FABIO MARCON ALFIERI

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  • article 19 Citação(ões) na Scopus
    Evaluation of body temperature in individuals with stroke
    (2017) ALFIERI, Fabio Marcon; MASSARO, Ayrton Roberto; FILIPPO, Thais Raquel; PORTES, Leslie Andrews; BATTISTELLA, Linamara Rizzo
    BACKGROUND: A stroke can cause alterations in thermal sensitivity. OBJECTIVE: to verify the conditions of body temperature in hemiplegic patients after stroke as compared to healthy individuals, as well as establish relations between thermal sensitivity and gender, age, Body Mass Index ( BMI), plegic side, time after stroke, reports of thermal alterations and the motricity of patients with stroke sequelae. METHODS: This cross-sectional study included 100 patients ( 55.6 +/- 13 years) with ischemic or hemorrhagic stroke sequelae with unilateral hemiparesis and thirty healthy subjects ( 55 +/- 12.9 years). Individuals with nervous peripheral lesions, diabetes, peripheral vascular diseases or tumors were not included in this study. The volunteers underwent axillary temperature evaluations with the use of a cutaneous thermometer and evaluations of cutaneous temperature of hands and feet as measured by infrared thermography captured by an infrared sensor (ThermaCAM(TM) SC 500-FLIR Systems). The mean temperature (degrees C) was analyzed with the SigmaStat 3.5 statistical package. RESULTS: The results have shown that healthy individuals have similar temperatures on either side of the body. The hemiplegic subjects presented a lower temperature on the plegic side and compared to the healthy subjects, both feet of the hemiparetic individuals were colder. The results have also shown that age, body mass index, and the time after stroke have no influence on the alterations in temperature. Regarding the paretic side, individuals with hemiplegia on the right side ( right foot) had a lower temperature than those affected on the left side. Motricity was not related to any difference in temperature between the limbs and the reports of temperature differences had no relation with the actual differences found in the study. CONCLUSIONS: Healthy individuals have temperature symmetry between between sides of the body, while individuals with stroke sequelae present lower temperature in the paretic side, especially on their feet.
  • article 76 Citação(ões) na Scopus
    Abandonment of assistive products: assessing abandonment levels and factors that impact on it
    (2018) SUGAWARA, Andre T.; RAMOS, Vinicius D.; ALFIERI, Fabio M.; BATTISTELLA, Linamara R.
    Purpose: To investigate the levels and factors that influence the abandonment of assistive products by users of a local reference rehabilitation center. Methods: This observational study involved users who received services and assistive products provided by our center of rehabilitation. Users were identified using the records of the center and their responses about the abandonment were collected through face-to-face interviews. Results: The abandonment level of assistive products was 19.38%. 83.5% of the users use at least one of the assistive products they have received. Rigid and folding frame wheelchairs, with and without postural support devices, as well as shower wheelchairs, presented the lowest abandonment levels, followed by canes and lower limb orthoses. Upper limb orthoses, Knee Ankle Foot Orthosis(KAFO), walkers, crutches and lower and upper limb prostheses all presented higher abandonment levels. Conclusion: The simultaneous use of mutiple assistive products, users perception on the importance of using them, and completing the rehabilitation treatment were found to impact on the short and longterm use of products. The study offers inputs to decision making and planning for assistive technology provision in developing countries with regard to expected demand and service delivery. IMPLICATIONS FOR REHABILITATION Data about the abandonment of assistive products in Sao Paulo, Brazil, could assist informing decision making on provision and servicing of these products in similar settings. The strong correlation found between abandonment levels and the simultaneous use of multiple devices should be taken into account by health professionals when prescribing assistive products and providing guidance to users. The need for follow up on the use of assistive products after discharge from rehabilitation treatment becomes strikingly clear, as data show that completing treatment is significantly relevant when evaluating abandonment levels. As assistive products users' perception about the importance of using these devices is shown to be significant in explaining abandonment, it is mandatory that health and rehabilitation professionals take it into account when providing guidance and training users.
  • article 12 Citação(ões) na Scopus
    Paraspinous Lidocaine Injection for Chronic Nonspecific Low Back Pain: A Randomized Controlled Clinical Trial
    (2016) IMAMURA, Marta; IMAMURA, Satiko Tomikawa; TARGINO, Rosa Alves; MORALES-QUEZADA, Leon; TOMIKAWA, Luis C. Onoda; TOMIKAWA, Luis G. Onoda; ALFIERI, Fabio M.; FILIPPO, Thais R.; ROCHA, Ivan D. da; NETO, Raul Bolliger; FREGNI, Felipe; BATTISTELLA, Linamara Rizzo
    In this large, sham-controlled, randomized trial, we examined the efficacy of the combination of standard treatment and paraspinous lidocaine injection compared with standard therapy alone in subjects with chronic low back pain. There is little research-based evidence for the routine clinical use of paraspinous lidocaine injection for low back pain. A total of 378 subjects with nonspecific chronic low back pain were randomized to 3 groups: paraspinous lidocaine injection, analgesics, and exercises (group 1, LID-INJ); sham paraspinous lidocaine injection, analgesics, and exercises (group 2, SH-INJ); and analgesics and exercises (group 3, STD-TTR). A blinded rater assessed the study outcomes at 3 time points: baseline, after treatment, and after 3 months of follow-up. There were increased frequency of pain responses and better low back functional scores in the LID-INJ group compared with the SH-INJ and STD-TTR groups. These effects remained at the 3-month follow-up but differed between all 3 groups. There were significant changes in pain threshold immediately after treatment, supporting the effects of this intervention in reducing central sensitization. Paraspinous lidocaine injection therapy is not associated with a higher risk of adverse effects compared with conventional treatment and sham injection. Its effects on hyperalgesia might correlate with changes in central sensitization. (C) 2016 Published by Elsevier Inc. on behalf of the American Pain Society
  • article 19 Citação(ões) na Scopus
    Body temperature of healthy men evaluated by thermography: A study of reproducibility
    (2018) ALFIERI, Fabio Marcon; BATTISTELLA, Linamara Rizzo
    BACKGROUND: Thermography is a safe, painless, and efficient method for checking the temperature of the skin. OBJECTIVE: Was to assess the pattern of skin temperature of healthy men, as well as to verify the reproducibility of the method. METHODS: This cross-sectional observational study was conducted with 30 men evaluated by thermography in two moments by using an infrared camera (FLIR +T650SC((R))). The skin temperature of 24 regions of interest (ROI) was measured. RESULTS: The mean difference in temperature of 10 ROIs in the two evaluations was not statistically significant. The comparisons of the triangle Tsk between the right and left sides by the two evaluations showed no differences. The intra-class correlation coefficient (ICC) between the two moments of evaluation were statistically significant, where the dorsal measurements (Left forearm and Right dorsal arm) showed poor correlations and the others ranged from moderate to strong. Greater reproducibility was confirmed for ventral and dorsal hand ROIs; however, they presented the highest coefficient of variation (9% and 8%).Conclusion: There is a similarity between the temperatures of the ROIs and the reproducibility in 22 of the 24 ROIs varies from moderate to strong, showing that thermography is a reproducible method in healthy men.
  • article 0 Citação(ões) na Scopus
    Immediate effect of a single cycle ergometry session on skin temperature of women with and without varicose veins: A case report
    (2021) DIAS, C. da Silva; ALFIERI, F. M.; ANDRADE, V. C. S. de; BATTISTELLA, L. R.
    BACKGROUND: Vascular diseases such as varicose veins can affect the distribution of skin temperature, and thermography can be a useful way to capture this. The aim of this case report is to show the changes in skin temperature induced by bicycling and to evaluate the thermal symmetry before and after physical activity in two women, one with and the other without varicose veins. MATERIALS AND METHODS: Two women, one with varicose veins (subject 1) and a healthy volunteer (subject 2), were examined before and after a single session of one-hour lasting cycle ergometry. They were assessed by a FLIR T650sc infrared camera before, immediately after and 15 minutes after the session. Total body thermograms were taken with subjects 4 meters away from the camera, in anterior and posterior views, and 6 regions of interest (ROIs) were defined. RESULTS: Subject 2, who used to exercise regularly, exhibited similar temperature values in the evaluated ROIs of the right and left body sides. In the subject 2, a more pronounced thermal symmetry was observed than in the subject 1 at all examination moments. In both individuals, the degree of thermal symmetry was not affected by cycling. CONCLUSION: Varicose veins are associated with moderate thermal asymmetry, while the lower extremities of a healthy person appeared thermally symmetric. Both distribution patterns of skin temperature were not affected by single session of cycling exercise. © 2021 European Association of Thermology. All rights reserved.
  • article
    Pain, disability and catastrophizing in individuals with knee osteoarthritis
    (2020) VARGAS E SILVA, Natália Cristina de Oliveira; CARDOSO, Thiago da Silva Gusmão; ANDRADE, Elisabete Agrela de; BATTISTELLA, Linamara Rizzo; ALFIERI, Fábio Marcon
    ABSTRACT BACKGROUND AND OBJECTIVES: Knee osteoarthritis is among the leading sources of chronic disability and may lead to depression, anxiety and pain catastrophizing, enhancing perceived pain. This study aimed at investigating the influence of pain catastrophizing on attitudes and perception of pain, and in the functionality of individuals with knee osteoarthritis. METHODS: This observational study involved 18 patients, who were assessed for weight and height, and completed the Pain-related Catastrophizing Thoughts Scale (PCTS), Survey of Pain Attitudes (SPA), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the visual analog scale (VAS). Symptoms and disability were assessed by the Lequesne Index, functional mobility was evaluated by the Timed Up and Go (TUG) test. Pressure pain tolerance thresholds (PPT) were assessed by a digital algometer. RESULTS: Mean body mass index of the sample was classified as obese (32,2±4,3). When split by the median of PCTS, differences were observed in most domains of SPA. Patients with more catastrophic thoughts took longer to perform TUG and presented more pain, joint stiffness and worse functionality (WOMAC). Despite the tendency to report more pain (VAS) in patients above the median score of PCTS, no differences were observed between groups with higher or lower catastrophizing regarding PPT. Positive and significant associations between the Rumination factor of PCTS and WOMAC outcomes were observed, as well as between the Hopelessness factor and TUG, Lequesne and WOMAC. CONCLUSION: The higher the presence of catastrophic thoughts, the worse the attitudes towards pain and the physical functionality of knee osteoarthritis patients.
  • article 42 Citação(ões) na Scopus
    Concentration of cytokines in patients with osteoarthritis of the knee and fibromyalgia
    (2014) IMAMURA, Marta; TARGINO, Rosa Alves; HSING, Wu Tu; IMAMURA, Satiko; AZEVEDO, Raymundo Soares; BOAS, Lucy Santos Villas; TOZETTO-MENDOZA, Tania Regina; ALFIERI, Fabio Marcon; FILIPPO, Thais Raquel; BATTISTELLA, Linamara Rizzo
    Introduction: Fibromyalgia and osteoarthritis may present a relationship with the -concentration of cytokines. The aim of this study was to compare the serum concentrations of IL-12p70, tumor necrosis factor, IL-10, IL-6, IL-1 beta, and IL-8 in patients with knee osteoarthritis and fibromyalgia. Materials and methods: The study included 53 women (71.2 +/- 7.6 years old) diagnosed with knee osteoarthritis with moderate-to-severe pain (visual analog scale. 4) for at least 3 months. Sixty women (54.1 +/- 8.1 years old) diagnosed with fibromyalgia according to the American College of Rheumatology criteria and with moderate-to-severe pain (visual analog scale. 4) also participated in this study. For the dosage of cytokines, blood was collected in the morning: 5 mL from the cubital vein. The material was centrifuged at 4 degrees C, separated into 100 mu L aliquots and stored at -80 degrees C until processing. Serum concentrations of the studied cytokines were assessed using the BD Cytometric Bead Array method. Data were analyzed with Student's t-test and the Mann-Whitney U test. Results: We found higher levels of IL-6, IL-10, and IL-1 beta in fibromyalgia patients. After adjustment of age as a covariate, there was no statistically significant difference in the concentration of any cytokine between fibromyalgia and knee osteoarthritis patients. Conclusion: Patients with knee osteoarthritis and fibromyalgia with the same duration and intensity of pain demonstrate similar concentrations of cytokines. Aging may play a role in cytokine profile, a finding not so extensively addressed in the literature and one that should be further investigated.
  • bookPart 0 Citação(ões) na Scopus
    Body temperature and thermography
    (2023) ALFIERI, F. M.; OLIVEIRA, N. C. de; BATTISTELLA, L. R.
    The interest in body temperature comes from the most remote times. It is known that the regulation of body temperature is important for the maintenance of homeostasis, which in turn is vital for the proper functioning of body fluids and tissues. Hypothalamus, located in the central region of the brain, is responsible for maintaining body temperature regulation between 35.5°C to 37.7°. Thermography is a method designed to assess skin surface temperature, able to provide data on the symmetry (or asymmetry) of body hemispheres. This chapter will discuss studies related to the physiology of body temperature, the importance of similar temperature distribution between body hemispheres, and normality patterns of this distribution evaluated by thermography. © 2023 Nova Science Publishers, Inc. All rights reserved.
  • article
    Acute Effect of Robotic Therapy (G-EO System) on the Lower Limb Temperature Distribution of a Patient with Stroke Sequelae
    (2019) ALFIERI, Fabio Marcon; DIAS, Caren da Silva; SANTOS, Artur Cesar Aquino dos; BATTISTELLA, Linamara Rizzo
    Robotic therapy has been gaining prominence in poststroke rehabilitation programs. An example of these devices is the G-EO System, which simulates gait as well as other more complexes standards of gait such as the steps on stairs. However, to the best of our knowledge, there are no studies that apply thermography as a tool to evaluate stroke patients who undertook rehabilitation programs with the aid of robotic devices. The patient IWPS undergoes sequelae of hemorrhagic stroke for 19 months and consequently hemiplegia, had scores of 93 points in the Fugl-Meyer scale, is undertaking a physical rehabilitation program for six months, has no complaints of discomfort due to thermic sensitivity imbalances between the plegic and the contralateral sides, and voluntarily reports that he realizes functionality improvements especially, according to his perception, due to the aid of the robotic therapy in his gait training with the G-EO System. The thermographic images were captured by an infrared sensor FLIR T650SC. By analyzing the temperature differences between both hemispheres of the body, before, immediately after, and 30 minutes after a robotic therapy for gait training, we observed that the values firstly increased immediately after the training, but after the 30-minute rest an important thermoregulation was achieved.
  • article 17 Citação(ões) na Scopus
    Relationships of Balance, Gait Performance, and Functional Outcome in Chronic Stroke Patients: A Comparison of Left and Right Lesions
    (2015) LOPES, Priscila Garcia; LOPES, Jose Augusto Fernandes; BRITO, Christina Moran; ALFIERI, Fabio Marcon; BATTISTELLA, Linamara Rizzo
    Introduction. This study compared the balance by center of pressure (COP) and its relationship with gait parameters and functional independence in left (LH) and right (RH) chronic stroke patients. Methods. In this cross-sectional study, twenty-one hemiparetic stroke patients were assessed for Functional Independence Measure (FIM), balance with a force platform, and gait in the Motion Analysis Laboratory. Results. The amplitudes of the COP in the anteroposterior and mediolateral directions were similar in both groups. The anteroposterior direction was greater than the mediolateral direction. Only the temporal parameters showed any statistically significant differences. The LH showed a significant correlation between stride length, step length, and gait velocity with COP velocity sway for the healthy and paretic lower limbs. In both groups, the area of COP was significantly correlated with stride length. Motor FIM was significantly correlated with the COP in the LH group. Conclusion. There was no difference in the performance of balance, gait, and functional independence between groups. The correlation of the COP sway area with stride length in both groups can serve as a guideline in the rehabilitation of these patients where training the static balance may reflect the improvement of the stride length.