Is economic growth enough to propel rehabilitation expenditures? An empirical analysis of country panel data and policy implications.

PURPOSE: Rehabilitation is a set of services designed to increase functioning and improve wellbeing across the life course. Despite being a core part of Universal Health Coverage, rehabilitation services often receive limited public expenditure, especially in lower income countries. This leads to limited service availability and high out of pocket payments for populations in need of care. The purpose of this research was to assess the association between macroeconomic conditions and rehabilitation expenditures across low-, middle-, and high-income countries and to understand its implications for overall rehabilitation expenditure trajectory across countries. MATERIALS AND METHODS: We utilized a panel data set from the World Health Organization's Global Health Expenditure Database comprising the total rehabilitation expenditure for 88 countries from 2016 to 2018. Basic macroeconomic and population data served as control variables. Multiple regression models were implemented to measure the relationship between macroeconomic conditions and rehabilitation expenditures. We used four different model specifications to check the robustness of our estimates: pooled data models (or naïve model) without control, pooled data models with controls (or expanded naïve model), fixed effect models with all controls, and lag models with all controls. Log-log specifications using fixed effects and lag-dependent variable models were deemed the most appropriate and controlled for time-invariant differences. RESULTS: Our regression models indicate that, with a 1% increase in economic growth, rehabilitation expenditure would be associated with a 0.9% and 1.3% increase in expenditure. Given low baseline levels of existing rehabilitation expenditure, we anticipate that predicted increases in rehabilitation expenditure due to economic growth may be insufficient to meet the growing demand for rehabilitation services. Existing expenditures may also be vulnerable during periods of economic recession. CONCLUSION: This is the first known estimation of the association between rehabilitation expenditure and macroeconomic conditions. Our findings demonstrate that rehabilitation is sensitive to macroeconomic fluctuations and the path dependency of past expenditures. This would suggest the importance of increased financial prioritization of rehabilitation services and improved institutional strengthening to expand access to rehabilitation services for populations.

Directiva sanitaria para el manejo de la atención estomatológica a la persona con discapacidad / Health directive for the management of dental care for people with disabilities

La presente publicación describe los criterios técnicos de referencia y contrarreferencia para la atención integral oportuna y de calidad de las personas con discapacidad., así como las actividades y procedimientos del personal que brinda atención estomatológica para disminuir el riesgo de complicaciones y aparición de nuevos casos por enfermedades estomatológicas

Introduction to target trial emulation in rehabilitation: a systematic approach to emulate a randomized controlled trial using observational data.

Rehabilitation providers and policymakers need valid evidence to make informed decisions about the healthcare needs of the population. Whenever possible, these decisions should be informed by randomized controlled trials (RCTs). However, there are circumstances when evidence needs to be generated rapidly, or when RCTs are not ethical or feasible. These situations apply to studying the effects of complex interventions, including rehabilitation as defined by Cochrane Rehabilitation. Therefore, we explore using the target trial emulation framework by Hernán and colleagues to obtain valid estimates of the causal effects of rehabilitation when RCTs cannot be conducted. Target trial emulation is a framework guiding the design and analysis of non-randomized comparative effectiveness studies using observational data, by emulating a hypothetical RCT. In the context of rehabilitation, we outline steps for applying the target trial emulation framework using real world data, highlighting methodological considerations, limitations, potential mitigating strategies, and causal inference and counterfactual theory as foundational principles to estimating causal effects. Overall, we aim to strengthen methodological approaches used to estimate causal effects of rehabilitation when RCTs cannot be conducted.

A general theory of rehabilitation: Rehabilitation catalyses and assists adaptation to illness.

BACKGROUND: There is no general theory of rehabilitation, only definitions and descriptions, with the biopsychosocial model of illness as a structure. OBJECTIVE: To develop a general theory of rehabilitation that explains how healthcare rehabilitation changes outcomes and to evaluate its validity. NEED: A general rehabilitation theory would help research, improve services, increase understanding, modify resource allocation and explain some anomalies, such as how rehabilitation helps when no natural recovery occurs. BUILDING BLOCKS: People adapt to change throughout their lives. Illness is a change, and people adapt to their illness. Adaptation's purpose is to maintain an equilibrium in a person's life. The balanced components are related to Maslow's five needs: basic, safety, affiliation, status and self-fulfilment. The general theory of behaviour suggests that a person's behaviours change to maintain balance, regulated by a central homeostatic mechanism. THE THEORY: Rehabilitation aids adaptation to changes associated with illness through accurate diagnosis and formulation, catalysing adaptation, optimising the environment and assisting the person in making necessary changes by safely practising activities and teaching self-management. IMPLICATIONS: The theory makes the person the central active agent, emphasises the importance of the environment in facilitating adaptation, explains why all conditions may benefit, including progressive and static conditions, suggests that health can be equated to someone maintaining their equilibrium and explains why a small dose may be very effective. CONCLUSION: The general theory of rehabilitation emphasises the catalytic effects of rehabilitation in facilitating and guiding adaptation and suggests areas for research and improvement.

Prevalence of Unmet Rehabilitation Needs Among Canadians Living With Long-term Conditions or Disabilities During the First Wave of the COVID-19 Pandemic.

OBJECTIVE: We aimed to describe the prevalence of unmet rehabilitation needs among a sample of Canadians living with long-term conditions or disabilities during the first wave of the COVID-19 pandemic. DESIGN: Cross-sectional survey. SETTING: Individuals residing in Canada during the first wave of the COVID-19 pandemic. PARTICIPANTS: Eligible participants were Canadians living with long-term conditions or disabilities, 15 years or older living in 1 of the 10 provinces or 3 territories (n=13,487). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: We defined unmet rehabilitation needs as those who reported needing rehabilitation (ie, physiotherapy/massage therapy/chiropractic, speech, or occupational therapy, counseling services, support groups) but did not receive it because of the COVID-19 pandemic. We calculated the national, age, gender, and province/territory-specific prevalence and 95% confidence interval of unmet rehabilitation needs. RESULTS: During the first wave of the pandemic, the prevalence of unmet rehabilitation needs among Canadians with long-term conditions or disabilities was 49.3% (95% confidence interval [CI]; 48.3, 50.3]). The age-specific prevalence was higher among individuals 15-49 years old (55.6%; 95% CI [54.2, 57.1]) than those 50 years and older (46.0%; 95% CI [44.5, 47.4]). Females (53.7%; 95% CI [52.6, 54.9]) had higher unmet needs than males (44.1%; 95% CI [42.3, 45.9]). Unmet rehabilitation needs varied across provinces and territories. CONCLUSIONS: In this sample, almost 50% of Canadians living with long-term conditions or disabilities had unmet rehabilitation needs during the first wave of the COVID-19 pandemic. This suggests that a significant gap between the needs for and delivery of rehabilitation care existed during the early phase of the pandemic.

Self-perceived oral health: a study with patients wearing removable dentures

Aim: This study aimed to investigate the relationship between self-perceived oral health and the prosthetic status of individuals who seek care in prosthodontics clinics. Methods: Self-perceived oral health was analyzed through the Geriatric Oral Health Assessment Index (GOHAI). Abutment tooth mobility was assessed, and denture status was determined by clinical assessment of stability, retention, occlusal balance, vertical dimension, and integrity of dentures. The frequency of individuals in each variable was determined for the low and very low GOHAI conditions. Chi-square, Pearson, and stepwise logistic regression tests were used for the statistical analyses (α = 0.05). Results: Ninety wearers of removable dentures with a mean age of 55.1±9.1 years were evaluated. None of the variables was related to GOHAI values (p > 0.05). The regression analysis showed that age predicts (p = 0.006) the variation of GOHAI conditions (OR = 0.924, CI = 0.873- 0.978), showing only 7.6% protective effect against very low GOHAI. Unsatisfactory stability showed the opposite effect (p = 0.034) and the individuals with this characteristic are more likely (OR = 3.055) to have very low GOHAI scores (CI = 1.085- 8.602). Conclusions: The self-perceived oral health of wearers of removable dentures worsens with age and unsatisfactory stability of dentures

Terapia espelho, impacto na recuperação funcional do doente pós AVC: revisão sistemática da literatura / Mirror therapy, impact on the functional recovery of post-stroke patients: a systematic review of the literature

O Acidente Vascular Cerebral (AVC) é uma das principais causas de morte e incapacidade a longo prazo em todo o mundo. A Terapia Espelho (TE) tem sido explorada como uma abordagem de reabilitação para melhorar os défices motores pós- AVC, e assim, contribuir para uma melhor autonomia nas Atividades da Vida Diária (AVD) e qualidade de vida. Objetivo ­ Avaliar o impacto da TE na reabilitação de pacientes pós-AVC, com base na evidência científica, e determinar o nível de recuperação funcional e melhoria na autonomia nas AVD. Métodos ­ Foi realizada uma revisão sistemática da literatura nas bases de dados eletrónicas: Medline via PubMed, ScienceDirect via Elsevier, Cochrane Central Register of Controlled Trials e B-ON (Biblioteca do Conhecimento Online). Os critérios de seleção incluíram artigos publicados nos últimos 10 anos que abordassem a eficácia da TE na reabilitação pós-AVC. Resultados ­ Dos 79,772 artigos identificados inicialmente, 6,026 artigos únicos foram avaliados após remoção de duplicatas. Posteriormente, 226 foram considerados para avaliação mais detalhada, dos quais 26 foram selecionados para análise completa. A maioria destes estudos confirmou que a TE foi eficaz na melhoria da função motora, com impacto positivo nas AVD e qualidade de vida dos pacientes. Contudo, alguns estudos apontam a necessidade de mais investigações com amostras maiores e designs mais rigorosos. Conclusões ­ A TE mostra-se como uma intervenção terapêutica promissora, podendo auxiliar significativamente na recuperação motora de pacientes que sofreram AVC e melhorar a sua autonomia nas atividades diárias.

Stroke is one of the leading causes of death and long-term disability worldwide. Mirror Therapy (MT) has been explored as a rehabilitation approach to improve post-stroke motor deficits, and thus contribute to better autonomy in Activities of Daily Living (ADLs) and quality of life. Objective - To evaluate the impact of MT on the rehabilitation of post-stroke patients, based on scientific evidence, and to determine the level of functional recovery and improvement in autonomy in ADLs. Methods - A systematic literature review was carried out using electronic databases: Medline via PubMed, ScienceDirect via Elsevier, Cochrane Central Register of Controlled Trials and B-ON (Online Knowledge Library). The selection criteria included articles published in the last 10 years that addressed the efficacy of MT in post-stroke rehabilitation. Results - Of the 79,772 articles initially identified, 6,026 unique articles were evaluated after removing duplicates. Subsequently, 226 were considered for further evaluation, of which 26 were selected for full analysis. Most of these studies confirmed that MT was effective in improving motor function, with a positive impact on patients' ADLs and quality of life. However, some studies point to the need for further research with larger samples and more rigorous designs. Conclusions - MT is a promising therapeutic intervention that can significantly aid the motor recovery of stroke patients and improve their autonomy in daily activities.

The Role and Importance of Using Sensor-Based Devices in Medical Rehabilitation: A Literature Review on the New Therapeutic Approaches.

Due to the growth of sensor technology, more affordable integrated circuits, and connectivity technologies, the usage of wearable equipment and sensing devices for monitoring physical activities, whether for wellness, sports monitoring, or medical rehabilitation, has exploded. The current literature review was performed between October 2022 and February 2023 using PubMed, Web of Science, and Scopus in accordance with P.R.I.S.M.A. criteria. The screening phase resulted in the exclusion of 69 articles that did not fit the themes developed in all subchapters of the study, 41 articles that dealt exclusively with rehabilitation and orthopaedics, 28 articles whose abstracts were not visible, and 10 articles that dealt exclusively with other sensor-based devices and not medical ones; the inclusion phase resulted in the inclusion of 111 articles. Patients who utilise sensor-based devices have several advantages due to rehabilitating a missing component, which marks the accomplishment of a fundamental goal within the rehabilitation program. As technology moves faster and faster forward, the field of medical rehabilitation has to adapt to the time we live in by using technology and intelligent devices. This means changing every part of rehabilitation and finding the most valuable and helpful gadgets that can be used to regain lost functions, keep people healthy, or prevent diseases.

Benefícios de um Programa de Reabilitação num doente internado na Unidade de Cuidados Paliativos / Benefits of a Rehabilitation Programme for a patient in the Palliative Care Unit

Os Cuidados Paliativos têm como objetivo principal proporcionar cuidados de saúde abrangentes e humanizados, focados especialmente no alívio do sofrimento de pessoas com doenças graves, avançadas e irreversíveis. Eles visam maximizar, na medida do possível, a qualidade de vida e a dignidade dos doentes. Objetivo: Compreender os benefícios de um programa de reabilitação num doente que recebe cuidados paliativos. Métodos: Na realização do presente estudo, recorreu-se à metodologia estudo de caso. Os dados foram colhidos através do histórico de enfermagem e aplicação de escalas validadas. A intervenção de enfermagem em reabilitação baseou-se na implementação de um programa de reabilitação num doente em situação paliativa, internado na Unidade de Cuidados Paliativos. Resultados: Entre a primeira e as avaliações subsequentes, verificou-se aumento da força nos segmentos articulares avaliados, aumento da independência para a alimentação e autocuidados e redução da dor relacionada com a imobilidade. Conclusão: Os resultados deste estudo de caso, indicam que a reabilitação funcional é uma estratégia que possibilitou a redução do declínio funcional e a melhoria da qualidade de vida da doente submetida à intervenção.

Palliative Care's main objective is to provide comprehensive and humanized healthcare, focused especially on alleviating the suffering of people with serious, advanced and irreversible illnesses. They aim to maximize, as far as possible, the quality of life and dignity of patients. Aim: Understand the benefits of a rehabilitation program for a patient receiving palliative care. Methods: In carrying out the present study, the case study methodology was used. Data were collected through nursing history and application of validated scales. The nursing intervention in rehabilitation was based on the implementation of a rehabilitation program on a patient in a palliative situation, admitted to the Palliative Care Unit. Results: Between the first and subsequent assessments, there was an increase in strength in the joint segments evaluated, an increase in independence in eating and self-care and a reduction in pain related to immobility. Conclusion: The results of this case study indicate that functional rehabilitation is a strategy that made it possible to reduce functional decline and improve the quality of life of the patient undergoing the intervention.

Prevalência da disfagia na pessoa com acidente vascular cerebral na fase aguda / Prevalence of dysphagia in people with stroke in the acute phase

Foi desenvolvido este trabalho no âmbito do mestrado em enfermagem de Reabilitação, sendo que a primeira parte do mesmo diz respeito ao relatório de estágio onde são elencadas as competências obtidas e as experiências vividas. A capacidade de deglutição, enquanto processo fisiológico fundamental da alimentação, irá interferir com todos os aspetos da vida social e de lazer, com grande impacto na qualidade de vida da pessoa que sofreu um acidente vascular cerebral (AVC). Assim, torna-se imperativo perceber se o impacto da disfagia é considerável e deve ser visto como uma questão de grande preocupação por todos os elementos envolvidos na equipa multidisciplinar e, neste caso específico, pelo EEER. Objetivo: Descrever as experiências vividas e as competências obtidas em contexto de estágio e avaliar a prevalência da disfagia em doentes pós acidente vascular cerebral na fase aguda. Métodos: Estudo de coorte retrospetivo utilizando uma base de dados, criada para este efeito, que inclui informação de todos doentes admitidos numa unidade de AVC entre janeiro e março de 2023. Resultados: 64 doentes com diagnóstico de AVC, maioritariamente mulheres, com uma idade média de 71,3 anos, prevalece o AVC isquémico com lesão predominante do hemisfério direito. Na admissão há um maior número de doentes que revelaram deglutição comprometida (53,1%), sendo que destes 12,5% apresentaram disfagia ligeira, 14,1% disfagia moderada e 23,4% disfagia grave. Na alta não houve uma alteração significativa destes valores. No entanto, houve um doente que alterou o grau de disfagia ligeira para sem disfagia e outro que, pelo contrário, de sem disfagia passou para disfagia ligeira. A disfagia grave manteve os mesmos valores (23,4%). A disfagia moderada aumentou os valores (17,2%), uma vez que houve dois doentes que agravaram o status de disfagia ligeira para moderada. Conclusão: Entre o momento da admissão e a alta, nesta amostra, não de verificaram grandes alterações no que diz respeito à gravidade e ao número de doentes com disfagia. Esta monitorização é importante para que se possa trabalhar preventivamente, minimizando as complicações que a disfagia pode espoletar.

This work was developed as part of the Master's program in Rehabilitation Nursing, with the first part of it relating to the internship report, listing the acquired skills and lived experiences. Wallowing capacity, as a fundamental physiological process in feeding, affects all aspects of social and leisure life, significantly impacting the quality of life for individuals who have experienced a stroke. Therefore, it is imperative to understand whether the impact of dysphagia is considerable and should be a matter of great concern for all members of the multidisciplinary team involved, particularly the EEER Aim: To evaluate the prevalence of dysphagia in patients during the acute phase following a stroke. Methods: We conducted a retrospective cohort study utilizing a hospital database specifically created for this purpose, which includes information on all patients admitted to a stroke unit between January and March 2023. Results: The study comprised 64 patients diagnosed with stroke, predominantly females, with an average age of 71,3 years. Ischemic stroke with predominant right hemisphere lesions was the most prevalent type. Upon admission, a higher number of patients (53,1%) exhibited compromised swallowing function, with 12,5% showing mild dysphagia, 14,1% moderate dysphagia, and 23,4% severe dysphagia. There were no significant changes in these values at the time of discharge. However, one patient transitioned from mild dysphagia to no dysphagia, while another patient changed from no dysphagia to mild dysphagia. Severe dysphagia remained constant at 23,4%. Moderate dysphagia increased in prevalence (17,2%) due to two patients whose status worsened from mild to moderate dysphagia Conclusion: In this sample, no significant changes were observed in the severity and number of patients with dysphagia between admission and discharge. Regular monitoring is essential to work preventively and minimize the complications that dysphagia may trigger.

Transição após a lesão medular na fase aguda. Vivência dos processos de eliminação vesical / Transition after spinal cord injury in the acute phase. Experiencing bladder elimination processes

A Lesão Medular é um evento devastador para a pessoa que a vivencia. Pode surgir em qualquer fase do ciclo vital e tem consequências na sua vida pessoal, familiar e social. Manifesta-se por alterações motoras e sensitivas abaixo do nível da lesão e tem repercussões na função gastrointestinal, na sexualidade e na eliminação vesical. Objetivo: Perceber como vivenciam as pessoas com LM na fase aguda, a transição dos processos de eliminação urinária durante o internamento hospitalar. Métodos: Estudo qualitativo com abordagem fenomenológica, através de entrevistas semiestruturadas a dezasseis pessoas com LM que tiveram um internamento em neurocirurgia. A informação transcrita foi validada pelos participantes, organizada e submetida à análise de conteúdo tendo como referência para categorização o modelo conceptual de enfermagem de Afaf Meleis. O tratamento de dados realizou-se com auxílio da ferramenta AtlasTi. Resultados: Dos 16 participantes, 13 apresentavam alterações da sua eliminação vesical. Nas narrativas das vivências, foram identificadas as categorias: Viver uma Transição, Fatores Facilitadores e Inibidores da Transição, Padrões de resposta (indicadores de processo e resultado) e Terapêuticas de Enfermagem. A transição saúde/doença foi vivenciada pelos participantes. A consciencialização, os pontos e eventos críticos, foram propriedades identificadas na transição. A volição, o conhecimento prévio, a família e os recursos da comunidade foram fatores influenciadores da gestão da eliminação vesical. Os indicadores Coping, o Sentir-se Ligado, a Mestria e Reformulação da Identidade, foram facilmente identificados nas narrativas. As Terapêuticas de Enfermagem foram valorizadas pelos participantes, onde a ligação, o suporte emocional dado por estes profissionais e o ensino das técnicas, foram determinantes na gestão dos processos de eliminação vesical. Conclusão: As pessoas com LM no internamento em fase aguda, vivenciam uma transição de saúde/doença em que as terapêuticas de enfermagem e os fatores facilitadores foram as categorias determinantes para uma transição saudável e uma boa gestão da eliminação vesical.

Spinal cord injury is a devastating event for the person who experiences it. It can occur at any stage of life and has consequences for personal, family and social life. It is manifested by motor and sensory alterations below the level of the injury and has repercussions on gastrointestinal function, sexuality and bladder elimination. Aim: Understand how people with SCI experience in the acute phase, the transition of urinary elimination processes during hospitalization. Methods: Qualitative study with a phenomenological approach, through semi- structured interviews with sixteen people with SCI who had been hospitalized in neurosurgery. The transcribed information was submitted to thematic-categorical content analysis, in the light of Afaf Meleis conceptual nursing model, using the content analysis technique and the AtlasTi tool. Results: Of the 16 participants, 13 had alterations to their bladder elimination. In the narratives of the experiences, were identified the following categories: Living a Transition, Transition Facilitating and Inhibiting Factors, Response Patterns (process and outcome indicators) and Nursing Therapies. The health/illness transition was experienced by the participants. Awareness, critical points and events were properties of the transitions manifested. Volition, prior knowledge, family and community resources was facilitating factors of bladder elimination management. Indicators Coping, Feeling Connected, Mastery and Identity Reformulation were easily identified in the narratives. Nursing Therapies were valued by the participants, where the connection, emotional support given by these professionals and the teaching of techniques were decisive in the management of bladder elimination processes. Conclusion: People with SCI in acute hospitalization experience a health/illness transition in which nursing therapies and facilitating factors were the determining categories for a healthy transition and good bladder elimination management.

Efeitos de um programa de reabilitação no doente submetido a artroplastia total da anca ­ revisão scoping / Effects of a rehabilitation programme on patients undergoing total hip arthroplasty - a scoping review

Hoje em dia, a artroplastia total da anca é amplamente utilizada, apresentando-se como um procedimento eficaz, com resultados positivos na qualidade de vida dos pacientes, aumentando a capacidade funcional, diminuindo a dor e melhorando a função coxofemoral, em que as intervenções pós-operatórias são essenciais para o sucesso do procedimento cirúrgico, assumindo-se como responsabilidade direta da equipa de enfermagem, particularmente para a correta mobilização e educação do paciente (Hommel et al., 2019; Silva et al., 2015). Desta forma, o planeamento de um programa de reabilitação deve proporcionar condição de funcionalidade e autonomia, aconselhamento sobre a relação repouso/atividade e reintegração do utente nas suas atividades de vida diária Objetivo: Avaliar os efeitos de um programa de reabilitação no doente submetido o artroplastia total da anca. Métodos: Foi realizada uma revisão scoping, utilizando a base de dados Google Académico, sendo analisados artigos publicados nos últimos 3 anos e que permitissem responder à questão de investigação: Quais os efeitos de um programa de reabilitação no doente submetido a artroplastia total da anca? Após aplicação dos critérios de inclusão foram selecionados 5 estudos para análise. Resultados: Os programas de reabilitação dos estudos selecionados revelaram ganhos significativos no que respeita à força, amplitude articular, capacidade funcional, qualidade de vida, menor risco de queda e ainda menos dias de internamento dos doentes submetidos a artroplastia total da anca. Conclusão: Após a realização da presente revisão scoping pode afirmar- que a realização de um programa de reabilitação após a artroplastia total da anca traz ganhos em saúde para o doente. Dos estudos analisados conseguiu observar-se a efetividade de um plano do EEER, os ganhos na amplitude de movimento, qualidade de vida e capacidade funcional dos doentes submetidos a ATA.

Nowadays, total hip arthroplasty is widely used, presenting itself as an effective procedure, with positive results in the quality of life of patients, increasing functional capacity, decreasing pain and improving coxofemoral function, in which post interventions -operative procedures are essential for the success of the surgical procedure, assuming the direct responsibility of the nursing team, particularly for the correct mobilization and education of the patient (Hommel et al., 2019; Silva et al., 2015). In this way, the planning of a rehabilitation program should provide a condition of functionality and autonomy, advice on the relationship between rest and activity and reintegration of the user in their daily activities. Aim: To evaluate the effects of a rehabilitation program on a patient undergoing total hip arthroplasty. Methods: A scoping review was carried out, using the Google Scholar database, analyzing articles published in the last 3 years and which allowed answering the research question: What are the effects of a rehabilitation program on patients undergoing total hip arthroplasty? After applying the inclusion criteria, 5 studies were selected for analysis. Results: The rehabilitation programs in the selected studies revealed significant gains in terms of strength, range of motion, functional capacity, quality of life, lower risk of falls and even fewer days spent in hospital for patients undergoing total hip arthroplasty. Conclusion: After carrying out this scoping review, it can be stated that carrying out a rehabilitation program after total hip arthroplasty brings health gains for the patient. From the analyzed studies, it was possible to observe the effectiveness of an EEER plan, the gains in range of motion, quality of life and functional capacity of patients undergoing TCA.

The role of collaborative robotics in assistive and rehabilitation applications.

Collaborative robotics principles and advancements may transform the field of assistive and rehabilitation robotics.

Intervenção do enfermeiro especialista em enfermagem de reabilitação na pessoa com afasia após AVC / Intervention by nurses specialising in rehabilitation nursing for people with aphasia after stroke

A afasia é uma alteração cognitiva, caraterizada por alterações da linguagem. Cerca de um 1/3 das pessoas com AVC apresentam afasia, o que resulta na dificuldade na comunicação, exclusão social e diminuição da participação em programas de reabilitação. A avaliação do utente com afasia é o primeiro passo para a intervenção eficaz do Enfermeiro Especialista em Enfermagem de Reabilitação. OBJETIVOS: Caraterizar a população de acordo com as variáveis sociodemográficas e clínicas; Caraterizar a gravidade da afasia na amostra em estudo; Contribuir para a definição de um plano de intervenção do Enfermeiro Especialista em Enfermagem de Reabilitação na pessoa com afasia após AVC. MÉTODOS: Estudo de coorte retrospetivo utilizando uma base de dados hospitalar que inclui informação relativa a variáveis sociodemográficas e clínicas de todos os utentes admitidos numa unidade de AVC em meio hospitalar do norte de Portugal entre os meses de janeiro e março de 2023. Para a avaliação da gravidade da afasia nestes utentes foi aplicada a escala Aphasia Rapid Test. RESULTADOS: Nos 75 utentes incluídos para este estudo, 34 (45,33%) são do género masculino, sendo que 36 (48%) têm idade superior a 73 anos. A afasia foi avaliada em 41 utentes (57,77%) sem história de AVC prévio, representando a nossa amostra. Entre os utentes com afasia, 22 (56,66%) são do género feminino, a média de idades é de 74,34 anos, sendo que 23 dos utentes (56,10%) apresenta idade acima de 73 anos e o diagnóstico de AVC Isquémico foi verificado em 35 (85,37%) dos utentes. Em relação aos dados da escala Aphasia Rapid Test, observou-se que a fluência verbal semântica foi o subteste mais afetado, em 39 (94,12%) dos utentes, seguida da execução de ordens complexas em 27 (65,85%) dos utentes. A disartria foi observada em 24 (58,54%) dos utentes. CONCLUSÃO: A avaliação da gravidade da afasia na pessoa após AVC no momento da admissão fornece um prognóstico sobre a evolução da afasia no utente. O contributo do Enfermeiro Especialista em Enfermagem de Reabilitação na pessoa com afasia após AVC é de extrema importância para estabelecer o diagnóstico e iniciar o mais precocemente um plano de cuidados de enfermagem de reabilitação.

Aphasia is a cognitive alteration characterized by language altera- tions. Approximately one-third of stroke survivors experience aphasia, which leads to difficulties in communication, social exclusion, and decreased participation in rehabilita- tion programs. The assessment of individuals with aphasia is the first step towards effec- tive intervention by the Specialist Nurse in Rehabilitation Nursing. OBJECTIVES: Characterize the population according to sociodemographic and clinical variables; Characterize the severity of aphasia in the study sample; To contribute for the development of a intervention plan by the Specialist Nurse in Rehabilitation Nursing for the individuals with aphasia after stroke. METHODS: A retrospective cohort study using a hospital database which includes so- ciodemographic and clinical information of all patients admitted to a stroke unit in a hos- pital in Northern Portugal between January and March 2023. The Aphasia Rapid Test scale was used to assess the severity of aphasia in these patients. RESULTS: Among the 75 patients included in this study, 34 (45.33%) were male, and 36 (48%) were over 73 years old. Aphasia was evaluated in 41 patients (57.77%) without a previous history of stroke, representing our sample. Among patients with aphasia, 22 (56.66%) were female, with a average age of 74,34 years, and 23 patients (56.10%) were over 73 years old. Ischemic stroke was diagnosed in 35 patients (85.37%). Regarding the Aphasia Rapid Test data, semantic verbal fluency was the most affected subtest in 39 patients (94.12%), followed by the execution of complex commands in 27 patients (65.85%). Dysarthria was observed in 24 patients (58.54%). CONCLUSION: The assessment of aphasia severity in individuals after stroke at the time of admission provides a prognosis regarding the progression of aphasia in the patient. The contribution of the Specialist Nurse in Rehabilitation Nursing for individuals with aphasia after stroke i tis extremely important in establishing the diagnosis and initiating an early rehabilitation nursing care plan.

Influencia de la higiene bucal en el estado de salud de los tejidos periimplantarios / Influence of oral hygiene on peri-implant tissue health status

Introducción: el estado de salud de los tejidos periimplantarios es de vital importancia en el éxito de la rehabilitación implantosoportada, por esta razón, es necesario observar todos aquellos factores que contribuyen a mantener este estado y dentro de ellos, principalmente: la higiene bucal. Objetivo: determinar la influencia de la higiene bucal en el estado de salud de los tejidos periimplantarios. Métodos: se realizó un estudio descriptivo, observacional y transversal en el servicio de Prótesis de la Facultad de Estomatología de Villa Clara, en el período comprendido entre los años 2017 y 2019. El universo de estudio estuvo constituido por 45 pacientes portadores de rehabilitaciones implantosoportadas; las unidades de análisis fueron los implantes y los tejidos que rodean a las 85 prótesis fijas realizadas a dichos pacientes que cumplieron con los criterios de inclusión. Se emplearon la observación clínica y radiográfica, y se elaboró un formulario como instrumento. Se evaluó la higiene bucal y el estado de los tejidos periimplantarios como principales variables. La información obtenida se recopiló en una base de datos, se procesó y se sometió a pruebas de independencia (el estadígrafo Ji cuadrado y su posibilidad asociada) para mostrar la relación entre las variables. Resultados: las variables analizadas evidenciaron una relación significativa de la higiene bucal con el estado de salud de los tejidos periimplantarios a favor de la buena higiene y los tejidos sanos. Conclusiones: la buena higiene bucal evidenciada contribuyó a que los tejidos periimplantarios se mantuvieran sanos.

Introduction: peri-implant tissue health state is of vital importance in the success of implant-supported rehabilitation; for this reason, it is necessary to observe all those factors that contribute to maintaining this state, mainly oral hygiene. Objective: to determine the influence of oral hygiene on peri-implant tissue health status. Methods: a descriptive, observational and cross-sectional study was carried out in the Prosthesis service at the Dental Faculty of Villa Clara between 2017 and 2019. The universe of study consisted of 45 patients with implant-supported rehabilitations; the units of analysis were the implants and the tissues surrounding the 85 fixed prostheses performed on those patients who met the inclusion criteria. Clinical and radiographic observations were used, and a form was developed as an instrument. Oral hygiene and peri-implant tissue state were evaluated as the main variables. The information obtained was compiled in a database as well as processed and subjected to independence tests (the Chi-square statistic and its associated possibility) to show the relationship among the variables. Results: the analyzed variables showed a significant relationship between oral hygiene and the peri-implant tissue health status in favour of good hygiene and healthy tissues. Conclusions: the evidenced good oral hygiene contributed to the maintenance of healthy peri-implant tissues.

Enfermagem de reabilitação no empowerment do doente com insuficiência cardíaca / Rehabilitation nursing in the empowerment of heart failure patients

Introdução: O presente trabalho integra-se no âmbito do Estágio de Natureza profissional do Curso de Mestrado em Enfermagem de Reabilitação da ESS-IPVC e à implementação, de um projeto de investigação no Serviço de Cardiologia/Unidade de Cuidados Intensivos de Cardiologia num hospital da zona Norte. Objetivos: Descrever as atividades desenvolvidas em contexto de estágio, adquirindo e aprimorando as competências comuns e específicas do EEER, com uma componente de investigação, contribuindo para uma prática baseada na evidência. O objetivo geral deste projeto é avaliar o impacto das intervenções do EEER no empowerment do doente com IC, no local de estudo. Metodologia: Foi utilizada uma abordagem metodológica de índole quantitativa, um estudo do tipo observacional descritivo longitudinal. A população do estudo era constituída por 33 doentes que foram submetidos a um plano de cuidados de reabilitação durante o internamento, com educação para a saúde, sobre a doença, o regime terapêutico, os fatores de risco cardiovasculares, os sinais e sintomas, os cuidados a ter e com mudanças no estilo de vida e de hábitos. O instrumento de colheita de dados utilizado foi através da aplicação do questionário a "Escala de Empowerment Individual" (Luz, Bastos, & Vieira, 2020), antes da intervenção do EEER e 20 a 40 dias após a alta hospitalar. Resultados: Foi possível verificar que a capacidade de empowerment dos doentes internados com diagnóstico de IC era baixo. As dimensões em estudo (Autoperceção; Participação nas decisões em saúde; Mestria; Determinação; Identidade; Autonomia e Poder; Relação com os profissionais de saúde) apresentam valores positivos após a intervenção do EEER. Na análise das hipóteses e no impacto das variáveis sociodemográficas e clínicas apenas foram encontradas diferenças estatisticamente significativas na variável da escolaridade. Conclusões: Verificamos que existe evidência estatisticamente significativa para afirmar que a intervenção do EEER melhora o empowerment global dos doentes internados com diagnóstico de IC.

Introduction: The present work is part of the Professional Nature Internship of the Master's Degree in Rehabilitation Nursing of the ESS-IPVC and the implementation of a research project in the Cardiology Service/Cardiology Intensive Care Unit in a hospital in the North zone. Objectives: To describe the activities developed in the context of an internship, acquiring and improving the common and specific competencies of the EEER, with a research component, contributing to an evidence-based practice. The overall objective of this project is to evaluate the impact of EEER interventions on HF patient empowerment at the study site. Methodology: A quantitative methodological approach was used, a longitudinal descriptive observational study. The study population consisted of 33 patients who underwent a rehabilitation care plan during hospitalization, with health education, about the disease, the therapeutic regimen, cardiovascular risk factors, signs and symptoms, care to be taken and changes in lifestyle and habits. The data collection instrument used was through the application of the questionnaire "Individual Empowerment Scale", before the intervention of the EEER and 20 to 40 days after hospital discharge. (Luz, Bastos, & Vieira, 2020) Results: It was possible to verify that the empowerment capacity of hospitalized patients diagnosed with HF was low. The dimensions under study (Self-perception; Participation in health decisions; Mastery; Determination; Identity; Autonomy and Power; Relationship with health professionals) present positive values after the intervention of the EEER. In the analysis of the hypotheses and in the impact of the sociodemographic and clinical variables, only statistically significant differences were found in the schooling variable. Conclusions: We found that there is statistically significant evidence to affirm that the EEER intervention improves the overall empowerment of hospitalized patients diagnosed with HF.