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- ItemAcesso aberto (Open Access)ASSESSMENT of the EFFECTIVENESS of A FUNCTIONAL SPLINT for OSTEOARTHRITIS of the TRAPEZIOMETACARPAL JOINT of the DOMINANT HAND: A RANDOMIZED CONTROLLED STUDY(Foundation Rehabilitation Information, 2010-05-01) Carreira, Ana Claudia Gomes; Jones, Anamaria [UNIFESP]; Natour, Jamil [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To assess the effectiveness of a functional splint for trapeziometacarpal osteoarthritis.Methods: Forty patients with a diagnosis of painful trapeziometacarpal osteoarthritis of the dominant hand were randomized into 2 groups. the study group received the splint at baseline and used it during activities of daily living for 180 days and the control group used the splint only during the evaluations for the first 90 days and during activities of daily living for the following 90 days. Pain, strength, hand function and dexterity (with and without splint) were measured by a blinded assessor at baseline, 45, 90 and 180 days.Results: the groups were homogenous at baseline for all outcomes evaluated. Pain without the splint was significantly different between groups over time; the study group experienced a decrease in pain beginning with the first evaluation (45 days), whereas the control group achieved a lower pain score only at the end of the study, after having used the splint for 90 days. No significant differences between groups were found for the other parameters.Conclusion: Splint use during activities of daily living for patients with trapeziometacarpal osteoarthritis reduces pain, but does not alter function, grip strength, pinch strength or dexterity.
- ItemSomente MetadadadosCoenzyme Q(10) exogenous administration attenuates cold stress cardiac injury(Japan Heart Journal, Second Dept of Internal Med, 2001-05-01) Murad, Neif [UNIFESP]; Takiuchi, Katia [UNIFESP]; Lopes, Antonio C. [UNIFESP]; Bonilha, André MM [UNIFESP]; Souza, Marcio M. [UNIFESP]; Demarchi, Lea Maria MF; Higuchi, Maria de Lourdes; Tucci, Paulo JF [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)The influence of coenzyme Q(10) (CoQ(10)) in cold stress test (-15 degreesC for 4 hours) cardiac functional impairment was studied in isolated isovolumic heart of control rats (C; n=12) and of placebo (P; n=11) and treated rats (CoQ(10); n=10). in addition, electron microscopic evaluation of left ventricular (LV) slices (n=3 in each group) allowed us to analyze the myocardial ultrastructure. Maximal values of developed pressure (DPmax) were similarly decreased in cold stressed animals (C=129 +/-3.9 mmHg; P=106 +/-6.7 mmHg; CoQ(10)=91 +/-3.9 mmHg); however, volume-induced enhancement of pressure generation (slope of DP / volume relations: C=0.248 +/-0.0203 mmHg/mul; P=0.2831 +/-0.0187 mmHg/mul; CoQ(10)=0.2387 (0.0225 mmHg/mul; p >0.05), and the duration of systole (C=80 +/- .6 ms; P=78 +/-1.3 ms; CoQ(10) = 80 +/-2.7 ms) were not altered. Myocardial relaxation, evaluated by the relaxation constant (C=39 +/-1.9 ins; P=42 +/-3.4 ms; CoQ(10)=51 +/-6.0 ms), as well as resting stress / strain relations were unaffected by cold stress. Myocardial samples showed that pretreatment with CoQ(10) attenuates myofibrillar and mitochondrial lesions, and prevents mitochondrial fractional area increase (P: 53.11%> CoQ(10): 38.78%=C: 33.87%; p <0.005) indicating that the exogenous administration of CoQ(10) can reduce cold stress myocardial injury.
- ItemSomente MetadadadosCommunicating with the non-dominant hemisphere Implications for neurological rehabilitation(Shenyang Editorial Dept Neural Regeneration Res, 2013-05-01) Oliveira, Fabricio Ferreira de [UNIFESP]; Marin, Sheilla de Medeiros Correia [UNIFESP]; Bertolucci, Paulo Henrique Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Aphasic syndromes usually result from injuries to the dominant hemisphere of the brain. Despite the fact that localization of language functions shows little interindividual variability, several brain areas are simultaneously activated when language tasks are undertaken. Mechanisms of language recovery after brain injury to the dominant hemisphere seem to be relatively stereotyped, including activations of perilesional areas in the acute phase and of homologues of language areas in the non-dominant hemisphere in the subacute phase, later returning to dominant hemisphere activation in the chronic phase. Plasticity mechanisms reopen the critical period of language development, more specifically in what leads to disinhibition of the non-dominant hemisphere when brain lesions affect the dominant hemisphere. the non-dominant hemisphere plays an important role during recovery from aphasia, but currently available rehabilitation therapies have shown limited results for efficient language improvement. Large-scale randomized controlled trials that evaluate well-defined interventions in patients with aphasia are needed for stimulation of neuroplasticity mechanisms that enhance the role of the non-dominant hemisphere for language recovery. Ineffective treatment approaches should be replaced by more promising ones and the latter should be evaluated for proper application. the data generated. by such studies could substantiate evidence-based rehabilitation strategies for patients with aphasia.
- ItemAcesso aberto (Open Access)EFFECTIVENESS of A NIGHT-TIME HAND POSITIONING SPLINT in RHEUMATOID ARTHRITIS: A RANDOMIZED CONTROLLED TRIAL(Taylor & Francis As, 2008-10-01) Silva, Ana Carolina [UNIFESP]; Jones, Anamaria [UNIFESP]; Silva, Paula Gabriel [UNIFESP]; Natour, Jamil [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the effectiveness of a night-time hand positioning splint in patients with rheumatoid arthritis.Design: Randomized controlled trial.Methods: Fifty patients with rheumatoid arthritis were divided randomly into 2 groups. the study group used a night-time splint starting at baseline, while the control group used the splint only, during evaluations. All patients attended evaluations wearing their splints, so that the assessor remained blinded to patient allocation. the splints used in the control group were stored in a cabinet between assessments. Participants were evaluated at baseline, 45 and 90 days, using the visual analogue scale for pain; the Jamar dynamometer for grip strength; a pinch gauge for pinch strength; a Health Assessment Questionnaire for function; the Disability of the Arm, Shoulder and Hand (DASH) questionnaire for upper limb disability and symptoms; and a Likert scale for patient satisfaction with treatment.Results: the groups were homogenous for all parameters at baseline. Pain, Health Assessment Questionnaire score, DASH score, grip strength and pinch strength were significantly different between groups over time and satisfaction with the splint was reported as better and much better by most participants.Conclusion: the use of a night-time hand positioning splint reduces pain, improves grip and pinch strength, upper limb function and functional status in patients with rheumatoid arthritis.
- ItemSomente MetadadadosEffects of customized bicarbonate buffered solutions for continuous renal replacement therapies on polymorphonuclear leukocytes function and viability(Blackwell Publishing Inc, 2004-06-01) Maccariello, E.; Dalboni, Maria Aparecida [UNIFESP]; Draibe, S. A.; Rocha, E.; Santos, OFP dos; Santos, B.; Cendoroglo, M.; Universidade Federal de São Paulo (UNIFESP); Universidade Federal Fluminense (UFF); Universidade Federal do Rio de Janeiro (UFRJ); Albert Einstein Jewish HospIt has previously been shown that the mixture of bicarbonate and calcium in the solutions used for continuous renal replacement therapy led to crystalization and significant changes in calcium concentration and pH. the aim of this study was to investigate the impact of bicarbonate/calcium and lactate/calcium solutions for Continuous Renal Replacement Therapies (CRRT) on the viability and function of polymorphonuclear cells (PMN). We tested four customized bicarbonate buffered solutions: single bag (bicarbonate and calcium mixed 24 h before testing), double bag (mixed immediately before testing), filtered single bag and double bag solutions, and a commercial lactate buffered solution. Blood from 6 volunteers was incubated with the solutions for 30 min followed by PMN isolation. After overnight incubation, viability, phagocytosis, and peroxide production by PMN were determined by flow cytometry. There was no difference between the test solutions with respect to PMN viability and function. Therefore, the presence of microcrystals and the consequent changes in electrolyte concentrations do not seem to impair PMN function.
- ItemSomente MetadadadosProgressive resistance exercise in women with osteoarthritis of the knee: a randomized controlled trial(Sage Publications Ltd, 2015-03-01) Borges Jorge, Renata Trajano [UNIFESP]; Souza, Marcelo Cardoso de [UNIFESP]; Chiari, Aline [UNIFESP]; Jones, Anamaria [UNIFESP]; Correa Fernandes, Artur da Rocha [UNIFESP]; Lombardi Júnior, Imperio [UNIFESP]; Natour, Jamil [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To determine the effect of a progressive resistance exercise (PRE) program on women with osteoarthritis (OA) of the knee.Methods: Eligible subjects included women aged 40 to 70 years with pain between 3 and 8 on a 10-cm pain scale. Among the 144 subjects screened, 60 met the eligibility criteria and were randomized to the experimental group (EG) or control group (CG). Subjects in the EG participated in a 12-week PRE program twice a week and CG remained on a waiting list for physical therapy. the PRE program consisted of strengthening exercises for knee extensors, knee flexors, hip abductors and hip adductors, all performed with 50% and 70% of the one-repetition maximum (1RM) using machines with free weights. Resistance was reevaluated every two weeks. Assessments of pain, muscle strength, walking distance, function and quality of life were performed at baseline, six weeks and 12 weeks by a blinded assessor.Results: Twenty-nine female subjects were randomly assigned to the EG and 31 were randomly assigned to the CG. Repeated-measures ANOVA revealed significantly better results in the EG pain (from 7.0 +/- 1.3 to 4.3 +/- 3.1 in the EG and from 7.0 +/- 1.2 to 6.6 +/- 1.5 in the CG - p<0.001), function (p<0.001), some domains of quality of life (physical function: p=0.002; physical role limitation: p=0.002; and pain: p=0.044) and muscle strength (extensors: p<0.001; flexors: p=0.002; and abductors: p<0.001).Conclusion: the PRE program was effective in reducing pain and improving function, some quality of life domains and strength in women with OA of the knee.
- ItemAcesso aberto (Open Access)Side-to-side growth discrepancies in children with hemiplegic cerebral palsy: association with function, activity and social participation(Academia Brasileira de Neurologia - ABNEURO, 2014-05-01) Zonta, Marise Bueno; Ramalho-júnior, Amâncio; Puppi, Marilene; Bruck, Isac; Magdalena, Neiva; Muzzolon, Sandra Regina B.; Carvalho-neto, Arnolfo De; Santos, Lúcia H Coutinho Dos; Curitiba; PR; Universidade Federal do Paraná Hospital de Clínicas Centro de Neuropediatria; São Paulo; SP; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Paraná Departamento de Pediatria; Universidade Federal do Paraná Departamento de Clínica Médica; Hospital Albert EinsteinObjective: Evaluate side-to-side discrepancies in children with hemiplegic cerebral palsy (HCP), and investigate associations of these discrepancies with patients’ age at initiation of physical therapy, motor and cognitive function, and degree of activities and social participation. Method: We obtained eight side-to-side measurements from 24 HCP children with mean age 49.3±5.2 months. Results: Early initiation of physical therapy was associated with lower discrepancy in hand length (p=0.037). Lower foot length discrepancy was associated with lower requirement for caregiver assistance in activities related to mobility. Increased side-to-side discrepancy was associated with reduced wrist extension and increased spasticity. Discrepancy played a larger role in children with hemineglect and in those with right involvement. Conclusion: Increased discrepancy in HCP children was associated with reduced degree of activity/social participation. These results suggest an association between functional use of the extremities and limb growth.