Objective. The purpose of this study was to analyze factors related to lower walking speed in persons with multiple sclerosis (PwMS). Methods. A cross-sectional survey was conducted. The study participants were 120 consecutive PwMS, who were able to walk, even with device assistance. Demographic and clinical data were collected. Walking speed was measured in 10 m walk test. Possible factors were assessed: disability, fatigue, visual functioning, balance confidence, physical activity level, walking impact, cognitive interference, and motor planning. A forward linear multiple regression analysis examined the correlation with lower speed. Results. Lower walking speed was observed in 85% of the patients. Fatigue (41%), recurrent falls (30%), and balance problems were also present, even with mild disability (average EDSS = 2.68). A good level of physical activity was noted in most of the subjects. Dual-task procedure revealed 11.58% of walking speed reduction. Many participants (69.57%) imagined greater walking speed than motor execution (mean ≥ 28.42%). Physical activity level was the only characteristic that demonstrated no significant difference between the groups (lower versus normal walking speed). Many mobility measures were correlated with walking speed; however, disability, balance confidence, and motor planning were the most significant. Conclusions. Disability, balance confidence, and motor planning were correlated with lower walking speed.
ARTICLE 521Walking execution is not affected by divided attention in patients with multiple sclerosis with no disability, but there is a motor planning impairment A execução da marcha não é afetada pela atenção dividida em pacientes com esclerose múltipla sem incapacidade, mas existe um comprometimento do planejamento motor ABSTRACT Purpose: We analysed the cognitive influence on walking in multiple sclerosis (MS) patients, in the absence of clinical disability. Method: A case-control study was conducted with 12 MS patients with no disability and 12 matched healthy controls. Subjects were referred for completion a timed walk test of 10 m and a 3D-kinematic analysis. Participants were instructed to walk at a comfortable speed in a dual-task (arithmetic task) condition, and motor planning was measured by mental chronometry. Results: Scores of walking speed and cadence showed no statistically significant differences between the groups in the three conditions. The dual-task condition showed an increase in the double support duration in both groups. Motor imagery analysis showed statistically significant differences between real and imagined walking in patients. Conclusion: MS patients with no disability did not show any influence of divided attention on walking execution. However, motor planning was overestimated as compared with real walking.Key words: mild cognitive impairment, multiple sclerosis, walking. RESUMOO objetivo do estudo foi analisar a influência cognitiva na caminhada de pacientes com esclerose múltipla (EM) sem incapacidade clínica. Foi conduzido um estudo caso-controle com 12 pacientes com EM sem incapacidade com 12 pessoas saudáveis como controles pareados. Os sujeitos fizeram um teste de caminhada de 10 metros , acompanhado de análise cinemática 3D, e foram orientados a caminhar em velocidade confortável, realizando dupla-tarefa (tarefa aritmética), e o planejamento motor foi medido pela cronometria mental. Os valores de velocidade da caminhada e da cadência não evidenciaram diferenças estatisticamente significativas entre os grupos nas três condições. A condição de dupla-tarefa demonstrou um aumento na duração do duplo apoio em ambos os grupos. A imagética motora evidenciou diferenças estatisticamente significativas entre a caminhada real e a imaginada nos pacientes com EM. Pacientes com EM sem incapacidade não apresentaram influência da atenção dividida na execução da caminhada. Entretanto, o planejamento motor esteve superestimado.Palavras-Chave: comprometimento cognitivo leve, esclerose múltipla, caminhada.
Objective: The purpose of this case report is to describe the management of using a combination of hip strengthening and manipulative therapy (MT) for a patient with plantar fasciitis. Clinical Features: A 44-year-old patient reported heel pain for approximately 1 year before treatment. The patient reported plantar heel pain and tenderness at the calcaneal tuberosity. The pain was most noticeable in the morning but was reduced after a 30-minute walk. A diagnosis of plantar fasciitis was made at the initial assessment. Intervention and Outcomes: Initially, a clinical evaluation was performed to measure pain intensity (Numeric Pain Rating Scale), pressure-pain threshold (algometry), and perceived exertion (OMNI Resistance Exercise Scale). The patient then underwent 10 sessions of hip strengthening and MT over a period of 3 months. After the treatment, the intensity of pain and the pressure-pain threshold was reevaluated. The patient reported an improvement in pain intensity (baseline score = 6 vs final score = 1) and an increase in the pressure-pain threshold (initial score = 2.6 vs final score = 7.1). Perceived exertion was also improved after hip muscle strength training (initial score = 10 vs final score = 8). Conclusion: The combination of hip strengthening and MT improved foot pain in a patient with a clinical diagnosis of plantar fasciitis. (J Chiropr Med 2016;15:310-313)
To mitigate the loss of efficiency of photovoltaic modules, protective films of polyethylene terephthalate with tin doped indium oxide (PET / ITO) may be a viable alternative. Thus, the article presents a review on the effect of the accumulation of dirt in photovoltaic modules and on the state of the art involving protective films made of PET / ITO. The review started in 2019 with a predominance of articles published abroad and in international journals. The results show that there are several studies on the effect of dirt on photovoltaic systems, but these are studies that do not take into account the comparison between studies done in the laboratory and in adverse conditions of the external environment such as rain, wind and film degradation.
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