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RAYNARA MARITSA CAVALCANTE PESSOA
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EVALUATION OF IMMEDIATE INTERFERENCE AFTER INTERVENTION WITH DOUBLE TASK IN ELDERLY
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Leader : NUBIA MARIA FREIRE VIEIRA LIMA
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MEMBRES DE LA BANQUE :
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CLAUDIA SANTOS OLIVEIRA
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ENIO WALKER AZEVEDO CACHO
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KELLY SOARES FARIAS
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NUBIA MARIA FREIRE VIEIRA LIMA
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SAIONARA MARIA AIRES DA CAMARA
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Data: 16 janv. 2019
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Afficher le Résumé
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Introduction: With aging, there is a decline in the adaptive responses necessary to perform daily activities, thus increasing susceptibility to diseases and functional limitations. The cognitive motor interference is the accomplishment of a motor task and a cognitive accomplished simultaneously, the elderly present greater difficulty to carry out these activities. Training can promote walking, balance and cognition, however, there are no types of tasks and duration established for this training. Objective: To investigate the immediate interference of an intervention proposal with different cognitive-motor and motor-motor tasks on the balance of the elderly. Methods: Eight questionnaires / tests were used, besides the evaluation in the force platform, the subjects were divided in two groups, one group was submitted to a single intervention proposal with Double Task and the other with Simple Tasks, after the intervention were reevaluated. Results: We evaluated 30 elderly people who were randomly distributed among the groups. Regarding the sociodemographic data, motor evaluation and cognitive performance, individuals from both groups presented in a homogeneous way, the self report of difficulty to double task presented similar results. Compared to the simple test, there was an increase in the duration of the F8W motor and cognitive TUG and cognitive TUG tests. After the intervention, the Dupla Task group maintained its performance in the tests and presented improvement in the cognitive performance of the activities of semantic fluency, calculation and figures during posturography, whereas the Simple Task group required more time for the simple and motor TUG and presented oscillation in the postural control in the condition of open eyes, semantic fluency and figures, without increase in the number of hits. Conclusions: The secondary tasks caused an increase in the time to perform the functional tests, except for the motor TUG. After the intervention, the performance in the tests of the Double Task group was superior to the Simple Task group, the number of hits was similar. In the posturographic evaluation, there was an improvement in cognitive performance for the Dupla Task group, whereas the Simple Task group presented a greater oscillation for some activities, without improvement in their cognitive performance. There was no difference between the groups on the self report of the frequency of difficulty to perform double task.
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2
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ELIDA RAYANNE VIANA PINHEIRO GALVAO
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TRANSCULTURAL ADAPTATION AND VALIDATION FOR THE USE IN BRAZIL OF THE MEASURE OF PARTICIPATION AND THE ENVIRONMENT - CHILDREN AND YOUTH (PEM-CY)
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Leader : EGMAR LONGO HULL
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MEMBRES DE LA BANQUE :
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EGMAR LONGO HULL
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KLAYTON GALANTE SOUSA
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ANA CAROLINA DE CAMPOS
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Data: 31 janv. 2019
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Introduction: Participation is defined by the International Classification of Functioning, Disability and Health (ICF) as the individual's involvement in everyday situations, being determined by intrinsic factors and the environment. Objectives: To carry out the cross-cultural adaptation of the Measure of Participation and the Environment - Children and Youth (PEM-CY) to Brazilian Portuguese; and to analyze their psychometric properties in a sample of children and youth with and without disabilities, aged 5-17 years. Methods: This is a methodological study developed in two stages. The first one comprised the process of cross-cultural adaptation, which was divided and executed in five stages, following the methodology widely used and recommended by Beaton and Collaborators. The stages were divided into: (I) Initial adaptation to Brazilian Portuguese; (II) Synthesis of the versions; (III) Back-translation; (IV) Committee of experts; (V) Parent understanding and back-translation for final approval. The second stage was characterized by the application of the questionnaire to 101 parents and/or caregivers of children and youth with and without disabilities from 3 Brazilian states, in order to attest their psychometric properties, as well as to identify supposed differences in participation and characteristics of the environment at home, at school and in the community between the two groups. Results: Linguistic and grammatical modifications were made to facilitate fluency, interpretation and comprehension in reading the instrument, as well as to make the expressions more equivalent to the language in the first stage of the study, giving rise to the definitive version of PEM-CY Brasil, which was approved by the authors of the original version and is commercially available on CanChild's official website. In the second stage, of the 101 children and youth recruited, 62 had a disability and 39 presented a typical development; 45.5% were female and 54.5% were male, with a mean age of 9.36 years (+/- 3.47). The internal consistency of the instrument varied from good to excellent when considering all the participation items and the environment, respectively, at home (α = 0.873 and α = 0.760), at school (α = 0.877 and α = 0.948) and in the community (α = 0.889 and α = 0.855). There were significant differences between groups in terms of the number of activities performed in the three scenarios, indicating that children with disabilities participated in fewer activities at home (p = 0.000), at school (p = 0.001) and in the community (p = 0.000 ). Children with disabilities were less involved than their non-disabled peers in school setting activities (p = 0.034). In relation to the environment, the disabled group perceived higher barriers at home (p = 0.001) and fewer aids in the home (p = 0.000), school (p = 0.002) and community (p = 0.011) settings than the non-disabled group. Conclusion: After the transcultural adaptation process, the Brazilian version of PEM-CY can be considered a valid and reliable instrument to measure participation in activities at home, at school and in the community, as well as the characteristics of the environment. At the same time, the instrument made it possible to identify differences between children and youth with and without disabilities in relation to participation and the environment.
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3
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YAGO TAVARES PINHEIRO
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EFFECT OF KINESIO TAPING ON PAIN, EDEMA, MUSCLE STRENGTH, PHYSICAL FUNCTION AND GLOBAL PERCEPTION OF CHANGE IN ELDERLY WOMAN WITH KNEE OSTEOARTRITE: RANDOMIZED, CONTROLLED, BLIND TRIAL
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Leader : CAIO ALANO DE ALMEIDA LINS
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MEMBRES DE LA BANQUE :
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CAIO ALANO DE ALMEIDA LINS
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JAMILSON SIMOES BRASILEIRO
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FRANCISCO LOCKS NETO
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Data: 31 mai 2019
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INTRODUCTION: Osteoarthritis (OA) is one of the most common diseases in the elderly population and the knee is one of the most affected joints, representing a potential cause of disability and reduced quality of life. In this perspective, kinesio taping (KT) appears as a cheap and practical therapeutic alternative for the treatment of these individuals. However, the current evidence on this technique is limited and conflicting, which means that its effects on the symptomatology of the disease are still uncertain. OBJECTIVE: To analyze the effects of KT application on pain, muscle strength, edema, physical function and overall perception of change in elderly women with knee OA (KOA). MATERIALS AND METHODS: In this randomized, blinded trial, 45 elderly women were allocated to three groups: G1 (placebo group), who received the application of KT without tension on the rectus femoris and knee; G2 (control group), submitted to a class on KOA; and G3 (intervention group) in which two KT techniques were applied simultaneously with 30% and 10% tension, respectively, on the rectus femoris and the knee. The pain was evaluated by Visual Analogue Scale (EVA), quadriceps muscle strength by handheld dynamometry, physical function by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and the 6-minute Walk Test (6MWT). Furthermore, edema was measured by knee perimetry and the overall perception of change by the Patient Global Impression of Change. All volunteers were evaluated before, immediately after and 72 hours after the intervention. The Kolmogorov-Smirnov and Levene tests were applied to evaluate the normality and homogeneity of the data, respectively. Intra and intergroup comparisons were evaluated using analysis of variance ANOVA of mixed model. In the presence of a significant F, the Benferroni pot-hoc test was used to identify where the difference occurred. For all statistical analyzes a significance level of 5% (p <0.05) and 95% confidence interval (95% CI) were adopted. Statistical analysis was performed using SPSS® software (Statistical Package Social Science) version 20.0. RESULTS: The intragroup analysis showed an improvement in pain in favor of the placebo group and intervention, in addition to the increase of quadriceps strength in the placebo group. Physical function improved in all groups assessed. On the other hand, no improvement was observed in relation to edema in any of the groups. In the intergroup analysis, no significant differences were observed for any of the variables analyzed in either group. Finally, volunteers in the intervention and placebo groups reported experiencing some beneficial change with treatment. CONCLUSION: KT is not able to improve pain, quadriceps muscle strength, edema and physical function of elderly women with KOA.
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4
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ANA GABRIELA DE FIGUEIREDO ARAUJO
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APPLICATION OF A THREE-DIMENSIONAL KINEMATIC MODEL FOR PREDICTION OF CURRENT VOLUME IN NEWBORNS: A PILOT STUDY
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Leader : SILVANA ALVES PEREIRA
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MEMBRES DE LA BANQUE :
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CRISTIANE APARECIDA MORAN
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DIEGO DE SOUSA DANTAS
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SILVANA ALVES PEREIRA
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Data: 3 juin 2019
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Background: Chest movement quantification and noninvasive monitoring have been useful in evaluation of newborn (NB) lung function. Different methods have already been tested, however, there is little progress regarding the agreement of these new tools in neonatal practice. Aim: To evaluate the agreement between the tidal volume (TV) estimated by the three-dimensional analysis of the thoracoabdominal movement in the Matlab® software and the TV predicted by the body weight of term newborns (NBs). Methods: This is a cross-sectional, quantitative and analytical study with NBs filmed for 2 minutes in a dorsal position and maximal exposure of the thoracoabdominal region. TV (in ml) was estimated from the three-dimensional analysis of thoracoabdominal movement in the Matlab® software and compared to the predicted TV per kilogram of weight for each NB (5 ml/kg), on a Bland-Altman plot. Results: Thirteen NBs (gestational age: 39.1 ± 0.8 weeks), with a mean weight and length of 3175.4 ± 493.8g and 49 ± 2.8cm, respectively, were included in the study. TV estimated by the kinematic analysis was 16.3 ± 4.2 ml and 15.9 ± 2.5 ml according to the calculation for the predicted value for weight. The difference between the means of the studied values was 0.4 ml (bias), with p = 0.624 and confidence interval of -5.2 to 6.0 ml. Conclusions: The methods for TV measuring are interchangeable in this sample of NBs, suggesting that the threedimensional analysis of thoracoabdominal motion in Matlab® software can estimate the TV of terms NBs, in a simple, fast and noninvasive way. Thus, the evaluation by Matlab® is promising and should be tested with methods that are gold standard for TV evaluation.
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5
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MARIA CECÍLIA DE ARAÚJO SILVESTRE
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CONSTRAINT INDUCED THERAPY IN GROUP FORMAT FOR RECOVERY OF MOTOR FUNCTION OF UPPER LIMB: COMPARING TWO PROTOCOLS
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Leader : ROBERTA DE OLIVEIRA CACHO
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MEMBRES DE LA BANQUE :
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ALYNE KALYANE CÂMARA DE OLIVEIRA
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ENIO WALKER AZEVEDO CACHO
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ROBERTA DE OLIVEIRA CACHO
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Data: 26 juin 2019
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Objective: To compare the administration of constraint-induced therapy (CIT) with the original protocol of 6 hours and modified protocol of 3 hours in the neurofunctional recovery of post-stroke patients in group format. Methods: Eleven patients from the Physiotherapy School Clinic of the UFRN / FACISA were selected, all of whom were diagnosed with stroke to participate in a group CIT program. Of these 11 patients, 8 participated in the first phase consisting of the application of the CIT protocol 3h daily for 10 treatment days, 5 months later 5 patients from the 8 patients who participated in the first phase and 3 new patients participated in an CIT program in group for 6h daily for 10 treatment days. In both protocols all major CIT principles (shaping, task practice and behavioral package) were used. In both phases the group of patients was supervised by a multidisciplinary team. The motor and functional recovery of the patients were evaluated through the Wolf Motor Function Test, the Motor Activity Log and the Canadian Occupational Performance Measure by an independent evaluator in six moments: immediately before the 3h program, immediately after the 3h program, 3 months after the program of 3, immediately before the program of 6h, immediately after the program 6h and 3 months after the program of 6h. Results: The CIT in group format demonstrated a motivating reinforcement for the study participants. Participants achieved statistically and clinically significant improvements in motor and functional recovery and were maintained over a 3-month follow-up period in both protocols, however the results were better in the 3-hour protocol. Conclusion: CIT in its group format produces favorable results and the application of a protocol with shorter duration (3 hours) presents more significant results, being more feasible its application.
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6
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ELIDA RAQUEL FREITAS NERI BULHOES
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Functioning in postpartum period: identification of categories of International Classification of Functioning, Disability, and Health from perspectives of brazilian physiotherapists
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Leader : DIEGO DE SOUSA DANTAS
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MEMBRES DE LA BANQUE :
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DIEGO DE SOUSA DANTAS
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NADJA VANESSA DE ALMEIDA FERRAIZ
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VANESSA PATRICIA SOARES DE SOUSA
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Data: 27 juin 2019
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Background: The puerperium comprises a unique and variable period in the life of all women who become mothers, starting after delivery until the organism returns to pre-gravid conditions. In addition, psychological and social changes are also present at this time. However, there is still a gap in the literature regarding the use of a specific and comprehensive instrument that addresses the full complexity of health and health-related states for postpartum women. Both the content and structure of the International Classification of Functioning, Disability and Health (CIF) allow us to broaden the understanding and optimize the planning of physiotherapeutic interventions designed to maintain the functionality of these patients. Objective: to identify categories of the International Classification of Functioning, Disability and Health (CIF) to evaluate the functionality of puerperae from the perception of Brazilian physiotherapists and to carry out content validation. Methods: a study developed from the Delphi methodology in three electronic rounds, including Brazilian physiotherapists with expertise in women's health. The process involved the capture of biopsychosocial aspects in the physiotherapeutic treatment of puerperae, identification of categories of the CIF and validation of content. Two independent researchers analyzed the categories, with concordance assessed by the Kappa coefficient. The Content Validity Index was calculated by category and in total, with cut-off point set at 0.80. Descriptive statistics served to characterize the sample. Results: The panel consisted of 45 participants, with a median age of 33 years, predominantly women (93.7%), doctoral (42.2%) and over 10 years of experience (40%). We identified 1,261 significant contents, associated to 258 categories of the CIF and Personal Factors. Initially, 74 categories obtained a sufficiently high consensus for judgment in the second round of Delphi, which were reduced to 66 specific categories validated by 89% of experts at the end of the third round, 11 of body functions, 14 for body structures, 14 activity and participation, 18 environmental factors and 9 personal factors. Conclusion: a total of 66 categories were identified based on the perception of physiotherapists regarding the functionality of puerperal women. These findings are unprecedented worldwide and may strengthen the implementation of the biopsychosocial health care model of this population.
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7
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ANA LÚCIA DE LIMA
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Transcranial Direct Current Stimulation for the treatment of generalized anxiety disorder: A Randomized Clinical Trial.
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Leader : RODRIGO PEGADO DE ABREU FREITAS
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MEMBRES DE LA BANQUE :
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ANDRÉ RUSSOWSKY BRUNONI
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HINDIAEL AERAF BELCHIOR
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RODRIGO PEGADO DE ABREU FREITAS
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Data: 27 juin 2019
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Introduction: Anxiety is a disorder that has been affecting a great number of individuals and Brazil being the country with the highest prevalence in Americas with 9.3%. Among the anxiety disorders, there is the generalized anxiety disorder (GAD), characterized mainly by tremors, muscular hypotonia, hyperventilation, sweating, palpitations, apprehension, restlessness, distractibility, loss of concentration and insomnia. GAD cause impairment in the functional, social, affective and cognitive life of the individual, thus, there is a need for an effective treatment that can minimize these effects. One of the techniques that has been used with positive results for treatments of some psychiatric disorders is Transcranial Continuous Current Stimulation (tDCS), which is a noninvasive neuromodulation technique that, through an electric microcurrent of 0, 5 to 2 mA cause stimulation or inhibition of neuronal activity. This stimulation causes specific changes in the behavior and motor activity of individuals by modulating specific brain areas. Despite many studies of tDCS in mood disorders, such as depression, and some studies in anxiety disorders such as panic, tDCS studies with GAD are still incipient. Thus, there is a need to evaluate the effects that tDCS can have on people affected by GAD. Objectives: To analyze the effects of anodic tDCS over the left dorsolateral prefrontal cortex (CPFDL) in people affected by GAD, presenting possible improvements in the symptoms of the disease. The study was designed as a randomized double-blind clinical trial, with a sample of 30 participants aged 20 to 40 years who had a clinical diagnosis of GAD according to the criteria of the American Psychiatric Association (DSM-V). Participants were divided into two groups, sham and experimental group, and the allocation was performed in a randomized, double-blind fashion. Results: No differences were found for anxiety, depression and affectivity. However, a significant improvement was found in the active group for physical symptoms of stress. Although intragroup analyzes showed decreases in anxiety, stress, negative affectivity, and depression scores, no intergroup comparison showed significant difference. Improvement in physical aspects of stress in GAD can improve life satisfaction, cognitive function, and psychological well-being. Conclusion: It is suggested that five sessions of anodic tDCS on CPFDL did not improve anxiety and mood symptoms in patients with GAD. However, the protocol showed improvement in physical symptoms of stress.
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8
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ADRIANO LOURENÇO
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SLEEP QUALITY, FUNCTIONING AND ITS CLINICAL ASSOCIATIONS IN BREAST CANCER SURVIVORS
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Leader : DIEGO DE SOUSA DANTAS
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MEMBRES DE LA BANQUE :
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DIEGO DE SOUSA DANTAS
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ILLIA NADINNE DANTAS FLORENTINO LIMA
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NADJA VANESSA DE ALMEIDA FERRAIZ
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Data: 27 juin 2019
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Background: Breast cancer (CM) is one of the main health problems among women, which can have an impact on morbidity and mortality. Currently breast cancer has great chances of cure, due to the early diagnosis and the less aggressive and more effective treatments, which still provoke deleterious effects. These include impairments in sleep quality and functionality, which contribute negatively to the health of women surviving CM. There was a lack of similar studies related to the subject. Objective: To identify sleep quality, functioning and its clinical associations in women survivors of breast cancer and out of clinical treatment. Methodology: This is a cross-sectional study of 32 women who survived CM at least one year after the clinical treatment between January and September 2018. Data collection instruments consisted of general and clinical information of the disease and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) questionnaires; Pittsburgh Sleep Quality Index (PSQI); Functional Assessment of Cancer Therapy-Fatigue (FACT-F); Disabilities of the arm and Shoulder (DASH); International Physical Activity Questionnaire (IPAQ, short version), plus the six-minute walk test (6MWT). Statistical analysis was performed using SPSS 20.0. The Shapiro-Wilk test was applied for the normality of the data and the Cronbach's alpha test (α), Spearman's and Pearson's correlation, the Student's t test and the Mann Whitney U test were used. The clinical effect was analyzed by Cohen's d and to verify the association of the data the bivariate linear regression test was used. We adopted p <0.05 for all tests. Results: Among the main outcomes, it is worth noting that there is a prevalence of women who survived breast cancer with sleep problems (71.9%) and functional limitations (90.6%) even after the end of the clinical treatment and throughout the survival free from disease. Poor sleep is correlated with subjective sleep quality (rs = 0.769), sleep disturbances (rs = 0.624), sleep latency (rs = 0.625), sleep duration (rs = 0.581), and sleep disturbances during the day (rs = 0.654), and functional limitation with cognition (rs = 0.758), mobility (rs = 0.709), domestic activity / labor (rs = 0.718) and participation (r = 0.701). We observed a significant difference in sleep quality with worse scores for the FACT-F, DASH and WHODAS 2.0 scales, as well as the functional limitation with the worst scores for the DASH, FACT-F and PSQI scales (p <0.05). It was also observed that poor sleep was a predictor of worse scores for FACT-F, DASH and WHODAS 2.0 (p <0.05). Conclusions: The findings demonstrate that poor sleep is a predictor of worse scores for fatigue, quality of life, functional performance of the upper limbs and functionality, and that higher levels of deficiency affect lower scores for functional performance of the upper limbs, fatigue, quality of life and quality of sleep, demonstrating the negative impacts of sleep precarisation and the functionality of these women, denoting the relevance and urgency of inclusion of aspects related to sleep and functionality and their clinical associations in the clinical evaluations and therapeutic behaviors directed at women surviving cancer of breast.
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9
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ANA ISABELE ANDRADE NEVES
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The capacity of pelvic floor muscle contraction influence in the urinary incontinence severity and the quality of life of the women?
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Leader : GRASIELA NASCIMENTO CORREIA
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MEMBRES DE LA BANQUE :
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ADRIANA GOMES MAGALHAES
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ANA SILVIA MOCCELLIN
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GRASIELA NASCIMENTO CORREIA
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Data: 28 juin 2019
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Introduction: Urinary incontinence (UI) is an involuntary loss of urine that affects up to 60% of the world's female population. Women with UI may have weakness of the pelvic floor muscles (MAP), however, no studies evaluating the influence of MAP strength on UI severity and quality of life (QoL) on urinary incontinence were found. Objective: To compare severity of UI and QV among women with normal MAP strength and weakness. Methodology: An observational study was carried out with 37 women, divided into two groups according to the contraction capacity of the MAPs evaluated by the Modified Oxford Scale (EMO). Women with MAP contractions between 0 and 2 degrees in the EMO formed the Weak MAP Group (GMAPF, n = 20); and between 3 and 5 degrees the Normal MAP Group (GMAPN, n = 17). Personal data collection, assessment of UI severity with Incontinence Severity Index Questionnaire (ISI-Q) and QOL with the King's Health Questionnaire (KHQ) were performed. In the physical evaluation, the 1 hour pad test, Function Evaluation and Manometry of the MAP were performed. In the statistical analysis, the Mann-Whitney and Chi-square tests were used, considering p≤0.05. Results: The GMAPN group had a poor QOL related to the sleep and disposition domain (p=0.048). There was no difference between groups in the other KHQ domains and in the severity of UI (p = 0.257). Conclusion: MAP weakness did not present worse severity of UI or QoL, except in the sleep and disposition domain.
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10
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ISABEL OLIVEIRA MONTEIRO
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EVALUATION OF THE CONVERGENT VADILITY AND REPRODUCIBILITY OF THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH (ICF) CORE SET FOR PHYSICAL HEALTH OF COMMUNITY-DWELLING OLDER ADULTS
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Leader : SAIONARA MARIA AIRES DA CAMARA
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MEMBRES DE LA BANQUE :
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DIEGO DE SOUSA DANTAS
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JOAO AFONSO RUARO
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SAIONARA MARIA AIRES DA CAMARA
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Data: 29 août 2019
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Introduction: The International Classification of Functioning, Disability and Health (ICF) is presented as a classification strategy that may be useful for the identification of multidimensional aspects related to the physical health of the elderly. Due to the extension of the ICF, the Core Sets are presented as strategies that facilitate its application. A Core Set of the ICF was proposed to classify the physical health of the elderly, but it is necessary to know its validity in relation to measures recognized for this purpose, as well as its reproducibility. Objective: To evaluate the convergent validity of the core set for the physical health of the elderly in relation to validated measures for the evaluation of this domain, as well as its reproducibility. Methods: This is a validity study, composed of a population of elderly residents in the city of Santa Cruz, Rio Grande do Norte, Brazil. A total of 101 elderly individuals over 60 years old, of both sexes, without cognitive alterations were included. We evaluated palmar grip strength, physical performance in the Short Physical Performance Battery (SPPB) and physical activity level by International Physical Activity Questionnaire (IPAQ) long version. The Core Set of the ICF was also applied, which is composed of 30 categories (14 body functions, 4 body structures, 9 activity and participation, and 3 environmental factors), from which the each component. To evaluate the reproducibility, the Intraclass Correlation Coefficient (ICC) was used between two measurements performed in a range of 5-8 days. The association between the core set results and the other research instruments was evaluated using the Kruskal-Wallis, Mann-Whitney and Spearman correlation tests. In all the steps were considered 5% alpha and 95% CI. Results: It was observed that elderly individuals with higher levels of physical activity in IPAQ had lower impairment index in the components body functions (p = 0.012) and in the performance (p = 0.002) and capacity (p = 0.005) constructs of the component activity and participation. For SPPB, it was observed that better results are related to lower impairment index in the body functions (p <0.001), body structures (p = 0.006), activity and participation (p <0.001), and lower use of aid devices and medications (p <0.001). A higher palmar grip strength was related to a lower impairment index in the body functions (p = 0.001), body structures (p = 0.004) and activity and participation (p <0.001), and the categories that treated of medication use (p = 0.002) and of aid devices (p = 0.004). The ICC analysis indicated good reproducibility for most components evaluated, with a minimum of 0.59 for the category of access to health services and a maximum of 0.95 for the category of medication use. Conclusion: The results show that the core set is valid in relation to the manual grip strength, lower limbs performance and physical activity level, and reproducible, indicating that the data obtained through this tool can be used with confidence by clinicians and researchers.
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11
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JULIANA SIMONELLY FELIX DOS SANTOS
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PROTOCOL MODELS AND EXERCISE PERIODIZATION OF EARLY MOBILIZATION STRATEGIES IN THE INTENSIVE CARE UNIT: A SYSTEMATIC REVIEW
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Leader : ILLIA NADINNE DANTAS FLORENTINO LIMA
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MEMBRES DE LA BANQUE :
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DIEGO DE SOUSA DANTAS
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ILLIA NADINNE DANTAS FLORENTINO LIMA
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LUCIEN PERONI GUALDI
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Data: 10 oct. 2019
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The mortality reduction in intensive care unit (ICU) has been accompanied by comorbidities for at least five years after hospital discharge. Early mobilization is the main intervention to prevent hospitalization-related declines. The prescription of physical exercise for this population is still poorly explored regarding dose response and exercise periodization. The aim of this study was to conduct a systematic review of the scientific literature to describe protocol models and periodization strategies of early mobilization prescription in ICUs in critical patients. Methods: The Preferred Reporting Itens for Systematic Reviews and Meta-Analyses (PRISMA) recommendations were followed. Medical Subject Headings (MeSH) was used for the search strategy: with combined concepts and boolean operators adapted to the databases: Medline, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and Scopus. After searching, 6,392 resumes were found and after screening, 121 complete articles were read and 13 were included in the systematic review. No study has shown inferior quality according to the Physiotherapy Evidence Database (PEDro) scale. It was analyzed 1,380 individuals who participated of the included papers in this review. The mobilization protocols found presented a duration of 10 to 30 minutes, 2x / day for 7x / week, with weekly accumulated volume equal to or greater than 200 minutes/week, consisting of mobility and progressive exercises based on sedation level and patient tolerance. The lack of data on protocols damage the periodization strategy use, however, based on the most commonly used progress statistics, the periodization of early mobilization resembles the wavy strategy. The studies still present an incipient presentation regarding the use of these systematized strategies in Intensive Care Units, despite the large number of available studies, an exercise prescription, dose response and periodization of ICU exercise.
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12
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JOÃO ANTONIO DA SILVA FILHO
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YOUNG CHILDREN'S PARTICIPATION AND ENVIRONMENT MEASURE (YC-PEM): TRANSLATION, ADAPTATION AND VALIDATION FOR USE IN BRAZIL.
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Leader : EGMAR LONGO HULL
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MEMBRES DE LA BANQUE :
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ANA PAULA MARTINS CAZEIRO
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ANA RAQUEL RODRIGUES LINDQUIST
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EGMAR LONGO HULL
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Data: 29 oct. 2019
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Introduction: The International Classification of Functioning, Disability and Health (ICF), published in 2001 by the World Health Organization (WHO), describes participation as the involvement of the individual in a real life situation. Being involved and participative in activities at home, at school and in the community is an important part of childhood and wellbeing indicator, as it improves health and quality of life, and is linked to social development outcomes and is an important rehabilitation goal. The Young Children's Participation and Environment Measure (YC-PEM) is a tool that assesses the frequency, involvement and impact of the environment on the participation of children between zero and five years of age, with and without disabilities, in home, daycare / pre-school environments. -school and community. Because it is a tool developed according to the ICF model, which has been extensively used in different contexts, the availability of translation and cross-cultural adaptation of this tool will be very useful to support future Brazilian validation. Objective: To translate and culturally adapt YC-PEM for use in Brazil. Method: The process was authorized by the authors of the original instrument. This is a methodological and multicenter study composed of 6 steps: (1) Translation from English - North American to Portuguese - Brazil; (2) Synthesis of translations; (3) Expert Committee Review; (4) Cognitive interview with parents / guardians; (5) back translation; (6) Consolidation of the final version. Results: Some terms, after the initial translation, had to be adapted to bring them closer to the cultural reality of the country. In step 2, all discrepancies found were carefully analyzed and the terms considered most common in Brazil were chosen. In steps 3 and 4, the item descriptions were replaced by better comprehension items and the examples were included in the questions, as well as a supplementary instruction material for self-application of the tool. In step 5 the final version was back-translated and sent to CanChild for evaluation and final approval (step 6). Conclusion: YC-PEM was translated into Brazilian Portuguese and cross-culturally adapted for this country and the final product, YC-PEM Brazil (Measurement of Participation and Environment - Small Children), was considered satisfactory. YC-PEM Brazil is expected to be able to help parents, guardians, and rehabilitation professionals identify the participation levels and environment characteristics of children aged zero to five, thus enabling the planning and implementation of rehabilitation interventions focused on these factors of great relevance to Brazilian children.
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13
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ROMULO LEMOS E SILVA
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Immediate Effects of Verbal Instructions on Quality of Movement During the Lateral Step-Down Test and Correlation of the Visual Assessment with Lower Limb Kinematics, Strength and Flexibility.
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Leader : RODRIGO SCATTONE DA SILVA
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MEMBRES DE LA BANQUE :
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FABIO VIADANNA SERRÃO
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RODRIGO SCATTONE DA SILVA
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WOUBER HÉRICKSON DE BRITO VIEIRA
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Data: 18 nov. 2019
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Introduction: Abnormal lower limb movement patterns during closed kinetic chain activities seem to contribute to the occurrence of knee injuries. The Lateral Step-Down test (LSD) is a simple test for the assessment of lower limb movement patterns. Verbal instructions may result in immediate improvements in movement patterns in certain functional activities; however, it remains unknown whether these instructions can cause these same improvements during the LSD. Objectives: the purposes of this dissertation were: 1) to conduct a narrative review regarding the assessment of quality of movement during the LSD, 2) to determine the immediate effects of a verbal instructions intervention in the quality of movement and trunk, pelvis and lower limb kinematics in healthy females during the LSD, 3) to verify possible associations between lower limb muscle strength and flexibility and the results of quality of movement and 3D kinematics during the LSD. Methods: For the first study, two independent reviewers conducted a literature review in different databases. For the experimental study, thirty-four healthy females performed the LSD and were assessed both visually and using a 3D kinematics analysis before and after receiving verbal instructions for movement correction. Participants were divided into Good Movement Group (GG) and Poor Movement Group (PG) according to their scores. Lower limb flexibility was measured using the Lunge Test and the assessment of passive hip stiffness. Muscle strength was measured using a handheld dynamometer. Verbal intervention included instructions aimed at improving the alignment of the trunk, pelvis, hip and knee during the LSD. Results: The narrative review identified a few confounding factors in the included studies that may interfere with the LSD results, such as step height and instructions given prior to the test. It was also found that the LSD is considered a simple test for clinical use, with moderate reliability (κ=0.59–0.81). Results from the experimental study showed that quality of movement during the LSD was positively correlated with kinematic measures of hip adduction, hip flexion and pelvic drop. Verbal instructions improved quality of movement of the volunteers in general, with the GG showing greater improvement in quality of movement after the instructions than the PG. In group comparisons, the PG presented greater pelvic drop, greater hip adduction and decreased hip flexion when compared to GG. Conclusions: The LSD has adequate reliability and should be standardized in order to minimize possible confounding factors. In the experimental investigation, the visual assessment of the LSD presented a significant association with pelvic drop and hip adduction during the 3D analysis in healthy females. Factors such as decreased ankle flexibility and increased hip flexibility are related to greater hip movements during the LSD. Verbal instructions caused an immediate improvement in lower limb quality of movement in healthy women during the LSD.
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14
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CAMILA LOBO DE AGUIAR GOMES
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Effects of attentional focus on improving upper limb motor performance of post stroke patients
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Leader : ENIO WALKER AZEVEDO CACHO
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MEMBRES DE LA BANQUE :
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ALINE BRAGA GALVAO SILVEIRA FERNANDES
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ENIO WALKER AZEVEDO CACHO
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RODRIGO LÍCIO ORTOLAN
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Data: 12 déc. 2019
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Background: Rehabilitation is an important process in the recovery of upper limb motor function after stroke. In addition, studies have shown that therapist verbal instruction during treatment is an effective strategy in this process. One way for the therapist to facilitate the command to be passed to the learner is by using verbal cues for guidance. They are called focus of attention: internal focus -IF (own body) and external focus -EF(consequence of movement in the environment). Objective: To verify the effects of focus types on post-stroke upper extremity motor performance. Methods: This study recruited twelve subjects and randomly into two groups by simple draw. The groups were asked to perform two motor tasks with the affected limb (16 repetitions), using verbal commands directed by a trained therapist. In the first phase, G1 received commands with IF, while G2 was instructed with commands with EF. After one week, the command type was changed between groups. To obtain the variables (movement time, average velocity and number of speed peaks), a device developed by the authors (Temporal Data Acquisition Instrument - TDAI) and free kinematic software - CVMob version 4.0 was used. Results: Both EF and IF promote significant differences in movement time and speed, however, only IF provided significant results in both tasks. Discussion: The benefits of one focus of attention on the other are not fully confirmed. However, not receiving any kind of attention guidance induces the patient to adopt their own strategies, compromising motor performance. It is pertinent that during the rehabilitation the therapist is aware of the importance of choosing the verbal commands that will be oriented Conclusion: Both focus provided similar motor enhancements and the results provides some support for the hypothesis that the benefits of the EF are accentuated when preceded by the IF.
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15
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VIVIANE TAVARES BEZERRA NÓBREGA
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Hemispheric especialization in assessing reach and grip in post-stroke patients: a cross-sectional observational study
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Leader : ROBERTA DE OLIVEIRA CACHO
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MEMBRES DE LA BANQUE :
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ENIO WALKER AZEVEDO CACHO
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KELLY SOARES FARIAS
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SAIONARA MARIA AIRES DA CAMARA
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Data: 20 déc. 2019
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Abstract: Unilateral brain injuries affecting the left hemisphere bring different clinical conditions than those affecting the right hemisphere. It is postulated that the left hemisphere is more responsible for the range acceleration phase and the right hemisphere for the deceleration (grip) phase. This statement stems from kinematic studies of human movement. The aim of this study was to analyze, through clinical instruments, whether patients with right hemisphere injury differ from patients with left hemispheric injury for reach and grasp movement. Methods: This is an observational cross-sectional analytical study conducted with patients who had stroke for more than six months and had unilateral impairment. Fifteen patients (nine with right injuries and six with left injuries) were selected and evaluated in the reach and bilateral grip movements using the Box and Block test (BBT) instruments, the Action Research Arm Test (ARAT), the functional range (REACH) and dynamometry. In order to compare clinical measures (ARAT, BBT and Reach Performance Scale) and hand dynamometry) between the two groups (GR x GL) and between individuals in the same group, the Mann-Whitney U test was performed. Correlation was performed by Spearman test. Results: Fifteen subjects met the eligibility criteria for the study and, as such, the subjects were divided into two groups, lesion in the right hemisphere and lesion in the left hemisphere. However, from the results found it was not possible to verify the hemispheric differences for reach and prehension activity through the clinical instruments. Conclusion: It was not possible to obtain evidence that hemispheric specialization can be measured from clinical assessment scales.
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