MARIANA CALLIL VOOS
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina
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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- The general movement assessment in non-European low- and middle-income countries(2018) TOMANTSCHGER, Iris; HERRERO, Dafne; EINSPIELER, Christa; HAMAMURA, Cristina; VOOS, Mariana Calil; MARSCHIK, Peter B.Abnormal general movements are among the most reliable markers for cerebral palsy. General movements are part of the spontaneous motor repertoire and are present from early fetal life until the end of the first half year after term. In addition to its high sensitivity (98%) and specificity (91%), the assessment of general movements is non-invasive and time- and cost-efficient. It is therefore ideal for assessing the integrity of the young nervous system, most notably in low-resource settings. Studies on the general movements assessment in low-and middle-income countries such as China, India, Iran, or South Africa are still rare but increasing. In Brazil, too, researchers have demonstrated that the evaluation of general movements adds to the functional assessment of the young nervous system. Applying general movements assessment in vulnerable populations in Brazil is therefore highly recommended.
- 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.
- Gait, posture and cognition in Parkinson's disease(2016) BARBOSA, Alessandra Ferreira; CHEN, Janini; FREITAG, Fernanda; VALENTE, Debora; SOUZA, Carolina de Oliveira; VOOS, Mariana Callil; CHIEN, Hsin FenABSTRACT Gait disorders and postural instability are the leading causes of falls and disability in Parkinson's disease (PD). Cognition plays an important role in postural control and may interfere with gait and posture assessment and treatment. It is important to recognize gait, posture and balance dysfunctions by choosing proper assessment tools for PD. Patients at higher risk of falling must be referred for rehabilitation as early as possible, because antiparkinsonian drugs and surgery do not improve gait and posture in PD.
- A didactic approach to presenting verbal and visual information to children participating in research protocols: the comic book informed assent(2018) MASSETTI, Thais; CROCETTA, Tania Brusque; GUARNIERI, Regiani; SILVA, Talita Dias da; LEAL, Andrea Fernanda; VOOS, Mariana Celli; MONTEIRO, Carlos Bandeira de MelloOBJECTIVE: When children participate in research protocols, consent (by a parent or legal guardian) and assent (by the children) must be given. Understanding research protocols can be challenging for an adult and even more difficult for a child. The aim of this study was to describe the development of a comic book created to facilitate children's understanding of informed assent with clear and simple language. METHODS: Five researchers with scores above seven according to the Fehring criteria developed the comic book, avoiding the use of technical terminology. Twenty children between 7 and 12 years old, and enrolled in a larger study, responded using a Likert scale and questions about the clarity of texts and illustrations. The final version met National Health System Resolutions (Resolucoes do Conselho Nacional da Sande - CNS n degrees 196/1996 and 466/2012). RESULTS: The comic book assent presents a short story containing information about a real study: the invitation to participate, objectives, methods, instruments, procedures, risks, benefits, and the researchers' contact information. Most of the participants answered that they perceived the content of the text to be ""Excellent"" (40%) and ""Very good"" (40%), and the illustrations were perceived as ""Excellent"" (45%) and ""Very good"" (55%). CONCLUSION: The construction of a simple and clear model of informed assent is possible, and this model should be used in experiments with children.
- 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.
- Hip Mobilization at Preterm Age May Accelerate Developmental Dysplasia Recovery(2018) VOOS, Mariana Callil; DRUMMOND, Soares de Moura Maria Clara; HASUE, Renata HydeePurpose. Few studies have described mobilization approaches in developmental dysplasia of the hip (DDH). The present study describes the hip mobilization of a preterm infant (born at 33 6/7 weeks of gestational age) diagnosed with DDH. Design and Methods. During the 43-day hospital stay, the infant was seen twice a week (ten sessions, 20 minutes each). All sessions included hip approximation maneuvers, with the hip positioned in abduction, lateral rotation and flexion, and lower limbs passive mobilization, which were taught to the mother. Early intervention with auditory, tactile, visual, and vestibular stimulations was also performed. The infant was assessed with hip ultrasound before and after treatment. Results. At 34 2/7 weeks of gestational age, she was classified as Graf IIa (left: alpha: 55 degrees, beta: 68 degrees; right: alpha: 59 degrees, beta: 64 degrees). At 40 5/7 weeks, she was classified as Graf I for left (alpha: 67 degrees; beta: 42 degrees) and right (alpha: 66 degrees; beta: 42 degrees) hips. Practical Implications. The intervention seemed to accelerate the acquisition of stability of dysplasic hips in a preterm infant. The outcome supports further investigation of hip approximation maneuvers as part of early stimulation in preterm infants with DDH during hospital stay.
- Cognitive or Cognitive-Motor Executive Function Tasks? Evaluating Verbal Fluency Measures in People with Parkinson's Disease(2017) BARBOSA, Alessandra Ferreira; VOOS, Mariana Callil; CHEN, Janini; FRANCATO, Debora Cristina Valente; SOUZA, Carolina de Oliveira; BARBOSA, Egberto Reis; CHIEN, Hsin Fen; MANSUR, Leticia LessaIntroduction. Executive function deficits are observed in people with Parkinson's disease (PD) from early stages and have great impact on daily living activities. Verbal fluency and oral diadochokinesia involve phonarticulatory coordination, response inhibition, and phonological processing and may also be affected in people with PD. This study aimed to describe the performance of PD patients and an age-and education-matched control group on executive function, verbal fluency, and oral diadochokinesia tests and to investigate possible relationships between them. Methods. Forty people with PD and forty controls were evaluated with Trail Making Test (TMT, executive function) and phonemic/semantic verbal fluency and oral diadochokinesia (/pataka/) tests. Groups were compared by ANOVA and relationships were investigated by Pearson tests. Results. People with PD showed longer times in parts A and B of TMT. They also said fewer words in phonemic/semantic verbal fluency tests and less syllables in the diadochokinesia test. Oral diadochokinesia strongly correlated to parts A and B of TMT and to phonemic verbal fluency. Conclusion. Oral diadochokinesia was correlated to executive function and verbal fluency. The cognitive-motor interaction in verbal fluency and oral diadochokinesia must be considered not to overestimate the cognitive or motor impairments in people with PD.
- Relationship Between Posturography, Clinical Balance and Executive Function in Parkinson ' s Disease(2019) SOUZA, Carolina de Oliveira; VOOS, Mariana Callil; BARBOSA, Alessandra Ferreira; CHEN, Janini; FRANCATO, Debora Cristina Valente; MILOSEVIC, Matija; POPOVIC, Milos; FONOFF, Erich Talamoni; CHIEN, Hsin Fen; BARBOSA, Egberto ReisThis study aimed to evaluate the relationship between posturography, clinical balance, and executive function tests in Parkinson ' s disease (PD). Seventy-one people participated in the study. Static posturography evaluated the center of pressure fluctuations in quiet standing and dynamic posturography assessed sit-to-stand, tandem walk, and step over an obstacle. Functional balance was evaluated by Berg Balance Scale, MiniBESTest, and Timed Up and Go test. Executive function was assessed by Trail Making Test (TMT) and semantic verbal fluency test. Step over obstacle measures (percentage of body weight transfer and movement time) were moderately correlated to Timed Up and Go, part B of TMT and semantic verbal fluency (r > 0.40; p < 0.05 in all relationships). Stepping over an obstacle assesses the responses to internal perturbations. Participants with shorter movement times and higher percentage of body weight transfer (higher lift up index) on this task were also faster in Timed Up and Go, part B of TMT, and semantic verbal fluency. All these tasks require executive function (problem solving, sequencing, shifting attention), which is affected by PD and contribute to postural assessment.