RESUMO
Therapeutic strategies capable of inducing and enhancing prosthesis embodiment are a key point for better adaptation to and acceptance of prosthetic limbs. In this study, we developed a training protocol using an EMG-based human-machine interface (HMI) that was applied in the preprosthetic rehabilitation phase of people with amputation. This is a case series with the objective of evaluating the induction and enhancement of the embodiment of a virtual prosthesis. Six men and a woman with unilateral transfemoral traumatic amputation without previous use of prostheses participated in the study. Participants performed a training protocol with the EMG-based HMI, composed of six sessions held twice a week, each lasting 30 mins. This system consisted of myoelectric control of the movements of a virtual prosthesis immersed in a 3D virtual environment. Additionally, vibrotactile stimuli were provided on the participant's back corresponding to the movements performed. Embodiment was investigated from the following set of measurements: skin conductance response (affective measurement), crossmodal congruency effect (spatial perception measurement), ability to control the virtual prosthesis (motor measurement), and reports before and after the training. The increase in the skin conductance response in conditions where the virtual prosthesis was threatened, recalibration of the peripersonal space perception identified by the crossmodal congruency effect, ability to control the virtual prosthesis, and participant reports consistently showed the induction and enhancement of virtual prosthesis embodiment. Therefore, this protocol using EMG-based HMI was shown to be a viable option to achieve and enhance the embodiment of a virtual prosthetic limb.
RESUMO
O Acidente Vascular Encefálico (AVE) é o evento neurológico que mais acomete a sociedade nos últimos anos, gerando incapacidades na população e morte. Pode ser definido como um conjunto de afecções neurológicas de causa vascular com sintomatologia semelhante, mas com etiologias diferentes. Atualmente o Centro de Reabilitação Lucy Montoro de São José dos Campos é referência no tratamento de pacientes com lesões neurológicas do Vale do Paraíba. Objetivo: Realizar um levantamento epidemiológico do perfil dos pacientes acometidos pelo AVE na região e atendidos neste centro. Métodos: Foram analisados os prontuários dos pacientes recebidos neste centro entre setembro de 2011 e dezembro de 2014. Foram excluídos pacientes com hemiplegia causada por outras etiologias. Resultados: Dos 230 prontuários válidos para o estudo, 60% eram homens e o perfil sócio demográfico mostrou que destes, 76% tinham idade superior a 50 anos. Tratando-se do tipo de evento, o AVE isquêmico foi o mais prevalente em nossa amostra. Foi constatada equivalência de acometimento da amostra, hemicorpos direito e esquerdo acometidos igualmente, 46% e 8 % classificados em dupla hemiparesia, já o padrão motor predominante da amostra foi de paresia 87%. Conclusão: Foi verificado que a população atendida pelo Centro de Reabilitação Lucy Montoro de SJC é constituída por maioria de homens acima dos 50 anos de idade, acometidos pelo AVE isquêmico (direito ou esquerdo) e com padrão motor parético prevalente
Vascular Accident (CVA) is the neurological event that most affects society in recent years, causing disabilities in the population and death. It can be defined as a set of neurological disorders causing similar symptoms, but with different etiologies. Currently, Lucy Montoro Rehabilitation Center of São José dos Campos is a reference in the treatment of patients neurologically squealed. Thus, the aim of this study was to make an epidemiological survey of the profile of patients affected by CVA in this region and seen at this center. Methods: The records of patients received in this center between September 2011 and December 2014 were used during this research. Patients with hemiplegia caused by other etiologies were not analyzed. Results: Of the 230 valid records for the study, 60% were men and the socio-demographic profile showed that of these, 76% were older than 50 years. Considering the type of event, ischemic stroke was the most prevalent in our sample. It was found the same involvement of body parts affected, right and left 46% and 8% classified into double hemiparesis, since the prevailing motor pattern of the sample was paresis 87%. Conclusion: It was found that the population served by Lucy Montoro Rehabilitation Center of SJC consists most of men above 50 years of age affected by ischemic stroke (right or left) and prevalent paretic motor pattern
Assuntos
Humanos , Centros de Reabilitação , Perfil de Saúde , Acidente Vascular Cerebral/epidemiologia , Prontuários Médicos/estatística & dados numéricosRESUMO
A Paralisia Cerebral é um distúrbio da postura e do movimento decorrente de uma lesão cerebral podendo resultar em comprometimentos neuromotores, geralmente associados à gravidade da sequela e idade da criança. Objetivo: Avaliar o perfil epidemiológico das crianças diagnosticadas com Paralisia Cerebral atendidas no Centro de Reabilitação Lucy Montoro de São José dos Campos. Método: Foram revisados 83 prontuários no período de dezembro de 2011 até dezembro de 2014. Foram verificados os fatores como idade, gênero, procedência, realização prévia de fisioterapia, tipos de paralisia cerebral de acordo com a distribuição anatômica, crises convulsivas, órteses, aplicação de toxina botulínica, meios auxiliares de locomoção, pontuação no GMFM e nível no GMFCS. Resultados: Houve predominância do gênero masculino (55%) e com faixa etária de 4 a 6 anos (32%). A maioria foi proveniente de São José dos Campos (33 indivíduos). Quanto aos tipos de Paralisia Cerebral observamos maior prevalência para tetraplegia e diplegia (43% cada); 61% dos pacientes não apresentaram crises convulsivas e 30% aplicaram toxina botulínica. Os que faziam uso de meios auxiliares de locomoção totalizaram 41%. A pontuação prevalente do GMFM foi de 0 a 25% (22 indivíduos) e a maioria dos pacientes (29%) classificados como nível IV no GMFCS. Conclusão: São necessários mais estudos que definam o perfil epidemiológico das crianças com Paralisia Cerebral para melhor caracterização desta população e direcionamento de futuras pesquisas.
Cerebral Palsy is a disorder of posture and movement due to a brain injury and may result in neurological and motor dysfunction, usually associated with the severity of the sequelae and the child's age. Objective: To evaluate the epidemiological profile of children diagnosed with Cerebral Palsy treated at the Lucy Montoro Rehabilitation Center in São José dos Campos in the state of São Paulo. Method: 83 medical records were reviewed from December 2011 through December 2014. Factors were recorded such as age, gender, origin, prior physical therapy, types of cerebral palsy according to anatomical distribution, seizures, orthoses, treatment with botulinum toxin, auxiliary means of locomotion, GMFM score, and GMFCS level. Results: There was a predominance of males (55%) and 32% of them were aged between 4 and 6 years. The majority were from São José dos Campos (33 individuals). As to the types of Cerebral Palsy, there was a higher prevalence for tetraplegia and diplegia (43% each); 61% of the patients did not have seizures, and 30% had applications of botulinum toxin. There were 41% who needed assistive devices for locomotion. The prevalent score of GMFM was 0-25% (22 individuals), and the largest portion (29%) classified as level IV in the GMFCS. Conclusion: Further studies are needed to define the epidemiological profile of children with Cerebral Palsy for a better characterization of this population and guidance for future research