Medical Express

ISSN (print): 2318-8111

ISSN (online): 2358-0429

Author's Articles

2 result(s) for: Danielli S Speciali

The use of the Gait Deviation Index for the evaluation Post-stroke Hemiparetic Subjects

Carolina C. Alcantara; Angelica Castilho Alonso; Danielli S. Speciali


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BACKGROUND: The Gait Deviation Index, initially conceived to evaluate the gait of children with cerebral palsy, has been used as a quantitative parameter of gait pattern changes of individuals with other conditions. However, there are no studies evaluating changes in the gait pattern of chronic hemiparetic post-stroke subjects based on this index.
AIMS: To characterize the changes in gait pattern according to the Gait Deviation Index and gait spatiotemporal parameters of chronic hemiparetic subjects compared to healthy subjects.
METHODS: Retrospective study. Data were obtained from the database of the Gait Laboratory of Hospital Israelita Albert Einstein. Thirty subjects were included in this study, with previous unilateral, ischemic or hemorrhagic chronic stroke (time post-lesion > 6 months) and ability of walking classified as 2, 3, 4 or 5 according to Functional Ambulation Category. Data from 87 healthy subjects were included in control group, obtained from a normality database. Statistical analysis was applied through the Kruskall Wallis test, followed by Mann-Whitney post-hoc test, considering a critical p value <0.05.
RESULTS: The Gait Deviation Index scores were decreased for both paretic (64.69 ± 16.29) and non-paretic limbs (64.88 ± 15.00) compared to control (101.01 ± 10.12; p < 0.001). No differences were observed in Gait Deviation Index scores between paretic and non-paretic limbs (p > 0.99).
CONCLUSION: The findings of the current study demonstrate that the Gait Deviation Index may be a sensitive parameter to identify changes in the gait pattern of chronic hemiparetic post-stroke subjects.

Keywords: stroke, gait, kinematic, hemiparetic.

Walking economy and aerobic power in Parkinson’s disease after endurance exercise training: A pilot study

Júlia Maria D´Andrea Greve; Paulo Roberto Santos-Silva; Danielli S Speciali


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OBJECTIVE: To verify the effect of an endurance exercise program in middle stages of Parkinson’s disease.
METHODS: The patients were two women and seven men with Parkinson’s disease, aged 56 to 74 years, classified at Hoehn and Yahr stages 2 to 2.5. The study was designed as an open long-term pilot trial over three months of supervised treadmill exercise training. Cardiopulmonary exercise test evaluations were performed before the start of the study (test 1) and after three months (test 2). The main outcome measure was walking economy (i.e., the rate of oxygen consumption during gait) measured between VT1 and VT2 speeds and Oxygen consumption (VO2).
RESULTS: No changes (p=0.551) were observed for maximal oxygen uptake (VO2max, 24.6 vs 23.6 between tests. The walking economy was 20% better (p<0.001) after three months of aerobic endurance training (266.7 vs 212.6, pre- vs. post-training); the Cohen’s “d” effect size (ES) was 0.99, a very large effect.
CONCLUSION: Evidence from this pilot study in individuals with Parkinson’s disease suggests that gains in walking economy occurs with a treadmill-training program without gain in aerobic power, but which may positively reduce the energy expenditure of activities of daily living in these patients.

Keywords: physical functioning, ventilatory threshold, maximal oxygen uptake.