• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 33
  • 30
  • 3
  • 3
  • 3
  • 3
  • 3
  • 3
  • 2
  • 2
  • 1
  • 1
  • 1
  • Tagged with
  • 80
  • 80
  • 32
  • 30
  • 23
  • 21
  • 15
  • 13
  • 13
  • 12
  • 12
  • 12
  • 11
  • 11
  • 11
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
41

O desenvolvimento neuropsicomotor de pacientes com Sequência de Robin isolada / The neurological development of patients with isolated Robin Sequence.

Tatiane Romanini Rodrigues Alencar 26 September 2014 (has links)
Objetivos: Avaliar o desenvolvimento neuropsicomotor de crianças com Sequência de Robin isolada (SRI), submetidas ao tratamento de obstrução das vias aéreas conforme protocolo do Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (HRAC/USP), com intubação nasofaríngea (INF) ou tratamento postural. Verificar se o desenvolvimento neuropsicomotor do grupo INF difere do grupo postural, e avaliar a eficácia da INF em evitar sequelas de hipóxia. Materiais e Métodos: Estudo prospectivo realizado no HRAC/USP, com crianças com SRI, de 2 a 6 anos, divididas em dois grupos de acordo com o tipo de tratamento realizado: INF (Grupo 1), e postural (Grupo 2). Dados do tempo de uso da INF e sonda nasogástrica (SNG), cirurgia de miringotomia, classificação socioeconômica, grau de escolaridade dos pais, entre outros, foram coletados. Os participantes foram avaliados por meio do Teste de Screnning de desenvolvimento de Denver II (Teste de Denver II) e Exame Neurológico Evolutivo Adaptado (ENEA). Resultados: Total de 62 crianças foram avaliadas, sendo 38 do Grupo 1 e 24 do Grupo 2. Os resultados do Teste de Denver II demonstraram que 73,7% das crianças do Grupo 1 e 79,2% do Grupo 2 apresentaram desenvolvimento normal. Os resultados do ENEA apresentaram-se normais para 89,5% das crianças do Grupo 1 e 87,5% do Grupo 2. Não houve diferença significativa entre os dois grupos no Teste de Denver (p=0,854) e no ENEA (p=0,789). Realizaram a miringotomia 47,3% das crianças do Grupo 1 e 58,3% do Grupo 2. Nos resultados dos dois testes, a área do desenvolvimento mais prejudicada foi a linguagem, o que pode ser reflexo das oscilações de audição e da disfunção velofaríngea. Houve concordância moderada (k=0,563) entre os resultados dos dois testes aplicados no Grupo 1, e concordância substancial (k=0,704) no Grupo 2. O tempo médio de uso da INF foi de 60 ± 28 dias. Na análise socioeconômica do Grupo 1, 42,1% se encaixavam na classificação baixa superior, e 28,9% na média inferior; no Grupo 2, 20,8% se encaixavam na baixa inferior, e 58,3% na baixa superior, sem diferença entre os grupos (p=0,211). Não houve associação significativa entre a classificação socioeconômica e os resultados dos testes de desenvolvimento aplicados. O nível de escolaridade mais encontrado entre os pais dos participantes foram: 3º grau completo (Grupo 1) e 2º grau completo (Grupo 2), sem diferença estatística entre os grupos. Conclusões: A maioria das crianças com SRI tratadas com INF apresentaram desenvolvimento neuropsicomotor normal, semelhante aos casos menos graves do grupo postural. As crianças tratadas com INF não apresentaram sinais clínicos evidentes de sequelas neurológicas da hipóxia. / Objectives: To assess the neurological and psychomotor development of children with Isolated Robin Sequence (IRS), submitted to the treatment of airway obstruction according to the protocol of the Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo (HRAC/USP), with nasopharyngeal intubation (NPI) or postural treatment. Verify if the neurodevelopment of the NPI group differs from postural group, and evaluate the effectiveness of NPI to prevent sequels of hypoxia. Materials and Methods: Prospective study conducted at HRAC/USP, with children SRI, with 2 to 6 years old, divided into two groups according to the type of treatment performed: NPI (Group 1) and postural (Group 2). Time data of use NPI, nasogastric tube (NGT), myringotomy surgery, socioeconomic status, education level of parents, among others, were collected. Participants were assessed through the development of Screnning Denver II Test (Denver II) and Neurologic Evolutionary Examination Adapted (NEEA). Results: The total of 62 children was evaluated, being 38 in the Group 1 and 24 in the Group 2. The results of the Denver Developmental Screening Test II showed that 73.7% of Group 1 and 79.2% of Group 2 presented with normal development. The results of NEEA had presented normal for 89.5% of children in the Group 1 and 87.5% in the Group 2. There was no significantly difference between the two groups at Denver Test (p=0.854) and in the NEEA Test (p=0.789). The myringotomy was performed by 47.3% of children in the Group 1 and 58.3% of children in the Group 2. The results showed language as the most impaired area, which may reflect fluctuations of hearing and velopharyngeal dysfunction. There was moderate agreement (k=0.563) between the results of the two tests applied in the Group 1, and substantial agreement (k=0.704) in the Group 2. The average time of use of the NPI was 60 ± 28 days. In the socioeconomic analysis of Group 1, 42.1% fit the low ranking higher, and 28.9% in the average lower. In the analyses of Group 2, 20.8% were in the low ranking lower, and 58.3% were in the low ranking the top. There was no different statistic between groups (p=0.211). There was no significant association between socioeconomic status and results of development tests performed. The levels of education most found between the participants parents were: completed graduation (Group 1), and secondary school (Group 2) with no statistical difference between groups. Conclusions: Most of children with IRS treated with NPI showed normal neurological and psychomotor development, similar of minor cases of postural group. The children treated with NPI didn\'t show evident clinical signs of neurological sequels of hypoxia.
42

O desenvolvimento motor de recém-nascidos pré-termo e a termo até a aquisição da marcha segundo Alberta Infant Motor Scale: um estudo de coorte / Motor development in preterm and term infants until walking independently according to Alberta Infant Motor Scale: a cohort study

Ana Paula Restiffe 28 August 2007 (has links)
A prematuridade se caracteriza por ser qualitativamente distinta do nascimento de termo, em função das intercorrências neonatais, do impacto do período de permanência na incubadora e da influência da ação da gravidade no desenvolvimento postural, do equilíbrio e da locomoção. Este estudo teve como OBJETIVOS: 1- comparar a coordenação motora axial de lactentes pré-termo (RNPT) saudáveis, com a de lactentes de termo (RNT), por meio dos escores da Alberta Infant Motor Scale (AIMS), segundo a idade cronológica (ICr) e corrigida (ICo), a partir do termo até a utilização da marcha independente como principal meio de locomoção; 2- verificar período de aquisição, entre RNPT e RNT, segundo ICo, de 7 itens avaliados pela AIMS (transição de quatro apoios para sentado; engatinhar; segurar o(s) pé(s) em supino; sentar-se independente; transição de sentado para quatro apoios; ficar em pé sem apoio; marcha independente); 3- determinar a influência de variáveis biológicas e sóciodemográficas para obtenção da marcha em RNPT. MÉTODOS: estudo coorte, prospectivo, observacional, mensal e comparativo entre 101 RNPT (grupo de estudo) e 52 RNT (grupo controle). Foram ajustados modelo de regressão beta e equações de estimação generalizada para curvas de ICr e ICo, a fim de comparar a média mensal dos escores entre os grupos. Para comparar as idades de aquisição dos sete itens da AIMS entre os RNT e RNPT, foram utilizadas estimativas de Turnbull da distribuição da idade e modelo de taxa de falhas proporcionais de Cox para censuras intervalares. Para análise estatística dos resultados das médias mensais entre os grupos e as idades de aquisição dos itens, recorreu-se à construção de intervalo de confiança (IC). Para análise das variáveis prognósticas no tempo da aquisição da marcha nos RNPT, análise de sobrevivência para censuras intervalares e modelo de regressão Weibull foram utilizados. O nível de significância considerado foi < 5%. RESULTADOS: Finalizaram o estudo 77 RNPT e 49 RNT. Os escores segundo ICr dos RNPT demonstraram ser estatisticamente inferiores em relação aos dos RNT. Segundo a ICo, os escores dos RNPT tornaram-se equivalentes aos dos RNT, não demonstrando diferença estatística significativa. Dos 7 itens analisados, somente em pé sem apoio e a marcha foram adquiridos mais tardiamente pelos RNPT. As variáveis biológicas com influência significante no tempo de aquisição da marcha foram: peso ao nascimento (PN), estatura ao nascimento (EN) e permanência no hospital após nascimento. CONCLUSÃO: A coordenação motora axial dos RNPT deve ser avaliada segundo ICo para não ser subestimada. A aquisição da marcha e a posição em pé sem apoio se desenvolvem mais tardiamente nos RNPT. Além disto, a aquisição da marcha em RNPT foi tão mais tardia quanto menor o PN e EN, assim como o longo período de internação após o nascimento retardaram a marcha nos RNPT. / The prematurity characterizes to be qualitatively different from term delivery, due to neonatal morbidities, impact of the long period in the incubator and the influence of gravidity in the postural development. This study has as OBJECTIVES:1- to compare the gross motor development in healthy preterm infants (PT) with term infants (T), using Alberta Infant Motor Scale (AIMS) scores, according to corrected and chronological ages, from term to walking independently; 2- To compare the age attainment of seven AIMS items, according to corrected age (four-point kneeling to sitting; reciprocal creeping; hands to feet in supine; sitting independently; sitting to four-point kneeling; stand alone; early stepping) between PT and T infants; 3- To study biologic and sociodemographic factors that affect walking attainment in PT. METHODS: cohort, prospective, observational monthly and comparative study between 101 PT and 52 T. In order to compare descriptively mean monthly scores, beta regression models and general estimated equations were used to adjust the chronological and corrected age graphics and for statistics purposes, the confidence interval of monthly mean scores were used. Turnbull estimation of age distribution and Cox´s proportional hazards model were used to compare the age in each seven items between groups. For prognostic factors of age walking attainment in PT, methods of Kaplan-Meyer and Weibull regression model were used. The level of significance was considered significant, if p < 5%. RESULTS: 77 PT and 49 T infants finished the study. Chronological age scores of PT were statistically lower in comparison with T scores. According to corrected age, PT monthly mean scores were not statistically different from T scores. Of seven analysed items, only standing alone and early stepping were attained later in PT infants. The variables that seemed to influence statistically in age of walking attainment were: birth weight and stature and duration of hospitalization. CONCLUSION: Gross motor development of PT infants should be assessed according to corrected age, in order not to be underestimated. The both milestones standing alone and early stepping developed later in PT infants. The lower the birth stature and weight were, the longer it took for the PT infants to attain walking, while the longer the PT newborns stayed hospitalized, the later they started walking.
43

Estudo randomizado controlado da estabilidade dinâmica postural em indivíduos saudáveis, pós-treinamento sensório-motor, realizado no solo ou no meio aquático / Controlled, randomized study of dynamic postural stability in healthy individuals following sensory-motor training carried out on the ground and in water

Andrea Forgas 21 June 2010 (has links)
Introdução: Tem se afirmado que não há a possibilidade de haver melhora da estabilidade dinâmica postural utilizando exercícios na água, isto é, onde a gravidade apresenta-se diminuída. Neste estudo randomizado e controlado avaliamos e comparamos a estabilidade dinâmica postural em indivíduos saudáveis que realizaram exercícios sensório-motor no solo ou na água. Métodos: Através do Biodex Balance System®, foram avaliados os limites de estabilidade postural, antes e após um programa de exercícios, de 60 indivíduos saudáveis do sexo masculino divididos em 3 grupos (solo, piscina e controle). Os indivíduos dos grupos solo e piscina realizaram um treinamento sensório-motor por 2 meses no solo e na água respectivamente; o grupo controle não realizou nenhum tipo de exercício. Resultados: 1) Foram encontradas diferenças significativas na estabilidade dinâmica entre o grupo solo e controle; 2) Foram encontradas diferenças significativas na estabilidade dinâmica entreo grupo piscina e controle; 3) Não foram encontradas diferenças significativas entre o grupo solo e piscina. Conclusões: realizar exercícios sensório-motor melhora a estabilidade postural em indivíduos saudáveis do sexo masculino, sem diferenças significativas entre os ambientes de treino (solo e água) comparados / Introduction: It has been stated that there is no way to improve dynamic postural stability using exercises in water, i.e. where there is reduced gravity. In this controlled, randomized study, we evaluate and compare postural dynamic stability in healthy individuals who performed sensory-motor exercises on the ground or in water. Methods: Through the Biodex Balance System®, the limits of postural stability were evaluated before and after a program of exercises, in 60 healthy males, divided into three groups (ground, swimming pool and control). The individuals in the ground and swimming pool groups carried out sensorial-motor training for two months, on the ground and in the water, respectively; the control group did not perform any kind of exercises. Results: 1) Significant differences were found in dynamic stability between the ground and control groups; 2) Significant differences were found in dynamic stability between the swimming pool and control groups; 3) No significant differences were found between the ground and swimming pool groups. Conclusions: performing sensory-motor exercises improves postural stability in healthy males, without significant differences between the training environments (ground and water) compared in this study
44

Programa de intervenção psicomotora para crianças com transtorno de déficit de atenção e hiperatividade - TDAH = Psychomotor intervention program for children with attention deficit hyperactivity disorder - ADHD / Programa de intervenção psicomotora para crianças com transtorno de déficit de atenção e hiperatividade - TDAH

Carvalho, Mariana Coelho, 1987- 28 August 2018 (has links)
Orientador: Cintia Alves Salgado Azoni / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-28T03:56:06Z (GMT). No. of bitstreams: 1 Carvalho_MarianaCoelho_M.pdf: 4326973 bytes, checksum: 9e3d420b0e1ceeb561a2e2992442bd99 (MD5) Previous issue date: 2015 / Resumo: Este estudo teve como objetivo verificar a eficácia de um programa de intervenção psicomotora em crianças com Transtorno do Déficit de Atenção e Hiperatividade (TDAH). Especificamente o estudo comparou o desempenho psicomotor e cognitivo (atenção e funções executivas), pré e pós testagem, em crianças com TDAH submetidas ao programa de intervenção psicomotora; comparou o desempenho psicomotor e cognitivo (atenção e funções executivas), pré e pós testagem, em crianças com TDAH não submetidas ao programa de intervenção psicomotora; além da comparação do desempenho psicomotor e cognitivo de crianças com TDAH e crianças controle na avaliação pré e pós-testagem. Participaram do estudo 26 crianças do gênero masculino, sendo 14 com TDAH, divididas em grupo experimental I e II (GEI e GEII) e 12 com desenvolvimento típico agrupados no grupo controle (GC), com idade cronológica entre 07 e 11 anos (M=9,00) e cursando do 2º ao 6º ano do ensino fundamental de escolas públicas e particulares. As crianças passaram por avaliação psicomotora e cognitiva. Os resultados deste estudo foram organizados em dois artigos, o primeiro referente ao desempenho psicomotor de crianças com TDAH e o segundo apresentando o efeito de um programa de intervenção psicomotora em crianças com TDAH. Os dados apresentados no primeiro artigo mostrou que as crianças com TDAH foram classificadas como "Eupráxico" 2(42,9%), 7(50%) "Dispráxico" e 1(7,1%) "Deficitário". Enquanto no grupo controle 11(91,7%) crianças foram classificadas como "Bom" e 1(8,3%) como "Superior". O desempenho psicomotor dos sujeitos com TDAH foi pior que do grupo controle em todas as áreas avaliadas. Os resultados sugerem que meninos com TDAH apresentam dificuldades psicomotoras que podem estar associadas a características do próprio quadro. A avaliação psicomotora pode favorecer o processo diagnóstico e de intervenção no TDAH. Os resultados apresentados no segundo artigo sugerem que a intervenção psicomotora foi eficiente para o tratamento de crianças com TDAH, uma vez que houve diferenças estatisticamente significativas nos escores de classificação do perfil psicomotor e nos testes de atenção e funções executivas. Além disso, houve melhora qualitativa, indicada pelo aumento das médias das funções de noção de corpo, equilibração, estruturação espaço temporal, praxia fina, lateralidade e tonicidade, respectivamente / Abstract: This study aimed to determine the effectiveness of a psychomotor intervention program for children with ADHD. Specifically, the study compared the psychomotor and cognitive performance (attention and executive functions), pre and post testing in children with ADHD, subject to psychomotor intervention program; He compared the psychomotor and cognitive performance (attention and executive functions), pre and post testing in children with ADHD not subject to psychomotor intervention program; beyond comparison psychomotor and cognitive performance of children with ADHD and control children in pre- and post-testing. The study included 26 male children, 14 with Attention Deficit Disorder and Hyperactivity Disorder (ADHD), divided into experimental group I and II (GEI and GEII) and 12 with typical development grouped in the control group (CG), aged chronological between 7:11 years (M = 9.00) and attending the 2nd to 6th grade of elementary school of public and private schools. The children underwent cognitive psychomotor assessment and pre and post-intervention. The results of this study were divided into two articles, the first referring to the psychomotor performance of children with ADHD and the second showing the effect of a psychomotor intervention program for children with ADHD. The data presented in the first article showed that children with ADHD were classified as "Eupráxico" 2 (42.9%), 7 (50%) "dyspraxic" and 1 (7.1%) "Underfunded". While in the control group 11 (91.7%) children were classified as "good" and 1 (8.3%) and "Superior". Psychomotor performance of subjects with ADHD was worse than the control group in all areas assessed. The results suggest that children with ADHD have psychomotor problems that may be associated with the frame itself features. Psychomotor assessment may favor the diagnosis and intervention process in ADHD. The results presented in the second article suggested that psychomotor intervention is effective for treating children with ADHD, since there were statistically significant differences in scores of psychomotor profile classification and tests of attention and executive functions. In addition, there was a qualitative improvement, indicated by the increase in average body notion of functions, balancing, timeline structure, fine praxis, laterality and tone respectively / Mestrado / Ciencias Biomedicas / Mestra em Ciências Médicas
45

The neural basis for auditory-motor interactions during musical rhythm processing

Chen, Joyce Lynn January 2008 (has links)
No description available.
46

Attention regulates the plasticity of multisensory timing

Heron, James, Roach, N.W., Whitaker, David J., Hanson, James Vincent Michael January 2010 (has links)
No / Evidence suggests than human time perception is likely to reflect an ensemble of recent temporal experience. For example, prolonged exposure to consistent temporal patterns can adaptively realign the perception of event order, both within and between sensory modalities (e.g. Fujisaki et al., 2004 Nat. Neurosci., 7, 773-778). In addition, the observation that 'a watched pot never boils' serves to illustrate the fact that dynamic shifts in our attentional state can also produce marked distortions in our temporal estimates. In the current study we provide evidence for a hitherto unknown link between adaptation, temporal perception and our attentional state. We show that our ability to use recent sensory history as a perceptual baseline for ongoing temporal judgments is subject to striking top-down modulation via shifts in the observer's selective attention. Specifically, attending to the temporal structure of asynchronous auditory and visual adapting stimuli generates a substantial increase in the temporal recalibration induced by these stimuli. We propose a conceptual framework accounting for our findings whereby attention modulates the perceived salience of temporal patterns. This heightened salience allows the formation of audiovisual perceptual 'objects', defined solely by their temporal structure. Repeated exposure to these objects induces high-level pattern adaptation effects, akin to those found in visual and auditory domains (e.g. Leopold & Bondar (2005) Fitting the Mind to the World: Adaptation and Aftereffects in High-Level Vision. Oxford University Press, Oxford, 189-211; Schweinberger et al. (2008) Curr. Biol., 18, 684-688).
47

Language-guided visual processing affects reasoning: the role of referential and spatial anchoring

Dimitru, M.L., Joergensen, G.H., Cruickshank, Alice G., Altmann, G.T.M. January 2013 (has links)
No / Language is more than a source of information for accessing higher-order conceptual knowledge. Indeed, language may determine how people perceive and interpret visual stimuli. Visual processing in linguistic contexts, for instance, mirrors language processing and happens incrementally, rather than through variously-oriented fixations over a particular scene. The consequences of this atypical visual processing are yet to be determined. Here, we investigated the integration of visual and linguistic input during a reasoning task. Participants listened to sentences containing conjunctions or disjunctions (Nancy examined an ant and/or a cloud) and looked at visual scenes containing two pictures that either matched or mismatched the nouns. Degree of match between nouns and pictures (referential anchoring) and between their expected and actual spatial positions (spatial anchoring) affected fixations as well as judgments. We conclude that language induces incremental processing of visual scenes, which in turn becomes susceptible to reasoning errors during the language-meaning verification process.
48

Does my step look big in this? A visual illusion leads to safer stepping behaviour

Elliott, David, Vale, Anna, Whitaker, David J., Buckley, John January 2009 (has links)
No / BACKGROUND: Tripping is a common factor in falls and a typical safety strategy to avoid tripping on steps or stairs is to increase foot clearance over the step edge. In the present study we asked whether the perceived height of a step could be increased using a visual illusion and whether this would lead to the adoption of a safer stepping strategy, in terms of greater foot clearance over the step edge. The study also addressed the controversial question of whether motor actions are dissociated from visual perception. METHODOLOGY/PRINCIPAL FINDINGS: 21 young, healthy subjects perceived the step to be higher in a configuration of the horizontal-vertical illusion compared to a reverse configuration (p = 0.01). During a simple stepping task, maximum toe elevation changed by an amount corresponding to the size of the visual illusion (p<0.001). Linear regression analyses showed highly significant associations between perceived step height and maximum toe elevation for all conditions. CONCLUSIONS/SIGNIFICANCE: The perceived height of a step can be manipulated using a simple visual illusion, leading to the adoption of a safer stepping strategy in terms of greater foot clearance over a step edge. In addition, the strong link found between perception of a visual illusion and visuomotor action provides additional support to the view that the original, controversial proposal by Goodale and Milner (1992) of two separate and distinct visual streams for perception and visuomotor action should be re-evaluated.
49

Changes to control of adaptive gait in individuals with long-standing reduced stereoacuity

Buckley, J. G., Panesar, G. K., MacLellan, M. J., Pacey, I. E., Barrett, B. T. January 2010 (has links)
PURPOSE: Gait during obstacle negotiation is adapted in visually normal subjects whose vision is temporarily and unilaterally blurred or occluded. This study was conducted to examine whether gait parameters in individuals with long-standing deficient stereopsis are similarly adapted. METHODS: Twelve visually normal subjects and 16 individuals with deficient stereopsis due to amblyopia and/or its associated conditions negotiated floor-based obstacles of different heights (7-22 cm). Trials were conducted during binocular viewing and monocular occlusion. Analyses focused on foot placement before the obstacle and toe clearance over it. RESULTS: Across all viewing conditions, there were significant group-by-obstacle height interactions for toe clearance (P < 0.001), walking velocity (P = 0.003), and penultimate step length (P = 0.022). Toe clearance decreased (approximately 0.7 cm) with increasing obstacle height in visually normal subjects, but it increased (approximately 1.5 cm) with increasing obstacle height in the stereo-deficient group. Walking velocity and penultimate step length decreased with increasing obstacle height in both groups, but the reduction was more pronounced in stereo-deficient individuals. Post hoc analyses indicated group differences in toe clearance and penultimate step length when negotiating the highest obstacle (P < 0.05). CONCLUSIONS: Occlusion of either eye caused significant and similar gait changes in both groups, suggesting that in stereo-deficient individuals, as in visually normal subjects, both eyes contribute usefully to the execution of adaptive gait. Under monocular and binocular viewing, obstacle-crossing performance in stereo-deficient individuals was more cautious when compared with that of visually normal subjects, but this difference became evident only when the subjects were negotiating higher obstacles; suggesting that such individuals may be at greater risk of tripping or falling during everyday locomotion.
50

Uticaj kognitivnih i motoričkih sposobnosti na stepen socijalne participacije kod obolelih od multiple skleroze / Influence of cognitive and motor abilities on the degree of social participation in patients with multiple sclerosis

Slavković Sanela 08 September 2016 (has links)
<p>Multipla skleroza (MS) je hronična, inflamatorna, demijelinizaciona i degenerativna bolest centralnog nervnog sistema koja rezultuje &scaron;irokim spektrom invaliditeta. U sklopu bolesti mogu da se pojave brojni simptomi koji se ispoljavaju kroz poremećaje kognitivnih i motoričkih sposobnosti. Efekti kognitivne i motoričke disfunkcije su veliki i ne utiču samo na obolelog već i na člano e porodice i udruženi su sa socijalnom participacijom osoba sa MS. Ciljevi istraživanja su: utvrditi stepen socijalne participaci je, prisutnost poremećaja kognitivnih sposobnosti (pamćenja, verbalne fluentnosti, vizuo prostorne funkcije, govora i pažnje) i poremećaja motoričkih sposobnosti (manuelnih sposobnosti i hoda) kod obolelih od MS. Istraživanje je sprovedeno tokom 2013. i 2014. godine na Klinici za neurologi ju, Kliničkog centra Vojvodi ne. Uzorak je činilo 108 ispitanika obolelih od MS (relapsno-remitentna forma) starosti od 20 do 53 godine (AS 39,86 godina; SD 8,20 godina). Metode primenjene u istraživanju su: Op&scaron;ti upitnik, Kognitivni skrining audio zapisom (Audio Recorded Cognitive Screen &ndash; ARCS), Tempom uslovljen auditivni test serijskog sabiranja (Paced Auditory Serial Additional Test &ndash; PASAT), Test 9 rupa (9 Hole Peg Test), Test 25 koraka (25 Foot Walk Test), Skala za procenu neurolo&scaron;kog deficita (Expanded Disability Status Scale &ndash; EDSS), Upitnik za procenu socijalne participacije i Skala za procenu invaliditeta 2.0 Svetske zdravstvene organizacije (World Health Organization Disability Assessment Schedule &ndash; WHO DAS 2.0). Prema na&scaron;im rezultatima, niži stepen neurolo&scaron;kog deficita praćen je vi&scaron;om participacijom i vi&scaron;im nivoom aktuelnog funkcionisanja i obrnuto (r=0,43, p=0,00). Ispitanici sa blagim neurolo&scaron;kim deficitom imaju bolju participaciju (niži skor na WHO DAS 2.0 skali) od osoba sa izraženim neurolo&scaron;kim deficitom. Pozitivna korelacija postoji između stepena poremećaja kognitivnih sposobnosti i stepena neurolo&scaron;kog deficita kod obolelih od MS, odnosno veći neurolo&scaron;ki deficit je praćen pri sutno&scaron;ću kognitivnih deficita (r=-0,27, p=0,00). Osobe bez neurolo&scaron;kog deficita i osobe sa blagim neurolo&scaron;kim deficitom imaju značajno niže skorove odnosno bo lje motoričke sposobnosti i gornjih i donjih ekstremiteta od osoba sa izraženim neurolo&scaron;kim deficitom (p=0,00). Korelacije izme đu kognitivnog funkcionisanja merenog ARCS i aktuelnog nivoa funkcionisanja (invaliditeta) su negativne. Vi&scaron;i stepen invalidnosti praćen je i lo&scaron;ijim kognitivnim statusom. Hijerarhijskom regresionom analizom se proveravao zajednički doprinos svih prediktorskih varijabli u obja&scaron;njavanju ukupne participacije osoba sa MS. Najveći doprinos imaju starost ispitanika, kognitivne sposobnosti i motoričke sposobnosti gornjih ekstremiteta. Rezultati omogućavaju uvid u motoričke i kognitivne sposobnosti obolelih od MS kao i saznanja o faktorima koji utiču na stepen socijalne participacije. Na osnovu ovih rezultata moguće je planiranje programa rehabilitacije i psiho socijalne podr&scaron;ke obolelima od MS. ARCS može da se primenju je kao nova, jednostavna, efikasna i jeftina metoda u skriningu kognitivnih sposobnosti kod obolelih od MS.</p> / <p>Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating degenerative disease of the central nervous system that results in a vast spectrum of disabilities. As part of the disease, many symptoms can occur that manifest as impairments of cognitive and motor abilities. The effects of cognitive and motor dysfunctions are significant and affect not only the patient but also his/her family, and are associated with the social participation of people with MS. The research objectives were to determine the degree of social participation, the presence of cognitive abilities (memory, verbal fluency, visuo spatial functions, speech and attention) and disorders of motor skills (manual skills and gait) in patients with MS. The study was conducted in 2013 and 2014 at the Neurology Clinic, Clinical Center of Vojvodina. The sample consisted of 108 patients suffering from the relapsing-remitting form of MS, aged 20-53 years (AS 39,86 years; SD 20,8 years). The methods applied in the study were the General Questionnaire, the Audio Recorded Cognitive Screen (ARCS), the Paced Auditory Serial Additional Test (PASAT), the 9 Hole Peg Test, the 25 Foot Walk Test, the Expanded Disability Status Scale (EDSS), and the World Health Organization Disability Assessment Schedule (WHO DAS 2.0). According to our results, a lower degree of neurological deficit was associated with a higher degree of participation and a higher level of current functioning, and vice versa (r= 0,43, p= 0,00). Subjects with mild neurological deficits had better social participation (a lower score on the WHO DAS 2.0 scale) compared with subjects with severe neurological deficits. A positive correlation was found between the degree of cognitive ability and the degree of neurological deficit in patients with MS, i.e. a greater neurological deficit was accompanied by the presence of cognitive deficits (r = -0,27, p= 0,00). Subjects with no neurological deficits and those with mild neurological deficits had significantly lower scores and better motor skills of both upper and lower extremities, compared with those with severe neurological deficits (p = 0,00). Correlations between cognitive functioning as measured by the ARCS and the current level of functioning (disability) were negative. A higher degree of disability was associated by a worse cognitive status. The hierarchical regression analysis was used to test the joint contribution of all predictor variables to the overall participation of people with MS. The highest contribution was found forage and cognitive and motor skills of upper extremities. The results provide insights in to the motor and cognitive abilities of patients with MS, as well as in formation about the factors influencing the level of their social participation. Based on these results it is possible to plan a program of rehabilitation and psychosocial support to patients with MS. The ARCS may be utilized as a new, simple, efficient and inexpensive method in the screening of cognitive abilities of people with MS.</p>

Page generated in 0.0689 seconds