No / We drew on an interdisciplinary research design to examine stroke survivors’ experiences of living with stroke and with technology in order to provide technology developers with insight into values, thoughts and feelings of the potential users of a to-be-designed robotic technology for home-based rehabilitation of the hand and wrist. Method: Ten stroke survivors and their family carers were purposefully selected. On the first home visit, they were introduced to cultural probe. On the second visit, the content of the probe packs were used as prompt to conduct one-to-one interviews with them. The data generated was analysed using thematic analysis. A third home visit was conducted to evaluate the early prototype. Results: User requirements were categorised into their network of relationships, their attitude towards technology, their skills, their goals and motivations. The user requirements were used to envision the requirements of the system including providing feedback on performance, motivational aspects and usability of the system. Participants’ views on the system requirements were obtained during a participatory evaluation. Conclusion: This study showed that prior to the development of technology, it is important to engage with potential users to identify user requirements and subsequently envision system requirements based on users’ views.

Abstract Background: Individuals with nonfluent aphasia may have significant difficulties with functional spoken communication tasks in their daily life. Aphasia treatment held in a group setting may provide an enriched communicative context wherein the requirements of spoken language are similar to those within functional day-to-day communicative situations. Thus engaging in a spoken language activity in a group setting may directly target generalization of trained skills to those required in real-life, social communication situations. The present study is concerned with an aphasia group treatment that requires focused practice of spoken language during a social-functional communication task. Intensive Language Action Therapy (ILAT) has demonstrated positive communication outcomes in some individuals with chronic aphasia. However, it remains to be seen which clinical measures best index outcomes for ILAT. The purpose of the current study was to determine the effectiveness of ILAT in individuals with nonfluent aphasia by exploring multiple, potential ILAT outcomes. The outcomes included change in performance on assessments of directly trained spoken social-functional communication abilities (proximal outcomes), untrained social-functional communication abilities and language abilities (primary outcomes), and cognitive-communication abilities (secondary outcome). Additionally, the project aimed to explore the participants' perceptions of ILAT (secondary outcome). Methods and Procedures: ILAT was implemented with four individuals with nonfluent aphasia, using a single-subject multiple baseline design. The treatment was conducted daily for 10 consecutive week days, totaling 25 hours of treatment. Treatment probes (i.e., using trained and untrained picture cards and an unrelated control-task of nonword repetition), a pre/post assessment battery, and a post-treatment survey/interview were administered to assess performance on the treatment task, generalization to other potential ILAT outcomes, and participants' perceptions. Outcomes & Results: Increased accuracy was observed for trained and untrained items. However, two of the four participants were not able to reach a criteria determined a priori for treatment performance. Performance on items that were untrained resulted in some improvements in performance for all participants. Three of the four participants demonstrated small effect sizes in response to ILAT. One participant who demonstrated a medium effect size in response to ILAT also demonstrated a clinical significant change in discourse abilities, a measure of spoken social-functional communication abilities. All participants demonstrated improvements on at least one primary outcomes measure. Two participants, however, demonstrated a decline. All participants, however, perceived a positive experience with ILAT on a qualitative posttreatment survey/interview. Conclusions: Patterns were found between skills directly trained during ILAT, proximal outcomes, and performance on primary and secondary outcome measures of language, social-functional communication, and cognitive-communication, meant to assess generalization of trained skills to similar or potentially related untrained skills. A substantial amount of change (e.g., at least a medium effect size) on proximal outcome measures may be required in order for improvements to occur in primary and secondary outcome measures. Participants' perceptions of a positive treatment experience associated with the ILAT program further supports the value of the treatment. Future research should aim to further examine the influence of ILAT treatment components and participants' characteristics.

abstract: Today's world is seeing a rapid technological advancement in various fields, having access to faster computers and better sensing devices. With such advancements, the task of recognizing human activities has been acknowledged as an important problem, with a wide range of applications such as surveillance, health monitoring and animation. Traditional approaches to dynamical modeling have included linear and nonlinear methods with their respective drawbacks. An alternative idea I propose is the use of descriptors of the shape of the dynamical attractor as a feature representation for quantification of nature of dynamics. The framework has two main advantages over traditional approaches: a) representation of the dynamical system is derived directly from the observational data, without any inherent assumptions, and b) the proposed features show stability under different time-series lengths where traditional dynamical invariants fail. Approximately 1\% of the total world population are stroke survivors, making it the most common neurological disorder. This increasing demand for rehabilitation facilities has been seen as a significant healthcare problem worldwide. The laborious and expensive process of visual monitoring by physical therapists has motivated my research to invent novel strategies to supplement therapy received in hospital in a home-setting. In this direction, I propose a general framework for tuning component-level kinematic features using therapists’ overall impressions of movement quality, in the context of a Home-based Adaptive Mixed Reality Rehabilitation (HAMRR) system. The rapid technological advancements in computing and sensing has resulted in large amounts of data which requires powerful tools to analyze. In the recent past, topological data analysis methods have been investigated in various communities, and the work by Carlsson establishes that persistent homology can be used as a powerful topological data analysis approach for effectively analyzing large datasets. I have explored suitable topological data analysis methods and propose a framework for human activity analysis utilizing the same for applications such as action recognition. / Dissertation/Thesis / Doctoral Dissertation Electrical Engineering 2016

Context: Researchers in serious games area and professionals in stroke rehabilitation, working collaboratively in explorative interdisciplinary research studies in order to develop usable and effective applications. In this context, physiotherapists and occupational therapy are important elements of stroke rehabilitation. Applications from such exploratory development reflect motivational and easy to use features, which could be further designed and developed by serious games developers. Objectives: The research study aims to investigate the role and usefulness of Video Capture Virtual Reality Technology (VCVRT) in motor impairment rehabilitation, to identify and explore the importance of this technology in healthcare, specifically in motor impairment rehabilitation. Likewise, to analyze the acceptance of VCVRT among the physiotherapists in terms of perceived ease of use, perceived usefulness and perceived intension to use. Methods: In this exploratory study literature review, workshop and survey including questionnaire and interview are used, taking Blekinge County Hospital (Karlshamn) as case study along with “TARGET” game as testing platform for introducing and evaluating VCVRT among physiotherapists. For exploring technology acceptance level among physiotherapists, Technology Acceptance Model (TAM) was used in the research work. Results: Video capture virtual reality technology can be used as a complement to conventional physiotherapy. This technology is cheap, easy to use and is useful as a home based rehabilitation tool, but together with physiotherapist supervision or coaching. Moreover, VCVRT is motivational for weak patients and useful in motor rehabilitation in terms of quantity, i.e. intensity of exercise can be increased. Physiotherapist centered approach is necessary for game design process; effective game design suggestions and the idea of single gaming framework consists of different games acquiring multiple rehabilitation goals, are achieved from physiotherapists during the research. Technology acceptance value is high among physiotherapists. Conclusion: The research study provides a more detailed understanding of the factors involved in the implication of video capture virtual reality technology in motor impairment rehabilitation. The authors concluded from the research study that video capture virtual reality technology is applicable for motor impairment rehabilitation while considering following factors, i.e. Physiotherapist centered approach, a gaming framework where a portfolio of games can be assembled for individual patients, and video capture virtual reality technology is applicable for home based rehabilitation under the supervision of physiotherapist. Furthermore, physiotherapists’ concerns and importance in the intervention of serious games and healthcare area are highlighted by this research work.

BACKGROUND: A comprehensive Primary Health Care approach includes clear referral and continuity of care pathways. South Africa lacks data that describe Intermediate Care (IC) services and its role in the health system. This study aimed to describe the model of service provision at an IC facility and the role it plays in the continuity of care in Cape Town. METHODS: Sixty-eight patients (65% Response Rate) were recruited in a prospective cohort design over a one-month period in mid-2011. Patient data were collected from a clinical record review and an interviewer-administered questionnaire, administered at a median interval between admission and interview of 11 days to assess primary and second ary diagnosis, knowledge of and previous use of Home Based Care (HBC) services, reason for admission, demographics and information on referring institution. A telephonic interviewer-administered questionnaire to patients or their family members post-discharge recorded their vital status, use of HBC post-discharge and their level of satisfaction with care received at the IC facility. A Cox regression model was run to identify predictors of survival and the effect of a Care-plan on survival. Seventy staff members (82%) were recruited in a cross-sectional study using a self-administered questionnaire to describe demographics, level of education and skills in relation to what they did for patients and what they thought patients needed. RESULTS: Of the 68 participants, 38 % and 24% were referred from a secondary and tertiary hospital, respectively, and 78% were resident of a higher income community. Stroke (35%) was the most common single reason for admission at acute hospital. The three most common reasons reported by patients why care was better at the IC facility than the referring institution was the caring and friendly staff, the presence of physiotherapy and the wound care. Even though a large proportion of the IC inpatients had been admitted in a health facility on the year preceding the study, only 13 patients (21%) had used a Community Health Worker (CHW) ever before and only 25% (n=15) of the discharged patients had a confirmed CHW visit post-discharge. The presence of a Care-plan was significantly associated with a 62% lower risk of death (Hazard Ratio: 0.380; CI 0.149-0.972). Notably, 46% of staff members reported performing roles that were outside their scope of practice and there was a mismatch between what staff reported doing and their actual tasks. In addition, of the 57 patients that could be traced on follow-up 21(37%) had died. CONCLUSION: Patients and family understood this service as a caring environment that is primarily responsible for rehabilitation services. Furthermore, a Care-plan which extends beyond admission could have a significant impact on reducing mortality. IC services should therefore be recognised as an integral part of the health system and it should be accessed by all who need it.

No description available.

Bakgrund Varje år insjuknar 25 000-30 000 personer i Sverige med stroke. Stroke är ett samlingsbegrepp för hjärninfarkt och hjärnblödning som leder till syrebrist eller direkt skada i hjärnan. Hjärnskadorna kan leda till bestående eller övergående funktionsnedsättningar i varierande grad. Patienterna tas om hand av multidisciplinära team där sjuksköterskan ingår i alla leden i vårdkedjan. Sjuksköterskan utför omvårdnad för att stödja patienterna i deras återhämtning, vilket kan bidra till att förbättra prognosen för dessa patienter. Syfte Syftet med litteraturöversikten var att belysa sjuksköterskans upplevelser och erfarenheter av att vårda patienter som insjuknat i stroke. Metod Studiedesignen var en icke-systematisk litteraturöversikt. Studien baserades på 15 artiklar av både kvalitativ och kvantitativ design. Artikelsökningarna genomfördes i databaserna PubMed och CINAHL. Vidare gjordes en kvalitetsgranskning av de 15 vetenskapliga artiklarnas kvalitet och trovärdighet. Slutligen användes en integrerad översiktsmetod som dataanalysmetod för att färdigställa resultatet. Resultat Litteraturöversikten sammanfattade sjuksköterskans upplevelser och erfarenheter av att vårda patienter som insjuknat i stroke. Betydelsefulla aspekter och förhållningssätt som identifierades var att känna ett yrkesansvar, arbeta i multidisciplinära team, arbeta utifrån personcentrerad vård och sjuksköterskans relation med patientens närstående. Förbättringsområden inom strokevård var enligt sjuksköterskorna mer strokeutbildning, bättre samarbete i det multidisciplinära stroketeamet och med patientens närstående. Återkommande problem var tidsbrist och underbemanning. Slutsats Genom att studera och sammanfatta sjuksköterskors upplevelser och erfarenheter av att vårda patienter som insjuknat i stroke kan betydelsefulla aspekter, förhållningssätt och förbättringsområden inom strokevården förstås. / Background Every year 25,000-30,000 people in Sweden take ill with stroke. Stroke is a collective term for cerebral infarction and cerebral hemorrhage that leads to a lack of oxygen or direct damage in the brain. Brain damage can lead to permanent or transient disabilities of varying degrees. Patients are cared for by multidisciplinary teams where the nurse is part of all stages of the care. The nurse performs nursing care to support patients in their recovery and can help improve prognosis for these patients. Aim The purpose of the literature review was to describe the nurse's experiences in caring for patients taken ill with stroke. Method The design of the study was a non-systematic literature review. The study was based on 15 articles of both qualitative and quantitative design. The article searches were made in the databases PubMed and CINAHL. Furthermore, a quality review was made of the quality and credibility of the 15 articles. Finally, an integrated overview was used as a data analysis method to complete the result. Results The literature review summarized the nurse's experiences of caring for stroke patients. Identified significant aspects and attitudes were as follows, to feel a professional responsibility, to work in multidisciplinary teams, to practice person-centered care, and the nurses' relationship with the patient's relatives. According to the nurses, areas for improvement in stroke care were more stroke training, and better collaboration in multidisciplinary stroke teams and with the patient's relatives. Recurring problems were lack of time and understaffing. Conclusions By studying and summarizing the nurse's experiences in caring for patients taken ill with stroke significant aspects, attitudes and areas for improvement in stroke care can be understood.

Thesis (Ph.D. (Physiotherapy))--University of the Witwatersrand, Faculty of Health Sciences, 2013. / Stroke impacts on a survivor’s ability to participate in community activities such as return to work (RTW) and affects people who are still within the working age. Return to work contributes to life satisfaction and social identity at least partly through independence gained from income-generation. The impact of RTW programmes for stroke survivors is limited and not generalisable to South Africa. This study aimed to bridge this gap in South Africa, and was conducted within the Gauteng province as it comprises the largest share of the South African population. Objectives and Methodology: The aim of the study was to determine the current practice in RTW intervention programmes for stroke survivors in the Gauteng Province of South Africa and to establish the effect of a workplace intervention programme on the rate of RTW of previously employed stroke survivors. This study had two stages: Stage one: A cross sectional survey was performed using a self administered questionnaire to establish current practice in RTW intervention programmes and the therapists’ perceived barriers and enablers of RTW after stroke. Stage two study included: a) a randomised controlled trial (RCT) to evaluate a six week RTW intervention, with follow-up at three and six months. The workplace intervention programme was tailored according to the functional ability and workplace challenges of each stroke survivor and was as follows: Week one: Assessment for work skill. The assessment included work modules which identified potential problems such as: visual discrimination; eye hand coordination; form and spatial perception; manual dexterity; colour discrimination; cognitive problems, and job specific physical demand factors. Week two: The therapist interviewed the stroke survivor and employer separately to establish perceived barriers and enablers of RTW. This was followed by a meeting between the therapist, stroke survivor and employer/supervisor to discuss and develop a plan to overcome identified barriers and to strengthen identified enablers based on consensus between stroke survivor and employer. Week three: A work visit for the stroke survivor to demonstrate what they did at work and identify what they could still do safely and what they could not do. This included vocational counselling and coaching; emotional support; adaptation of the working environment; advice on coping strategies to compensate for mobility and upper limb functional limitations; and fatigue management. Weeks four, five and six: continuation of the work visits, while monitoring progress, and making necessary adjustments as per stroke survivor and employer’s needs. This was done at the workplace while the participants continued with their usual therapy at the hospital. The control group received usual care. The primary outcome was RTW rate. The secondary outcomes included activities of daily living (measured with the Barthel Index); mobility (measured with the Modified Rivermead Mobility Index); basic cognitive function (measured with the Montreal Cognitive Assessment) and perceived quality of life (measured with the Stroke Specific Quality of life Scale). Another aim of stage two study was to: b) establish the stroke survivors’ and employers’ perceived barriers and enablers of RTW (this was done with the experimental group only); and to: c) identify predictors of RTW. Stage one study results: Thirty six (68%) of the 53 questionnaires sent to stroke rehabilitation facilities were returned. Seventeen (47%) of the 36 clinical settings referred stroke survivors to facilities offering RTW services; 12 (33%) facilities did not refer stroke survivors for RTW and did not offer RTW services; and seven (20%) facilities offered RTW services. Of the seven facilities that rendered RTW services for stroke survivors, five (71%) communicated with the employer to discuss reasonable accommodation and four (57%) did assessments for potential to RTW. The most common reason given by the 29 facilities for not offering RTW services was that they referred stroke survivors to other therapists who offered these services. The second most common reason was the unemployment status of the stroke survivor at the time of having stroke. The therapists’ most commonly perceived barriers of RTW were the severity of the stroke survivors’ physical impairments (n = 3) (36%) and their employment status (n = 11) (31%) at the time of having stroke. The most commonly perceived enablers were willingness of the employer to reasonably accommodate the stroke survivor at work (n = 12) (33%), family support (n = 8) (22%) and increased length of hospital stay to allow for intensive rehabilitation (n = 7) (19%). Stigma in the workplace was the only variable which had a statistically significant relationship with the type of clinical facility therapists worked at (p = 0.02). Stage two study results: The average age for the study group was 45 (SD: 8.7) years and the average stroke duration was 4.6 (SD: 1.8) weeks. There were 41 (51%) male stroke survivors and 39 (49%) female stroke survivors. Majority (55%) of the stroke survivors were breadwinners (63%), had a grade 11 to 12 educational level (64%), an income above R5000 (46%) and had a helper (74%) whom they did not have to pay (81%). Stroke survivors who returned to work had better quality of life at six months after stroke than those who did not RTW (p = 0.05). Results from the qualitative study indicated that the perceived enablers of RTW included: ability of the employer to provide reasonable accommodation and good interpersonal working relationships between stroke survivor, employer and co-workers. The perceived barriers of RTW included: unaffordable reasonable accommodation costs; inaccessible transport; having cognitive (memory and attention) and speech impairments and high unemployment rates. The overall RTW rate was 20% at three months follow-up and 40% at six months follow-up. Twenty seven percent of the stroke survivors in the intervention group returned to work at three months compared to 12% in the control group (p = 0.13). At six months, the majority of stroke survivors (60%) in the intervention group returned to work compared to 20% in the control group (p <0.001). The following factors were predictive of RTW: male gender (p = 0.03); fewer speech problems (p = 0.02); increased time off work post stroke (p = 0.001); ability to perform activities of daily living (p = 0.02); good mobility (p = 0.01) and good cognitive ability (p = 0.02). The stroke survivors in the intervention group were 5.2 times more likely to RTW than those in the control group at six months following stroke, and for every unit increase in the activities of the Barthel Index and Montreal Cognitive assessment score, the likelihood of RTW increased by 1.7 and 1.3 respectively. Conclusion: A RTW intervention consisting of workability assessments and workplace visits was effective in facilitating RTW for stroke survivors in Gauteng province, South Africa. Key predictors of RTW included male gender; increased time off work post stroke; ability to perform activities of daily living; good mobility and good cognitive ability and were identified as facilitating RTW; speech problems were identified as barriers to RTW. Overall, these results suggest the need to direct resources towards increasing work place intervention strategies after stroke.

O Acidente Vascular Encefálico (AVE) freqüentemente ocasiona alterações de equilíbrio, decorrentes de lesões no sistema nervoso central que afetam os aspectos motores, sensoriais e de integração do controle do movimento. Os objetivos deste estudo foram descrever as alterações de equilíbrio em indivíduos hemiparéticos que haviam sofrido AVEs isquêmicos nos 12 meses anteriores (grupo de estudo - GE), em comparação a um grupo de indivíduos saudáveis (grupo controle, GC), e correlacionar medidas observacionais (Escala de Equilíbrio de Berg: EEB; e Sub-Escala de Equilíbrio do teste de Fugl-Meyer: SEE-FM) e laboratoriais (resultados da Posturografia Dinâmica computadorizada - PDC) no GE. Na PDC, foram realizados o teste de organização sensorial e o teste de controle motor. Foram avaliados 21 pacientes que apresentavam alto nível de desempenho funcional (avaliado pelo Índice de Barthel e pela Categoria de Deambulação Funcional, CDF), e comprometimento neurológico leve (avaliado pela escala de AVE do National Institutes of Health, NIHSS) e sensório-motor dos membros inferiores (avaliado pela sub-escala motora de membros inferiores de Fugl-Meyer). O desempenho do GE foi inferior ao do GC em todas as avaliações de equilíbrio. Os resultados da PDC indicaram pior integração das informações visual e vestibular no GE, comparado ao GC. Adicionalmente, os indivíduos do GE apresentaram maior assimetria na distribuição de peso e na força empregada pelos membros inferiores para se recuperarem de desequilíbrios impostos pelo teste. A PDC foi o único instrumento cujos resultados foram associados a comprometimento da dorsiflexão ativa e da propriocepção na articulação do tornozelo. Houve correlação estatisticamente significativa entre o Índice de Barthel e as escalas de equilíbrio, mas não com a PDC. As pontuações na CDF e na sub-escala motora de membros inferiores de Fugl-Meyer se correlacionaram significativamente com todas as medidas de avaliação de equilíbrio. As pontuações na NIHSS não se correlacionaram significativamente com as medidas observacionais nem com os resultados da PDC. Os três instrumentos de avaliação do equilíbrio apresentaram correlação entre si, e com o antecedente de quedas. As informações obtidas através da PDC contribuíram para melhor caracterização das anormalidades de equilíbrio em doentes hemiparéticos após o AVE. / Abnormal balance after stroke can be a consequence of changes in motor, sensory and integrative aspects of motor control. The aims of this study were to describe balance impairments in hemiparetic patients with ischemic strokes in the last 12 months compared to healthy subjects, and to correlate observational scores (Berg Balance Scale and balance subscale of the Fugl-Meyer assessment scale) and laboratory measurements (results of the Computerized Dynamic Posturography CDP) in the stroke group. The Sensory Organization Test and the Motor Control Test were performed in PDC. Twenty-one patients were evaluated. They had high functional levels (evaluated with the Barthel Index and with the Functional Ambulatory Category, FAC), mild neurological deficits (evaluated with the National Institutes of Health Stroke Scale, NIHSS) and mild sensory and motor impairment in the lower limbs (evaluated with the motor subscale of the Fugl-Meyer assessment scale). Patients had lower scores than healthy volunteers in all balance evaluations. CDP results showed worse visual and vestibular integration in the stroke group compared to healthy subjects. Weight and strength asymmetries in the lower limbs were greater in the stroke group. Only CDP results were significantly correlated with ankle dorsiflexion and proprioception. The Barthel Index correlated significantly with balance scales but not with PDC results. FAC and the motor subscale of the Fugl-Meyer assessment scale correlated significantly with all types of balance assessment. NIHSS scores did not correlate with observational scores or CDP results. The three instruments of balance evaluation were significantly correlated with each other and with history of falls after stroke. Information provided by CDP contributed to better characterize balance abnormalities in hemiparetic stroke patients.

Made available in DSpace on 2014-07-29T15:08:20Z (GMT). No. of bitstreams: 1 Capas.pdf: 96877 bytes, checksum: e977ec105e31fdc80abe54bac72c2e5b (MD5) Previous issue date: 2008-09-05 / Os Acidentes Vasculares Encefálicos (AVE) representam, atualmente, a principal causa de incapacidades neurológicas e uma das doenças com maior índice de mortalidade e morbidade do mundo moderno. Entre os prejuízos que esta patologia provoca, se destaca a hemiplegia, distúrbio do movimento que limita ou impede a utilização do hemicorpo plégico em atividades funcionais. As estratégias utilizadas atualmente para a reabilitação de indivíduos hemiplégicos baseiam-se nos conceitos de neuroplasticidade e aprendizado motor, e têm por objetivo influenciar a capacidade do cérebro de reagir a estímulos organizados com alterações de sua estrutura e função. Dentre os métodos de tratamento utilizados na reabilitação da hemiplegia, a Realidade Virtual (RV) vem se destacando como ferramenta de apoio ao tratamento, já que os Sistemas de RV permitem, ao paciente, experimentar a prática intensiva e sistematizada de movimentos em um ambiente interativo, motivante, desafiador e lúdico, além de possibilitarem ao terapeuta, a adequação do grau de dificuldade das tarefas e a avaliação objetiva dos ganhos obtidos. Neste contexto, este trabalho tem como objetivo identificar se um programa de reabilitação utilizando o sistema de Realidade Virtual não imersiva denominado SisTeV (Sistema de Terapia Virtual para Membros Superiores) provocaria variações nas características do movimento realizado pelo membro superior de indivíduos hemiparéticos em decorrência do AVE. Buscou-se identificar também se os ganhos de desempenho motor, advindos do treinamento, seriam generalizados para situações do cotidiano destes indivíduos. Estudaram-se também alternativas para sugerir possíveis mudanças na arquitetura dos ambientes do SisTeV. Para tanto, foram selecionados como sujeitos da pesquisa, cinco indivíduos hemiparéticos (amostragem não probabilística do tipo intencional), pacientes do Centro de Reabilitação e Readaptação Dr. Henrique Santillo (CRER), que se encontravam em fase crônica de evolução do AVE. Os mesmos participaram de 12 sessões de 45 minutos de treinamento com o SisTeV, em um período de 12 dias consecutivos, com folgas aos domingos. Estes pacientes foram previamente avaliados com o Teste da Função Manual de Jebsen, com a análise de movimentos por cinemetria, durante a execução de um dos exercícios do SisTeV, por parâmetros do próprio sistema e por meio de entrevista. Nos resultados obtidos não houve uma uniformidade dos tempos encontrados com o Teste de Jebsen. Um melhor desempenho na realização dos exercícios feitos nos ambientes do SisTeV foi observado. Alterações das variáveis cinemáticas, identificadas na análise de movimento, sugerem que ocorreu melhora do controle motor após o treinamento, mas a amostragem reduzida não permite extrapolações. As respostas colhidas com as entrevistas sinalizam para a possibilidade de generalização dos ganhos. Sugestões de modificações na arquitetura dos ambientes do SisTeV também foram descritas