TALITA DIAS DA SILVA
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- Can individuals with down syndrome improve their performance after practicing a game on a mobile phone?-A new insight study(2020) MENEZES, Lilian Del Ciello de; SILVA, Talita Dias da; CAPELINI, Camila Miliani; TONKS, James; WATSON, Suzanna; MORAES, Ibis Ariana Pena de; MALHEIROS, Silvia Regina Pinheiro; MUSTACCHI, Zan; MONTEIRO, Carlos Bandeira de MelloIntroduction: Down syndrome (DS) is a genetic disorder characterized by the presence of an extra chromosome, which is typically associated with motor and cognitive changes that interfere with the ability to perform daily activities. To enable gains in motor skills in individuals with DS, one option is to use new technologies such as mobile phone tasks in a virtual reality environment. Objective: To explore whether a mobile phone game is a feasible tool to improve motor performance of upper limbs in individuals with DS. Method: The game Marble Maze Classic (R) was used, in which the participants moved the mobile phone to guide a virtual marble through a maze design. We evaluated 100 individuals, 50 with DS and 50 individuals with typical development matched by gender and age. The participants were divided into two conditions: a 'condition with an original maze', with 25 individuals in the comparison group (typical development) and 25 in the experimental group (DS) and a 'reverse condition' with the same number of participants that used a maze design with an opposite path to the original as a counter-balance measure. The dependent variable used was time in seconds to finish the maze path. ANOVA was used in analysis of group differences. Post-hoc comparisons were performed using Tukey's Honest Significant Difference test (p < 0.05). Results: The comparison group improved during practice and maintained performance in the retention phase; they were able to transfer learning to different mazes. The DS group improved and retained motor performance, but transferred motor performance only in the original maze, not in the reverse condition. That is, the DS group failed to transfer learning as effectively as the comparison group. Conclusion: People with DS managed to adapt to the task but underperformed compared to people with TD. Difficulty in maintaining performance with increased task difficulty was observed in the DS participants, highlighting the need to differentiate such tasks in improving performance.
- The use of serial casting in the treatment of children with cerebral palsy: a study protocol(2023) SOUSA, R. M. de; PARO, M. de Paula; SIMCSIK, A. O.; AIROLDI, M. J.; SANTOS, B. V. dos; MORAES, Í. A. P. de; DAWES, H.; MONTEIRO, C. B. de Mello; SILVA, T. D. daIntroduction: Cerebral Palsy (CP) is characterized by a disorder of posture and movement, commonly leading to disabling orthopedic alterations, including muscle shortening, especially in the lower limbs. Stretching methods, performed gradually, are necessary to delay the impairment in function from muscle shortening. The use of serial casting aims to promote proper alignment, and an ideal and stable support base, in addition to better bone and joint health, leading to better posture, mobility, muscle function, and, subsequently, increased fitness and health. Objective: evaluate range of motion, postural control, and motor performance in children with CP, using serial casting, as well as to measure its effect on fitness through the autonomic nervous system (ANS). Methods: Sixty children and adolescents with CP, of both sexes, 3 to 12 years of age, will be divided into three groups: Groups A, B, and C, with 20 individuals each. Group A will use serial casting, Group B will use the orthosis continuously (with removal only allowed for bathing), and Group C will use the orthosis in their daily routine. Range of motion of the ankle of first and second resistance levels (R1 and R2), gross motor function measure (GMFM), and balance (measured by BERG scale) will be used in the initial and final assessments, and after 6 months and one year of follow-up. Timed-up-and-go (TUG), load distribution (baropodometry), motor performance measured through a real basketball game and the virtual MoveHero game, analysis of body angulation with “mydartfish”, and cardiac autonomic modulation through heart rate variability will be assessed in three different situations: barefoot, with orthosis, and with casting. Conclusion: Serial casting demonstrates the potential to produce positive results in the treatment of individuals with CP regarding better alignment, with consequent motor and autonomic improvement.
- Analysis of Heart Rate, Perception of Physical Effort and Performance of Individuals with Down Syndrome Submitted to a Protocol of Virtual Games for Home-Based Telerehabilitation(2023) ROSA, Renata Martins; TEZZA, Maria Helena Santos; VALENZUELA, Elisa de Jesus; DIAS, Eduardo Dati; MORAES, ibis Ariana Pena de; ARAUJO, Luciano Vieira de; RE, Alessandro Hervaldo Nicolai; SILVA, Talita Dias da; MONTEIRO, Carlos Bandeira de MelloDown syndrome (DS) is a genetic condition associated with impairments in several body systems, which may negatively influence the habit of practicing physical activities (PAs), increasing sedentary habits and the risk of comorbidities. Additionally, difficulty in accessing services, financial limitations and lack of interest may interfere with the practice of PAs. Considering the necessity of developing effective treatment alternatives, to increase the possibility of access and the interest of participants, we conducted a study using telerehabilitation with a virtual task to promote PA and analyze the motor performance of DS individuals. Our protocol consisted of 11 sessions of the virtual game called MoveHero. A total of 34 individuals with DS and 34 individuals with typical development participated in the study. Heart rate (HR) and rating of perceived effort (RPE) were collected at rest and during the game. Our results show that virtual reality presents a great possibility to promote PA and a way out of a sedentary lifestyle for DS individuals, considering the enhancement in HR and RPE found during the protocol for both groups. Moreover, our results show positive outcomes regarding motor performance, with significant improvement in the task with practice, demonstrating that individuals with DS are able to improve their motor proficiency with adequate stimuli in the virtual environment.
- Cardiac autonomic modulation in response to postural transition during a virtual reality task in individuals with spinal cord injury: A cross-sectional study(2023) PAPA, Denise Cardoso Ribeiro; MENEZES, Lilian Del Ciello de; PENA, Ibis Ariana; SILVEIRA, Ana Clara; PADULA, Natalia; SILVA, Suellen de Oliveira Veronez; GASPAR, Roberta Caveiro; DIAS, Eduardo Dati; FERREIRA, Celso; ARAUJO, Luciano Vieira de; ASTORINO, Todd A.; DAWES, Helen; MONTEIRO, Carlos Bandeira de Mello; SILVA, Talita Dias daPurpose The postural transition from sitting to standing is a moment of dysautonomic occurrence in individuals with Spinal Cord Injury (SCI). Different tools can be used to minimize this event, such as virtual reality. Thus, we aimed to analyze cardiac autonomic modulation in individuals with SCI during postural transition from the sitting to orthostatism position using a cognitive virtual reality (VR) task. Methods Individuals with and without SCI were positioned on the Easy Stand (R) device, sitting at rest, at 0 degrees considering the angle between the seat and the floor, elevation at 45 degrees, and orthostatism at 90 degrees, for 5 minutes in each position. Heart rate variability (HRV) measures of sympathovagal balance were collected (heart rate receiver: Polar V800). The groups were subdivided into two groups, one that performed VR as an intervention during the postural angle changes and another group that did not perform VR. Results We evaluated 76 individuals, 40 with a medical diagnosis of SCI and 36 who composed the able-bodied control group without SCI, matched by age and sex. The HRV results showed that the SCI group who performed the task in VR demonstrated no significant difference in parasympathetic activation and global variability between the sitting versus 90 degrees positions. There was better sympathovagal balance in SCI and able-bodied control groups who performed the VR task between the sitting versus 90 degrees positions. Conclusion The use of a VR task seems to contribute to better sympathovagal balance, with the potential to reduce dysautonomia during postural changes.
- Effect of Combined Therapy of Virtual Reality and Transcranial Direct Current Stimulation in Children and Adolescents With Cerebral Palsy: A Study Protocol for a Triple-Blinded Randomized Controlled Crossover Trial(2020) SILVA, Talita Dias da; FONTES, Anne Michelli Gomes Goncalves; OLIVEIRA-FURLAN, Barbara Soares de; ROQUE, Tatiane Tedeschi; LIMA, Ana Izabel Izidorio; SOUZA, Bruna Mayara Magalhaes de; ALBERISSI, Camila Aparecida de Oliveira; SILVEIRA, Ana Clara; MORAES, Ibis Ariana Pena de; COLLETT, Johnny; SILVA, Roger Pereira; AIROLDI, Marina Junqueira; RIBEIRO-PAPA, Denise Cardoso; DAWES, Helen; MONTEIRO, Carlos Bandeira de MelloBackground: Transcranial direct current stimulation (tDCS) and therapy-based virtual reality (VR) have been investigated separately. They have shown promise as efficient and engaging new tools in the neurological rehabilitation of individuals with cerebral palsy (CP). However, the recent literature encourages investigation of the combination of therapy tools in order to potentiate clinic effects and its mechanisms. Methods: A triple-blinded randomised sham-controlled crossover trial will be performed. Thirty-six individuals with gross motor function of levels I to IV (aged 4-14 years old) will be recruited. Individuals will be randomly assigned to Group A (active first) or S (sham first): Group A will start with ten sessions of active tDSC combined with VR tasks. After a 1-month washout, this group will be reallocated to another ten sessions with sham tDCS combined with VR tasks. In contrast, Group S will carry out the opposite protocol, starting with sham tDCS. For the active tDCS the protocol will use low frequency tDCS [intensity of 1 milliampere (mA)] over the primary cortex (M1) area on the dominant side of the brain. Clinical evaluations (reaction times and coincident timing through VR, functional scales: Abilhand-Kids, ACTIVLIM-CP, Paediatric Evaluation of Disability Inventory-PEDI- and heart rate variability-HRV) will be performed at baseline, during, and after active and sham tDCS. Conclusion: tDCS has produced positive results in treating individuals with CP; thus, its combination with new technologies shows promise as a potential mechanism for improving neurological functioning. The results of this study may provide new insights into motor rehabilitation, thereby contributing to the better use of combined tDCS and VR in people with CP.
- Seating and positioning system in wheelchairs of people with disabilities: a retrospective study(2021) PONTES, Fernando Vicente de; LUZO, Maria Candida de Miranda; SILVA, Talita Dias da; LANCMAN, SelmaObjective: To characterize and quantify the seating and positioning items in wheelchairs prescribed and dispensed from 2005-2018 in relation to the necessities of the diagnoses served. Methods: A convenience cross-sectional sample survey was used in the setting of an occupational therapy service from a specialized orthopaedic hospital. Records of people with disabilities who use a wheelchair (n = 1730) were surveyed for the following data: sociodemographic information (gender and age), diagnosis, whether a new wheelchair was received, whether wheelchair seating and positioning system were received, and the prescribed items. Results: Of the 1730 users, 73.7% received a new wheelchair and 26.3% already had one donated by other services and/or purchased by the patient. Almost all the wheelchairs needed seating and positioning system in their structure (82.3%), and only 307 wheelchairs (17.7%) did not require any. The most frequent item was the hip belt (82.3%), followed by the removable solid wooden seat, and removable solid wooden backrest (81.3 and 80.9%, respectively). Conclusions: It is noted that the sample studied required many seating and positioning items for their wheelchairs. Despite the high demand for these assistive technological resources, research in this area is scarce. Little is known about which seating and positioning system is ideal for each user profile, which makes it difficult to organize the services that act in the provision of such equipment and the professional practice based on evidence.
- Bilateral Transfer of Performance between Real and Non-Immersive Virtual Environments in Post-Stroke Individuals: A Cross-Sectional Study(2023) MOTA, D. M. S.; MORAES, Í. A. P.; PAPA, D. C. R.; FERNANI, D. C. G. L.; ALMEIDA, C. S.; TEZZA, M. H. S.; DANTAS, M. T. A. P.; FERNANDES, S. M. S.; Ré, A. H. N.; SILVA, T. D.; MONTEIRO, C. B. M.(1) Background: Post-stroke presents motor function deficits, and one interesting possibility for practicing skills is the concept of bilateral transfer. Additionally, there is evidence that the use of virtual reality is beneficial in improving upper limb function. We aimed to evaluate the transfer of motor performance of post-stroke and control groups in two different environments (real and virtual), as well as bilateral transfer, by changing the practice between paretic and non-paretic upper limbs. (2) Methods: We used a coincident timing task with a virtual (Kinect) or a real device (touch screen) in post-stroke and control groups; both groups practiced with bilateral transference. (3) Results: Were included 136 participants, 82 post-stroke and 54 controls. The control group presented better performance during most parts of the protocol; however, it was more evident when compared with the post-stroke paretic upper limb. We found bilateral transference mainly in Practice 2, with the paretic upper limb using the real interface method (touch screen), but only after Practice 1 with the virtual interface (Kinect), using the non-paretic upper limb. (4) Conclusions: The task with the greatest motor and cognitive demand (virtual—Kinect) provided transfer into the real interface, and bilateral transfer was observed in individuals post-stroke. However, this is more strongly observed when the virtual task was performed using the non-paretic upper limb first.
- Autonomic Modulation in Duchenne Muscular Dystrophy During a Computer Task: A Prospective Transversal Controlled Trial Assessment by Non-linear Techniques(2021) ALVAREZ, Mayra Priscila Boscolo; MONTEIRO, Carlos Bandeira de Mello; SILVA, Talita Dias da; VALENTI, Vitor E.; FERREIRA-FILHO, Celso; STERR, Annette; VANDERLEI, Luiz Carlos Marques; FERREIRA, Celso; GARNER, David M.Introduction: Due to functional and autonomic difficulties faced by individuals with Duchenne Muscular Dystrophy (DMD), the use of assistive technology is critical to provide or facilitate functional abilities. The key objective was to investigate acute cardiac autonomic responses, by application of Heart Rate Variability (HRV), during computer tasks in subjects with DMD via techniques based on non-linear dynamics.Method: HRV was attained via a Polar RS800CX. Then, was evaluated by Chaotic Global Techniques (CGT). Forty-five male subjects were included in the DMD group and age-matched with 45 in the healthy Typical Development (TD) control group. They were assessed for 20 min at rest sitting, and then 5 min whilst performing the maze task on a computer.Results: Both TD and DMD subjects exhibited a significantly reduced HRV measured by chaotic global combinations when undertaking the computer maze paradigm tests. DMD subjects presented decreased HRV during rest and computer task than TD subjects.Conclusion: While there is an impaired HRV in subjects with DMD, there remains an adaptation of the ANS during the computer tasks. The identification of autonomic impairment is critical, considering that the computer tasks in the DMD community may elevate their level of social inclusion, participation and independence.
- The use of a task through virtual reality in cerebral palsy using two different interaction devices (concrete and abstract) - a cross-sectional randomized study(2020) LEAL, Andrea Fernanda; SILVA, Talita Dias da; LOPES, Priscila Bianchi; BAHADORI, Shayan; ARAUJO, Luciano Vieira de; COSTA, Murillo Vinicius Brandao da; MORAES, Ibis Ariana Pena de; MARQUES, Ricardo Henrique; CROCETTA, Tania Brusque; ABREU, Luiz Carlos de; MONTEIRO, Carlos Bandeira de MelloBackground Cerebral Palsy (CP) is characterised by variable difficulties in muscular action, resulting in inability of the individual to perform functional movement. An option to provide functionality to the individual with CP is the use of computer innovation. The aim of this paper was to verify if there was any performance improvement in a task performed in a virtual environment and if there was transfer to the task performed in the real environment and vice versa in this population. Methods A computer program was developed comprising a motor task, but with two possibilities of user interaction: a) concrete interface (with physical contact): in which the individual touches the computer screen to finish the task and b) abstract interface (no physical contact): in which the individual performs a hand movement in front of the Kinect device. Participants were split into two groups. The experimental group consisted of 28 individuals with CP within the ages of 6 and 15 years old. The control group included 28 typically developing individuals mirroring the age and sex of the experimental group. Results Individuals from both groups were able to improve task performance and retain acquired information. The CP group presented worse performance than the control group in all phases of the study. Further findings showed that the CP group presented better performance in the abstract interface than in the concrete interface, whereas, in the control group, the opposite occurred: their best performance was in the concrete. Conclusions Motor tasks performed by individuals with CP through an interface with a more virtual environment feature (abstract interface: Kinect) provided better performance when compared to an interface with a more real characteristic (concrete interface: Touchscreen).
- Heart Rate Variability during Virtual Reality Activity in Individuals after Hospitalization for COVID-19: A Cross-Sectional Control Study(2023) RIBEIRO, Cinthia Mucci; GOMES, Renata de Andrade; MONTEIRO, Carlos Bandeira de Mello; DIAS, Rodrigo Martins; SIMCSIK, Amanda Orasmo; ARAUJO, Luciano Vieira de; MAIA, Laura Cristina Pereira; OLIVEIRA, Adriana Paulino; FREITAS, Bruna Leal de; DAWES, Helen; FERREIRA, Celso; MORAES, Ibis Ariana Pena de; SILVA, Talita Dias da(1) Background: COVID-19 can lead to many complications, including cardiorespiratory complications and dysautonomia. This can be assessed by heart rate variability (HRV), which reflects the autonomic nervous system. There are different possibilities for physical rehabilitation after COVID, one of which that has been growing fast is the use of Virtual reality (VR) for rehabilitation. VR may represent an innovative and effective tool to minimize deficits that could lead to permanent disabilities in patients of outpatient rehabilitation services. The aim of this protocol is to establish whether practicing a task using a VR game with body movements influences physiological variables, such as heart rate, HRV, oxygen saturation, blood pressure, and perceptual variables during exercise in individuals post-hospitalization for COVID. (2) Methods: This cross-sectional study evaluated individuals divided into two groups, a post-hospitalization for COVID-19 group and a healthy control group. Subjects underwent one session of a VR task, and physiological variables, including HRV, were measured during rest, VR activity, and recovery. In addition, considering the influence of age in HRV and the impact of COVID-19, we divided participants by age. (3) Results: In all HRV indices and in both groups, an increase in sympathetic and a decrease in parasympathetic activity were found during VR. Additionally, the older post-COVID-19 group performed worse in non-linear indices, peripheral oxygen saturation, and rating of perceived exertion (RPE). (4) Conclusions: The VR game positively affects physiological variables and can therefore be utilized as a secure physical activity in both healthy individuals and individuals after hospitalization for COVID-19. COVID-19 affects the autonomic nervous system of older patients' post-hospitalization, which may be partly due to a higher BMI and the reduced exercise capacity in this population, affecting their ability to perform exercise activities. Other important observations were the higher RPE in COVID-19 patients during and after exercise, which may reflect altered physiological and autonomic responses. Taken together with the high reporting of fatigue after COVID-19, this is an important finding, and considering that RPE is usually lower during VR exercise compared to non-VR strengthens the potential for the use of VR in COVID-19 patients.
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