and participation. RESULTS Eighty stroke survivors were analyzed. Mean age was 57.98±13.85 years and 45.2% had severe impairment. Excellent reliability was found (intra-observer ICC2,1 = 0.90; 95% CI: 0.84, 0.93; inter-observer ICC2,1 = 0.89; 95% CI: 0.83, 0.93). The Bland-Altman plot demonstrated satisfactory agreement. In the analysis of concurrent validity, a strong, positive, significant correlation was found between SATIS-Stroke and SS-QOL (rs = 0.74; p <0.001 with an r2=0.44; p=0.001). Diagnostic accuracy was satisfactory, with 80.8% sensitivity and 85.2% specificity. CONCLUSION The Brazilian version of the SATIS-Stroke questionnaire exhibited adequate reliability, concurrent validity, and diagnostic accuracy. Therefore, this is a valid, reproducible measure for the assessment of satisfaction with regard to activities and participation following a stroke.
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Affiliation(s)
- Gabriela Santos Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Fernanda Ishida Corrêa
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Cíntia Elord Júlio
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Jean-Louis Thonnard
- Institute of Neuroscience, Universite Catholique de Louvain, Brussels, Belgium
| | - Edouard Bouffioulx
- Département de Kinésithérapie et d'Ergothérapie, Haute École Louvain en Hainaut, Charleroi, Belgium
| | - João Carlos Ferrari Corrêa
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil.
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Andressa de Souza J, Ferrari Corrêa JC, Marduy A, Dall'Agnol L, Gomes de Sousa MH, Nunes da Silva V, Alves AB, Silva SM, Fregni F, Corrêa FI. To Combine or Not to Combine Physical Therapy With tDCS for Stroke With Shoulder Pain? Analysis From a Combination Randomized Clinical Trial for Rehabilitation of Painful Shoulder in Stroke. Front Pain Res 2021; 2:696547. [PMID: 35295490 PMCID: PMC8915613 DOI: 10.3389/fpain.2021.696547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Transcranial Direct Current Stimulation (tDCS) is an intervention that seems to be an ideal tool to enhance the effects of rehabilitation therapies given it facilitates generation of plasticity in the stimulated brain area. In stroke this strategy has been highly utilized; however, the results have been mixed. In this trial we have evaluated the analgesic and functional effects of Transcranial Direct Current Stimulation (tDCS) combined with physiotherapy in stroke survivors with shoulder pain.Methods: Twenty-six stroke surviving adults with shoulder pain received 10 sessions of passive mobilization and performed upper limb exercises using a cycle ergometer, combined with active or sham tDCS. The intensity of pain in the hemiplegic shoulder was measured using the Visual Analog Scale (VAS); secondary outcomes were the level of motor impairment, handgrip strength, range of motion, motor function of the upper limbs, and quality of life (QOL) assessed before and after 10 sessions and 1 month after the end of the treatment.Results: A clinically important pain reduction (3 points) was found in both groups and was maintained at follow-up; there was no significant difference between groups (p = 0.3). Similarly, the shoulder range of motion improved, motor function and quality of life improved showed no significant differences between groups. One result that needs to be underscored is that both groups had a significant effect size toward improvement in all of these outcomes.Conclusions: We discuss in this study that tDCS is not a useful combination strategy when the physical therapy has a large effect by itself and we also review other negative trials of combined therapy under this framework of ceiling effect of the main physical therapy.Trial registry: Trial registration: Brazilian Registry of Clinical Trials, RBR-8F5MNY (http://www.ensaiosclinicos.gov.br/rg/RBR-8f5mny/). Registered on June 2, 2017.Beginning of the recruitment of the volunteers: august, 2017.
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Affiliation(s)
- Janaina Andressa de Souza
- Doctorate and Masters Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - João Carlos Ferrari Corrêa
- Doctorate and Masters Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Anna Marduy
- Department of Physical Medicine and Rehabilitation, Neuromodulation Center, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Letizzia Dall'Agnol
- Doctorate and Masters Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Maria Helena Gomes de Sousa
- Doctorate and Masters Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Victor Nunes da Silva
- Doctorate and Masters Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - André Barreto Alves
- Doctorate and Masters Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Soraia Micaela Silva
- Doctorate and Masters Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Felipe Fregni
- Department of Physical Medicine and Rehabilitation, Neuromodulation Center, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States
- Felipe Fregni
| | - Fernanda Ishida Corrêa
- Doctorate and Masters Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
- *Correspondence: Fernanda Ishida Corrêa
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Kunitake AI, Corrêa JCF, Nascimento KS, de Oliveira BBC, Muniz NM, Silva SM, Corrêa FI. Protocol for a controlled, randomized, blind, clinical trial to assess the effects of anodal transcranial direct current stimulation dorsolateral prefrontal cortex associated with balance training using games in the postural balance of older people. F1000Res 2021; 9:1018. [PMID: 33335715 PMCID: PMC7713885 DOI: 10.12688/f1000research.25164.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 12/02/2022] Open
Abstract
Aims: This study aims to evaluate the additional effect of anodal transcranial direct current stimulation (a-tDCS) applied on dorsolateral pré-frontal cortex on training postural balance with the use of video games in the aged. Methods: This is a blinded, randomized, controlled clinical trial protocol, with older people of both genders. Participants will be randomized into three training groups: Group 1 (videogame balance training), group 2 (videogame balance training associated with anodal tDCS), group 3 (videogame balance training associated with sham tDCS). The training will be carried out twice a week for four weeks, totaling eight sessions, and will be performed with the Nintendo Wii videogame console, using games that stimulate the postural balance associated with tDCS, with anode applied over the left dorsolateral prefrontal cortex and cathode on the contralateral supraorbital region at 2 mA for 20 minutes. The postural balance will be assessed using the Mini Test of the Balance Assessment System and posturography. Evaluations will be carried out before and after eight training sessions and 30 days after the end of treatment. Discussion: Some studies show favorable results from the use of video games in improving postural balance in older people; however, their effect does not remain long-term. TDCS associated with other therapies can potentiate and prolong the effects of these therapies owing to its ability to stimulate neurotrophins important for neurogenesis, facilitating tasks that require attention, and helping to consolidate learning and memory. The effect of the two associated techniques on balance has not yet been tested in this population. Registration: Brazilian Registry of Clinical Trials ID
U1111-1213-4266; registered on 15 October 2018.
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Affiliation(s)
- Andre Issao Kunitake
- Universidade Nove de Julho, Nove de Julho University, São Paulo, São Paulo, 01504-001, Brazil
| | | | - Klaine Silva Nascimento
- Universidade Nove de Julho, Nove de Julho University, São Paulo, São Paulo, 01504-001, Brazil
| | | | - Natalia Maciel Muniz
- Universidade Nove de Julho, Nove de Julho University, São Paulo, São Paulo, 01504-001, Brazil
| | - Soraia Micaela Silva
- Universidade Nove de Julho, Nove de Julho University, São Paulo, São Paulo, 01504-001, Brazil
| | - Fernanda Ishida Corrêa
- Universidade Nove de Julho, Nove de Julho University, São Paulo, São Paulo, 01504-001, Brazil
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15
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Kunitake AI, Corrêa JCF, Nascimento KS, de Oliveira BBC, Muniz NM, Silva SM, Corrêa FI. Protocol for a controlled, randomized, blind, clinical trial to assess the effects of anodal transcranial direct current stimulation dorsolateral prefrontal cortex associated with balance training using games in the postural balance of older people. F1000Res 2020; 9:1018. [PMID: 33335715 PMCID: PMC7713885 DOI: 10.12688/f1000research.25164.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 08/24/2023] Open
Abstract
Aims: This study aims to evaluate the additional effect of anodal transcranial direct current stimulation (a-tDCS) applied on dorsolateral pré-frontal cortex on training postural balance with the use of video games in the aged. Methods: This is a blinded, randomized, controlled clinical trial protocol, with older people of both genders. Participants will be randomized into three training groups: Group 1 (videogame balance training), group 2 (videogame balance training associated with anodal tDCS), group 3 (videogame balance training associated with sham tDCS). The training will be carried out twice a week for four weeks, totaling eight sessions, and will be performed with the Nintendo Wii videogame console, using games that stimulate the postural balance associated with tDCS, with anode applied over the left dorsolateral prefrontal cortex and cathode on the contralateral supraorbital region at 2 mA for 20 minutes. The postural balance will be assessed using the Mini Test of the Balance Assessment System and posturography. Evaluations will be carried out before and after eight training sessions and 30 days after the end of treatment. Discussion: Some studies show favorable results from the use of video games in improving postural balance in older people; however, their effect does not remain long-term. TDCS associated with other therapies can potentiate and prolong the effects of these therapies owing to its ability to stimulate neurotrophins important for neurogenesis, facilitating tasks that require attention, and helping to consolidate learning and memory. The effect of the two associated techniques on balance has not yet been tested in this population. Registration: Brazilian Registry of Clinical Trials ID U1111-1213-4266; registered on 15 October 2018.
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Affiliation(s)
- Andre Issao Kunitake
- Universidade Nove de Julho, Nove de Julho University, São Paulo, São Paulo, 01504-001, Brazil
| | | | - Klaine Silva Nascimento
- Universidade Nove de Julho, Nove de Julho University, São Paulo, São Paulo, 01504-001, Brazil
| | | | - Natalia Maciel Muniz
- Universidade Nove de Julho, Nove de Julho University, São Paulo, São Paulo, 01504-001, Brazil
| | - Soraia Micaela Silva
- Universidade Nove de Julho, Nove de Julho University, São Paulo, São Paulo, 01504-001, Brazil
| | - Fernanda Ishida Corrêa
- Universidade Nove de Julho, Nove de Julho University, São Paulo, São Paulo, 01504-001, Brazil
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Costa GC, Corrêa JCF, Silva SM, Corso SD, da Cruz SF, de Souza Cunha M, Souza PHL, Saldanha ML, Corrêa FI. Effect of transcranial direct current stimulation and multicomponent training on functional capacity in older adults: protocol for a randomized, controlled, double-blind clinical trial. Trials 2020; 21:203. [PMID: 32075673 PMCID: PMC7031910 DOI: 10.1186/s13063-020-4056-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 01/08/2020] [Indexed: 11/10/2022] Open
Abstract
Introduction When physical activity contains training of at least three components such as balance, coordination and strength, among others, it is called multicomponent training. This type of training is recommended for improving the functional capacity in elderly individuals but has no lasting effects. The association of transcranial direct current stimulation (tDCS) with other types of therapy has been shown to facilitate the enhancement and prolongation of therapy outcomes. Aim The objective of this study is to evaluate the effect of multicomponent training associated with active or sham tDCS on the performance of functional capacity in the elderly before treatment, after treatment and 30 days after the end of treatment. The secondary objective will be to correlate the performance of the primary outcome (functional capacity assessed by the Glittre Daily Life Activity Test) with walking capacity (by 6-min walk test), balance (with the mini-Balance Evaluation Systems Test), functional independence (by the Functional Independence Measure) and quality of life (with the World Health Organization Quality of Life Instrument). Methods Twenty-eight elderly people from the community will participate in the study, and will be randomized into two groups: 1) multicomponent training associated with active tDCS; and 2) multicomponent training associated with sham tDCS. The multicomponent training sessions will be held twice a week for 12 weeks, totaling 24 sessions. The tDCS will be administered over the dominant dorsolateral prefrontal cortex at the same time as multicomponent training, with an intensity of 2 mA, for 20 min. The evaluations will be made pretraining, after 24 training sessions and 30 days after the end of the training. Discussion We hypothesize that tDCS, when associated with multicomponent training, can potentiate and prolong the effects of this training on the functional capacity of the elderly. If this hypothesis is confirmed, this protocol may contribute to a longer-lasting physical rehabilitation of the elderly, encouraging them to maintain their independent daily activities for longer. Trial registration The study was registered in the Brazilian Clinical Trial Registry (RBR-2crd42) and received approval from the Human Research Ethics Committee of University Nove de Julho, São Paulo, Brazil (process number 3.077.953).
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Affiliation(s)
- Glaucio Carneiro Costa
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
| | - João Carlos Ferrari Corrêa
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Simone Dal Corso
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | | | | | | | | | - Fernanda Ishida Corrêa
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
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Silva SM, Corrêa FI, de Morais Faria CDC, Corrêa JCF. Discriminatory power of Stroke Specific Quality of Life questionnaire items to evaluate the participation component of the International Classification of Functioning, Disability and Health. International Journal of Therapy and Rehabilitation 2020. [DOI: 10.12968/ijtr.2018.0077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims This study aimed to estimate the discriminatory power of 26 items on the Stroke Specific Quality of Life Scale questionnaire to evaluate the participation component of the International Classification of Functioning, Disability and Health. Methods A prospective study was conducted using accuracy procedures based on the Standards for Reporting Diagnostic Accuracy Studies to evaluate individuals with hemiparesis stemming from a stroke. Discriminatory power was estimated based on the area under the receiver operating characteristic curve with a 95% confidence interval. Two groups were defined for the analysis: community-dwelling and institutionalised individuals. A 5% level of significance (α=0.05) was considered for all analyses. Results The area under the receiver operating characteristic curve was 0.888 (95% confidence interval: 0.794–0.949; P=0.001). Analysis indicated a cut-off point of ≥80 with 73.9% sensitivity and 100% specificity. Conclusions The 26 items of the Stroke Specific Quality of Life questionnaire that evaluate the participation component of the International Classification of Functioning, Disability and Health demonstrate adequate discriminatory power. A cut-off point of ≥80 seems to best discriminate the perception of participation between community-dwelling and institutionalised stroke survivors.
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Affiliation(s)
- Soraia Micaela Silva
- Postgraduate Programme in Rehabilitation Sciences, University Nove de Julho, São Paulo, Brazil
| | - Fernanda Ishida Corrêa
- Postgraduate Programme in Rehabilitation Sciences, University Nove de Julho, São Paulo, Brazil
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Heinz G, De Angelis K, Dal Corso S, Sousa MHGD, Viana A, Dos Santos F, Corrêa JCF, Corrêa FI. Effects of Transcranial Direct Current Stimulation (tDCS) and Exercises Treadmill on Autonomic Modulation of Hemiparetic Patients Due To Stroke-Clinic Test, Controlled, Randomized, Double-Blind. Front Neurol 2020; 10:1402. [PMID: 32038465 PMCID: PMC6988776 DOI: 10.3389/fneur.2019.01402] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 12/20/2019] [Indexed: 11/13/2022] Open
Abstract
Background: After a Stroke, there is an autonomic nervous system (ANS) changes. Transcranial Direct Current Stimulation (tDCS) can promote the reorganization of the affected circuits. Objective: To evaluate the effects of tDCS applied before a session of physical activity on the treadmill, in the modulation of the autonomic nervous system of post-stroke patients. Methodology: Cross-over study, were randomized 12 adult hemiparetic subjects in 2 groups, Group 1 (active tDCS before exercise on the treadmill) and Group 2 (sham tDCS before exercise on the treadmill). Stimulation times were 20 min; treadmill time was 20 min. The heart rate variability (HRV) and Variability of Systolic Blood Pressure (VSBP) were evaluated for 15 min, in 3 periods (pre and post tDCS and during exercise recovery on the treadmill). Results: There was no difference in the VSBP and the HRV between the groups, compared with the baseline data; however, in the intragroup analysis, the parasympathetic modulation after active tDCS increased by 18% over baseline by the RMSSD with IC 95% (−7.85 to −0.34). In group 1, the post-tDCS active and post-exercise periods presented a value of variance above baseline, indicating a better prognosis. In group 2, there was a significant reduction of 38% of Variance values (p = 0.003) after tDCS sham. Conclusion: tDCS does not generate immediate effects on HRV and VSBP, except for intragroup comparison, which has greater participation in parasympathetic modulation in the group receiving active tDCS.
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Affiliation(s)
- Glauber Heinz
- Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Katia De Angelis
- Doctorate and Master Program in Medicine School of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Simone Dal Corso
- Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Maria Helena Gomes De Sousa
- Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Ariane Viana
- Doctorate and Master Program in Medicine School of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Fernando Dos Santos
- Arterial Hypertension Unit, Instituto do Coração (InCor), Medical School of Universidade de São Paulo, São Paulo, Brazil
| | - João Carlos Ferrari Corrêa
- Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Fernanda Ishida Corrêa
- Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
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de Souza JA, Corrêa JCF, Agnol LD, Dos Santos FR, Gomes MRP, Corrêa FI. Effects of transcranial direct current stimulation on the rehabilitation of painful shoulder following a stroke: protocol for a randomized, controlled, double-blind, clinical trial. Trials 2019; 20:165. [PMID: 30876431 PMCID: PMC6419802 DOI: 10.1186/s13063-019-3266-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 02/27/2019] [Indexed: 12/02/2022] Open
Abstract
Background Shoulder pain is reported to be one of the major challenges faced in the functional recovery of patients in rehabilitation following a stroke. In such cases, transcranial direct current stimulation (tDCS) has been used as an additional therapeutic tool for improvements in central and peripheral pain. The aim of the proposed study is to evaluate the effect of tDCS when combined with upper limb physical therapy on pain intensity and functional improvement in stroke survivors with shoulder pain in the hemiplegic limb. Methods A randomized, placebo-controlled, double-blind, clinical trial is proposed. The volunteers will be randomly allocated to receive passive movement on the upper limb, which will be performed by the therapist for 20 min followed by either active tDCS or sham tDCS (current stimulation for 30 s) during simultaneous physical activity of the upper limb (“mini-bike”) for 20 min, totaling 40 min of intervention performed in 10 consecutive sessions. The anode electrode will be positioned over the primary motor cortex with a current of 2 mA and the cathode electrode will be positioned in the supraorbital region contralateral to the anode. The primary outcome will be shoulder pain intensity, which will be measured using the visual analog scale (VAS) on three occasions: 1) pre-intervention; 2) after 10 interventions (5 weekly sessions, for 2 weeks); and 3) 30 days after the end of the interventions. The secondary outcomes will be motor performance, upper limb function, and quality of life. Trial registration Brazilian Registry of Clinical Trials, RBR-8F5MNY. Registered on June 2, 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3266-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Janaina Andressa de Souza
- Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Avenida Angélica, 1905-Apt161, São Paulo, SP, Brasil.
| | - João Carlos Ferrari Corrêa
- Postgraduate program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Letizzia Dall' Agnol
- Undergraduate course in Physical Therapy, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | | | - Fernanda Ishida Corrêa
- Postgraduate program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
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Costa IP, Politti F, Cahalin LP, de Carvalho EFT, Costa D, Corrêa JCF, Vieira RP, Oliveira-Junior MC, De Angelis K, Stirbulov R, Dal Corso S, de Carvalho PDT, Parizotto NA, Arena R, Sampaio LM. Acute Effects Using Light-Emitting Diode Therapy (LEDT) for Muscle Function during Isometric Exercise in Asthma Patients: A Pilot Study. Biomed Res Int 2019; 2019:7501870. [PMID: 30775383 PMCID: PMC6354134 DOI: 10.1155/2019/7501870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/18/2018] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the effectiveness of acute application of LEDT in improving peripheral muscle performance during isometric exercise in patients with asthma. Eleven patients, with a mean age 38 ± 10, underwent a single LEDT and sham application in the femoral quadriceps' dominant member (cluster with 50 LED λ = 850 nm, 50 mW, 15 s; 37.5 J), 48 h apart in a randomized crossover design. Before and after LEDT and sham application, the patients were submitted an isometric endurance test (60% of the maximum isometric voluntary contraction), up to the limit of tolerance simultaneous recording of surface electromyography. There were no statistically significant differences between groups at the time of contraction (before 41±14 versus 44±16; after 46±12 versus 45±20 s) during the isometric contraction test and inflammatory markers before and after a single LEDT application. A single application of LEDT in the parameters and dose according to the equipment used in the study were not able to promote differences in the time of contraction and the fatigue response in asthmatic patients. However, the chronic effects of LEDT application for improving muscle performance in these patients are unknown and may present different responses during applications for a long time.
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Affiliation(s)
- Ivan Peres Costa
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Fabiano Politti
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | | | | | - Dirceu Costa
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - João Carlos Ferrari Corrêa
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Rodolfo P. Vieira
- Universidade Brasil, Post-Graduation Program in Bioengineering and Biomedical Engineering, São Paulo, Brazil
- Federal University of São Paulo (UNIFESP), Post-Graduation Program in Sciences in Human Movement and Rehabilitation, Santos, Brazil
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil
| | | | - Kátia De Angelis
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | | | - Simone Dal Corso
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Paulo de Tarso de Carvalho
- Post-Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Nivaldo Antonio Parizotto
- Department of Physiotherapy, Laboratory of Electrothermophototherapy, Federal University of São Carlos (UFSCAR), São Paulo, Brazil
- Post-Graduation Program in Biotechnology, University of Araraquara, Brazil
| | - Ross Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois, Chicago, USA
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Silva DDDO, Corrêa JCF, de Sá MDAF, Normando VMF, Silva SM, dal Corso S, Corrêa FI. Validación y reproducibilidad de la prueba Glittre de actividades de la vida diaria en personas con enfermedad de Parkinson. Rev Neurol 2019; 69:395-401. [DOI: 10.33588/rn.6910.2019217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fernandes WVB, Blanco CR, Politti F, de Cordoba Lanza F, Lucareli PRG, Corrêa JCF. The effect of a six-week osteopathic visceral manipulation in patients with non-specific chronic low back pain and functional constipation: study protocol for a randomized controlled trial. Trials 2018; 19:151. [PMID: 29499728 PMCID: PMC5833057 DOI: 10.1186/s13063-018-2532-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/06/2018] [Indexed: 11/25/2022] Open
Abstract
Background The aim of the proposed study is to analyze the effect of a six-week osteopathic visceral manipulation (OVM) program on the flexion-relaxation phenomenon in individuals with non-specific chronic low back pain (LBP) and functional constipation. Methods/Design An assessor-blinded, two-arm, randomized, placebo-controlled trial will be conducted. The sample will comprise 76 individuals with non-specific chronic LBP who have functional intestinal constipation, aged 18–65 years. The participants will be randomly allocated to two groups: (1) OVM and (2) sham OVM (SOVM). Evaluations will involve an interview, the Oswestry Disability Index, Fear-Avoidance Beliefs Questionnaire, functional constipation according to Rome III criteria, Biering-Sorensen test to normalize electromyographic (EMG) data, T12–L1 paraspinal level of the EMG signal during the flexion-relaxation phenomenon, 11-point numeric pain rating scale and fingertip-to-floor test. OVM and SOVM will be performed once per week for six weeks. Group 1 will receive OVM for 15 min and Group 2 will receive a sham visceral technique. Evaluations will be performed before and after the first session, after six weeks of treatment, and three months after randomization (follow-up). The findings will be analyzed statistically considering a 5% significance level (p ≤ 0.05). The limitation of the study is that the therapist will not be blinded. Discussion This will be the first trial to analyze the clinical response and electromyographic signals during the flexion-relaxation phenomenon after OVM. Trial registration Brazilian Clinical Trial Registry, RBR-7sx8j3. Registered on 26 October 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2532-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Walkyria Vilas Boas Fernandes
- Doctoral Program in Rehabilition Sciences, Nove de Julho University (UNINOVE), São Paulo, Brazil. .,Federal University of Mato Grosso (UFMT), Rondonópolis, Brazil. .,Human Movement Analysis Laboratory, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil.
| | | | - Fabiano Politti
- Doctoral Program in Rehabilition Sciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | | | | | - João Carlos Ferrari Corrêa
- Doctoral Program in Rehabilition Sciences, Nove de Julho University (UNINOVE), São Paulo, Brazil.,Human Movement Analysis Laboratory, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
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Silva SM, Corrêa JCF, Pereira GS, Corrêa FI. Social participation following a stroke: an assessment in accordance with the international classification of functioning, disability and health. Disabil Rehabil 2017; 41:879-886. [DOI: 10.1080/09638288.2017.1413428] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - João Carlos Ferrari Corrêa
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Gabriela Santos Pereira
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Fernanda Ishida Corrêa
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), São Paulo, SP, Brazil
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Fruhauf AMA, Politti F, Dal Corso S, Costa GC, Teodósio ADC, Silva SM, Corrêa JCF, Corrêa FI. Immediate effect of transcranial direct current stimulation combined with functional electrical stimulation on activity of the tibialis anterior muscle and balance of individuals with hemiparesis stemming from a stroke. J Phys Ther Sci 2017; 29:2138-2146. [PMID: 29643591 PMCID: PMC5890217 DOI: 10.1589/jpts.29.2138] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 09/20/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of the present study was to evaluate the immediate effects of transcranial direct current stimulation (tDCS) and functional electrical stimulation (FES) on activity of the tibialis anterior muscle (TA) and static balance of individuals with hemiparesis stemming from stroke. [Subjects and Methods] A randomized, double-blind, crossover, clinical trial conducted with 30 individuals with chronic post-stroke hemiparesis. Median frequency of electrical activity of the TA were determined using electromyography in five contractions concentrics and Static balance (body sway velocity and frequency), both before and immediately after the intervention. The participants were submitted to four 20-minute intervention protocols with 48-hour interval: anodal tDCS + sham FES; sham tDCS + active FES; anodal tDCS + active FES and sham tDCS + sham FES. Anodal tDCS was administered over C3 or C4, the cathode was positioned in the supraorbital region on the contralateral side and FES was administered to the affected TA. [Results] No significant differences among the protocols were found regarding electrical activity of the TA and static balance. [Conclusion] The results demonstrate that tDCS alone or in combination with FES had no immediate effect on electrical activity of the TA and static balance of the 30 individuals analyzed.
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Affiliation(s)
- Aline Marina Alves Fruhauf
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho: Rua Adolpho Pinto 109, Barra Funda, São Paulo, Brazil
| | - Fabiano Politti
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho: Rua Adolpho Pinto 109, Barra Funda, São Paulo, Brazil
| | - Simone Dal Corso
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho: Rua Adolpho Pinto 109, Barra Funda, São Paulo, Brazil
| | - Gláucio Carneiro Costa
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho: Rua Adolpho Pinto 109, Barra Funda, São Paulo, Brazil
| | - Amanda da Conceição Teodósio
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho: Rua Adolpho Pinto 109, Barra Funda, São Paulo, Brazil
| | - Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho: Rua Adolpho Pinto 109, Barra Funda, São Paulo, Brazil
| | - João Carlos Ferrari Corrêa
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho: Rua Adolpho Pinto 109, Barra Funda, São Paulo, Brazil
| | - Fernanda Ishida Corrêa
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho: Rua Adolpho Pinto 109, Barra Funda, São Paulo, Brazil
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Silva SM, Corrêa FI, Pereira GS, Faria CDCDM, Corrêa JCF. Construct validity of the items on the Stroke Specific Quality of Life (SS-QOL) questionnaire that evaluate the participation component of the International Classification of Functioning, Disability and Health. Disabil Rehabil 2016; 40:225-231. [DOI: 10.1080/09638288.2016.1250117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Soraia Micaela Silva
- Postgraduate program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Fernanda Ishida Corrêa
- Postgraduate program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Gabriela Santos Pereira
- Postgraduate program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), São Paulo, Brazil
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Silva SM, Corrêa FI, Faria CDCDM, Pereira GS, Attié EADA, Corrêa JCF. Reproducibility of the items on the Stroke Specific Quality of Life questionnaire that evaluate the participation component of the International Classification of Functioning, Disability and Health. Disabil Rehabil 2016; 38:2413-8. [DOI: 10.3109/09638288.2015.1130178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, University Nove De Julho (UNINOVE), São Paulo, SP, Brazil
| | - Fernanda Ishida Corrêa
- Postgraduate Program in Rehabilitation Sciences, University Nove De Julho (UNINOVE), São Paulo, SP, Brazil
| | | | - Gabriela Santos Pereira
- Postgraduate Program in Rehabilitation Sciences, University Nove De Julho (UNINOVE), São Paulo, SP, Brazil
| | - Edna Alves dos Anjos Attié
- Postgraduate Program in Rehabilitation Sciences, University Nove De Julho (UNINOVE), São Paulo, SP, Brazil
| | - João Carlos Ferrari Corrêa
- Postgraduate Program in Rehabilitation Sciences, University Nove De Julho (UNINOVE), São Paulo, SP, Brazil
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Micaela Silva S, Carlos Ferrari Corrêa J, da Silva Mello T, Rodrigues Ferreira R, Fernanda da Costa Silva P, Ishida Corrêa F. Impact of depression following a stroke on the participation component of the International Classification of Functioning, Disability and Health. Disabil Rehabil 2016; 38:1830-5. [DOI: 10.3109/09638288.2015.1107774] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Silva SM, Corrêa FI, Faria CDCDM, Buchalla CM, Silva PFDC, Corrêa JCF. Evaluation of post-stroke functionality based on the International Classification of Functioning, Disability, and Health: a proposal for use of assessment tools. J Phys Ther Sci 2015; 27:1665-70. [PMID: 26180294 PMCID: PMC4499957 DOI: 10.1589/jpts.27.1665] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 02/07/2015] [Indexed: 11/24/2022] Open
Abstract
This study aimed to identify the International Classification of Functioning, Disability,
and Health categories addressed by the assessment tools commonly used in post-stroke
rehabilitation and characterize patients based on its evaluation model. [Subjects and
Methods] An exploratory, descriptive, cross-sectional study was conducted involving 35
individuals with chronic post-stroke hemiparesis. Handgrip strength was assessed to
evaluate body functions and structures. The 10-meter gait speed test and Timed Up and Go
test were administered to evaluate activity. The Stroke Specific Quality of Life scale was
used to evaluate participation. Moreover, a systematic review of the literature was
performed to identify studies that have associated these assessment tools with the
International Classification of Functioning, Disability, and Health categories. [Results]
The tools employed in this study for evaluating function addressed 63 International
Classification of Functioning, Disability, and Health categories: 24 related to body
functions and structures; 36 related to activity and participation; and 3 related to
environmental factors. [Conclusion] The assessment tools employed in this study addressed
63 International Classification of Functioning, Disability, and Health categories and
allowed a more complete evaluation of stroke survivors with hemiparesis. Use of this
classification can therefore be more easily incorporated into clinical practice.
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Affiliation(s)
- Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), Brazil
| | - Fernanda Ishida Corrêa
- Postgraduate Program in Rehabilitation Sciences, University Nove de Julho (UNINOVE), Brazil
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Silva SM, Corrêa FI, Faria CDCDM, Corrêa JCF. Psychometric properties of the stroke specific quality of life scale for the assessment of participation in stroke survivors using the rasch model: a preliminary study. J Phys Ther Sci 2015; 27:389-92. [PMID: 25729175 PMCID: PMC4339145 DOI: 10.1589/jpts.27.389] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/24/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of the present study was to analyze the psychometric properties of the Stroke Specific Quality of Life (SS-QOL) scale for the assessment of social participation following a stroke. [Methods] A preliminary analysis was performed of the SS-QOL items that address the participation category. For this, the scoring patterns of the answers of individuals and internal consistence were determined using the Rasch model. Reliability was assessed by intraclass correlation coefficients (ICC). [Results] The reliability coefficients analyzed by the Rasch model were 0.91 for the items and 0.87 for the patients. The separation index was 3.19 for the items and 2.58 for the patients. The findings indicate that the items separated the patients into three levels of participation: low, medium, and high. Among the 26 items addressing participation, three did not fit the model. All items showed adequate reliability (ICC ≥ 0.60). [Conclusion] The Rasch analysis detected three items with erratic behavior; however, the erratic patterns of these items may be explained by individual peculiarities among the patients. These items should be monitored to determine if the problems found in the present study persist. If so, the items should also be revised or possibly even eliminated.
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Affiliation(s)
- Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, University
Nove de Julho (UNINOVE), Brazil
| | - Fernanda Ishida Corrêa
- Postgraduate Program in Rehabilitation Sciences, University
Nove de Julho (UNINOVE), Brazil
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Ramos E, de Oliveira LVF, Silva AB, Costa IP, Corrêa JCF, Costa D, Alves VL, Donner CF, Stirbulov R, Arena R, Sampaio LM. Peripheral muscle strength and functional capacity in patients with moderate to severe asthma. Multidiscip Respir Med 2015; 10:3. [PMID: 25973197 PMCID: PMC4429482 DOI: 10.1186/2049-6958-10-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 12/16/2014] [Indexed: 11/12/2022] Open
Abstract
Background The adequate control of asthma includes the absence of nocturnal symptoms, minimal use of medication, normal or nearly normal lung function and no limitations to physical activity. The choice of a more sedentary lifestyle can lead to physical de-conditioning, thereby aggravating asthma symptoms and increasing the risk of obesity. Methods This study aimed at performing a battery of function-related assessments in patients with asthma and comparing them to a healthy control group. A prospective, transversal and case–control study was designed. It was set up at Santa Casa de Misericórdia Hospital –Sao Paulo and Nove de Julho University on a population of outpatients. Subjects of the study were patients affected by moderate to severe asthma. A case–control study was carried out involving 20 patients with moderate to severe asthma and 15 healthy individuals (control group). All participants underwent body composition analysis (BMI and BIA) and a controlled walk test (Shuttle test), resistance muscle test (1RM) and answered a physical activity questionnaire (IPAQ). The group with asthma also answered a questionnaire addressing the clinical control of the illness (ACQ). Results In comparison to the control group (unpaired Student’s t-test), the patients with asthma had a significantly higher BMI (31.09 ± 5.98 vs. 26.68 ± 7.56 kg/m2) and percentage of body fat (38.40 ± 6.75 vs. 33.28 ± 8.23%) as well as significantly lower values regarding distance traveled on the walk test (369 ± 110 vs. 494 ± 85 meters) and metabolic equivalents (3.74 ± 0.87 vs. 4.72 ± 0.60). A strong correlation was found between the distance completed and peripheral muscle strength (r: 0.57, p < 0.05) and METs (Metabolic equivalents – minutes/week) and peripheral muscle strength of 1RM (r: 0.61, p = 0.009). Conclusions The individuals with asthma had lower functional capacity and levels of physical activity as well as a higher percentage of body fat compared to healthy individuals. This suggests that such patients have a reduced physical performance stemming from a sedentary lifestyle. Despite the existence of few studies reporting moderate to severe asthmatic patients and functional capacity assessment, it is clear that the assessment presented in the current study is a valid and accessible tool in clinical practice.
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Affiliation(s)
- Elisangela Ramos
- Rehabilitation Sciences Master's Program, Nove de Julho University, São Paulo, Brazil
| | | | | | - Ivan Peres Costa
- Rehabilitation Sciences Master's Program, Nove de Julho University, São Paulo, Brazil
| | | | - Dirceu Costa
- Rehabilitation Sciences Master's Program, Nove de Julho University, São Paulo, Brazil
| | - Vera Lucia Alves
- Santa Casa de Misericórdia São Paulo Hospital, São Paulo, Brazil
| | - Claudio F Donner
- Mondo Medico, Multidisciplinary and Rehabilitation Outpatient Clinic, Borgomanero, NO Italy
| | | | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL USA
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Artilheiro MC, Corrêa JCF, Cimolin V, Lima MO, Galli M, de Godoy W, Lucareli PRG. Three-dimensional analysis of performance of an upper limb functional task among adults with dyskinetic cerebral palsy. Gait Posture 2014; 39:875-81. [PMID: 24373786 DOI: 10.1016/j.gaitpost.2013.11.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 11/19/2013] [Accepted: 11/27/2013] [Indexed: 02/02/2023]
Abstract
Patients with dyskinetic cerebral palsy (DCP) experience considerable variability in their purposeful movements due to involuntary movements that contribute to functional impairment. Movement analyses can demonstrate how the movements involved in bringing a mug to the mouth are performed by patients with DCP. Sixteen adults with DCP (29.63±4.42 years) and eleven healthy adults (24.09±3.73 years) performed six consecutive movements of bringing a mug to the mouth using their dominant arm. The mug was placed at 75% of each subject's maximum reach. Kinematic data were captured by 10 cameras and processed using biomechanical software. Fifteen reflexive markers were placed on predetermined bony landmarks on the head, trunk and upper limbs. DCP adults required more time to perform the going (bringing the mug to the mouth), adjusting (simulating taking a drink) and returning (lowering the mug back to the table) phases, and their movements were less smooth than the controls, as indicated by the index of curvature, average jerk and number of movement units. The DCP adults took a longer time to complete the task than controls as indicated by the peak velocities, mean velocities and times to peak velocity. With respect to the angular parameters, DCP adults had a smaller range of motion for shoulder and elbow flexion and forearm pronation compared with the controls. The analysis of functional tasks represents an important measure for the evaluation of dyskinetic movements and permits the quantitative characterization of upper limb impairment in adults with DCP.
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Affiliation(s)
- Mariana Cunha Artilheiro
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil.
| | - João Carlos Ferrari Corrêa
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil.
| | - Veronica Cimolin
- Department of Electronics, Informations and Bioengineering, Politecnico di Milano, Italy.
| | - Mario Oliveira Lima
- Department of Physical Therapy, Universidade do Vale do Paraiba, São José dos Campos, São Paulo, Brazil.
| | - Manuela Galli
- Department of Electronics, Informations and Bioengineering, Politecnico di Milano, Italy; IRCCS San Raffaele Pisana, Tosinvest Sanità, Roma, Italy.
| | - Wagner de Godoy
- Movement Analysis Laboratory, Albert Einstein Hospital, São Paulo, Brazil.
| | - Paulo Roberto Garcia Lucareli
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil.
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Silva SM, Corrêa JCF, Salvador RMM, Martinez TS, Corrêa FI. Eight-point binding as a physical therapeutic resource for rehabilitation of functional performance after a stroke. Fisioter Pesqui 2014. [DOI: 10.1590/1809-2950/203210114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A stroke may leave neurological, motor and sensory sequelae, interfering with the function of movements and culminating in gait and balance changes. Therefore, it is necessary to demonstrate the efficacy of eight-point binding, a low-cost technique that functions to provide proprioceptive information and promote the biomechanical alignment of the ankle, acting against mechanisms that lead to equinovarus foot. This study aims to determine the immediate effect of eight-point binding as a physical therapy resource for the rehabilitation of function performance after a stroke. To this end, 22 patients who were able to walk alone without an orthosis were evaluated, and performed the Timed Up and Go (TUG) functional mobility test, a gait speed assessment and the Berg Balance Scale, with and without the eight-point binding in the paretic lower limb. When comparing the results after the eight-point binding, it was possible to observe a statistically significant difference (p<0.05) in all of the studied variables. After analyzing the results, it was concluded that after a single application of eight-point binding, it is possible to identify statistically significant improvement in gait speed, functional mobility and balance after a stroke.
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Grecco LAC, Duarte NDAC, de Mendonça ME, Pasini H, Lima VLCDC, Franco RC, de Oliveira LVF, de Carvalho PDTC, Corrêa JCF, Collange NZ, Sampaio LMM, Galli M, Fregni F, Oliveira CS. Effect of transcranial direct current stimulation combined with gait and mobility training on functionality in children with cerebral palsy: study protocol for a double-blind randomized controlled clinical trial. BMC Pediatr 2013; 13:168. [PMID: 24112817 PMCID: PMC3852945 DOI: 10.1186/1471-2431-13-168] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 09/17/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The project proposes three innovative intervention techniques (treadmill training, mobility training with virtual reality and transcranial direct current stimulation that can be safely administered to children with cerebral palsy. The combination of transcranial stimulation and physical therapy resources will provide the training of a specific task with multiple rhythmic repetitions of the phases of the gait cycle, providing rich sensory stimuli with a modified excitability threshold of the primary motor cortex to enhance local synaptic efficacy and potentiate motor learning. METHODS/DESIGN A prospective, double-blind, randomized, controlled, analytical, clinical trial will be carried out.Eligible participants will be children with cerebral palsy classified on levels I, II and III of the Gross Motor Function Classification System between four and ten years of age. The participants will be randomly allocated to four groups: 1) gait training on a treadmill with placebo transcranial stimulation; 2) gait training on a treadmill with active transcranial stimulation; 3) mobility training with virtual reality and placebo transcranial stimulation; 4) mobility training with virtual reality and active transcranial stimulation. Transcranial direct current stimulation will be applied with the anodal electrode positioned in the region of the dominant hemisphere over C3, corresponding to the primary motor cortex, and the cathode positioned in the supraorbital region contralateral to the anode. A 1 mA current will be applied for 20 minutes. Treadmill training and mobility training with virtual reality will be performed in 30-minute sessions five times a week for two weeks (total of 10 sessions). Evaluations will be performed on four occasions: one week prior to the intervention; one week following the intervention; one month after the end of the intervention;and 3 months after the end of the intervention. The evaluations will involve three-dimensional gait analysis, analysis of cortex excitability (motor threshold and motor evoked potential), Six-Minute Walk Test, Timed Up-and-Go Test, Pediatric Evaluation Disability Inventory, Gross Motor Function Measure, Berg Balance Scale, stabilometry, maximum respiratory pressure and an effort test. DISCUSSION This paper offers a detailed description of a prospective, double-blind, randomized, controlled, analytical, clinical trial aimed at demonstrating the effect combining transcranial stimulation with treadmill and mobility training on functionality and primary cortex excitability in children with Cerebral Palsy classified on Gross Motor Function Classification System levels I, II and III. The results will be published and will contribute to evidence regarding the use of treadmill training on this population. TRIAL REGISTRATION ReBEC RBR-9B5DH7.
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Affiliation(s)
- Luanda André Collange Grecco
- Master’s and Doctoral Programs in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
- Rua Diogo de Faria 775, Vila Mariana, CEP 04037-000 São Paulo, SP, Brazil
| | | | | | - Hugo Pasini
- Master’s and Doctoral Programs in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Vânia Lúcia Costa de Carvalho Lima
- Master’s and Doctoral Programs in Communication disordes: Speech area, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Renata Calhes Franco
- Master’s and Doctoral Programs in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | | | | | - João Carlos Ferrari Corrêa
- Master’s and Doctoral Programs in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Nelci Zanon Collange
- 4th Pediatric Neurosurgery, University of São Paulo and the Federal Pediatric Neurosurgical Center (CENEPE), São Paulo, Brazil
| | - Luciana Maria Malosá Sampaio
- Master’s and Doctoral Programs in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Manuela Galli
- Associate professor of Dipartimento di Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Felipe Fregni
- Laboratory of Neuromodulation & Center of Clinical Research Learning, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Claudia Santos Oliveira
- Master’s and Doctoral Programs in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
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Fonseca LA, Grecco LAC, Politti F, Frigo C, Pavan E, Corrêa JCF, Oliveira CS. Use a Portable Device for Measuring Spasticity in Individuals with Cerebral Palsy. J Phys Ther Sci 2013. [DOI: 10.1589/jpts.25.271] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Letícia Alves Fonseca
- Program in Rehabilitation Sciences and Physical Therapy Course, Universidade Nove de Julho: Avenida Adolpho Pinto 109, Barra Funda, São Paulo - SP, Brazil
| | - Luanda André Collange Grecco
- Program in Rehabilitation Sciences and Physical Therapy Course, Universidade Nove de Julho: Avenida Adolpho Pinto 109, Barra Funda, São Paulo - SP, Brazil
| | - Fabiano Politti
- Program in Rehabilitation Sciences and Physical Therapy Course, Universidade Nove de Julho: Avenida Adolpho Pinto 109, Barra Funda, São Paulo - SP, Brazil
| | - Carlo Frigo
- Movement Biomechanics and Motor Control Lab, Bioengineering Department, Politecnico di Milano, Milan, Italy
| | - Esteban Pavan
- Movement Biomechanics and Motor Control Lab, Bioengineering Department, Politecnico di Milano, Milan, Italy
| | - João Carlos Ferrari Corrêa
- Program in Rehabilitation Sciences and Physical Therapy Course, Universidade Nove de Julho: Avenida Adolpho Pinto 109, Barra Funda, São Paulo - SP, Brazil
| | - Cláudia Santos Oliveira
- Program in Rehabilitation Sciences and Physical Therapy Course, Universidade Nove de Julho: Avenida Adolpho Pinto 109, Barra Funda, São Paulo - SP, Brazil
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Faria CDCDM, Silva SM, Corrêa JCF, Laurentino GEC, Teixeira-Salmela LF. [Identification of ICF participation categories in quality-of-life instruments utilized in cerebrovascular accident victims]. Rev Panam Salud Publica 2012; 31:338-344. [PMID: 22652975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 02/26/2011] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE To identify the categories of the participation component of the International Classification of Functionality, Incapacity, and Health (ICF) which are currently related to Health-related Quality of Life (HRQOL) instruments commonly used in cerebrovascular accident (CVA) victims-Nottingham Health Profile (NHP), Short-Form Health Survey (SF-36), and Stroke Specific Quality of Life (SS-QOL)-and suggest the utilization of these instruments to assess and/or characterize that component in that population. METHODS Through searches in the Medline, SciELO, and Lilacs databases, a compilation of studies which associated the concepts measured by the NHP, SF-36, and SS-QOL items with the ICF components and categories, was carried out. RESULTS Of the 24 identified studies, four met the established criteria: two assessed the three HRQOL instruments, one assessed the NHP and SF-36, and the other just the SS-QOL. For each instrument, three studies were found which associated their concepts up to, at least, the second hierarchical level of the ICF categories. Considering the results that were in agreement between the three studies that assessed the same instrument, nine participation categories were associated with the NHP, seven with the SF-36, and 15 with the SS-QOL, although just one was specific to the NHP, one to the SF-36, and seven to the SS-QOL. CONCLUSIONS To assess the participation of CVA victims based upon the ICF framework, the SS-QOL appeared to be the most suitable instrument in that, in addition to assessing the greatest number of categories, it also assesses the greatest number of distinct categories, when compared to the other two HRQOL instruments, which added just one category to those measured by SS-QOL.
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de Oliveira AR, Corrêa FI, Corrêa JCF, de Oliveira LVF. Análisis de la fatiga asociada al movimiento periódico de las extremidades durante el sueño en pacientes con antecedente de poliomielitis. Rev Neurol 2012. [DOI: 10.33588/rn.5401.2011520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Corrêa JCF, Oliveira ARD, Oliveira CS, Corrêa FI. A existência de alterações neurofisiológicas pode auxiliar na compreensão do papel da hipotonia no desenvolvimento motor dos indivíduos com síndrome de Down? Fisioter Pesqui 2011. [DOI: 10.1590/s1809-29502011000400014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A proposta deste estudo foi analisar e verificar a existência de alterações neurofisiológicas nos indivíduos com síndrome de Down, como a hiporreflexia, estática e dinâmica, que, se presente, pode ocasionar prejuízo no controle sensório-motor dos músculos, e consequentemente a hipotonia, contribuindo para alterações no desenvolvimento motor. O sinal eletromiográfico (EMG), início e término do sinal eletromiográfico, foi coletado de 24 voluntários com diagnóstico de síndrome de Down e 25 voluntários como grupo controle, durante 2 situações distintas: período de latência dinâmico e teste de reflexo monossináptico (estático) patelar e aquileu. Em relação aos aspectos neurofisiológicos, observou-se que, para todas as variáveis analisadas, houve diferença estatisticamente significante (p<0,05) entre os grupos. A existência de alterações neurofisiológicas (retardo do período de latência) comprovadas neste estudo, oriundas de um prejuízo no controle sensório-motor, as quais podem ser responsáveis pela hipotonia muscular, mostrou-se como um dos vários possíveis fatores determinantes pelas alterações no desenvolvimento motor dessas crianças, tornando-se importante devido às alterações neuromusculares que podem interferir nas atividades funcionais.
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de Almeida P, Lopes-Martins RAB, De Marchi T, Tomazoni SS, Albertini R, Corrêa JCF, Rossi RP, Machado GP, da Silva DP, Bjordal JM, Leal Junior ECP. Red (660 nm) and infrared (830 nm) low-level laser therapy in skeletal muscle fatigue in humans: what is better? Lasers Med Sci 2011; 27:453-8. [PMID: 21814736 PMCID: PMC3282894 DOI: 10.1007/s10103-011-0957-3] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 06/24/2011] [Indexed: 11/05/2022]
Abstract
In animal and clinical trials low-level laser therapy (LLLT) using red, infrared and mixed wavelengths has been shown to delay the development of skeletal muscle fatigue. However, the parameters employed in these studies do not allow a conclusion as to which wavelength range is better in delaying the development of skeletal muscle fatigue. With this perspective in mind, we compared the effects of red and infrared LLLT on skeletal muscle fatigue. A randomized double-blind placebo-controlled crossover trial was performed in ten healthy male volunteers. They were treated with active red LLLT, active infrared LLLT (660 or 830 nm, 50 mW, 17.85 W/cm2, 100 s irradiation per point, 5 J, 1,785 J/cm2 at each point irradiated, total 20 J irradiated per muscle) or an identical placebo LLLT at four points of the biceps brachii muscle for 3 min before exercise (voluntary isometric elbow flexion for 60 s). The mean peak force was significantly greater (p < 0.05) following red (12.14%) and infrared LLLT (14.49%) than following placebo LLLT, and the mean average force was also significantly greater (p < 0.05) following red (13.09%) and infrared LLLT (13.24%) than following placebo LLLT. There were no significant differences in mean average force or mean peak force between red and infrared LLLT. We conclude that both red than infrared LLLT are effective in delaying the development skeletal muscle fatigue and in enhancement of skeletal muscle performance. Further studies are needed to identify the specific mechanisms through which each wavelength acts.
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Affiliation(s)
- Patrícia de Almeida
- Post Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), Rua Vergueiro, 235, 01504-001, São Paulo, SP, Brazil
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Rocco CCDM, Sampaio LMM, Stirbulov R, Corrêa JCF. Neurophysiological aspects and their relationship to clinical and functional impairment in patients with chronic obstructive pulmonary disease. Clinics (Sao Paulo) 2011; 66:125-9. [PMID: 21437448 PMCID: PMC3044581 DOI: 10.1590/s1807-59322011000100022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 11/01/2010] [Accepted: 11/25/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The purpose was to assess functional (balance L-L and A-P displacement, sit-to-stand test (SST) and Tinetti scale - balance and gait) and neurophysiological aspects (patellar and Achilles reflex and strength) relating these responses to the BODE Index. INTRODUCTION The neurophysiological alterations found in patients with chronic obstructive pulmonary disease (COPD) are associated with the severity of the disease. There is also involvement of peripheral muscle which, in combination with neurophysiological impairment, may further compromise the functional activity of these patients. METHODS A cross-sectional study design was used. Twenty-two patients with moderate to very severe COPD (> 60 years) and 16 age-matched healthy volunteers served as the control group (CG). The subjects performed spirometry and several measures of static and dynamic balance, monosynaptic reflexes, peripheral muscle strength, SST and the 6-minute walk test. RESULTS The individuals with COPD had a reduced reflex response, 36.77 ± 3.23 (p < 0.05) and 43.54 ± 6.60 (p < 0.05), achieved a lower number repetitions on the SST 19.27 ± 3.88 (p < 0.05), exhibited lesser peripheral muscle strength on the femoral quadriceps muscle, 24.98 ± 6.88 (p < 0.05) and exhibited deficits in functional balance and gait on the Tinetti scale, 26.86 ± 1.69 (p < 0.05), compared with the CG. The BODE Index demonstrated correlations with balance assessment (determined by the Tinetti scale), r = 0.59 (p < 0.05) and the sit-to-stand test, r = 0.78 (p < 0.05). CONCLUSIONS The individuals with COPD had functional and neurophysiological alterations in comparison with the control group. The BODE Index was correlated with the Tinetti scale and the SST. Both are functional tests, easy to administer, low cost and feasible, especially the SST. These results suggest a worse prognosis; however, more studies are needed to identify the causes of these changes and the repercussions that could result in their activities of daily living.
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Oliveira AR, Corrêa FI, Valim MM, Oliveira CS, Corrêa JCF. Determination of muscle fatigue index for strength training in patients with Duchenne dystrophy. Fisioter mov 2010. [DOI: 10.1590/s0103-51502010000300002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Muscle weakness is the most prominent impairment in Duchenne muscular dystrophy (DMD) and often involves the loss of functional ability as well as other limitations related to daily living. Thus, there is a need to maintain muscle strength in large muscle groups, such as the femoral quadriceps, which is responsible for diverse functional abilities. However, the load and duration of training for such rehabilitation has proven to be a great unknown, mainly due to the undesired appearance of muscle fatigue, which is a severe factor for the injury of muscle fibers. OBJECTIVES: The aim of the present study was to determine a fatigue index by means of surface electromyography (EMG) for the parameterization of muscle strengthening physiotherapy training. METHODS: A cross-sectional study (case series) was carried out involving four patients with DMD. Three pairs of surface electrodes were placed on the motor point of the Rectus femoris, Vastus lateralis and Vastus medialis of the dominant limb, maintaining the knee at 60º of flexion. The participants were instructed to perform the extension movement of this joint at four strength levels (100%, 80%, 60% and 40% of maximal voluntary isometric contraction). RESULTS: The slope of the linear regression line was used for the determination of the fatigue index, performed by Pearson's test on the median frequency of each strength level. CONCLUSION: Electromyographic measurements of the strength index for muscle training proved to be a simple accessible assessment method, as well as an extremely valuable tool, allowing the design of a muscle strength training program with an individualized load threshold.
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Corrêa FI, Corrêa JCF, Tessarolo ADA, Melo ADS, Sampaio LMM, Costa MS, Oliveira CS. Avaliação do ácido lático em indivíduos com hemiparesia pós-acidente vascular encefálico após estimulação elétrica para fortalecimento muscular. Fisioter Pesqui 2009. [DOI: 10.1590/s1809-29502009000200015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
O fortalecimento da musculatura parética promove melhora da capacidade funcional, o que pode ser obtido pela estimulação elétrica funcional (EEF), porém são necessários parâmetros específicos para evitar fadiga muscular. Este estudo visou verificar, em indivíduos com hemiparesia pós-AVE, o tempo de repouso (time off) necessário para reabsorção do ácido lático durante a EEF, de modo a evitar a fadiga - detectada por lactacidemia (concentração excessiva de ácido lático). Foram coletadas amostras de sangue de 18 indivíduos portadores de hemiparesia em sete momentos, antes, durante e após a EEF. A corrente quadrada bifásica, de 50 Hz, foi usada com time on de 10 segundos (s) e o time off variou de 10 s (protocolo 1) a 30 s (protocolo 2), sobre o ponto motor do músculo tibial anterior. Na análise do sangue coletado, não foi encontrada diferença estatisticamente significante (p>0,05) entre os dois protocolos; tampouco foi registrada diferença no período imediatamente pós-terapia. Pode-se pois afirmar que a ferramenta utilizada para mensurar lactacidemia não se mostrou eficaz na detecção da fadiga muscular, inviabilizando verificar o tempo ideal de repouso (time off), sendo necessários mais estudos em busca de protocolos seguros. Sugere-se a continuidade deste estudo, com alteração do músculo e atividade funcional eliciada pela estimulação elétrica, bem como uma ferramenta alternativa na mensuração e detecção da fadiga muscular.
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Corrêa JCF, Rocco CCDM, de Andrade DV, Peres JA, Corrêa FI. Electromyographic and neuromuscular analysis in patients with post-polio syndrome. Electromyogr Clin Neurophysiol 2008; 48:329-333. [PMID: 19097472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Proceed to a comparative analysis of the electromyographic (EMG) activity of the muscles rectus femoris, vastus medialis and vastus lateralis, and to assess muscle strength and fatigue after maximal isometric contraction during knee extension. Eighteen patients with post-polio syndrome, age and weight matched, were utilized in this study. The signal acquisition system utilized consisted of three pairs of surface electrodes positioned on the motor point of the analyzed muscles. It was possible to observe with the results of this study a decreased endurance on initial muscle contraction and during contraction after 15 minutes of the initial maximal voluntary contraction, along with a muscle fatigue that was assessed through linear regression executed with Pearson's test. There were significant differences among the comparative analysis of EMG activity of the muscles rectus femoris, vastus medialis and vastus lateralis after maximal isometric contraction during knee extension. Initial muscle contraction and contraction after a 15 minute-rest from initial contraction decreased considerably, indicating a decreased endurance on muscle contraction, concluding that a lower limb muscle fatigue was present on the analyzed PPS patients.
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Affiliation(s)
- J C F Corrêa
- Physical Therapy Clinic, Health Sciences Department, Nove de Julho University Center-UNINOVE, São Paulo, SP, Brazil.
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Corrêa JCF, Rocco CCDM, de Andrade DV, Oliveira CS, Corrêa FI. Functional implication of gait after left or right-sided stroke. Electromyogr Clin Neurophysiol 2008; 48:323-327. [PMID: 19097471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To quantify and compare parameters of muscle electrical activity and ground reaction force of lower limb during gait in post-stroke patients with left or right side functional involvement. METHOD Fifteen post-stroke volunteers with left side functional involvement were age, gender and weight matched and compared to fifteen post-stroke volunteers with right side functional involvement. Comparison was executed by means of electromyography with four pairs of surface electrodes positioned on the affected side (spastic side), on the muscles rectus femoris, tibialis anterior, soleus, and medial portion of the hamstrings, and with a ground reaction force plate. RESULTS There was no statistically significant difference on electromyographic activity of analyzed muscles (p = 0.6), nor on the analysis of ground reaction vertical forces, stride duration, weight bearing index, gait velocity, cadence and stride length (p = 0.53). CONCLUSION According to the electromyographic parameters and to the ground reaction force during gait among the post-stroke volunteers with right or left side involvement; we could suggest that functional rehabilitation presented no differences for these individuals.
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Affiliation(s)
- J C F Corrêa
- Master of Rehabilitation Sciences, July Nine University Center -UNINOVE, São Paulo, SP, Brazil.
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Corrêa FI, Soares F, Andrade DV, Gondo RM, Peres JA, Fernandes AO, Corrêa JCF. Atividade muscular durante a marcha após acidente vascular encefálico. Arq Neuro-Psiquiatr 2005; 63:847-51. [PMID: 16258668 DOI: 10.1590/s0004-282x2005000500024] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Buscar parâmetros da marcha de pacientes após ter sofrido acidente vascular encefálico (AVE) com hemiparesia. MÉTODO: Comparados 15 voluntários pós-AVE e 15 voluntários saudáveis com a mesma idade, gênero e peso. A comparação foi feita por eletromiografia utilizando cinco pares de eletrodos de superfície do lado comprometido (espástico) e um eletrogoniômetro sobre o eixo articular de rotação da articulação do tornozelo em estudo. RESULTADOS: O início da atividade eletromiográfica, a partir da fase de apoio, para os músculos glúteo medial, reto femoral, tibial anterior, sóleo, e porção medial dos isquiotibiais foi significantemente ativados anteriormente durante o ciclo da marcha nos voluntários pós-AVE. O final da atividade eletromiográfica para os músculos reto femoral, tibial anterior, sóleo, e porção medial dos isquiotibiais foi significantemente prolongado nos voluntários pós-AVE. Voluntários pós-AVE demonstraram também mais co-ativação dos músculos agonistas e antagonistas da articulação do tornozelo e joelho durante a fase de balanceio. CONCLUSÃO: Essas alterações e co-contrações musculares da marcha permitem que os voluntários pós-AVE adotem um padrão de marcha mais seguro e mais estável para compensar a diminuição da informação sensorial da articulação do tornozelo.
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Affiliation(s)
- Fernanda Ishida Corrêa
- Clínica de Fisioterapia, Departamento de Ciências da Saúde, Centro Universitário Nove de Julho, São Paulo, SP, Brasil
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