Browsing by Author "Fernandes, B"
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- Effects of lower limb strengthening on balance and function in persons who suffered a strokePublication . Fernandes, B; Batista, F; Beckert, P; Evangelista, I; Ferreira, MJ; Prates, L; Sérgio, JIntroduction - Cerebrovascular diseases, and among them, cerebral vascular accidents, are one of the main causes of morbidity and disability at European Union countries. Clinical framework resulting from these diseases include important limitations in functional ability of the these patients Postural control dysfunctions are one of the most common and devastating consequences of a stroke interfering with function and autonomy and affecting different aspects of people’s life and contributing to decrease quality of life. Neurological physiotherapy plays a central role in the recovery of movement and posture, however it is necessary to study the efficacy of techniques that physiotherapists use to treat these problems. Objectives - The aim of this study was to investigate the effects of a physiotherapy intervention program, based on oriented tasks and strengthening of the affected lower limb, on balance and functionality of individuals who have suffered a stroke. In addition our study aimed to investigate the effect of strength training of the affected lower limb on muscle tone.
- Knee muscle strength, balance and functional independence in persons with strokePublication . Fernandes, B; Batista, F; Beckert, P; Ivangelista, I; Ferreira, MJ; Prates, L; Sérgio, JPurpose: To investigate the relationship between knee muscle strength, balance and functional independence within the first month after stroke. Relevance: Cerebral vascular disease is one of the main causes of morbidity, disability and mortality in developed countries. Problems with movement control are frequent after stroke. Lower limb weakness and impaired balance are common problems that are related with the risk of falls and are likely to interfere with the ability to perform daily life activities. Physiotherapy intervention usually starts early after stroke and addresses impairments related to movement and posture in order to improve motor recovery and restore function. Participants: Subjects were recruited at Physiotherapy Department of Hospital Fernando Fonseca within the first month after stroke. We studied 8 patients, all males, mean age 62,5±6,2y, with unilateral stroke (7 ischemic, 1 hemorrhagic), in the middle cerebral artery territory, who were admitted to physiotherapy department. All subjects have no cognitive impairment according to Mini Mental State, no history of lower limb orthopedic problems and no other disease that could interfere with physiotherapy treatments. All subjects gave their informed consent to participate in this investigation. Methods: A test protocol was set up. Knee muscle strength (extensors and flexors) was measured on an isokinetic dynamometer. Balance and functional independence were assessed using the Berg Balance Scale (BBS) and the Modified Barthel Index (MBI) respectively. Analysis: The results were analyzed in an SPSS program version 17.0. Descriptive statistics were used to characterize the participants. A correlation analysis was performed using knee muscle strength, BBS and MBI. The significance level was set at p < 0,05. Results: Knee extensors from the affected lower limb show a deficit of 26,6% regarding knee extensors from the opposite knee. For knee flexors the deficit is 34,5%. Mean score for BBS is 29,63 ± 14,81 in a 56 point scale which indicates risk of fall. MBI mean score of 65,63 ± 17,33 indicates functional dependence. The correlation analysis demonstrates a positive correlation between BBS and MBI (Spearman correlation coefficient is 0,898 with p value = 0,002 < 0,01. These results indicate that function increase with balance. Conclusions: After stroke knee strength from the affected lower limb is impaired. It appears to be important to improve knee muscle strength from the affected lower limb to reduce weakness. In addition persons with stroke have higher risk of falls and are functionally dependent. There is evidence that balance is an important feature for functional independence in persons with stroke. Further research is needed to investigate the effect of knee muscle strength training on balance and function. Implications: These results indicate that early physiotherapy is needed after stroke. Intervention must focus on strength and balance training in order to improve stability and help persons with stroke to become functionally independent .
- Relationship of balance to function independence in stroke survivorsPublication . Fernandes, B; Prates, L; Ferreira, MJ; Beckert, P; Evangelista, I; Sérgio, JCerebral vascular disease is the primary cause of permanent disability in Portugal. Impaired stability is considered an important feature after stroke as it is related with higher risk of falls and functional dependence. Physiotherapy intervention usually starts early after stroke in order to direct motor recovery and help patients to improve their ability to perform activities of daily living (ADL). Purpose: to investigate the relationship of balance to functionality in acute stroke patients. Methods: 16 subjects (8 women and 8 men), mean age 63,62 ± 2,16y, with unilateral ischemic stroke in the middle cerebral artery territory, who were admitted to physiotherapy department of Fernando Fonseca Hospital in Portugal, within the first month after stroke were recruited to participate in this study. All subjects have no cognitive impairment according to Mini Mental State, no history of lower extremity orthopedic problems and no other disease that could interfere with treatments. All patients gave their inform consent to participate in this study. Subjects were assessed with the Modified Barthel Index (MBI) and the Berg Balance Scale (BBS).
- The Portuguese Severe Asthma Registry: Development, Features, and Data Sharing PoliciesPublication . Sá-Sousa A1, A; Fonseca, JA; Pereira, AM; Ferreira, A; Arrobas, A; Mendes, A; Drummond, M; Videira, W; Costa, T; Farinha, P; Soares, J; Rocha, P; Todo-Bom, A; Sokolova, A; Costa, A; Fernandes, B; Loureiro, C; Longo, C; Pardal, C; Costa, C, et al.The Portuguese Severe Asthma Registry (Registo de Asma Grave Portugal, RAG) was developed by an open collaborative network of asthma specialists. RAG collects data from adults and pediatric severe asthma patients that despite treatment optimization and adequate management of comorbidities require step 4/5 treatment according to GINA recommendations. In this paper, we describe the development and implementation of RAG, its features, and data sharing policies. The contents and structure of RAG were defined in a multistep consensus process. A pilot version was pretested and iteratively improved. The selection of data elements for RAG considered other severe asthma registries, aiming at characterizing the patient's clinical status whilst avoiding overloading the standard workflow of the clinical appointment. Features of RAG include automatic assessment of eligibility, easy data input, and exportable data in natural language that can be pasted directly in patients' electronic health record and security features to enable data sharing (among researchers and with other international databases) without compromising patients' confidentiality. RAG is a national web-based disease registry of severe asthma patients, available at asmagrave.pt. It allows prospective clinical data collection, promotes standardized care and collaborative clinical research, and may contribute to inform evidence-based healthcare policies for severe asthma.