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Objective: The aim of this study was to describe the phases of a decannulation protocol and the results from its application in hospitalized children., Methods: This is a retrospective, observational study. Data were collected from medical records of decannulated patients followed up in a pediatric hospital in Belo Horizonte, Minas Gerais between 2011 and 2021., Results: Among the children followed up in the service (n=526), 23% (n=120) were successfully decannulated. Children aged between 2 months and 16 years, with a mean age of 4 years, 69% of whom were male, were evaluated. About 75% of the patients have tracheostomy due to upper airway obstruction and 60% of these due to acquired subglottic stenosis. At the beginning of the decannulation protocol, 5.5% of the patients had moderate oropharyngeal dysphagia, while 80.4% had normal swallowing. Correction in the upper airway pre-decannulation was performed in 39.5% of the patients, dilation in 63.8%, and endoscopic correction was performed in 55.3%. After performing the decannulation, none of the patients had complications., Conclusions: The described decannulation protocol is safe, since no complications such as death and need for recannulation happened.

Objective: To investigate the concurrent validity of the Human Activity Profile (HAP) in individuals after stroke to provide the peak oxygen uptake (V̇o 2peak ) and the construct validity of the HAP to assess exercise capacity, and to provide equations based on the HAP outcomes to estimate the distance covered in the Incremental Shuttle Walking Test (ISWT)., Design: Cross-sectional study., Setting: University laboratory., Participants: Individuals (N=57) aged 54±11 years who have experienced stroke., Intervention: Not applicable., Main Outcome Measures: Agreement between the V̇o 2peak provided by the HAP (lifestyle energy consumption [LEC] outcome, in mL/kg - 1/min -1 ) and the criterion standard measure of the V̇o 2peak (mL/kg -1 /min -1 ), obtained through the symptom-limited Cardiopulmonary Exercise Test (CPET). Correlation between the HAP outcomes (LEC, maximum activity score [MAS], and adjusted activity score [AAS]) and the construct measure: the distance covered (in meters) in the ISWT. An equation to estimate the distance covered in the ISWT was determined., Results: High magnitude agreement was found between the V̇o 2peak , in mL/kg -1 /min -1 , obtained by the symptom-limited CPET and the value of V̇o 2peak , in mL/kg -1 /min -1 , provided by the HAP (LEC) (intraclass correlation coefficient, 0.75; P<.001). Low to moderate magnitude correlations were found between the distance covered in the ISWT and the HAP (LEC/MAS/AAS) (0.34≤ρ≤0.58). The equation to estimate the distance covered in the ISWT explained 31% of the variability of the ISWT (ISWT estimated , -361.91+(9.646xAAS))., Conclusion: The HAP questionnaire is a clinically applicable way to provide a valid value of V̇o 2peak (in mL/kg -1 /min -1 ) and to assess the exercise capacity of individuals after stroke. Furthermore, an equation to estimate the distance covered in the submaximal field exercise test (ISWT) based on the result of the AAS (in points) was provided., (Copyright © 2022 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: To identify interventions employed to increase post-stroke physical activity, evaluate their efficacy, and identify the gaps in literature. Materials and methods: Randomized controlled trials published until March 2018 were searched in MEDLINE, PEDro, EMBASE, LILACS, and SCIELO databases. The quality of each study and overall quality of evidence were assessed using the PEDro and the GRADE scales. Results: Eighteen studies were included (good PEDro and very low GRADE-scores). In seven, the experimental groups showed significant increases in physical activity (aerobics, resistance, and home-based training; counseling, aerobics, resistance, and home-based training; electrical stimulation during walking; functional-task training; robot-assisted arm therapy; accelerometer-based feedback, and physical activity encouragement). In seven, there were no significant between-group differences (physical activity plan; stretching, use of toe-spreaders, standard treatment; counseling; circuit video-game; functional-task; counseling and cognitive training). The combined experimental and control groups showed significant declines in physical activity in one study (aerobic training or stretching) and increases in three others (aerobic, resistance or sham resistance training; stroke-with advice or only stroke-counseling; aerobic training, educational sessions, standard treatment, and coaching, or mobilization and standard treatment). A meta-analysis could not be performed, due to heterogeneity. Conclusions: Some interventions improved physical activity after stroke. However, the interpretability is limited.Implications for rehabilitationIndividuals with stroke show low physical activity, which may compromise function and health.The use of interventions aimed at improving and maintaining physical activity of individuals with stroke are recommended.Some interventions, such as aerobic, resistance, and combined home-based training, electrical stimulation during walking, functional task training, and arm robot-assisted therapy, could improve the physical activity after stroke.

Objective: To investigate the reliability (test-retest and inter-rater) and criterion-related validity of the modified sphygmomanometer test (MST) for the assessment of upper limb muscle strength in subjects with chronic stroke, and to determine whether the results are affected by the number of trials., Patients and Methods: The strength of 11 upper limb muscle groups of 57 subjects with stroke was bilaterally assessed with portable dynamometers and the MST (measured in mmHg). To investigate whether the number of trials would affect the results, 1-way analysis of variance was applied. For the test-retest/inter-rater reliabilities and criterion-related validity of the MST, intra-class correlation coefficients (ICCs), Pearson's correlation coefficients, and coefficients of determination were calculated., Results: Different numbers of trials provided similar values for all assessed muscles (0.01 ≤ F ≤ 0.18; 0.83 ≤ p ≤ 0.99) with adequate test-retest (0.83 ≤ ICC ≤ 0.97; p < 0.0001) and inter-rater reliabilities (0.79 ≤ ICC ≤ 0.97; p < 0.0001) and validity (0.61 ≤ r ≤ 0.95; p < 0.0001). The values obtained with the MST were good predictors of those obtained with portable dynamometers (0.60 ≤ r2 ≤ 0.86), except for pinch strength (0.39 ≤ r2 ≤ 0.54)., Conclusion: The MST showed adequate measurement properties for the assessment of the strength of the upper limb muscles of subjects with chronic stroke. After familiarization a single trial provided adequate strength values.

Objectives: To investigate the criterion-related validity, test-retest and inter-rater reliabilities of the modified sphygmomanometer test (MST) for assessment of the strength of the trunk and lower limb muscles in subjects with chronic stroke, and to verify whether the number of trials affected the results., Patients and Methods: Fifty-nine subjects with stroke (mean age 57.80 years; standard deviation 13.79 years) were included in the study. Maximum isometric strength was assessed with a hand-held dynamometer and the MST. To investigate whether the number of trials affected the results, one-way analysis of variance was applied. For the criterion-related validity, test-retest and inter-rater reliabilities of the MST, Pearson correlation coefficients, coefficients of determination, and intra-class correlation coefficient (ICC) were calculated., Results: Different numbers of trials provided similar values for all assessed muscles (0.003 ≤ F ≤ 0.08; 0.92 ≤ p ≤ 1.00) with adequate validity (0.79 ≤ r ≤ 0.90; p ≤ 0.001), test-retest (0.57 ≤ ICC ≤ 0.98; p ≤ 0.001), and inter-rater reliabilities (0.53 ≤ ICC ≤ 0.97; p ≤ 0.001), except for the inter-rater reliability of the non-paretic ankle plantar flexors. The values obtained with the MST were good predictors of those obtained with the hand-held dynamometer (0.57 ≤ r2 ≤ 0.79)., Conclusion: In general, the MST showed adequate criterion-related validity, test-retest and inter-rater reliabilities for the assessment of strength of the lower limb and trunk muscles in subjects with chronic stroke. For the majority of the assessed muscles, only one trial, after familiarization, provided adequate strength values.