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
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- 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.
- 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 RizzoRobotic 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.
- Decentralizing Rehabilitation: Using Blockchain to Store Exoskeletons' Movement(2019) SILVA, Daniela America da; LELIS, Claudio Augusto Silveira; COURA, Luiz Henrique; SANTOS, Samara Cardoso dos; YANAGUYA, Leticia; OZORIO JUNIOR, Jose Crisostomo; TIBURCIO, Isaias da Silva; GONCALVES, Gildarcio Sousa; FONSECA, Breslei Max Reis da; NASCIMENTO, Alexandre; MARQUES, Johnny Cardoso; DIAS, Luiz Alberto Vieira; CUNHA, Adilson Marques da; TASINAFFO, Paulo Marcelo; TERRANOVA, Thais Tavares; SIMIS, Marcel; CASTRO, Pedro Claudio Gonsales de; BATTISTELLA, Linamara Rizzo
- Superficial temperature and pain tolerance in patients with chronic low back pain(2019) ALFIERI, Fabio Marcon; LIMA, Alessandra Rodrigues Souto; BATTISTELLA, Linamara Rizzo; SILVA, Natalia Cristina de Oliveira Vargas eIntroduction: Low back pain is a common and very prevalent disease and can impose limitations that negatively impact patients. The objective of this study was to verify and compare the association between lumbar superficial temperature and pressure pain tolerance thresholds in individuals with chronic nonspecific low back pain and healthy controls. Methods: This was a cross-sectional observational study involving 38 individuals with nonspecific chronic low back pain and 19 healthy controls. Volunteers underwent thermographic (infrared sensor), pain perception (visual analog scale), and pressure pain tolerance thresholds (algometry) evaluations in the right and left paravertebral muscles and L4-L5 ligament. Results: A lower tolerance to pressure pain was found in patients compared to controls at all evaluated sites (p <= 0.003). Superficial temperature was significantly higher in the sites evaluated in the low back pain group (p < 0.001). In patients with low back pain, pain perception was weakly and inversely correlated with pressure pain tolerance (r = -0.31; p = 0.05) and moderately correlated to the temperature of the evaluated sites (r = 0.51 to 0.59, p <= 0.001). Also, an inverse and weak to moderate association was observed between pressure pain tolerance thresholds and temperature in patients only (r = - 0.36 to -0.49; p <= 0.02). Conclusion: Individuals with low back pain have lower pressure pain tolerance thresholds and higher superficial temperature in the lumbar region when compared to healthy individuals. The associations observed show that the higher the pain perception, the lower the pain tolerance and the higher the superficial temperature in the lumbar region. Also, the higher the temperature, the lower the pain tolerance.
- Two innovative Brazilian programs relating to road safety prevention. A case study(2019) CARNEIRO, Leandro Piquet; BATTISTELLA, Linamara RizzoBACKGROUND: The World Health Organization (WHO) 2017 Global Conference in Montevideo, Uruguay, was dedicated to promoting successful cases and best practices in fighting and preventing noncommunicable disease (NCDs). The global effort undertaken by WHO aims to reduce road traffic deaths in order to meet goal number 3.4 of the sustainable development goals. OBJECTIVES: To describe two Brazilian road safety prevention programs, presented at the WHO 2017 Global Conference: Sao Paulo Traffic Safety Movement (Movimento Paulista de Seguranca no Transito) and Safe Life Program of Brasilia (Programa Brasilia Vida Segura), along with their governance structures, models and results. DESIGN AND SETTING: This was a descriptive case study conducted in Sao Paulo and Brasilia from 2015 to 2018. These programs aimed to reduce the number of deaths caused by road accidents to 8.3 deaths per 100,000 inhabitants in Sao Paulo by 2020 and in Brasilia by 2016; and to reduce harmful use of alcohol by 10% by 2020. METHODS: These two initiatives were designed, managed and operated to bring together government and civil society, i.e. industry, academia, non-governmental organizations (NGOs), etc., around the common goal of saving lives. They were collaborative and guided by sharing of best practices, learning and information, thereby making it possible to attain more and better results. Their format enables reproduction in cities across all Brazilian regions. RESULTS: The results attest to the efficacy of the programs implemented in these two cities. In Brasilia, the initiative helped reduce the number of traffic-related deaths by 35% (2017). In the same year in the state of Sao Paulo, 7,600 deaths were avoided. CONCLUSION: Both programs are innovative public policies that deal with health issues caused by the external agents that ultimately account for the rapid increase in days lost to disability. Prevention of external causes of deaths and injuries, such as traffic violence, strongly correlates with changes in habits and actions, especially excessive consumption of alcohol, and with NCDs in Brazil.
- Post-discharge mortality in patients with traumatic spinal cord injury in a Brazilian hospital: a retrospective cohort(2019) LEITE, Victor F.; SOUZA, Daniel R. de; IMAMURA, Marta; BATTISTELLA, Linamara R.Study design Retrospective cohort. Objective To evaluate the survival outcomes in patients with traumatic spinal cord injury (TSCI). Setting A teaching hospital in Brazil. Methods A total of 434 patients diagnosed with TSCI (2004-2014) were included. Overall survival, standardized mortality ratios (SMR), and causes of death were assessed by Student's t-test, chi(2) test, Kaplan-Meier analysis, and Cox proportional-hazards regression. Results The mean follow-up was 4.8 years (+/- 3.3 years). Individuals with tetraplegia had a median survival of 11 years, with participants in the paraplegia group not reaching median survival. The overall mortality rate was 37 per 1000 person-years. Age-adjusted SMR was 28.8 (95% CI: 22.8-36). There were 77 deaths with 56 defined causes, of which pneumonia was the most frequent (35.7%). Combined infectious etiologies caused 55.3% of deaths. Multivariate analysis revealed higher mortality among individuals with tetraplegia vs. paraplegia in the first 2 years post injury (HR = 8.28, 95% CI: 2.76-24.80), after 2 years post injury (HR = 2.35, 95% CI: 1.31-4.24), and in all years combined (HR = 3.36, 95% CI: 2.04-5.52). Conclusion Mortality among patients with TSCI was 28.8 times higher than in the reference population. In more than half of the cases, the cause of death was linked to infectious diseases. Pneumonia caused two times more deaths in individuals with tetraplegia than in individuals with paraplegia, with a higher impact in the first 2 years post injury. Reported findings indicate the need for a surveillance and prevention program with emphasis on vaccination and respiratory rehabilitation.
- Identification of relevant categories for inpatient physical therapy care using the International Classification of Functioning, Disability and Health: a Brazilian survey(2019) PASCHOAL, Luciana Narciso; SOUZA, Patricia Nery De; BUCHALLA, Cassia Maria; BRITO, Christina May Moran De; BATTISTELLA, Linamara RizzoBackground: Hospitalized patients are at risk for the loss of function and impairment. Physical therapists aim to improve functionality and prevent disabilities. The International Classification of Functioning, Disability and Health (ICF) propose a universal language to classify the functionality of patients across different health care settings and over diverse health conditions. Objectives: To identify the International Classification of Functioning, Disability and Health categories that describe most common and relevant patient problems managed by physical therapists in Brazilian hospitals in the acute and post-acute care settings. Subjects: The participants were physical therapists who worked in hospitals with a minimum work experience of two years. Methods: A consensus-building, two-round, emailed survey was conducted using the Delphi technique. Results: For the development of an ICF short list, 47 physical therapists from the acute care setting and 30 physical therapists from the post -acute care setting responded to the Delphi exercise. Most of the professionals were from the cardiorespiratory physical therapy area. A 80% level of consensus or higher was established for the selection of the categories of the ICF components (Body Functions, Body Structures, Activities and Participation, and Environmental Factors). We obtained two short lists to be used in clinical practice comprising 39 ICF categories for acute care settings and 53 for post-acute care settings. Conclusion: This study is the first to identify the most relevant aspects for physical therapy in Brazilian hospitals using the ICF framework. Our results can help to promote the adoption of the ICF in physical therapy clinical practice in the hospital setting.
- Cross-cultural adaptation and validation of the neurogenic bladder symptom score questionnaire for brazilian portuguese(2019) CINTRA, Lisley Keller Liidtke; BESSA JUNIOR, Jose de; KAWAHARA, Victor Ikky; FERREIRA, Thereza Phitoe Abe; SROUGI, Miguel; BATTISTELLA, Linamara Rizzo; SOUZA, Daniel Rubio de; BRUSCHINI, Homero; GOMES, Cristiano MendesObjective: To cross-culturally adapt and check for the reliability and validity of the neurogenic bladder symptom score questionnaire to Brazilian portuguese, in patients with spinal cord injury and multiple sclerosis. Materials and Methods: The questionnaire was culturally adapted according to international guidelines. The Brazilian version was applied in patients diagnosed with neurogenic bladder due to spinal cord injury or multiple sclerosis, twice in a range of 7 to 14 days. Psychometric properties were tested such as content validity, construct validity, internal consistency, and test-retest reliability. Results: Sixty-eight patients participated in the study. Good internal consistency of the Portuguese version was observed, with Cronbach alpha of 0.81. The test-retest reliability was also high, with an Intraclass Correlation Coefficient of 0.86 [0.76 - 0.92] (p<0.0001). In the construct validity, the Pearson Correlation revealed a moderate correlation between the Portuguese version of the NBSS and the Qualiveen-SF questionnaire (r = 0.66 [0.40-0.82]; p < 0.0001). Conclusions: The process of cross-cultural adaptation and validation of the NBSS questionnaire for the Brazilian Portuguese in patients with neurogenic lower urinary tract dysfunction was concluded.