Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-20T20:16:16Z No. of bitstreams: 1 Gileno Edu Lameira de Melo.pdf: 2303187 bytes, checksum: dfdc9eb2889c78ff7007dee09856d636 (MD5) / Made available in DSpace on 2018-07-20T20:16:16Z (GMT). No. of bitstreams: 1 Gileno Edu Lameira de Melo.pdf: 2303187 bytes, checksum: dfdc9eb2889c78ff7007dee09856d636 (MD5) Previous issue date: 2017-10-24 / Objective: Determine the effect of gait training with virtual reality in comparison to over ground training and treadmill training on balance and gait in individuals with Parkinson’s disease. Material and Methods: Study I: A systematic review was performed of articles published between 2011 and 2016 retrieved from four databases using the following keywords and synonyms: Parkinson’s Disease, Gait, and Virtual Reality Exposure Therapy. Study II: Detailed description of the study protocol. Study III: A population-based sample was composed of 37 individuals with Parkinson’s randomly allocated to three groups (control, treadmill and virtual reality). The participants were evaluated on four occasions: pre-intervention; immediately after first intervention session; post-intervention; and one month after last intervention session). Evaluations involved the administration of the Hoehn & Yahr scale, the motor section of the Unified Parkinson’s Disease Rating Scale and Parkinson ’s disease Questionnaire (PDQ-39 for the evaluation of quality of life). Long-distance walking was evaluated using the Six-Minute Walk Test with the aid of the G-WALK (BTS) inertial sensor and monitoring of heart rate, blood pressure and perceived exertion (modified Borg scale). Training was performed in 20-minute sessions at a frequency of three sessions per week for four weeks. Study IV: Thirty-seven individuals with Parkinson’s were allocated to a control group, treadmill group and Xbox group Training in each group was performed in 12 sessions. The participants were evaluated on four occasions: pre-intervention; immediately after first training session; after 12 sessions; and one month after last training session). The evaluations involved the administration of the Hoehn & Yahr scale, the motor section of the Unified Parkinson’s Disease Rating Scale, Parkinson’s Disease Questionnaire (PDQ-39 for the evaluation of quality of life), the Berg Balance Scale, and the Tinetti Test. For the evaluation of spatiotemporal gait variables, the Timed Up and Go test was performed using the G-WALK (BTS) inertial sensor. Results: Study I: Twenty-one studies with a methodological quality of 5 or more points on the PEDro scale were analyzed and the review was published in the journal Archives of Neuropsychiatry. Study II: Protocol study published in the journal Manual Therapy. Study III: Significant improvements in the distance travelled and velocity on the Six-Minute Walk Test were found in the virtual reality and treadmill groups in comparison to the control group (p < 0.05), whereas no significant differences were found between the virtual reality and treadmill groups. Study IV: Improvements in the Berg Balance Scale, Tinetti balance and cognition subscales and mobility domain of the PDQ-39 were found in the treadmill and Xbox groups in comparison to the control group. Conclusion: The results of Studies III and IV suggest that, when used with the aim of improving mobility, balance and spatiotemporal gait variables in individuals with Parkinson’s disease, training with virtual reality is as effective as treadmill training. / Objetivo: Verificar o efeito do treino de marcha com realidade virtual em comparação com treino de marcha em esteira e treino de marcha livre sobre o equilíbrio e a marcha de indivíduos com doença de Parkinson (DP). Material e método: Estudo I: Foi realizada uma revisão sistemática com uma busca em quatro bases de dados com as seguintes palavras chave e seus sinônimos: doença de Parkinson, Marcha, Terapia de exposição à realidade virtual, publicados entre 2011 e 2016. Estudo II: Descrição detalhada do protocolo do estudo. Estudo III: A amostra populacional foi composta de 37 indivíduos com DP, alocados randomicamente em três grupos (Grupo Controle; Grupo Esteira e Grupo Realidade Virtual). Os participantes foram avaliados: pré-intervenção, efeito imediato, pós-intervenção e um mês após a última intervenção. A avaliação foi composta pela Escala de Hoehn e Yahr, pela seção motora da Escala Unificada de Avaliação da Doença de Parkinson e a percepção da qualidade de vida pelo questionário de Qualidade de Vida na Doença de Parkinson (PDQ-39). Para avaliação da caminhada de longa distância, realizou o Teste de Caminhada de 6 minutos, utilizando o sensor inercial G-WALK- BTS e os parâmetros clínicos da Frequência Cardíaca, Pressão Arterial e escala de Borg modificada. Os treinos foram realizados durante quatro semanas, com três sessões por semana, com duração de 20 minutos de treino. Estudo IV: 37 parkinsonianos foram alocados em grupo controle, grupo esteira e grupo Xbox. Realizaram quatro avaliações distintas antes da intervenção, após a primeira sessão de treino, após 12 sessões de treino e 30 dias após o último treino. As avaliações foram constituídas dos seguintes testes e escalas: Escala de Hoehn e Yahr, pela seção motora da Escala Unificada de Avaliação da Doença de Parkinson e a percepção da qualidade de vida, pelo questionário de Qualidade de Vida na Doença de Parkinson (PDQ-39), Escala de Equilíbrio de Berg, Teste de Tinetti. E para avaliação dos parâmetros espaço temporais da marcha, Teste Timed Up and Go, utilizando o sensor inercial G-WALK- BTS. Foram realizadas 12 sessões de treino para cada grupo. Resultados: Estudo I: 21 estudos foram encontrados com uma qualidade metodológica de 5 pontos ou mais na escala PEDro e submetido à publicação na Revista Arquivos de Neuropsiquiatria. Estudo II: artigo publicado na revista Terapia Manual. Estudo III: O grupo Realidade virtual e Esteira apresentou estatisticamente melhora nos parâmetros da distância e velocidade, durante o teste de caminhada de 6 minutos em relação ao grupo controle (p<0,05). Não foram encontradas diferenças significativas entre o grupo esteira e o grupo Realidade Virtual. O estudo IV: Para as escalas clínicas, os grupos Esteira e XBOX apresentaram melhores escores para a Escala de Berg, Tinetti-equilíbrio e cognição e mobilidade do PDQ-39 do que o grupo controle. Conclusão: os resultados dos estudos III e IV sugerem que o treino com RV, quando utilizado para a melhoria da mobilidade, equilíbrio e dos parâmetros espaço temporais da marcha, tem efeito positivo em indivíduos com DP tanto quanto o treinamento em esteira.

A Lesão Medular (LM) afeta a funcionalidade do indivíduo e pode reduzir drasticamente a independência. A restauração da mobilidade e do andar, é uma das principais metas das intervenções na população com LM, e nesse contexto o treinamento locomotor (TLSP) é uma intervenção utilizada com objetivo de fornecer estímulos sensoriais específicos ao sistema nervoso danificado para estimular as redes e circuitos preservados da medula. A velocidade é uma aferência sensorial importante durante o TLSP em esteira. Objetivo: investigar o efeito da variação de velocidade sobre as respostas motoras de indivíduos com lesões medulares durante TLSP em esteira. Método: 20 sujeitos sem LM denominado de grupo controle (GC) e 13 com LM completa (GLM) foram submetidos ao protocolo TLSP em esteira nas velocidades 2, 3 e 4 km/h. Foi realizada uma análise de EMG para avaliar atividade muscular de vasto lateral (VL), bíceps femural (BF), tibial anterior (TA) e gastrocnêmio lateral (GL) ao longo do ciclo do passo. Resultados: O GC apresentou maior atividade muscular distal TA e GL quando comparado ao GLM com maior atividade proximal VL e BF durante todas as fases da marcha. A velocidade que apresentou maior atividade muscular foi a intermediária (3km/h), quando comparado as velocidades 2Km/h e 4km/h. O aumento da velocidade resultou em maior influência nos músculos distais. Conclusão: a velocidade pode influenciar nas respostas motoras locomotoras de indivíduos com LM. O aumento da velocidade teve um papel importante no aumento da atividade muscular, contudo a atividade muscular foi maior na velocidade intermediária (3km/h) / Spinal Cord Injury (SCI) affects the individual\'s functionality and can gradually reduce independence. The restoration of mobility and walking, is one of the main goals of the interventions in SCI population. In this context body weight support treadmill training (BWSTT) is an intervention used to provide specific sensory stimuli to the damaged nervous system to stimulate the networks and circuits preserved in the spinal cord. Velocity is an important sensory afferment during the BWSTT. Objective: to investigate the effect of speed variation on motor responses of use with spinal cord injuries BWSTTl. Method: 20 healthy subjects composed the control group (CG) and 13 with complete SCI (SCIG) were submitted to BWSTT at speeds 2, 3 and 4 km/h. An EMG analysis was performed to evaluate the muscle activity of lateral vastus (LV), biceps femorales (BF), tibial anterior (TA) and gastrocnemius lateral (GL) throughout the cycle of the step. Results: The CG had greater distal muscle activity TA and GL when compared to GLM with greater proximal activity, VL and BF, during all gait phases. The velocity that presented greater muscular activity was the intermediate (3km/h), when compared as speeds 2Km/h and 4km/h. Increased speed resulted in greater influence on the distal muscles. Conclusion: the velocity can influence motor responses. Increased speed had an important role in increasing muscle activity, however, muscle activity was greater at intermediate velocity (3km / h)

The aim of this study was to investigate whether exercise could improve motor behavioral deficits and alter expression of glial fibrillary acidic protein (GFAP) in dorsal striatum in a 6-hydroxydopamine (6-OHDA) rat model of Parkinson’s disease (PD). To this end, animals were randomly divided into 4 groups: sham sedentary (SS, n = 7); sham trained (ST, n=8); lesioned sedentary (LS, n=8) and lesioned trained (LT, n = 8). Rats were unilaterally lesioned with 6-OHDA (10 μg/3 μg) injected into the left medial forebrain bundle and sham groups were only injected with vehicle solution. The treadmill training protocol consisted of running with progressive increase in velocity, 5 days/week, during 4 weeks. Behavioral tasks were applied to asses the motor abilities of all animals prior to 6-OHDA injection and at 8th and 29th days post-injection. The tyrosine hydroxylase (TH - in substantia nigra pars compacta) and GFAP (in dorsal striatum) immunostaining was evaluated by semiquantitative analysis of the intensity (optical density - OD). The 6-OHDA lesion decreased the OD of TH and increased the OD of GFAP. In addition, the 6-OHDA lesion increased the number of ipsilateral rotations induced by methylphenidate (40 mg/kg, i.p., 30 min) and caused motor behavioral deficits. On the other hand, the treadmill training resulted in an increase in maximal exercise capacity in both trained groups (ST and LT). The training was able to reduce the number of ipsilateral rotations and ameliorated the motor behavioral deficits on 8th and 29th days postlesion. Interestingly, the exercise led to a significant increase in OD of GFAP in the LT group while there was no such effect in ST group. Our results indicate that treadmill training can improve motor behavioral deficits and suggest that the effects of exercise may be directly or, indirectly, mediated by astrocytes, as an increase in GFAP was observed in the dorsal striatum. Nevertheless, these are the first data showing an increase in GFAP expression post-exercise in this model and further research is needed to determine the precise action of exercise on astrocytes in Parkinson’s disease.

Made available in DSpace on 2016-06-02T20:19:18Z (GMT). No. of bitstreams: 1 4361.pdf: 2546261 bytes, checksum: 0ea61741466b8717008009085044d937 (MD5) Previous issue date: 2012-02-29 / The objective of this longitudinal study was to verify if the treadmill gait training improves the gross motor function in children with cerebral palsy (PC). This study evaluated 18 children with CP separated in two groups according with Gross Motor Function Classification System (GMFCS). To guarantee more homogeneity in the motor conditions two studies had been carried out: study 1 (levels I/II of the GMFCS) and 2 (levels III and IV of the GMFCS). Study 1 was composed for nine children with average of age of nine years and four months (5,7-13,2 years), level I (3 children) and II (6 children) of the GMFCS and study 2 was composed also for nine children with average of age of nine years (4 - 15 years), level III (3 children) and IV (6 children). Studies 1 and 2 had been lead in three phases: baseline, intervention and retention. The intervention phase consisted of treadmill gait training held twice a week in sessions of 25 minutes for six consecutive weeks. At each stage, the participants were evaluated using the Gross Motor Function Measure (GMFM) and 10m Walk Test (WT). In the retention phase, a Satisfaction Questionnaire for parents / caregivers was applied. Study 2 also used Functional Mobility Scale (FMS) to verify the influence of the protocol in functional mobility. In the statistics analysis, the ANOVA was applied in the two studies, separately. ANOVA with repeated measures was applied (group X evaluation) to analyze the total sample of the participants of the two studies. Study 1 showed positive changes in the scores of the GMFM in six participants and the WT-10m in five participants for normal speed and six for fast speed. The ANOVA indicated that it did not have significant difference between the evaluations. The Questionnaire showed that seven parents/caretakers had observed that the children were walking more rectified and that they were changing the steps easily less tired and needed less help. Study 2 showed positive changes in the scores of the GMFM in seven participants and the WT-10m in seven participants for the normal speed and in six for the fast. The ANOVA showed that it did not have significant difference between the evaluations. The Questionnaire showed that all the parents /caretakers had told that their children had started to walk more rectified, eight had reported that they had become less tired to walk the same distance in its daily routine and five had found that they had walked with more easiness and they had needed less help. The ANOVA with repeated measures showed that group levels I/II presented higher scores of the GMFM (p=0,001) and WT-10m in normal speed (p=0,001) and fast (p=0,001). It had difference between the evaluations for the total scores of the GMFM (p=0,019), being that GMFM 2 superior to GMFM 1 (p=0,06). In relation to the WT-10m, only for the fast speed had difference between the evaluations (p=0,027), being that in the after-intervention the average was greater than in the baseline (p=0,027). The protocol showed to significant changes in the motor function of the children with CP levels I/II and III/IV of GMFCS when the two groups had been analyzed jointly for the two applied quantitative measurements. In the analysis of study 1 and 2 separately, we did not find significant statistical results, however performance improvement was evidenced for the most part of the participants of the two groups, suggesting trend the improvement. The treadmill gait training leads to improvement of the gross motor function in children with CP levels I, II, III and IV. / O objetivo deste estudo longitudinal foi verificar se o treino de marcha em esteira melhora a função motora grossa em crianças com paralisia cerebral (PC). Este estudo avaliou 18 crianças com PC sendo estas separadas em dois grupos de acordo com o nível do Gross Motor Function Classification System (GMFCS). Para garantir mais homogeneidade nas condições motoras foram realizados dois estudos: estudo 1 (níveis I e II do GMFCS) e 2 (níveis III e IV do GMFCS). O estudo 1 foi composto por nove crianças com média de idade de nove anos e quatro meses (5,7-13,2 anos), classificadas nos níveis I (3 crianças) e II (6 crianças) do GMFCS; e o estudo 2 foi composto também por nove crianças com média de idade de nove anos (4 - 15 anos), classificadas nos níveis III (3 crianças) e IV (6 crianças). Os estudos 1 e 2 foram conduzidos em três fases: linha de base, intervenção e retenção. A fase de intervenção consistiu do treino de marcha em esteira realizado duas vezes por semana em sessões de 25 minutos por seis semanas consecutivas. Em todas as fases, os participantes foram avaliados usando Gross Motor Function Measure (GMFM) e Teste de caminhada de 10- m (TC). Na fase de retenção, um Questionário de Satisfação para pais/cuidadores foi aplicado. O estudo 2 também utilizou a Functional Mobility Scale (FMS), escala de avaliação usada para verificar a influência do protocolo na mobilidade funcional. Na análise estatística, foi aplicada a ANOVA nos dois estudos, separadamente. Foi aplicada ANOVA com medidas repetidas (grupo X avaliação) para analisar a amostra total dos participantes dos dois estudos. O estudo 1 mostrou mudanças positivas nos escores do GMFM em seis participantes e no TC-10m em cinco participantes para velocidade normal e em seis para velocidade rápida. A ANOVA indicou que não houve diferença significativa entre as avaliações. O Questionário mostrou que sete pais/cuidadores observaram que as crianças estavam andando mais retificadas e que estavam trocando os passos com mais facilidade, se cansavam menos e precisavam de menos ajuda. O estudo 2 mostrou mudanças positivas nos escores do GMFM em sete participantes e no TC-10m em sete participantes para a velocidade normal e em seis para a rápida. A ANOVA mostrou que não houve diferença significativa entre as avaliações. O Questionário mostrou que todos os pais /cuidadores relataram que suas crianças começaram a andar mais retificadas, oito reportaram que elas tornaram-se menos cansadas para andar a mesma distância na sua rotina diária e cinco acharam que andaram com mais facilidade e precisaram de menos ajuda. A ANOVA com medidas repetidas mostrou que o grupo níveis I/II apresentou maiores escores do GMFM (p=0,001) e TC-10m em velocidade normal (p=0,001) e rápida (p=0,001). Houve diferença entre as avaliações para o escore total do GMFM (p=0,019), sendo que o GMFM 2 superior ao GMFM 1 (p=0,006). Em relação ao TC- 10m, somente para a velocidade rápida houve diferença entre as avaliações (p=0,027), sendo que na pós-intervenção a média foi maior que na linha de base (p=0,027). O protocolo mostrou mudanças significativas na função motora das crianças com PC de GMFCS níveis I/II e III/IV quando os dois grupos foram analisados conjuntamente para as duas mensurações quantitativas aplicadas. Na análise do estudo 1 e 2 separadamente, não encontramos resultados estatisticamente significativos, porém melhora de desempenho foi constatada na maior parte dos participantes dos dois grupos, sugerindo tendência a melhora. O treino de marcha em esteira favorece a melhora da função motora grossa em crianças com PC dos níveis I, II, III e IV.

The aim of this study was to investigate whether exercise could improve motor behavioral deficits and alter expression of glial fibrillary acidic protein (GFAP) in dorsal striatum in a 6-hydroxydopamine (6-OHDA) rat model of Parkinson’s disease (PD). To this end, animals were randomly divided into 4 groups: sham sedentary (SS, n = 7); sham trained (ST, n=8); lesioned sedentary (LS, n=8) and lesioned trained (LT, n = 8). Rats were unilaterally lesioned with 6-OHDA (10 μg/3 μg) injected into the left medial forebrain bundle and sham groups were only injected with vehicle solution. The treadmill training protocol consisted of running with progressive increase in velocity, 5 days/week, during 4 weeks. Behavioral tasks were applied to asses the motor abilities of all animals prior to 6-OHDA injection and at 8th and 29th days post-injection. The tyrosine hydroxylase (TH - in substantia nigra pars compacta) and GFAP (in dorsal striatum) immunostaining was evaluated by semiquantitative analysis of the intensity (optical density - OD). The 6-OHDA lesion decreased the OD of TH and increased the OD of GFAP. In addition, the 6-OHDA lesion increased the number of ipsilateral rotations induced by methylphenidate (40 mg/kg, i.p., 30 min) and caused motor behavioral deficits. On the other hand, the treadmill training resulted in an increase in maximal exercise capacity in both trained groups (ST and LT). The training was able to reduce the number of ipsilateral rotations and ameliorated the motor behavioral deficits on 8th and 29th days postlesion. Interestingly, the exercise led to a significant increase in OD of GFAP in the LT group while there was no such effect in ST group. Our results indicate that treadmill training can improve motor behavioral deficits and suggest that the effects of exercise may be directly or, indirectly, mediated by astrocytes, as an increase in GFAP was observed in the dorsal striatum. Nevertheless, these are the first data showing an increase in GFAP expression post-exercise in this model and further research is needed to determine the precise action of exercise on astrocytes in Parkinson’s disease.

Made available in DSpace on 2016-12-12T17:32:57Z (GMT). No. of bitstreams: 1 Resumo Caroline Cunha.pdf: 22726 bytes, checksum: 98af822763c56d74f9949f09d5842553 (MD5) Previous issue date: 2014-08-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The mTOR protein is involved in growth, proliferation and cell metabolism. In skeletal muscle the mTOR is considered the major regulator of muscle fiber size, modulating the proteic synthesis. In neuronal cells, increased protein synthesis is associated with the activation of mTOR and its substrate p70S6K via BDNF. It is known that locomotor treadmill training (LTT) is able to modulate the expression of BDNF, what could be interfering in the mTOR/p70S6K activation. However, the regulatory mechanism of muscular protein synthesis mediated by the LTT was not described in the literature. Thus the aim of this study was to investigate the possible effects of LTT on muscle trophism and its protein signaling pathway in rats with incomplete spinal cord injury (SCI). Thirty-three females rats were randomly divided into 3 groups: control (no LME and untrained, n = 11), SCI trained (n = 11) and untrained SCI (n = 11). The animals were first anesthetized and a toracic laminectomy (T8-T9) was performed to display the dorsal spinal cord. The animals in groups with SCI received a latero-lateral compression using a neurovascular clip for 1 minute. All animals underwent weekly evaluation of locomotor recovery using the BBB scale. Seven days after injury, the LTT was employed with partial body weight support lasting 30 minutes, carried 1/day, 5 times a week, for 4 weeks. After the last session, the animals received an anesthetic overdose, and had the soleus muscles dissected and weighed to calculate the muscle trophism, measured by the ratio of muscle weight / weight of the animal. Samples of the central portion of the right soleus muscle were removed and frozen for quantification of the mTOR, p-p70S6K, TrkB and BDNF protein expressions using Western blot and ELISA biochemical techniques. The BBB scale scores were analyzed using repeated measures ANOVA. While the analysis of the muscular trophism and quantification of protein expressions were performed using one-way ANOVA. All animals recovered locomotor activity, with similar trends for both the trained and untrained groups. However, the LTT was effective for increasing muscle trophism in rats with SCI (p <0.05) and this morphological change was accompanied by increasing the expression of the mTOR protein (p <0.05) and its substrate p - p70S6K (p <0.05) in the soleus muscle of the trained group. Furthermore, LTT increase the trkB receptor and reduce the amount of BDNF expression (p <0.05) in the studied muscle. These results suggest that LTT increased muscle sensitivity for capture BDNF, by increasing the TrkB receptor expression, causing the reduction of this neurotrophin in studied muscle. Thus, this study made an evidence that muscle trophism induced by LTT involves activation cascade mTOR/p70S6K possibly up- regulated by BDNF. / A proteína mTOR está envolvida no crescimento, proliferação e metabolismo celular. No músculo esquelético a mTOR é considerada a maior reguladora do tamanho da fibra muscular, modulando a síntese de proteínas. Em células neuronais, o aumento da síntese proteica está relacionado com a ativação da proteína mTOR e seu substrato p70S6K via BDNF. Sabe-se que treinamento locomotor em esteira (TLE) é capaz de modular a expressão de BDNF, o que poderia interferir na via mTOR/p70S6K nos tecidos neuronal e muscular. Contudo, o mecanismo regulatório da síntese proteica muscular mediado pelo TLE, ainda não foi descrito na literatura. Assim o objetivo do estudo foi investigar os efeitos do TLE sobre o trofismo muscular e sua via de sinalização proteica, em ratos com lesão medular espinal (LME) incompleta. Trinta e três ratas foram randomicamente divididas em 3 grupos: controle (sem LME e sem treinamento, n=11), LME treinado (n=11) e LME não treinado (n=11). Os animais foram primeiramente anestesiados e uma laminectomia torácica foi realizada (T8-T9) para exposição dorsal da medula espinal. Os animais dos grupos com LME receberam uma compressão medular latero-lateral realizada por um clipe neurovascular por 1 minuto. Todos os animais foram submetidos à avaliação semanal da recuperação locomotora utilizando à escala BBB. Sete dias após a lesão, iniciou-se o TLE com suporte parcial de peso com duração de 30 minutos, realizado 1x/dia, 5x/semana por 4 semanas. Após a última sessão, os animais receberam uma overdose anestésica, tiveram os músculos sóleos dissecados e pesados para o calculo do trofismo muscular, mensurado pela relação do peso do músculo/peso do animal. Amostras da porção central do músculo sóleo direito foram retiradas e congeladas para quantificação da expressão das proteínas mTOR, p-p70S6K, TrKB e BDNF utilizando as técnicas bioquímicas Western Blot e ELISA. Os escores da escala BBB, foram analisados usando ANOVA para medidas repetidas. Enquanto a analise do trofismo muscular e da quantificação da expressão proteica foram realizadas utilizando ANOVA one way. Todos os animais com LME recuperaram a atividade locomotora, com evolução similar para ambos o grupos treinados e não treinados. Contudo, o TLE se mostrou eficaz para o aumento do trofismo muscular em ratos com LME (p<0,05) sendo que esta mudança morfológica foi acompanhada do aumento da expressão da proteína mTOR (p<0,05) e de seu substrato p-p70S6K (p<0,05) para o grupo treinado. Além disso, o TLE aumentou a expressão do receptor TrKB e reduziu a quantidade de BDNF (p<0,05). Estes resultados sugerem que o TLE aumentou a sensibilidade do músculo em capturar BNDF, via um aumento da expressão dos receptores TrKB, provocando a redução desta neurotrofina no músculo estudado. Dessa forma, este estudo evidencia que o trofismo muscular induzido pelo TLE envolve a ativação da cascata mTOR/p70S6K, possivelmente regulada pelo BDNF.

The aim of this study was to investigate whether exercise could improve motor behavioral deficits and alter expression of glial fibrillary acidic protein (GFAP) in dorsal striatum in a 6-hydroxydopamine (6-OHDA) rat model of Parkinson’s disease (PD). To this end, animals were randomly divided into 4 groups: sham sedentary (SS, n = 7); sham trained (ST, n=8); lesioned sedentary (LS, n=8) and lesioned trained (LT, n = 8). Rats were unilaterally lesioned with 6-OHDA (10 μg/3 μg) injected into the left medial forebrain bundle and sham groups were only injected with vehicle solution. The treadmill training protocol consisted of running with progressive increase in velocity, 5 days/week, during 4 weeks. Behavioral tasks were applied to asses the motor abilities of all animals prior to 6-OHDA injection and at 8th and 29th days post-injection. The tyrosine hydroxylase (TH - in substantia nigra pars compacta) and GFAP (in dorsal striatum) immunostaining was evaluated by semiquantitative analysis of the intensity (optical density - OD). The 6-OHDA lesion decreased the OD of TH and increased the OD of GFAP. In addition, the 6-OHDA lesion increased the number of ipsilateral rotations induced by methylphenidate (40 mg/kg, i.p., 30 min) and caused motor behavioral deficits. On the other hand, the treadmill training resulted in an increase in maximal exercise capacity in both trained groups (ST and LT). The training was able to reduce the number of ipsilateral rotations and ameliorated the motor behavioral deficits on 8th and 29th days postlesion. Interestingly, the exercise led to a significant increase in OD of GFAP in the LT group while there was no such effect in ST group. Our results indicate that treadmill training can improve motor behavioral deficits and suggest that the effects of exercise may be directly or, indirectly, mediated by astrocytes, as an increase in GFAP was observed in the dorsal striatum. Nevertheless, these are the first data showing an increase in GFAP expression post-exercise in this model and further research is needed to determine the precise action of exercise on astrocytes in Parkinson’s disease.

A Lesão Medular (LM) afeta a funcionalidade do indivíduo e pode reduzir drasticamente a independência. A restauração da mobilidade e do andar, é uma das principais metas das intervenções na população com LM, e nesse contexto o treinamento locomotor (TLSP) é uma intervenção utilizada com objetivo de fornecer estímulos sensoriais específicos ao sistema nervoso danificado para estimular as redes e circuitos preservados da medula. A velocidade é uma aferência sensorial importante durante o TLSP em esteira. Objetivo: investigar o efeito da variação de velocidade sobre as respostas motoras de indivíduos com lesões medulares durante TLSP em esteira. Método: 20 sujeitos sem LM denominado de grupo controle (GC) e 13 com LM completa (GLM) foram submetidos ao protocolo TLSP em esteira nas velocidades 2, 3 e 4 km/h. Foi realizada uma análise de EMG para avaliar atividade muscular de vasto lateral (VL), bíceps femural (BF), tibial anterior (TA) e gastrocnêmio lateral (GL) ao longo do ciclo do passo. Resultados: O GC apresentou maior atividade muscular distal TA e GL quando comparado ao GLM com maior atividade proximal VL e BF durante todas as fases da marcha. A velocidade que apresentou maior atividade muscular foi a intermediária (3km/h), quando comparado as velocidades 2Km/h e 4km/h. O aumento da velocidade resultou em maior influência nos músculos distais. Conclusão: a velocidade pode influenciar nas respostas motoras locomotoras de indivíduos com LM. O aumento da velocidade teve um papel importante no aumento da atividade muscular, contudo a atividade muscular foi maior na velocidade intermediária (3km/h) / Spinal Cord Injury (SCI) affects the individual\'s functionality and can gradually reduce independence. The restoration of mobility and walking, is one of the main goals of the interventions in SCI population. In this context body weight support treadmill training (BWSTT) is an intervention used to provide specific sensory stimuli to the damaged nervous system to stimulate the networks and circuits preserved in the spinal cord. Velocity is an important sensory afferment during the BWSTT. Objective: to investigate the effect of speed variation on motor responses of use with spinal cord injuries BWSTTl. Method: 20 healthy subjects composed the control group (CG) and 13 with complete SCI (SCIG) were submitted to BWSTT at speeds 2, 3 and 4 km/h. An EMG analysis was performed to evaluate the muscle activity of lateral vastus (LV), biceps femorales (BF), tibial anterior (TA) and gastrocnemius lateral (GL) throughout the cycle of the step. Results: The CG had greater distal muscle activity TA and GL when compared to GLM with greater proximal activity, VL and BF, during all gait phases. The velocity that presented greater muscular activity was the intermediate (3km/h), when compared as speeds 2Km/h and 4km/h. Increased speed resulted in greater influence on the distal muscles. Conclusion: the velocity can influence motor responses. Increased speed had an important role in increasing muscle activity, however, muscle activity was greater at intermediate velocity (3km / h)

Made available in DSpace on 2016-06-02T20:18:13Z (GMT). No. of bitstreams: 1 3132.pdf: 3107997 bytes, checksum: 1b931ab55a545210b8e98eae0eee3ce1 (MD5) Previous issue date: 2010-05-10 / Universidade Federal de Sao Carlos / This work is composed of three distinct studies. In the first one, we compared the muscle coactivation of tibialis anterior (TA) and gastrocunemius medialis (GM) during quiet stance and the also during the stance phase of gait in hemiparetic subjects (hemiparetic group, HG, n=12) and in subjects with no neurologic injuries (control group, CG, n=10). We evaluated the TA and GM electromyographic signal and calculated their overlapping ratio (OR). We concluded that these individuals do not present significant coactivation alterations in the stance phase of gait, but in quiet stance they seem to use the coactivation of the non-paretic limb to maintain postural stability. In the second study we investigated the effects of the association of treadmill training with body weight support (TTBWS) associated with strength training of ankle muscles on the motor control in chronic hemiparetic subjects. Fifteen volunteers were distributed into 2 treatment groups: 1) TTBWS (G1; n=7); and 2) TTBWS associated with resistance training for dorsi and plantar flexors (G2; n=8). We evaluated muscle performance of plantar flexion and dorsiflexion in an isokinetic dynamometer through peak torque (PT), total work (TW) and acceleration time (AT) at the speeds of 60°/s and 120°/s. For gait analysis we assessed the ground reaction forces (GRF). There was an increase in PT and TT of plantar flexion at 60°/s in the paretic side, and an increase in the positive peak of the anterior-posterior GRF component in both sides of G2. We suggested that the proposed intervention leads to improvements in the components related to propulsion of gait. In the third study, we evaluated the effect of the robot assisted gait training (RAGT) in children with spastic diplegia. Twenty children (12 male, 5-13 years old) were evaluated for functional outcomes and spatial-temporal patterns of gait before, after and 3 months after the end of the intervention. Comparisons revealed significant improvements on functional outcomes and in gait mechanics. We concluded that RAGT promotes better gait patterns, and that the learning of this new task is retained even after the end of the intervention. / Este trabalho é composto por três estudos distintos. Inicialmente comparamos a coativação dos músculos tibial anterior (TA) e gastrocnêmio medial (GM) em postura ortostática e durante a fase de apoio da marcha de indivíduos hemiparéticos (grupo hemiparético, GH; n = 12) e de indivíduos sem lesões neurológicas (grupo controle, GC; n = 10). Avaliamos o sinal eletromiográfico do TA e do GM e calculamos a taxa de sobreposição dos mesmos (ICoa). Em atividade estática observamos maior ICoa no membro não parético do GH quando comparado com o membro dominante do GC. Concluímos que hemiparéticos não apresentam alterações significativas da coativação na fase de apoio da marcha, mas em atividade estática parecem utilizar o aumento da coativação do lado não parético para a manutenção da estabilidade. No segundo estudo investigamos os efeitos da associação do treino de marcha em esteira com suporte parcial do peso corporal (TMESPP) ao treinamento de força para a musculatura do tornozelo sobre o controle motor em indivíduos hemiparéticos crônicos. Quinze voluntários foram distribuídos em 2 grupos de tratamento: 1) TMESPP (G1; n=7) e 2) TMESPP associado ao fortalecimento da musculatura do tornozelo (G2; n=8). Avaliamos o desempenho muscular nos movimentos de plantiflexão e dorsiflexão em dinamômetro isocinético nas velocidades de 60°/s e 120°/s, através dos valores de pico de torque (PT), trabalho total (TT) e tempo de aceleração (TA). Para avaliação da marcha analisamos as forças de reação do solo (FRS). Houve aumento do PT e do TT da plantiflexão a 60°/s do lado parético, e aumento dos picos positivos do componente ântero-posterior das FRS em ambos os lados do G2. Sugerimos que a intervenção proposta provoca melhora nos componentes da propulsão da marcha. O terceiro estudo avaliou o efeito do treino de marcha assistido por robô (TMAR) em 20 crianças com diparesia espástica (12 sexo masculino, 5-13 anos). Avaliamos medidas funcionais e padrões espaço-temporais da marcha antes, após e três meses depois do término da intervenção. As comparações revelaram melhora significativa nas medidas funcionais e na mecânica da marcha. Concluímos que o TMAR promove melhoras nos padrões da marcha, e que a aprendizagem dessa nova tarefa é retida mesmo após a interrupção do treino.

Made available in DSpace on 2016-06-02T19:02:40Z (GMT). No. of bitstreams: 1 3747.pdf: 6525981 bytes, checksum: 7091d3e5dff2ebc0abdf60c75dabc78a (MD5) Previous issue date: 2011-06-29 / Financiadora de Estudos e Projetos / The objective of this study was to investigate the effects of infrared-LED illumination associated with treadmill training. Forty five postmenopausal women (50-60 years old) participated in this study. They were randomly separated into 3 groups: (i) the LED group, with phototherapy during the treadmill training; (ii) the exercise group, carried out only treadmill training and (iii) the sedentary group, with neither phototherapy nor physical exercise. The treadmill training consisted of walking twice a week for 45 min at intensities between 85% to 90% maximal heart rate during 1 year. The irradiation parameters were 100mW, 40 mW/cm2, 108 J/cm2 and the treatment time of 45 min. The treatment was evaluated through maximal effort testing using treadmill, isokinetic dynamometry, anthropometry, body composition, blood exams, quality of life, bone mineral density, thermography, photographic documentation and nutritional aspects. The two-way ANOVA and one-way ANOVA with Bonferroni adjustments were used for the statistical analysis. The significance level was set at p<0.05. The most important results for the LED group were: improving the maximal exercise tolerance (&#916;Tlim=432±180seg, p=0.001 e; &#916;METs=4.2±1, p=0.01), increasing the muscle power (&#916;=21±6W, p=0.04) and reducing fatigue (&#916;=-7±4%, p=0.006). There were no significant differences in the body composition (p&#8805;0.05), but a qualitative difference of the skin was seen concerning the treatment of cellulite. There were reducted cholesterol levels (&#916;total cholesterol=-42±23 mg/dl, p=0.0003 and &#916;LDL=-35±20 mg/dl, p=0.001), as well as an increase of the quality of life (from 82±17 to 89±17, p=0.04). There were no significant differences noted concerning the bone mass loss (p&#8805;0.05). The cutaneous temperature increased during the exercise with the LEDs (from 33.5±0.8°C to 34.6±0.9°C, p=0.03). The results showed that the LED-illumination (850nm) improved physical performance and showed clinical benefits for the group of women investigated. Phototherapy associated with treadmill training can therefore be potentially used for sports, rehabilitation and aesthetics protocols to achieve certain positive results. / O objetivo deste estudo foi investigar os efeitos da iluminação-LED infravermelha durante o treinamento em esteira ergométrica. Participaram deste estudo 45 mulheres na pós-menopausa com idade entre 50-60 anos que foram separadas aleatoriamente em 3 grupos: (i) grupo LED, que realizou o treinamento na esteira ergométrica com fototerapia; (ii) grupo exercício, que realizou apenas o treinamento em esteira ergométrica e; (iii) grupo sedentário, que não realizou exercício físico e nem fototerapia. O treinamento foi realizado 2 vezes por semana durante 45 minutos em intensidade entre 85-90% da frequência cardíaca máxima durante 1 ano. Os parâmetros de irradiação foram 100 mW, 40 mW/cm2, tempo de tratamento de 45 minutos e 108 J/cm2 de fluência. O tratamento foi avaliado através de teste de esforço máximo em esteira ergométrica, dinamometria isocinética, antropometria, composição corporal, exames bioquímicos, qualidade de vida, densidade mineral óssea, termografia, documentação fotográfica e aspectos nutricionais. Para análise estatística foram utilizados ANOVA two-way e ANOVA one-way com ajustamentos de Bonferroni. O nível de significância foi p<0.05. Os principais resultados para o grupo LED foram: maior tolerância ao exercício máximo (&#916;Tlim=432±180seg, p=0.001 e; &#916;METs=4.2±1, p=0.01), maior potência muscular (&#916;=21±6W, p=0.04) e reduzida fadiga (&#916;=-7±4%, p=0.006). Não foram constatadas diferenças significativas na composição corporal (p&#8805;0.05), mas diferenças qualitativas na pele com redução de celulites. Houve também, a redução dos níveis de colesterol (&#916;colesterol total=- 42±23 mg/dl, p=0.0003 e &#916;LDL=-35±20 mg/dl, p=0.001), bem como, aumento da qualidade de vida (de 82±17 para 89±17, p=0.04). Não foi constatada redução significativa da massa óssea (p&#8805;0.05). Ainda, a temperatura cutânea aumentou durante o exercício com LEDs (de 33.5±0.8°C para 34.6±0.9°C, p=0.03). Os resultados mostraram que a iluminação-LED (850nm) pode potencializar o desempenho físico e os benefícios clínicos no grupo de mulheres investigado. Neste contexto, a fototerapia associada ao treinamento em esteira ergométrica pode ser potencialmente usada em protocolos de esporte, reabilitação e estética.