FATIMA APARECIDA CAROMANO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
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- Avaliação interdisciplinar da diadococinesia: um estudo piloto(2017) ALBUQUERQUE, Jessica Talita da Cruz; MACEDO, Tamara Passos; FAVERO, Francis Meire; BARBOSA, Alessandra Ferreira; CAROMANO, Fátima Aparecida; VOOS, Mariana CallilABSTRACT Diadochokinesis is the ability to perform fast, repeated and alternate movements. Diadochokinesis tests can assess both speech and upper extremities. The primary objective was to present an interdisciplinary diadochokinesis assessment protocol. The secondary objectives were to compare the performance with different phonemes of the oral diadochokinesis test (/papapa/, /tatata/, /kakaka/ and /pataka/); to compare the performance with different conditions of the upper extremities diadochokinesis test (conducted with both upper extremities in a mirrored manner, only with the right upper extremity, only with the left upper extremity, with both upper extremities in an alternately manner); and to investigate possible relationships between oral and upper extremities diadochokinesis. A total of fifteen healthy adults/seniors from 40 to 70 years old participated. Data were represented by descriptive statistics. The syllable numbers in /papapa/, /tatata/, /kakaka/ and /pataka/ conditions and the numbers of movements in mirrored, right, left and alternated conditions were compared by ANOVA and correlated by Pearson test. There was no significant difference in results between the phonemes of oral diadochokinesis test (p<0.001). There was difference between the conditions assessed in the upper extremities diadochokinesis test (p<0.001). The number of repeated phonemes was correlated with the alternate performance of upper extremities. We concluded that the correlation between scores of oral and upper extremities diadochokinesis tests can be explained by the fact that motor and language programs are predominantly represented in the left hemisphere. Common/connected brain areas or motor programs in common can guide these tasks.
- How often should sitting and rising from a chair be evaluated in patients with Duchenne muscular dystrophy?(2017) HUKUDA, Michele Emy; CAROMANO, Fatima Aparecida; ESCORCIO, Renato; CARVALHO, Eduardo Vital de; BLASCOVI-ASSIST, Silvana Maria; VOOS, Mariana CallilObjective: To determine how often sitting/rising from a chair should be assessed in Duchenne muscular dystrophy (DMD) patients to avoid redundant/missing data. Methods: Sitting/rising from a chair was evaluated in 26 DMD children (5-12 yrs), in three-month intervals, over twelve months, with the Functional Evaluation Scale (domain sitting/rising from a chair). Scores were compared by effect sizes (ES) and standardized response means (SRM) (responsiveness analysis). Results: Sit-to-stand showed low -to-moderate responsiveness in three-month intervals (ES:0.23-0.32; SRM:0.36-0.68), moderate-to-high responsiveness in six-month intervals (ES:0.52-0.65; SRM:0.76-1.28), high responsiveness at nine-month (ES:0.84-0.91; SRM:1.26-1.64) and twelve-month intervals (ES:1.27; SRM:1.48). Stand-to-sit showed low responsiveness in three-month intervals (ES:0.26-0.49; SRM:0.37-0.42), moderate responsiveness in six-month intervals (ES:0.50-0.78; SRM:0.56-0.71), high responsiveness in nine-month (ES:0.94-1.00; SRM:0.84-1.02) and twelve-month intervals (ES:1.13; SRM:1.52). Conclusion: Six months or longer intervals for reassessment are indicated to evaluate sitting/standing from a chair in DMD patients.
- Manual action verbs modulate the grip force of each hand in unimanual or symmetrical bimanual tasks(2018) SILVA, Ronaldo Luis da; LABRECQUE, David; CAROMANO, Fatima Aparecida; HIGGINS, Johanne; FRAK, VictorManual action verbs modulate the right-hand grip force in right-handed subjects. However, to our knowledge, no studies demonstrate the ability to accomplish this modulation during bimanual tasks nor describe their effect on left-hand behavior in unimanual and bimanual tasks. Using load cells and word playlists, we evaluated the occurrence of grip force modulation by manual action verbs in unimanual and symmetrical bimanual tasks across the three auditory processing phases. We found a significant grip force increase for all conditions compared to baseline, indicating the occurrence of modulation. When compared to each other, the grip force variation from baseline for the three phases of both hands in the symmetrical bimanual task was not different from the right-hand in the unimanual task. The left-hand grip force showed a lower amplitude for auditory phases 1 and 2 when compared to the other conditions. The right-hand grip force modulation became significant from baseline at 220 ms after the word onset in the unimanual task. This moment occurred earlier for both hands in bimanual task (160 ms for the right-hand and 180 for the left-hand). It occurred later for the left-hand in unimanual task (320 ms). We discuss the hypothesis that Broca's area and Broca's homologue area likely control the left-hand modulation in a unilateral or a bilateral fashion. These results provide new evidence for understanding the linguistic function processing in both hemispheres.
- Força de preensão e destreza manual na criança com Síndrome de Down(2013) PRIOSTI, Paula Aivazoglou; BLASCOVI-ASSIS, Silvana Maria; CYMROT, Raquel; VIANNA, Denise Loureiro; CAROMANO, Fátima AparecidaChildren with Down Syndrome (DS) present delays in motor skills acquisition compared to those with normal development, which may interfere in activities such as grip strength and manual dexterity. The evaluation of these activities can provide performance indicators in daily activities. The objective was to analyze the correlation between grip strength and manual dexterity in children with DS and healthy children aged 7 to 9 years old. Twenty-six children with DS, of both genders, who formed the DS Group, and 30 healthy ones, constituting the Control Group (CG) participated in this study. The grip strength evaluation was performed with the Jamar dynamometer and manual dexterity through the Box and Block Test. The DS Group presented a lower performance in both grip strength and in manual dexterity compared to CG. There was no significant correlation between grip strength and manual dexterity in the DS Group, but in the CG there was it. There was no difference in performance between genders for the items assessed in the two groups; performance on tests of grip strength and manual dexterity in the CG showed an evolution in the course of aging, in the DS Group these developments did not happen. It is concluded that differences were found in the performance of the two groups, indicating peculiar characteristics to DS. Further investigation must be done on these data, since they can contribute to the identification of objectives to be considered in stimulation programs.
- Functional performance and muscular strength in symptomatic female carriers of Duchenne muscular dystrophy(2020) SILVA, Thiago Henrique da; ANEQUINI, Isabela Pessa; FAVERO, Francis Meire; VOOS, Mariana Callil; OLIVEIRA, Acary Souza Bulle; TELLES, Juliana Aparecida Rhein; CAROMANO, Fatima AparecidaDuchenne muscular dystrophy (DMD) usually affects men. However, women are also affected in rare instances. Approximately 8% of female DMD carriers have muscle weakness and cardiomyopathy. The early identification of functional and motor impairments can support clinical decision making. Objective: To investigate the motor and functional impairments of 10 female patients with dystrophinopathy diagnosed with clinical, pathological, genetic and immunohistochemical studies. Methods: A descriptive study of a sample of symptomatic female carriers of DMD mutations. The studied variables were muscular strength and functional performance. Results: The prevalence was 10/118 (8.4%) symptomatic female carriers. Deletions were found in seven patients. The age of onset of symptoms in female carriers of DMD was quite variable. Pseudohypertrophy of calf muscles, muscular weakness, compensatory movements and longer timed performance on functional tasks were observed in most of the cases. Differently from males with DMD, seven female patients showed asymmetrical muscular weakness. The asymmetric presentation of muscle weakness was frequent and affected posture and functionality in some cases. The functional performance presents greater number of compensatory movements. Time of execution of activities was not a good biomarker of functionality for this population, because it does not change in the same proportion as the number of movement compensations. Conclusion: Clinical manifestation of asymmetrical muscle weakness and compensatory movements, or both can be found in female carriers of DMD mutations, which can adversely affect posture and functional performance of these patients.
- Relationship between the climbing up and climbing down stairs domain scores on the FES-DMD, the score on the Vignos Scale, age and timed performance of functional activities in boys with Duchenne muscular dystrophy(2014) FERNANDES, Lilian A. Y.; CAROMANO, Fatima A.; ASSIS, Silvana M. B.; HUKUDA, Michele E.; VOOS, Mariana C.; CARVALHO, Eduardo V.Background: Knowing the potential for and limitations of information generated using different evaluation instruments favors the development of more accurate functional diagnoses and therapeutic decision-making. Objective: To investigate the relationship between the number of compensatory movements when climbing up and going down stairs, age, functional classification and time taken to perform a tested activity (TA) of going up and down stairs in boys with Duchenne muscular dystrophy (DMD). Method: A bank of movies featuring 30 boys with DMD performing functional activities was evaluated. Compensatory movements were assessed using the climbing up and going down stairs domain of the Functional Evaluation Scale for Duchenne Muscular Dystrophy (FES-DMD); age in years; functional classification using the Vignos Scale (VS), and TA using a timer. Statistical analyses were performed using the Spearman correlation test. Results: There is a moderate relationship between the climbing up stairs domain of the FES-DMD and age (r=0.53, p=0.004) and strong relationships with VS (r=0.72, p=0.001) and TA for this task (r=0.83, p< 0.001). There were weak relationships between the going down stairs domain of the FES-DMD-going down stairs with age (r=0.40, p=0.032), VS (r=0.65, p=0.002) and TA for this task (r=0.40, p=0.034). Conclusion: These findings indicate that the evaluation of compensatory movements used when climbing up stairs can provide more relevant information about the evolution of the disease, although the activity of going down stairs should be investigated, with the aim of enriching guidance and strengthening accident prevention. Data from the FES-DMD, age, VS and TA can be used in a complementary way to formulate functional diagnoses. Longitudinal studies and with broader age groups may supplement this information. Keywords: disability; evaluation; neuromuscular diseases; rehabilitation; child; motor activity.
- Educational status influences cognitive-motor learning in older adults: going to university provides greater protection against aging than going to high school(2017) VOOS, Mariana Callil; PIEMONTE, Maria Elisa Pimentel; MANSUR, Leticia Lessa; CAROMANO, Fatima Aparecida; BRUCKI, Sonia Maria Dozzi; VALLE, Luiz Eduardo Ribeiro doObjective: To investigate if middle-aged and older adults with a higher education would differ from those with an average education in cognitive-motor tasks involving lower limb function. Methods: A walking version of the Trail Making Test (Walking Executive Function Task, [ WEFT]) was used. Eighty volunteers (40: 50-65 years; 40: 66-80 years) were subdivided into average (6-11years of education) and higher education (12-17 years). They received two training sessions (session 1: eight repetitions, session 2: four repetitions), with a one week-interval between them. The Timed Up and Go (TUG) test was performed before and after the training. Results: Volunteers with an average education showed longer times on the WEFT than those with a higher education. Older adults showed lower retention than middle-aged adults (p < 0.001). The TUG was faster after the WEFT training (p < 0.001). Conclusion: The impact of education was observed when locomotion was associated with cognitive tasks. Average education resulted in poorer performance and learning than higher education, mainly in older adults. Gait speed increased after training.
- Mudança na biomecânica da postura sentada afeta a função pulmonar(2019) CONTESINI, Adriana Maria; SILVA, Thiago Henrique da; FAVERO, Francis Meire; BLASCOVI-ASSIS, Silvana Maria; VOOS, Mariana Callil; CAROMANO, Fátima AparecidaABSTRACT The objective of this study was to characterize the postures induced by two different chair-desk systems and analyze their effects on lung function. This was a cross-sectional, descriptive study of single subject with intra-series type analysis (A-B, B-A) during consecutive days of data collection. Fifteen volunteers participated using two chair-desk systems: conventional (A) and experimental (B). Postural evaluation was performed in both systems using photogrammetry. These images were analyzed using AutoCAD® 2010, estimating the average position of the joint angles of individuals in each system. These values were analyzed verifying the averages in each posture. Postural and respiratory data were compared by checking whether the different positions adopted by the participants resulted in changes in the spirometry values. Conventional chair-desk system promoted two different postural patterns, considering that one presented joint angles similar to experimental system, with similar spirometry results and the other presented body angles according to the reference of standards and spirometry results significantly lower in FEV1, FEV1/FVC and FEFmax. Experimental system differed from values of literature in standing posture only in FEFmax, suggesting similarity of postural situation. It was concluded that the experimental furniture proved a tool capable of benefiting respiratory function in sitting posture and may be an option to benefit people in special conditions such as pregnant women, obese individuals and people with chronic pulmonary diseases.
- Reliability, validity and description of timed performance of the Jebsen-Taylor Test in patients with muscular dystrophies(2018) ARTILHEIRO, Mariana Cunha; FAVERO, Francis Meire; CAROMANO, Fatima Aparecida; OLIVEIRA, Acary de Souza Bulle; CARVAS JUNIOR, Nelson; VOOS, Mariana Callil; SA, Cristina dos Santos Cardoso deBackground: The Jebsen-Taylor Test evaluates upper limb function by measuring timed performance on everyday activities. The test is used to assess and monitor the progression of patients with Parkinson disease, cerebral palsy, stroke and brain injury. Objectives: To analyze the reliability, internal consistency and validity of the Jebsen-Taylor Test in people with Muscular Dystrophy and to describe and classify upper limb timed performance of people with Muscular Dystrophy. Methods: Fifty patients with Muscular Dystrophy were assessed. Non-dominant and dominant upper limb performances on the Jebsen-Taylor Test were filmed. Two raters evaluated timed performance for inter-rater reliability analysis. Test-retest reliability was investigated by using intraclass correlation coefficients. Internal consistency was assessed using the Cronbach alpha. Construct validity was conducted by comparing the Jebsen-Taylor Test with the Performance of Upper Limb. Results: The internal consistency of Jebsen-Taylor Test was good (Cronbach's alpha=0.98). A very high inter-rater reliability (0.903-0.999), except for writing with an Intraclass correlation coefficient of 0.772-1.000. Strong correlations between the Jebsen-Taylor Test and the Performance of Upper Limb Module were found (rho = 0.712). Conclusion: The Jebsen-Taylor Test is a reliable and valid measure of timed performance for people with Muscular Dystrophy.
- Responsiveness of the domain climbing up and going down stairs of the Functional Evaluation scale for Duchenne Muscular Dystrophy: a one-year follow-up(2016) ALBUQUERQUE, Priscila S.; VOOS, Mariana C.; SIMOES, Mariene S.; MARTINI, Joyce; MONTEIRO, Carlos B. M.; CAROMANO, Fatima A.Objective: To determine the responsiveness of the domain climbing up and going down stairs of the Functional Evaluation Scale for Duchenne Muscular Dystrophy (FES-DMD-D3) in a one-year follow-up study. Method: The study included 26 patients with DMD. Effect Size (ES) and Standardized Response Mean (SRM) described the scale's responsiveness. Results: For climbing up stairs, ES showed that responsiveness was low in the three-month assessments (0.26; 0.35; 0.13; 0.17), low to moderate in the six-month assessments (0.58; 0.48; 0.33), moderate in the nine-month assessments (0.70; 0.68), and high in the 12-month assessment (0.88). SRM showed that responsiveness was low in the three-month assessments (0.29; 0.38; 0.18; and 0.19), low to moderate in the six-month assessments (0.59; 0.51; 0.36), moderate in the nine-month assessments (0.74 and 0.70), and high in the 12-month assessment (0.89). For going down stairs, ES showed that responsiveness was low in the three-and six-month assessments (0.16; 0.25; 0.09; 0.08 and 0.48; 0.35; 0.18, respectively), low to moderate in the nine-month assessments (0.59; 0.44), and moderate in the 12-month assessment (0.71). SRM showed that responsiveness was low in the three-and six-month assessments (0.25; 0.35; 0.12; 0.09 and 0.47; 0.38; 0.21, respectively), low to moderate in the nine-month assessment (0.62; 0.49), and moderate in the 12-month assessment (0.74). Conclusion: Climbing up stairs should be assessed at intervals of nine months or longer, when responsiveness is moderate to high. Going down stairs should be assessed annually because moderate responsiveness was observed in this period.