Programa de pós-graduação em Ciências da Reabilitação
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Master Thesis Fatores preditores da incapacidade de pacientes pós-acidente vascular cerebral: um estudo transversal baseado na classificação internacional de funcionalidade, incapacidade e saúde(Universidade Federal do Rio Grande do Norte, 2024-10-18) Santos, Raweny Thayna Gomes dos; Fernandes, Aline Braga Galvão Silveira; https://orcid.org/0000-0002-7976-8009; http://lattes.cnpq.br/9406431536920693; http://lattes.cnpq.br/6126246188956527; Cacho, Enio Walker Azevedo; Castro, Shamyr Sulyvan deIntroduction: Stroke causes global complications that impact the lives of survivors. Therefore, it is necessary to evaluate these patients more thoroughly, considering all components and the perspective of the International Classification of Functioning (ICF). Objective: To evaluate the predictors of disability in post-stroke patients considering the ICF model. Material and methods: This is a cross-sectional study that evaluated 60 post-stroke patients of both sexes aged 18 years and older. Patients were evaluated using specific forms and questionnaires on various areas of their lives that are related to functioning and disability, namely: WHODAS, Motricity Index, Hospital Anxiety and Depression Scale, Pittsgurgh Sleep Quality, International Consultation on Incontinence Questionnaire and International Physical Activity Questionnaire. Results: The study included 60 individuals with a mean age of 68,0 ± 12,0 years. The majority are male (56,7%), unemployed (81,7%) and with ischemic stroke (66,7%). In the multiple linear regression, in general, it was seen that the level of physical activity, the presence of depressive symptoms, the use of orthoses, the decrease in limb strength, the amount of medication used, poor sleep quality, the presence of urinary incontinence and the habit of not leaving the house were predictive factors of general disability and its specific domains. Conclusion: It is concluded that the analysis of disability in post-stroke patients, based on the ICF biopsychosocial model, allowed the identification of important predictors, such as low level of physical activity, depressive symptoms, use of orthosis, reduced limb strength, greater use of medications, poor sleep quality, urinary incontinence and the habit of not leaving the house.Master Thesis Avaliação cognitiva em pacientes pós-AVC e sua relação com a aprendizagem motora implícita(Universidade Federal do Rio Grande do Norte, 2024-04-24) Araújo, Josefa Lidiany Ferreira da Silva; Cacho, Enio Walker Azevedo; Alves, Marcus Vinicius Costa; http://lattes.cnpq.br/1441158405773422; http://lattes.cnpq.br/7371695127039138; http://lattes.cnpq.br/5936189428464272; Fonseca Filho, Gentil Gomes da; Zibetti, Murilo RicardoStroke is among the leading causes of death in the world, with a considerable number of new cases registered annually. Most interventions are aimed at physical rehabilitation and focused on facilitating recovery using principles of motor learning, and cognitive processes starting from explicit and implicit aspects. The objective of this study was to analyze if there is a relationship between cognitive functions and implicit motor learning in post-stroke patients. It is a descriptive, cross-sectional study conducted with a sample of 20 individuals, based on the number of hospital admissions in the Unified Health System in 2021, related to the 5th health region of Rio Grande do Norte, with the cause being unspecified stroke. The median age of the participants was 61.5 (55.7/72.0) years, with higher prevalence of males 14 (63.6%), and an average of 8.0 (4.0/11.0) years of education. The most frequent type of stroke in the sample was ischemic, accounting for 14 (63.6%). For clinical characterization, was used the NIH Stroke Scale (NIHSS), indicating mild impairment at 1.5 (0.0/4.2). The Fugl-Meyer Scale showed marked motor impairment at 73.0 (57.7/90.0), and the DASS-21 indicated moderate levels of stress at 18.0 (15.0/24.0) and anxiety at 12.0 (6.0/14.5), with no indication of depression at 11.0 (5.5/16.5). The cognitive evaluation was performed using the Neupsilin, showing difficulties in visual memory at 2.0 (1.0/2.0), arithmetic skills at 4.0 (0.0/5.2), and language 47.5 (20.5/49.2). The Random Number Generation task did not show difficulties with executive functions 0.3 (0.3/0.5). The workload in the NASA Task Load Index after the Player Feedback task (used to assess implicit motor learning) was 20.3 (17.8/27.8). In the Player Feedback task, the average number of correct responses was 49.0 (17.0/79.2) in the more affected arm and 69.0 (37.0/90.5) in the less affected arm. The highest number of consecutively correct sequences had an average of 0.0 (0.0/0.0) in the more affected arm and 0.0 (0.0/0.5) in the less affected arm. For statistical analysis, JASP 0.17.1.0 software was used, employing Spearman's correlation and Mann-Whitney U test for non-normal samples. Implicit motor learning showed a negative correlation with stress (rho -0.511 / p-0.043); depression (rho -0.499 / p-0.049); short-term visual memory (rho -0.507 / p-0.045); spontaneous writing (rho -0.540 / p-0.031) and workload (rho -0.570 / p-0.021). And showed a positive correlation with Face perception (rho 0.456 / p-0.043) and Reflexive praxis (rho 0.456 / p-0.043). It is concluded that, in the evaluated sample, implicit motor learning showed correlation with certain cognitive and emotional aspects.Master Thesis Percepção biológica do movimento humano em indivíduos após acidente vascular cerebral(Universidade Federal do Rio Grande do Norte, 2022-12-19) Oliveira, Marcella Cabral de; Cacho, Enio Walker Azevedo; http://lattes.cnpq.br/7371695127039138; http://lattes.cnpq.br/9980035687038572; Souza, Luciane Aparecida Pascucci Sande de; Cacho, Roberta de OliveiraIntroduction: To study the perception of biological movement (BM), a method known as point-of-light animation has been used, which preserves the kinematic characteristics of human movement and provides adequate information for movement recognition. Several studies describe systems and databases that propose to verify this ability in young adults, but there is a lack of analyzes in individuals with neurological injuries and the elderly. Objectives: Article 1 - To develop and test the usability of a system for analyzing the perception of BM in healthy elderly patients and Article 2 - To assess whether post-stroke individuals have impaired biological perception of movement. Material and Methods: Article 1 is a pilot study and Article 2 is a cross-sectional, quantitative experimental study with post-stroke patients and healthy elderly subjects submitted to the task of biological perception of human movement. The task consisted of presenting stimuli from points-of-light of natural and unnatural forms of human beings, male and female, of thirteen movements: march, lateral march, high jump, long jump, sit and stand, pedaling, kicking, playing ball, picking up an object on the floor, sweeping, bringing a bottle of water to your mouth, waving and greeting between two people. To analyze the participants' perception, for each of the experimental conditions, we calculated the correct and incorrect rates of each participant, in addition to the response time and the number of correct verbal responses by the participants for the natural movements. Results: In Article 1, the system was developed to allow data acquisition, capture and processing of outcome variables. In addition, it was built to be easily used by the therapist in a clinical environment and capable of producing feedback on the individual's perception of BM. At the end of the experiment, the system provides a report with information regarding the characterization of the user, added to the generated variables. In Article 2, the control group showed an increase in the total number of correct answers in the tasks, although there was no difference between the groups (p = 0.1620). Mean response time was different between groups in the following tasks: waving (p = 0.0022), gait (anterior posterior p = 0.0006; lateral p = 0.0376), kicking (p = 0.0284), picking up an object from the floor (p = 0.0284), sitting down and getting up (p = 0.0452), pedaling (p = 0.0233) and sweeping (p = 0.0257). This impaired perception was more evident for tasks involving objects and may be related to the severity of sensorimotor impairment in these individuals. Conclusion: The developed system met the expected objectives, being low cost, easy and quick to apply, and can be used to assess the perception of BM. In addition, poststroke patients presented a perception of impaired BM compared to healthy elderly. Therefore, the implementation of point-of-light stimuli to analyze BM perception can be useful in the area of neurological rehabilitation, in order to minimize difficulties in interpersonal communication and in the social functioning of these individuals.Master Thesis Player feedback - equipamento para avaliação da aprendizagem motora pós-AVC: estudo piloto(Universidade Federal do Rio Grande do Norte, 2021-05-06) Taveira, Raíssa Souza; Cacho, Enio Walker Azevedo; http://lattes.cnpq.br/7371695127039138; http://lattes.cnpq.br/5754278479103211; Lima Filho, Paulo Augusto de; http://lattes.cnpq.br/6923870491324619; Cacho, Roberta de Oliveira; http://lattes.cnpq.br/9802587696943482; Pacheco, Thaiana Barbosa Ferreira; http://lattes.cnpq.br/5579550584415825Background: Stroke has been reported as the second cause of death and one of the leading causes of disability worldwide. Deficits caused by stroke, mainly in upper limb, lead to limitations in daily, professional, and social life activities. Motor learning principles are included in many rehabilitation interventions to improve upper limb function. However, only few devices are available for motor learning assessment and training. Therefore, this study aimed to develop a device to assess motor learning using in post-stroke individuals. Methods: This study follows Tseng's methodology for innovative product design and development, consisting of two stages (device development and testing). Then, eight individuals were intentionally recruited for device testing by measuring the number of correct answers, number of advanced correct answers, average reaction time, learning sequence, total of correct sequences, and score. Results and discussion: A simple, low-cost, user-friendly, and quickly applied device was developed. Player Feedback development and design aimed to guide upper limb movements by visual stimuli linked to a control module containing software to compute motor performance variables, using reaching/pointing task and considering motor learning theories. Player Feedback measurements can be used in rehabilitation, therapeutic monitoring, and new therapeutic approaches development since these motor learning variables are not observed in clinical instruments and are often altered post-stroke. Conclusion: The Player Feedback is a motivating and innovative tool to perform reaching/pointing tasks in post-stroke individuals. Motor learning assessment using Player Feedback showed to be effective in poststroke individuals, improving sequence learning task performance. Therefore, this approach further befits the neurorehabilitation process, guiding evaluation, therapy, patients, and health professionals for treatment optimization.Master Thesis Conhecimento dos fisioterapeutas sobre estilo de vida ativo e comportamento sedentário pós-AVC: um estudo observacional(Universidade Federal do Rio Grande do Norte, 2021-05-14) Carvalho, Adriano Araújo de; Cacho, Roberta de Oliveira; http://lattes.cnpq.br/9802587696943482; http://lattes.cnpq.br/8186655830322218; Lima, Illia Nadinne Dantas Florentino; http://lattes.cnpq.br/9427677288797166; Seki, Karla Luciana Magnani; http://lattes.cnpq.br/6370249106562076INTRODUCTION: The low level of physical activity and sedentary behavior worsen the condition of patients after stroke. (CVA), they can even increase the risk of these patients having new stroke events. Therefore, physical exercise programs that promote an active lifestyle must be implemented in post-stroke patients. However, do professionals who care for these patients know the influence of sedentary behavior and the importance of an active lifestyle? PURPOSE: to evaluate the knowledge of physical therapists in Brazil about the active lifestyle of post-stroke patients and to compare the knowledge between physical therapists working of in the fieldwith neurofunctional physiotherapy and those not working. METHODOLOGY: This is a cross-sectional observational study using an online questionnaire with physiotherapy professionals from Brazil who were divided into two groups: those who worked in the neurofunctional area as the area of major activity and those from other areas. Professionals who were away from therapeutic practice were excluded. The questionnaire was developed on the Google Forms® platform, sent through social networks and email registered in the respective Regional Councils of Physiotherapy and Occupational Therapy. RESULTS: Of the 174 participants, we saw that professionals working in neurofunctional physical therapy have greater knowledge of studies that show the importance of physical activity (p < 0.0001). However, in relation to knowing the expression sedentary behavior, half (50%) of the professionals working in neurofunctional physical therapy did not know the expression and there was no difference between the groups (p=0.311). CONCLUSION: there was a difference in knowledge among professionals working with neurofunctional physiotherapy regarding the importance of physical activity practice and the benefits of this training in post-stroke patients, even half not to knowing the term sedentary time.