Abstract Introduction: The perception of biological motion refers to the ability to perceive the moving shape of a human figure from points of light. This ability may be altered under various conditions that compromise human perceptual and visual capabilities, such as following a stroke, impairing the acquisition of motor skills. Objective: To evaluate whether biological motion perception in post-stroke patients is compromised. Methods: This article is characterized as a cross-sectional and analytical study with a quantitative approach. Two groups were formed: one consisting of 10 post-stroke patients and the other of 10 healthy elderly individuals. Study participants were clinically characterized using instruments assessing muscle tone, sensorimotor function, laterality, and cognitive status. Subsequently, they judged tasks involving presentations of natural-shaped light point stimuli divided into three categories: movements without objects, movements with objects, and social interactions. To analyze participants' biological motion perception, we calculated each participant's number of correct judgments and response times. Results: The control group had higher correct judgments in most tasks (70 - 90%) compared to the post-stroke group (40 - 60%). No significant statistical differences were found, but response times were shorter in controls. For the waving task, the mean time was 1.2 seconds for controls and 2.5 seconds for the post-stroke group (p = 0.0022). In walking (anterior-posterior view), it was 1.5 versus 3.0 seconds (p = 0.0006). Conclusion: Biological motion perception in post-stroke participants appears to be slower, however, there seems to be no compromise in judgment capability.

Abstract Introduction The ability to sit independently is essential for children, serving as a foundation for reaching and for daily activities. For children with cerebral palsy, especially bilateral spastic cerebral palsy (BSCP), this skill is often unattainable because of impaired neuromuscular control. Objective We aimed to report the protocol for a randomized controlled trial of the novel Sensory Perceptual-Motor Core Stability Exercise Program (SPMCSEP) in improving sitting control in children with BSCP. Methods This is a double-blinded, rando-mized, controlled trial. Seventy-two children with cerebral palsy (Gross Motor Function Classification Scale – ER III - IV) aged between 3 and 7 years will be recruited and randomly allocated to SPMCSEP and conventional therapy groups. Independent sitting will be evaluated at baseline, 6 weeks, and 8 weeks for all children using the Trunk Control Measurement Scale. Conclusion This study explains the background, hypotheses, rationale, and methodology of the SPMCSEP protocol for children with BSCP, and will adhere to Consolidated Standards of Reporting Trials and Standard Protocol Items Recommendations for Interventional Trials guidelines for reporting. The proposed SPMCSEP represents a novel approach for addressing impaired sitting control in children with BSCP.

Abstract Introduction Monitoring the long-term consequences of COVID-19 and its impact on different aspects is es-sential. Objective To assess functional capacity and as-sociated factors up to one year after hospital discharge in COVID-19 survivors. Methods This cross-sectional study included individuals aged 18 years or older, re-sidents of a medium city in Rio Grande do Sul, Brazil, with a laboratory diagnosis of COVID-19, who required hospitalization. Data collection was performed through home visits, face-to-face interviews, and physical tests, which assessed a set of sociodemographic, clinical, and health characteristics. The primary outcomes were func-tional status and muscle strength assessed by the Post-COVID-19 Functional Status Scale and the Medical Re-search Council Score. Analyses were performed using crude and adjusted logistic regression models. Results Of the 160 individuals, the majority were female (53.1%), white (71.9%), with a mean age of 64 years. Functional limitations were identified in 67.5% (95%CI 46.2 - 70.2) of the sample, with 50.9% (95%CI: 41.8 - 60.0) present-ing changes in muscle strength, 10% of which (95%CI 5.8 - 17.0) presented muscle weakness. An association was found between greater functional limitation and diagnosis of respiratory diseases (p = 0.002). Changes in muscle strength were associated with female gender (p = 0.009), diagnosis of sarcopenia (p = 0.036), smoking (p = 0.022) and need for orotracheal intubation (p = 0.009). Conclusion It was observed that, within one year after hospital discharge, individuals presented significant functional limitations, with more than half present-ing some type of muscle strength impairment and a portion showing signs of muscle weakness.

Abstract Introduction: Mechanical ventilation is commonly used in patients with respiratory failure and delivered through an endotracheal tube. This tube includes an inflatable cuff that requires regular pressure monitoring to en-sure adequate sealing between the tube and the trachea, thereby preventing air leaks and associated complications. Objective: To evaluate the use of a low-cost device for continuous cuff pressure monitoring and compare clinical outcomes. Methods: A randomized clinical trial was conducted in an adult intensive care unit with intubated patients who had been on mechanical ventilation for up to 48 hours. Patients were followed throughout the study according to group allocation. In the intervention group, cuff pressure was continuously monitored using the AccuCuff™ Cuff Pressure Indicator, while in the control group cuff pressure was intermittently measured with a handheld manometer, following standard care. Results: A total of 55 patients of both sexes were enrolled, 27 in the AccuCuff™ group and 28 in the standard care group. Baseline characteristics were similar between groups. Both groups experienced episodes of cuff pressure reduction, with comparable frequencies and no significant difference in the need for adjustments across time periods (p = 0.307). Conclusion: Continuous cuff pressure monitoring with AccuCuff™ is a viable alternative, providing measurements consistent with device specifications and facilitating bedside monitoring. Its use in the hospital setting may be beneficial, and implementing regular measurement intervals is recommended to prevent prolonged periods of low cuff pressure.

Abstract Introduction: The spinal cord injury (SCI) affects functional independence. There are few studies that evaluate functional independence among individuals with SCI in Brazil. Objective: To evaluate the functional indepen-dence of individuals with SCI in Brazil, and explore the association between functional independence and personal, social, injury, and bladder and bowel-related factors. Methods: Data of 121 individuals with SCI about functional independence, personal, demographic, injury, bladder, and bowel factors were collected by interview and analyzed. It was used Spearman's rank correlation coefficient and the Mann-Whitney U test with p < 0.01 for correlations and p < 0.05 for post hoc tests significance level. Results: The region of the neurological level had the most substantial correlation with functional independence (0.370 to 0.570, p ≤ 0.001), followed by sex (0.270, p = 0.003), American Spinal Injury Association (ASIA) Impairment Scale (AIS) classification (0.345, p = 0.001), and patterns in the bowel (−0.295, p = 0.001) and bladder functions (−0.281 to −0.334, p ≤ 0.002). Conclusion: The region of the neurological level emerged as the most significant non-modifiable factor influencing functional independence. Furthermore, factors like sex, AIS classification, and bladder and bowel patterns, while demonstrating weaker associations, remain pertinent to functional independence.

Abstract Introduction: Critically ill patients are exposed to immobility. Critical patient spend more time in bed rest and the physiologic effects can impact on functional capacity. Mobility and high posture have been encouraged for these patients. Few studies have objectively measured how long patients spend lying, sitting or standing during intensive care unit (ICU) stay and if there is association with functional outcomes. Objective: To evaluate the time patients spend lying, sitting and standing during ICU stay and its association with status functional at ICU discharge. Methods: This was a prospective observational study that included 161 patients older than 18 years, admitted to the ICU, who presented Barthel index score = 100 points before hospitalization. An accelerometer was used to assess patient’s mobility during the stay in ICU. The variables used in the analysis were percentage of time and amount of time in sitting, standing and lying down. The patient’s functionality was assessed using the Barthel index at ICU discharge. Results: Patients spent 89% of the time lying down, 7% seated and 4% on standing position. The age (OR = 1.08; 95%CI 1.04 – 1.13) and percentage of time lying down (OR = 1.1; 95%CI 1.04 – 1.17) were independent factors for functional dependence. Time in standing (OR = 0.76; 95%CI 0.66 – 0.88) was associated with maintenance of functionality. Conclusion: There is association with time in bed rest and worse status functional at ICU discharge. On the other hand, the time in standing position was a protective factor for functional dependency.

Abstract Introduction: Post-COVID-19 condition refers to persistent symptoms following SARS-CoV-2 infection. Objective: Investigate the profile of patients with post-COVID-19 condition, classified as obese and non-obese according to body mass index (BMI), and determine whether obe-se individuals present with worse clinical and functional status. Methods: A cross-sectional observational study with adults of both sexes who have a history of hospitalization for SARS-CoV-2 infection and post-COVID-19 condition, referred for pulmonary rehabilitation between August 2020 and October 2022. The data were obtained from physiotherapy assessments. Participants were classified as obese or non-obese, and evaluated in terms of their health history, length of hospital stay, dyspnea during activities of daily living (ADLs), and respiratory muscle strength. Results: A total of 54 individuals participated in the study, mostly women, with an average age of 55 years. The majority were obese (75.9%), sedentary, white, and worked in retail or civil construction. There was no association between obesity and the variables hypertension (p = 0.057), diabetes (p = 0.113), dyspnea (p = 0.368), or fatigue (p = 0.750). Length of hospital stay (p = 0.592), days in the intensive care unit (p = 0.478), days on invasive mechanical ventilation (0.075), modified Medical Research Council scale - mMRC (p = 0.633), and maximum inspiratory (p = 0.625) and expiratory pressure (p = 0.967) were not influenced by obesity. Conclusion: Although participants with obesity were more likely to require pulmonary rehabilitation due to post-COVID-19 condition, they did not exhibit worse clinical and functional status on assessment of health history, length of hospital stay, dyspnea in activities of daily living, and respiratory muscle strength.

Abstract Introduction: Assessing health conditions based on out-patient care data is one of the tools used to support the development of an appropriate health action plan aimed at meeting the real needs of the population. Objective: Analyze the spatiotemporal distribution of outpatient physiotherapy services in primary health care in Brazil and its geographic regions from 2008 to 2022. Methods: This was an analytical ecological time series study using secondary data from the Outpatient Information System and Brazilian Institute of Geography and Statistics. The Kruskal-Wallis test was used to identify differences in outpatient care between regions by year and joinpoint regression to estimate temporal trends from 2008 to 2022. Results: The South obtained the highest outpatient physiotherapy visit rates when compared to other Brazilian regions across six consecutive years from 2013 to 2022, except in 2016. Temporal trends in Brazil and the North, Northeast, and Central-West remained stationary between 2008 and 2022. However, there were significant increases of 12.3 and 6.4% in care provided in the South and Southeast, respectively. Spatial distribution by seven-year periods indicated high outpatient visit rates in the South in 2015 and 2022. Conclusion: The temporal trend of outpatient physiotherapy services in Brazil from 2008 to 2022 was stationary in the North, Northeast, and Central-West, but experienced growth in the South and Southeast.

Abstract Introduction: Kinesiophobia, the fear of movement due to perceived pain or re-injury, is a significant barrier to rehabilitation and recovery, particularly for stroke patients. This case study examines the impact of kinesiophobia on rehabilitation in a stroke survivor with left-sided weakness and limited shoulder range of motion. Objective: To explore the efficacy of a virtual reality-based intervention on kinesiophobia, shoulder range of motion and pain management in a post-stroke patient using the Reach Shoulder Health app. Methods: A 54-year-old male with hypertension and type 2 diabetes experienced left-sided weakness following a non-haemorrhagic infarct in the right middle cerebral artery space. Limited shoulder range of motion was observed, particularly during voluntary movements, linked to kinesiophobia and left shoulder pain. A virtual reality-based app, Reach Shoulder Health, featuring the Oculus Quest and Star Beam games, was used for 25-minute sessions, five days a week, over three weeks. The effectiveness of intervention was evaluated using the Tampa Scale of Kinesiophobia, Visual Analogue Scale, and goniometer. Results: Post-intervention, the patient showed a marked reduction in kinesiophobia, a significant improvement in shoulder range of motion, and a noticeable decrease in pain intensity, demonstrating the positive effects of the virtual reality intervention. Conclusion: This case study demonstrates the potential of virtual reality as an effective tool for reducing kinesiophobia and improving rehabilitation outcomes in stroke patients. The integration of immersive technologies could offer substantial benefits for patients with rehabilitation challenges.

Abstract Introduction: Chronic migraine is a common neurological condition, especially among women, and significantly affects quality of life and productivity. Although pharmacological treatment is the main strategy, its limited effectiveness and adverse effects justify the search for complementary approaches such as manual therapy (MT). Objective: To analyze the effectiveness of MT on pain intensity, frequency of episodes, disability, self-efficacy, sleep quality, and quality of life in adults with chronic migraine. Methods: A randomized controlled clinical trial was performed with 40 adults with chronic migraine. Participants were randomly allocated to a control group (CG; n = 20) or a manual therapy group (MTG; n = 20). The MTG received ten MT sessions, once a week for 12 weeks. Both groups continued the use of pharmacological treatment. The choice of MT was based on its potential to modulate pain and improve musculoskeletal function. Outcome measures included: HIT-6, MIDAS, PSQI-BR, SF-36, and HMSE-10. Results: Mean age was 36.7 ± 10.2 years. The intervention was associated with a significant improvement in the total HIT-6 score (p = 0.014) and in the domains of physical limitations (p = 0.02) and general health status (p = 0.03) of the SF-36. The proportion of participants with severe disabilities was 57.1% in the CG and 21.4% in the MTG (p < 0.05). The median cervical flexion was −10.0° in the CG and 5.0° in the MTG (p = 0.005). Conclusion: MT associated with pharmacological treatment demonstrated positive outcomes and may be an effective approach for managing chronic migraine.