Trastorno del procesamiento sensorial. Una mirada conjunta desde la terapia ocupacional y la otorrinolaringología / Sensory processing disorder. A vision statement from occupational therapy and otolaryngology

Resumen El trastorno del procesamiento sensorial (TPS) es una condición frecuente, pero poco conocida por muchos profesionales de la salud. El procesamiento sensorial se define como la capacidad que posee el sistema nervioso central de interpretar y organizar las sensaciones del propio cuerpo y del ambiente, para su uso efectivo en el entorno mediante respuestas adaptativas. Por lo tanto, cualquier disfunción en el procesamiento (registro, modulación y/o discriminación) de estos estímulos se expresa como una respuesta desadaptativa, siendo significativo cuando esta impacta en la vida diaria del paciente. Es deber del médico sospechar este trastorno, acogiendo al paciente y su familia, derivando oportunamente a terapia ocupacional para su correcta evaluación y eventual manejo de acuerdo con las necesidades de cada paciente.

Abstract Sensory processing disorder (SPD) is an unknown condition for many health care professionals. Sensory processing is defined as the capacity of the central nervous system to interpretate and organize sensations from our own body and from the environment, for their proper use by adaptive responses. Any dysfunction in this processing (registration, modulation and or discrimination) is expressed by a maladaptive response, being considered abnormal when this response has a negative impact in the patient's daily activities. Is our duty as health care workers to suspect this disorder, help our patients and their families by doing a proper referral to an occupational therapist for their evaluation and management, according to each patient needs.

Multidisciplinary protocol for the management of fibromyalgia associated with imbalance. Our experience and literature review

SUMMARY OBJECTIVE We reported our multidisciplinary protocol for the management of fibromyalgia associated with imbalance. Our aim was to verify the effectiveness of a proprioceptive training program as a complementary therapy for a traditional protocol of education, mindfulness, and exercise training for the management of fibromyalgia associated with imbalance. METHODS Retrospective cohort study on 84 women, with primary fibromyalgia associated to imbalance. A group of patients performed traditional exercise training; in a second group the training was supplemented with proprioception exercises. Each session lasted from 40 to 60 minutes and was performed three times a week for 12 weeks. RESULTS After three months of training and eight months after the end of the training, the balance evaluation revealed significant differences in the comparison of the Timed Up and Go test, Berg Balance Scale, and Tinetti scale with the baseline, there was a better improvement in the proprioceptive training group (p<0.05). A reduction in pain and improvement in functional and muscular performance and quality of life were observed in both groups (p<0.05), but with no significant differences between them in the Numeric Pain Rating Scale, Fibromyalgia Impact Questionnaire, and Short Form Health Survey (p>0.05). Fifteen months after the end of the program, the effects of training were not maintained. CONCLUSION The present study revealed that training supplemented with proprioception exercises has beneficial effects on clinical findings and improves balance in patients with fibromyalgia, even if the positive results did not persist after the interruption of the rehabilitative program in the long term.

RESUMO OBJETIVO Relatamos nosso protocolo multidisciplinar para o manejo da fibromialgia associada ao desequilíbrio. Nosso objetivo foi verificar a eficácia do programa de treinamento proprioceptivo como terapia complementar de um protocolo tradicional (exercícios aeróbicos, de resistência e flexibilidade). MÉTODOS Estudo retrospectivo em 84 mulheres com fibromialgia primária associada a desequilíbrio. Um grupo de pacientes realizou o treinamento tradicional; em um segundo grupo o treinamento foi complementado com exercícios de propriocepção. Cada sessão durou de 40 a 60 minutos e foi realizada três vezes por semana durante 12 semanas. RESULTADOS Após três meses de treinamento e oito meses após o término do treinamento, a avaliação do equilíbrio revelou diferenças significativas nos testes Timed Up and Go, Escala de Equilíbrio de Berg e Escala de Tinetti em comparação com a linha de base, com uma melhora maior no grupo de treinamento proprioceptivo (p<0,05). Redução da dor e melhora do desempenho funcional e muscular e da qualidade de vida foram observadas em ambos os grupos (p<0,05), mas sem diferenças significativas entre eles na Escala Numérica de Dor, Fibromyalgia Impact Questionnaire e Short Form Health Survey (p>0,05). Quinze meses após o final do programa, os efeitos do treinamento não foram mantidos. CONCLUSÃO O presente estudo revelou que o treinamento suplementado com exercícios de propriocepção tem efeitos benéficos sobre os achados clínicos e melhora o equilíbrio em pacientes com fibromialgia, mesmo que os resultados positivos não tenham persistido após a interrupção do programa de reabilitação no longo prazo.

Aspectos clínicos e funcionais do equilíbrio corporal em idosos com vertigem posicional paroxística benigna / Clinical and functional aspects of body balance in elderly subjects with benign paroxysmal positional vertigo

Vertigem Posicional Paroxística Benigna (VPPB) pode alterar o equilíbrio corporal em pacientes idosos. OBJETIVO: Observar os efeitos da manobra de Epley em idosos com VPPB, avaliando os aspectos clínicos e funcionais do equilíbrio corporal. Forma de estudo: clínico e prospectivo. MÉTODO: Após o diagnóstico da doença (teste de DixHallpike), os testes Time Up and Go (TUGT), Clinical test of Sensory Interaction and Balance (CTSIB) e o teste de membros inferiores (MMI) foram realizados antes e após a manobra de reposicionamento de Epley modificada. RESULTADOS: O gênero feminino foi o mais prevalente e a média etária foi de 70,10 anos (DP = 7,00). Todos os pacientes apresentaram ductolitíase de canal posterior. Os seguintes sintomas melhoraram após a manobra: a instabilidade postural (p = 0,006), náusea e vômito (p = 0,021) e zumbido (p = 0,003). Em relação ao TUGT e o escore do teste de MMII, observou-se diminuição significante do tempo pós-manobra de Epley (p < 0,001). Observou-se melhora no CTSIB pós-manobra de Epley nas condições 2 (p < 0,003), condição 3 (p < 0,001), condição 4 (p < 0,001), condição 5 (p < 0,001), e condição 6 (p < 0,001). CONCLUSÃO: Houve melhora nos aspectos clínicos e funcionais do equilíbrio corporal em idosos com VPPB após o tratamento com a Manobra de Epley modificada.

Benign paroxysmal positional vertigo (BPPV) may compromise the balance of elderly subjects. OBJECTIVE: To observe the effects of the Epley maneuver in elderly subjects with BPPV and assess clinical and functional aspects of body balance. METHOD: This is a prospective clinical study. Patients diagnosed with BPPV (Dix-Hallpike test) were submitted to the Timed Up & Go (TUG) test, the Clinical Test of Sensory Interaction and Balance (CTSIB), and lower limb testing before and after they were repositioned using the modified Epley maneuver. RESULTS: Most subjects were females, and the group's mean age was 70.10 years (SD = 7.00). All patients had canalithiasis of the posterior canal. The following symptoms improved after the maneuver: postural instability (p = 0.006), nausea and vomiting (p = 0.021), and tinnitus (p = 0.003). Subjects improved their times significantly in the TUG and lower limb tests after the Epley maneuver (p < 0.001). Patients performed better on the CTSIB after the Epley maneuver on condition 2 (p < 0.003), condition 3 (p < 0.001), condition 4 (p < 0.001), condition 5 (p < 0.001), and condition 6 (p < 0.001). CONCLUSION: Clinical and functional aspects of body balance in elderly with BPPV improved after treatment with the modified Epley maneuver.

Effects of the use of MIG3 bioceramics fabrics use - long infrared emitter - in pain, intolerance to cold and periodic limb movements in post-polio syndrome / Efeitos do uso de tecidos com biocerâmica MIG3 - emissora de infravermelho longo - na dor, intolerância ao frio e movimentos periódicos dos membros na síndrome pós-poliomielite

The main post-polio syndrome (PPS) symptoms are new-onset weakness, new-onset atrophy, fatigue, cold intolerance, and pain associated with sleep disturbances. The polysomnographic study is the gold pattern to analyze sleep disorders. OBJECTIVE: To assess pain, intolerance to cold and periodic limb movements (PLM) index before and after the use of MIG3 bioceramic fabrics over 4 weeks. METHOD: 12 patients with PPS from UNIFESP/EPM. All patients were submitted to polysomnography and infra-red examinations with answered scales of pain and intolerance to cold before and after the use of MIG3 bioceramics fabrics. RESULTS: There were significant decreases in pain and PLM index. CONCLUSION: MIG3 bioceramic fabrics can help in the treatment of pain and PLM in PPS patients.

Dentre as manifestações clínicas da SPP destacam-se nova fraqueza, fadiga, dor, intolerância ao frio, nova atrofia e transtornos do sono. A polissonografia de noite inteira permanece sendo padrão ouro para análise do sono e diagnóstico de transtornos do sono. OBJETIVO: Avaliar o comportamento da dor, intolerância ao frio (IF) e índice de movimentos periódicos de membros (PLMs) após uso de colchonete e roupas com biocerâmica MIG3 por 4 semanas. MÉTODO: 12 pacientes com SPP, da UNIFESP/EPM. Todos realizaram exames de polissonografia e infravermelho e responderam a questionários de dor e IF antes e após o uso dos materiais. RESULTADOS: Houve diminuição significativa da dor e dos PLMs. CONCLUSÃO: Os tecidos com biocerâmica MIG3 podem ser um coadjuvante ao tratamento da dor e dos PLMs nos pacientes com SPP.

Las alteraciones del equilibrio en el adulto mayor / Balance disorders in the elderly

Esta comunicación analiza: 1) Los aspectos multifactoriales de la etiología de las alteraciones del equilibrio en el adulto mayor: 2) Los test validados para su evaluación. 3) El abordaje multidisciplinario de su terapéutica y rehabilitación. 4) Se describe el sistema del equilibrio como un sistema de control y el valor de la posturografía para la evaluación y el seguimiento clínico de estos pacientes.

This communication analyze: 1) The multiple factors involved in the etiology of the balance disorders in the elderly population: 2) The validated test for the assessment of this pathology, 3) The description of the balance system as a control system and the value of the posturography for the evaluation and follow up of these patients. 4) The necessary multidisciplinary approach for the treatment and rehabilitation.

Sensory integration disorders: assessment, treatment and preventive procedures

The paper discusses sensory integration theory and practice as it is used in occupational therapy, and as an adjunct to interdisciplinary educational, medical management of the child, and adult who exhibit pervasive or specific developmental disorders, as well as the psychosocial correlates that result from these developmental disorders. The paper defines sensory integration terminology, highlights the contributions of the sensory systems traces its historical roots, its research foundation, as well as its especially designed assessment technology and intervention procedures. Selected cases illustrate the clinical picture of sensory integration disorders