Assessment of Passive Upper Limb Stiffness and Its Function in Post-Stroke Individuals Wearing an Inertial Sensor during the Pendulum Test.

This article proposes the evaluation of the passive movement of the affected elbow during the pendulum test in people with stroke and its correlation with the main clinical scales (Modified Ashworth Scale, Motor Activity Log, and Fulg Meyer). An inertial sensor was attached to the forearm of seven subjects, who then passively flexed and extended the elbow. Joint angles and variables that indicate viscoelastic properties, stiffness (K), damping (B), E1 amp, F1 amp, and relaxation indices were collected. The results show that the FM scale is significantly correlated with the natural frequency (p = 0.024). The MAL amount-of-use score correlates with the natural frequency (p = 0.024). The variables E1 amp, F1 amp, RI, and ERI are not correlated with the clinical scales, but they correlate with each other; the variable E1 amp correlates with F1 amp (p = 0.024) and RI (p = 0.024), while F1 amp correlates with ERI (p = 0.024). There was also a correlation between the natural frequency and K (r = 0.96, p = 0.003). Non-linear results were found for the properties of the elbow joint during the pendulum test, which may be due to the presence of neural and non-neural factors. These results may serve as a reference for future studies if alternative scales do not provide an accurate reflection.

Functional mobility assessment is reliable and correlated with satisfaction, independence and skills.

Mobility is essential for activities of daily living and therapists should give priority to evaluate its effects in their client's performance. We aimed to ascertain the intra- and inter-rater reliability of Functional Mobility Assessment (FMA) and to identify correlations among satisfaction, independence, and skills in 44 users of manual wheelchairs and three users of powered wheelchairs. We analyzed the test-retest and inter-rater reliability of the FMA in a sample of 47 wheelchair users using the Cronbach's Alpha. For correlations with FMA were used the Quebec User Evaluation of Satisfaction with Assistive Technology, Functional Independence Measure, and Wheelchair Skills Test Questionnaire (manual and powered forms). The test-retest reliability showed good internal consistency (α > 0.9). Associations between functional independence, wheelchair skills, and functional mobility were significant (p < .05). The Brazilian version of the FMA is reliable for use among wheelchair users, and its correlation with other measurements suggests cohesion among assessments related to mobility devices.

O novo código de ética para fisioterapeutas incorporou tendências da bioética? / Has the new code of ethics for physiotherapists incorporated bioethical trends? / ¿El nuevo código de ética para los fisioterapeutas ha incorporado las tendencias de la bioética?

Considerando que avanços tecnológicos em saúde geralmente incorporam discussões bioéticas em textos que tratam do cuidado prestado por profissionais, surge a questão: o atual código de ética para fisioterapeutas incorporou essas discussões? Partindo desse ponto, objetivamos verificar a proporção das abordagens deontológicas e bioéticas no novo código de ética em comparação com sua versão anterior, investigando relações entre autonomia profissional e clientes no cuidado em saúde. Aplicaram-se métodos de análise de conteúdo em documentos escritos, a fim de verificar a proporção de conteúdos deontológicos e bioéticos no novo código. Os enfoques bioéticos formam a maior parte do conteúdo desse novo código (53%), principalmente em relação à categoria de justiça (21,9% do total das unidades textuais encontradas). As mudanças no documento revelam influência da bioética, mas não houve alterações significativas na relação entre autonomia profissional e clientes, o que mostra a necessidade de mais discussões sobre o assunto.

Advances in health technology incorporate bioethical discussions in texts that address professional care. Would the new code of ethics for physiotherapists have incorporated such discussions? Given the issue, we aimed to verify the ratio of deontological and bioethical approaches in the new code of ethics when compared to the old one, investigating relationships between professional and client autonomies in healthcare. Content analysis methods were applied to written documents in order to verify in what proportion deontological and bioethical approaches are present in the new code. The bioethical approaches compose the large part of the content in this new code (53%) specially related to the justice category which represents 21,9% of the total textual units found. Changes in the new document reveal bioethical influences in the conception of the new code, which still did not modify the relationship between professional and client autonomies, revealing the need for further discussions.

Los avances tecnológicos en salud incorporan debates bioéticos en textos relacionados con la atención recibida por los profesionales. ¿El actual código de ética para los fisioterapeutas incorporó estas discusiones? Ante esta pregunta, con el objetivo de comprobar proporciones de los enfoques deontológicos y bioéticos en el nuevo código de ética en comparación con su versión anterior, se han investigado las relaciones entre la autonomía profesional versus el cliente en el cuidado de la salud. Métodos de análisis de contenido se aplicaron en los documentos escritos con el fin de verificar la proporción de contenidos categorizados en deontológicos y bioéticos en el nuevo código. Los enfoques bioéticos forman la mayor parte de los contenidos de este nuevo código (53%), principalmente relacionados con la categoría de justicia que constituye el 21,9% de las unidades textuales encontradas. Los cambios en el documento actual revelan influencias bioéticas en el diseño del nuevo código de ética que todavía no cambió la relación de la autonomía profesional frente al cliente, dejando al descubierto la necesidad de nuevas discusiones sobre el tema.

Reliability of muscle strength assessment in chronic post-stroke hemiparesis: a systematic review and meta-analysis.

BACKGROUND: Muscle weakness is the main cause of motor impairment among stroke survivors and is associated with reduced peak muscle torque. OBJECTIVE: To systematically investigate and organize the evidence of the reliability of muscle strength evaluation measures in post-stroke survivors with chronic hemiparesis. DATA SOURCES: Two assessors independently searched four electronic databases in January 2014 (Medline, Scielo, CINAHL, Embase). STUDY SELECTION: Inclusion criteria comprised studies on reliability on muscle strength assessment in adult post-stroke patients with chronic hemiparesis. DATA EXTRACTION: We extracted outcomes from included studies about reliability data, measured by intraclass correlation coefficient (ICC) and/or similar. The meta-analyses were conducted only with isokinetic data. RESULTS: Of 450 articles, eight articles were included for this review. After quality analysis, two studies were considered of high quality. Five different joints were analyzed within the included studies (knee, hip, ankle, shoulder, and elbow). Their reliability results varying from low to very high reliability (ICCs from 0.48 to 0.99). Results of meta-analysis for knee extension varying from high to very high reliability (pooled ICCs from 0.89 to 0.97), for knee flexion varying from high to very high reliability (pooled ICCs from 0.84 to 0.91) and for ankle plantar flexion showed high reliability (pooled ICC = 0.85). CONCLUSION: Objective muscle strength assessment can be reliably used in lower and upper extremities in post-stroke patients with chronic hemiparesis.

Definição de dados essenciais para software que sinalizará condições de desospitalização para a internação no domicílio / Definition of essential data to software which will point out thedehospitalization conditions for home care / Definición de los datos esenciales para el software que señalará lascondiciones de desempeño de los pacientes a la atención domiciliaria

Objetivou-se aplicar formulário para identificação de dados essenciais à gestão da desospitalização com vistas na elaboração de software. Depois de revisados os documentos, um grupo de discussão propôs lista inicial de dados estruturados em formulário para definição de subgrupo de dados essenciais, cuja validade de conteúdo foi definida por profissionais da internação domiciliar no Distrito Federal. O formulário foi então concebido reunindo dois conjuntos de dados iniciais, cuja essencialidade foi definida por escolha ou qualificação. Foram considerados essenciais 15 dos 29 dados para escolha e 27 dos 45 dados para qualificação. Dados essenciais foram aqueles cuja validade de conteúdo foi definida pelos futuros usuários, que estabeleceram os requisitos iniciais para elaboração de um software. Entretanto, um dado importante (procedência) não foi considerado essencial pelo método, o que reforça a necessidade de análise qualitativa no final do processo para a propriada definição da essencialidade e dos requisitos para desenvolvimento do software...

The aim was to apply a form to identify essential data for dehospitalization management, breaking new groundto design software. Documents were used to propose an initial data list by discussion group which elaboratesthe form to define a subset of essential data whose content validity was defined by home care professionalsin the Distrito Federal. The form was then designed in two initial datasets whose essentiality was defined bychoice or qualification. In the form, it was considered essential 15 among 29 chose data and 27 among 45qualification data. The data considered essential had their content validity defined by future users informinginitial requirements for a software. Nevertheless, an important data (origin) was not considered essential bythe applied method, reinforcing the need for qualitative analysis at the end of the process for appropriatedefinition of essentiality and requirements which will give support to software development...

Su objetivo era implementar formulario para identificar datos esenciales a la deshospitalización. Despuésde documentos revisados, un grupo de discusión ha propuesto lista de datos que se ha estructurado en formulariopara definir subconjunto de datos cuya validez fue definida por profesionales de la hospitalizacióndomiciliaria en el Distrito Federal. El formulario está diseñado en dos conjuntos de datos cuya esencialidadha sido definida por elección o calificación. Fueron considerados 15 de 29 concernientes a la elección dedatos y 27 de los 45 datos de calificación. Datos esenciales fueran aquellos cuya validez de contenido hasido definida por los futuros usuarios, los cuales estableceron los requisitos iniciales para el desarrollodel software. Uno dato importante (procedencia), sin embargo, no ha sido esencial por el método, lo quemuestra la necesidad de un análisis cualitativo al final del proceso para obtener una definición apropiadade esencialidad y requisitos para software...