LINAMARA RIZZO BATTISTELLA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de MedicinaLegal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina - Docente
Instituto de Medicina Física e de Reabilitação, Hospital das Clínicas, Faculdade de Medicina
FMUSP, Hospital das Clínicas, Faculdade de Medicina
LIM/40 - Laboratório de Imunohematologia e Hematologia Forense, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto de Medicina Física e de Reabilitação, Hospital das Clínicas, Faculdade de Medicina
FMUSP, Hospital das Clínicas, Faculdade de Medicina
LIM/40 - Laboratório de Imunohematologia e Hematologia Forense, Hospital das Clínicas, Faculdade de Medicina - Líder
82 resultados
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- Evaluation of body temperature in individuals with stroke(2017) ALFIERI, Fabio Marcon; MASSARO, Ayrton Roberto; FILIPPO, Thais Raquel; PORTES, Leslie Andrews; BATTISTELLA, Linamara RizzoBACKGROUND: 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.
bookPart Modelo assistencial do serviço de reabilitação(2014) BRITO, Christina May Moran de; BATTISTELLA, Linamara Rizzo; BAIA, Wania Regina Mollo- Effects of Combined and Alone Transcranial Motor Cortex Stimulation and Mirror Therapy in Phantom Limb Pain: A Randomized Factorial Trial(2021) GUNDUZ, Muhammed Enes; PACHECO-BARRIOS, Kevin; PINTO, Camila Bonin; DUARTE, Dante; VELEZ, Faddi Ghassan Saleh; GIANLORENCO, Anna Carolyna Lepesteur; TEIXEIRA, Paulo Eduardo Portes; GIANNONI-LUZA, Stefano; CRANDELL, David; BATTISTELLA, Linamara Rizzo; SIMIS, Marcel; FREGNI, FelipePhantom limb pain (PLP) is a frequent complication in amputees, which is often refractory to treatments. We aim to assess in a factorial trial the effects of transcranial direct current stimulation (tDCS) and mirror therapy (MT) in patients with traumatic lower limb amputation; and whether the motor cortex plasticity changes drive these results. In this large randomized, blinded, 2-site, sham-controlled, 2 x 2 factorial trial, 112 participants with traumatic lower limb amputation were randomized into treatment groups. The interventions were active or covered MT for 4 weeks (20 sessions, 15 minutes each) combined with 2 weeks of either active or sham tDCS (10 sessions, 20 minutes each) applied to the contralateral primary motor cortex. The primary outcome was PLP changes on the visual analogue scale at the end of interventions (4 weeks). Motor cortex excitability and cortical mapping were assessed by transcranial magnetic stimulation (TMS). We found no interaction between tDCS and MT groups (F = 1.90, P = .13). In the adjusted models, there was a main effect of active tDCS compared to sham tDCS (beta coefficient = -0.99, P = .04) on phantom pain. The overall effect size was 1.19 (95% confidence interval: 0.90, 1.47). No changes in depression and anxiety were found. TDCS intervention was associated with increased intracortical inhibition (coefficient = 0.96, P = .02) and facilitation (coefficient = 2.03, P = .03) as well as a posterolateral shift of the center of gravity in the affected hemisphere. MT induced no motor cortex plasticity changes assessed by TMS. These findings indicate that transcranial motor cortex stimulation might be an affordable and beneficial PLP treatment modality.
bookPart Reabilitação de Pacientes Oncológicos(2016) BRITO, Christina May Moran de; CECATTO, Rebeca Boltes; BATTISTELLA, Linamara Rizzo- 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 RizzoIn 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
- Physical Medicine and Rehabilitation in Latin America: Development and Current Status(2019) SCHIAPPACASSE, Carolina; GUZMAN, Juan Manuel; DEAN, Maria Herrera; CORLETTO, Sandra; BATTISTELLA, Linamara Rizzo; IMAMURA, Marta; GUTIERREZ, Jorge; BORELLI, Graciela; MUZIO, Diana; MICHEO, WilliamDisability disproportionately affects women, older individuals, and ethnic minorities in low-income countries, many of which are located in Latin America. Physical Medicine and Rehabilitation (PM&R) is the medical specialty that manages disability and works on restoring function, and over the past 6 decades has significantly expanded its importance in Latin America. The specialty has developed graduate and postgraduate educational programs, provides services to individuals of all ages in inpatient and outpatient settings, has increased its research productivity, and has become an advocate for patients with disabling conditions, which has resulted in improved access to care for many patients.
- Body temperature of healthy men evaluated by thermography: A study of reproducibility(2018) ALFIERI, Fabio Marcon; BATTISTELLA, Linamara RizzoBACKGROUND: 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.
- The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb(2018) PAI, Marcus Yu Bin; TERRANOVA, Thais Tavares; SIMIS, Marcel; FREGNI, Felipe; BATTISTELLA, Linamara RizzoNeurologic disorders such as stroke and cerebral palsy are leading causes of long-term disability and can lead to severe incapacity and restriction of daily activities due to lower and upper limb impairments. Intensive physical and occupational therapy are still considered main treatments, but new adjunct therapies to standard rehabilitation that may optimize functional outcomes are being studied. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that polarizes underlying brain regions through the application of weak direct currents through electrodes on the scalp, modulating cortical excitability. Increased interest in this technique can be attributed to its low cost, ease of use, and effects on human neural plasticity. Recent research has been performed to determine the clinical potential of tDCS in diverse conditions such as depression, Parkinson's disease, and motor rehabilitation after stroke. tDCS helps enhance brain plasticity and seems to be a promising technique in rehabilitation programs. A number of robotic devices have been developed to assist in the rehabilitation of upper limb function after stroke. The rehabilitation of motor deficits is often a long process requiring multidisciplinary approaches for a patient to achieve maximum independence. These devices do not intend to replace manual rehabilitation therapy; instead, they were designed as an additional tool to rehabilitation programs, allowing immediate perception of results and tracking of improvements, thus helping patients to stay motivated. Both tDSC and robot-assisted therapy are promising add-ons to stroke rehabilitation and target the modulation of brain plasticity, with several reports describing their use to be associated with conventional therapy and the improvement of therapeutic outcomes. However, more recently, some small clinical trials have been developed that describe the associated use of tDCS and robot-assisted therapy in stroke rehabilitation. In this article, we describe the combined methods used in our institute for improving motor performance after stroke.
- EXPLORING A LONG-TERM GLOBAL APPROACH FOR MUSCULOSKELETAL ULTRASOUND TRAINING: WORLD-MUSCULUS(2012) IMAMURA, Marta; OZCAKAR, Levent; FREGNI, Felipe; HSING, Wu Tu; BATTISTELLA, Linamara Rizzo
- 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 MarconABSTRACT 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.