Transcranial direct current stimulation combined with upper limb functional training in children with spastic, hemiparetic cerebral palsy: study protocol for a randomized controlled trial

The aim of the proposed study is to perform a comparative analysis of functional training effects for the paretic upper limb with and without transcranial direct current stimulation over the primary motor cortex in children with spastic hemiparetic cerebral palsy

Static balance and function in children with cerebral palsy submitted to neuromuscular block and neuromuscular electrical stimulation: Study protocol for prospective, randomized, controlled trial

BACKGROUND: The use of botulinum toxin A (BT-A) for the treatment of lower limb spasticity is common in children with cerebral palsy (CP). Following the administration of BT-A, physical therapy plays a fundamental role in potentiating the functionality of the child. The balance deficit found in children with CP is mainly caused by muscle imbalance (spastic agonist and weak antagonist). Neuromuscular electrical stimulation (NMES) is a promising therapeutic modality for muscle strengthening in this population. The aim of the present study is to describe a protocol for a study aimed at analyzing the effects of NMES on dorsiflexors combined with physical therapy on static and functional balance in children with CP submitted to BT- A. METHODS/DESIGN: Protocol for a prospective, randomized, controlled trial with a blinded evaluator. Eligible participants will be children with cerebral palsy (Levels I, II and III of the Gross Motor Function Classification System) between five and 12 years of age, with independent gait with or without a gait-assistance device. All participants will receive BT-A in the lower limbs (triceps surae). The children will then be randomly allocated for either treatment with motor physical therapy combined with NMES on the tibialis anterior or motor physical therapy alone. The participants will be evaluated on three occasions: 1) one week prior to the administration of BT-A; 2) one week after the administration of BT-A; and 3) four months after the administration of BT-A (end of intervention). Spasticity will be assessed by the Modified Ashworth Scale and Modified Tardieu Scale. Static balance will be assessed using the Medicapteurs Fusyo pressure platform and functional balance will be assessed using the Berg Balance Scale. DISCUSSION: The aim of this protocol study is to describe the methodology of a randomized, controlled, clinical trial comparing the effect of motor physical therapy combined with NMES on the tibialis anterior muscle or motor physical therapy alone on static and functional balance in children with CP submitted to BT-A in the lower limbs. This study describes the background, hypotheses, methodology of the procedures and measurement of the results. TRIAL REGISTRATION: RBR5qzs8

Percepção das usuárias sobre as ações de Prevenção do Câncer do Colo do Útero na Estratégia Saúde da Família em uma Distrital de Saúde do município de Ribeirão Preto, São Paulo, Brasil User perception on the actions of Cervix Cancer Prevention of Family Health Strategy in a Health District of the municipality of Ribeirão Preto, in São Paulo, Brazil

OBJETIVOS: analisar a percepção das mulheres atendidas nas Unidades de Saúde da Família (USF), da Área Básica de uma Distrital de Saúde do Município de Ribeirão Preto, São Paulo, sobre as práticas de Prevenção do câncer do colo do útero (PCCU) desenvolvidas nestes serviços. MÉTODOS: utilizou-se como referencial teórico a Atenção Primária à Saúde (APS). Trata-se de uma pesquisa de abordagem qualitativa, do tipo exploratória e descritiva. Foram entrevistadas 14 mulheres. Utilizou-se para coleta de dados a entrevista semi-estruturada, procedendo à análise dos dados, orientados pela análise temática. A análise dos dados foi estruturada em três temas: Temática 1 - O Olhar da Mulher sobre o Processo Saúde-Doença; Temática 2 - A Mulher e a Prevenção do Câncer do Colo do Útero; Temática 3 - As Práticas de Prevenção do Câncer do Colo do Útero nos Núcleos de Saúde da Família. RESULTADOS: a maioria das mulheres envolvidas apresentam um conceito holístico de saúde, tendo inclusive um conhecimento popular bastante elaborado do conceito de prevenção. CONCLUSÕES: as práticas de educação em saúde precisam ser reforçadas a partir da inclusão de toda equipe. As USF têm potencialidades para qualificar a prática da PCCU e promover maior integralidade das ações em saúde, utilizando o conhecimento da APS.<br>OBJECTIVES: to analyze the perception of women seen at the Family Health Units (FHU) of the Basic Health District in the municipality of Ribeirão Preto, São Paulo, on the practices of cervix cancer prevention developed by these services. METHODS: a theoretical reference of primary healthcare was utilized. This is a qualitative survey of the exploratory, descriptive type. Fourteen women were interviewed. A semi-structured interview was used for data collection, data analysis oriented by thematic analysis. Data analysis was structured in three themes: Theme 1 - Women's view of the Health-Disease Process; Theme 2 - Women and Cervix Cancer Prevention; Theme 3: Cervix Cancer Prevention in Family Health Centers. RESULTS: the majority of women involved demonstrated a holistic concept of health and a rather elaborate concept of prevention. CONCLUSIONS: education practices in healthcare need to be reinforced based on staff inclusion. Family Health Units have the potential to improve cervix cancer prevention practices and to further integrate primary health care programs