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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- 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.
- 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.
- Effects of resistance training on postural control in Parkinson's disease: a randomized controlled trial(2021) CHEN, Janini; CHIEN, Hsin Fen; FRANCATO, Debora Cristina Valente; BARBOSA, Alessandra Ferreira; SOUZA, Carolina de Oliveira; VOOS, Mariana Callil; GREVE, Julia Maria D'Andrea; BARBOSA, Egberto ReisBackground: Postural instability affects Parkinson's disease (PD) patients' postural control right from the early stages of the disease. The benefits of resistance training (RT) for balance and functional capacity have been described in the literature, but few studies have been conducted showing its effects on PD patients' postural control. Objective: To investigate the effects of a three-month RT intervention on static posturography (SP) measurements and clinical functional balance assessment among PD patients. Methods: Seventy-four patients were randomly assigned to a three-month RT intervention consisting of using weightlifting machines at a gym (gym group) or RT consisting of using free weights and elastic bands (freew group), or to a control group. The participants were evaluated at baseline, three months and six months. We evaluated changes of SP measurements under eyes-open, eyes-closed and dual-task conditions (primary endpoint), along with motor performance and balance effects by means of clinical scales, dynamic posturography and perceptions of quality of life (secondary endpoints). Results: There were no significant interactions in SP measurements among the groups. Unified Parkinson Disease Rating Scale (UPDRS-III) motor scores decreased in both RT groups (p<0.05). Better perceived quality of life for the mobility domain was reported in the gym group while functional balance scores improved in the freew group, which were maintained at the six-month follow-up (p<0.05). Conclusions: This study was not able to detect changes in SP measurements following a three-month RT intervention. Both RT groups of PD patients showed improved motor performance, with positive balance effects in the freew group and better perceived quality of life in the gym group.
- 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.
- Conventional physical therapy and physical therapy based on reflex stimulation showed similar results in children with myelomeningocele(2017) AIZAWA, Carolina Y. P.; MORALES, Mariana P.; LUNDBERG, Carolina; MOURA, Maria Clara D. Soares de; PINTO, Fernando C. G.; VOOS, Mariana C.; HASUE, Renata H.We aimed to investigate whether infants with myelomeningocele would improve their motor ability and functional independence after ten sessions of physical therapy and compare the outcomes of conventional physical therapy (CPT) to a physical therapy program based on reflex stimulation (RPT). Twelve children were allocated to CPT (n = 6, age 18.3 months) or RPT (n = 6, age 18.2 months). The RPT involved proprioceptive neuromuscular facilitation. Children were assessed with the Gross Motor Function Measure and the Pediatric Evaluation of Disability Inventory before and after treatment. Mann-Whitney tests compared the improvement on the two scales of CPT versus RPT and the Wilcoxon test compared CPT to RPT (before vs. after treatment). Possible correlations between the two scales were tested with Spearman correlation coefficients. Both groups showed improvement on self-care and mobility domains of both scales. There were no differences between the groups, before, or after intervention. The CPT and RPT showed similar results after ten weeks of treatment.
- Translation and cross-cultural adaptation to Brazilian Portuguese of the Modified Tardieu Scale for muscle tone assessment among patients with spinal cord injury(2021) SANTOS, Patricia Lima do Amaral; GASPAR, Roberta Caveiro; PADULA, Natalia; ALMEIDA, Daniela Melo; VOOS, Mariana CallilBackground: Assessment of muscle tone is of great importance for evaluating people with spinal injuries. Objective: To translate and adapt the Modified Tardieu Scale (MTS) to Brazilian Portuguese and validate its use for evaluating patients with spinal cord injury. Methods: The translation and adaptation of the ""Escala de Tardieu Modificada"" went through the steps of translation, translation synthesis, backtranslation and expert committee meeting. Two evaluators rated the tone of the elbow flexors/extensors, wrist extensors, knee flexors/extensors and ankle plantar flexors of 51 patients with spinal cord injury. These patients were reevaluated after one week. Validation included intra and inter-rater reliability (ICC) and internal and external consistency. The Modified Ashworth Scale (MAS) was used in the evaluations, to investigate the correlations. Results: The Brazilian Portuguese version of the MTS is presented in this study. ICCs ranged from 0.60 to 0.99 (intra and inter-examiner) and there was a moderate to strong correlation with MAS. Conclusions: The MTS proved to be adequate for assessing the muscle tone of people with spinal cord injury in Brazil.
- Pain characterization in Duchenne muscular dystrophy(2016) SILVA, Talita Dias da; MASSETTI, Thais; MONTEIRO, Carlos Bandeira de Mello; TREVIZAN, Isabela Lopes; ARAB, Claudia; CAROMANO, Fatima Aparecida; VOOS, Mariana Callil; OLIVEIRA, Acary Souza Bulle; FAVERO, Francis MeireDuchenne muscular dystrophy (DMD) is an X-linked recessive disorder, characterized by progressive muscle weakness. Historically, pain has not been considered to be a major symptom in DMD. Objective: To investigate the relationship between DMD and pain. Methods: We conducted a systematic review in Medline/PubMed and BVS (virtual library in health) databases. We searched for articles that showed the terms ""Muscular Dystrophy, Duchenne"" and ""Pain"" in all fields. All studies included boys diagnosed with DMD and the occurrence/amount of pain on this population. Results: Initially, there were 175 studies. 167 articles were excluded for not meeting the inclusion criteria. The remaining eight eligible studies, involving pain assessment in DMD, were analyzed. Conclusion: Pain is a frequent problem in this population and this symptom is potentially tractable. Studies conclude that pain can directly influence the quality of life of this population.
- The competition with a concurrent cognitive task affects posturographic measures in patients with Parkinson disease(2015) BARBOSA, Alessandra Ferreira; SOUZA, Carolina de Oliveira; CHEN, Janini; FRANCATO, Debora Valente; CAROMANO, Fatima Aparecida; CHIEN, Hsin Fen; BARBOSA, Egberto Reis; GREVE, Julia Maria D'Andrea; VOOS, Mariana CallilObjectives: To estimate the impact of a sensory-motor-cognitive task on postural balance, in Parkinson disease patients (Hoehn and Yahr 2-3) and to investigate possible relationships between posturography and functional balance clinical scales. Method: Parkinson disease patients (n = 40) and healthy controls (n = 27) were evaluated with fluency tests, Berg Balance scale, Mini Best test and static posturography on the conditions eyes open, eyes closed and dual-task (simultaneous balance and fluency tasks). Results: Posturographic data showed that Parkinson disease patients performed worse than controls in all evaluations. In general, balance on dual-task was significantly poorer than balance with eyes closed. Posturographic data were weakly correlated to clinical balance scales. Conclusion: In clinical practice, Parkinson disease patients are commonly assessed with eyes closed, to sensitize balance. Our study showed that adding a cognitive task is even more effective. Static posturographic data should be carefully overgeneralized to infer functional balance impairments.
- Epidemiological and clinical factors impact on the benefit of riluzole in the survival rates of patients with ALS(2017) FAVERO, Francis Meire; VOOS, Mariana Callil; CASTRO, Isac de; CAROMANO, Fatima Aparecida; OLIVEIRA, Acary Souza BulleObjective: To investigate the impact of epidemiological and clinical factors on the benefit of riluzole in patients with amyotrophic lateral sclerosis (ALS). Methods: The survival rate of 578 patients with ALS (1999-2011) was analyzed by descriptive statistics and Kaplan-Meier curves. Considering the median of the sample survival time (19 months), patients were divided in two groups: below (B19) and above the median (A19). Kaplan-Meier curves compared the survival rates of patients treated with riluzole and with patients who did not take the medication. Results: Riluzole increased the survival rates of patients with lower limb onset who were diagnosed after the first appointment in B19. Patients with bulbar onset and diagnosed on the first, or after the first appointment showed higher survival rates in A19. Males lived longer than females in both groups. Conclusion: Epidemiological and clinical factors influenced the benefit of riluzole in the survival rates of patients with ALS.
- The relationship between motor function, cognition, independence and quality of life in myelomeningocele patients(2017) LUZ, Carolina Lundberg; MOURA, Maria Clara Drummond Soares de; BECKER, Karine Kyomi; TEIXEIRA, Rosani Aparecida Antunes; VOOS, Mariana Callil; HASUE, Renata HydeeMotor function, cognition, functional independence and quality of life have been described in myelomeningocele patients, but no study has investigated their relationships. We aimed to investigate the relationships between motor function, cognition, functional independence, quality of life, age, and lesion level in myelomeningocele patients, and investigate the influence of hydrocephalus on these variables. We assessed 47 patients with the Gross Motor Function Measure (motor function), Raven's Colored Progressive Matrices (cognition), Pediatric Evaluation of Disability Inventory (functional independence) and the Autoquestionnaire Qualite de vie Enfant Image (quality of life). Spearman's correlation tests determined relationships between the variables. The Friedman ANOVAs determined the influence of hydrocephalus. Motor function was strongly related to mobility and lesion level, and moderately related to cognition, self-care and social function. Cognition and quality of life were moderately related to functional independence. Age correlated moderately with functional independence and quality of life. Hydrocephalus resulted in poorer motor/cognitive outcomes and lower functional independence.