[Home-based rehabilitation in the functional recovery of patients with cerebrovascular disease]. / Rehabilitacion domiciliaria en la recuperacion funcional de los pacientes con enfermedad cerebrovascular.

INTRODUCTION: The study of the effectiveness of rehabilitation treatment applied to patients with sequelae following a cerebrovascular disease (CVD) plays a decisive role nowadays in planning their management in public healthcare and to improve existing guidelines regarding assessment and treatment. AIM: To describe the characteristics presented by patients who have suffered a CVD and were treated in mobile rehabilitation-physiotherapy units (MRPU) and how such treatment affects their functional recovery. PATIENTS AND METHODS: Descriptive, prospective study conducted on 124 patients referred to the MRPUs in the province of Almeria between 2008 and 2011. The variables analysed (both pre- and post-treatment) included personal history and characteristics, Barthel index, Modified Ashworth Spasticity Scale, pain (shoulder) and the Canadian Neurological Scale. RESULTS: The final sample consisted of 106 participants (mean age: 73.72 years). The disabling process was ischaemic in 77.4% and hypertension was the most prevalent risk factor (81%). The mean initial Barthel index was 31.04 and the mean final index was 57.62 (t = -11.75; p < 0.001). The Canadian Neurological Scale showed a favourable progression in the level of consciousness, orientation and language (p < 0.001). Altogether 56.2% of the patients were discharged as a result of the improvement of their condition, and did not require any further outpatient rehabilitation. CONCLUSIONS: The results obtained reflect an important functional improvement in patients treated in the MRPUs. Home-based rehabilitation is considered a necessary tool for persons with greater clinical vulnerability and no access to outpatient care, which provides them with the benefits of effective treatment.

TITLE: Rehabilitacion domiciliaria en la recuperacion funcional de los pacientes con enfermedad cerebrovascular.Introduccion. El estudio de la eficacia en los tratamientos de rehabilitacion aplicados a pacientes con secuelas tras una enfermedad cerebrovascular (ECV) resulta decisivo en la actualidad para planificar su abordaje desde la sanidad publica y mejorar las directrices de evaluacion y tratamiento existentes. Objetivo. Describir las caracteristicas que presentan los pacientes que han sufrido ECV atendidos por las unidades moviles de rehabilitacion-fisioterapia (UMRF) y como influyen estos tratamientos sobre su recuperacion funcional. Pacientes y metodos. Estudio descriptivo prospectivo en 124 pacientes derivados a las UMRF de la provincia de Almeria entre 2008 y 2011. Se analizaron variables (pre y postratamiento) como las caracteristicas y antecedentes personales, indice de Barthel, escala de espasticidad de Ashworth modificada, dolor (hombro) y escala neurologica canadiense. Resultados. La muestra final estuvo compuesta por 106 participantes (edad media: 73,72 años). El proceso discapacitante fue isquemico en un 77,4%, y la hipertension, el factor de riesgo mas prevalente (81%). La media del indice de Barthel inicial fue de 31,04, y la media del indice final, de 57,62 (t = ­11,75; p < 0,001). La escala canadiense mostro una evolucion favorable en el nivel de conciencia, orientacion y lenguaje (p < 0,001). El 56,2% de los pacientes recibio alta por mejoria, sin precisar rehabilitacion ambulatoria adicional. Conclusiones. Los resultados obtenidos reflejan una importante mejora funcional en los pacientes tratados en las UMRF. La rehabilitacion domiciliaria se plantea como una herramienta necesaria para las personas con mayor vulnerabilidad clinica y sin acceso a los cuidados ambulatorios, que logra los beneficios de tratamientos que son efectivos.

Análisis de la actividad en las unidades móviles de rehabilitación-fisioterapia en atención primaria / Analysis of the activity of mobile rehabilitation-physiotherapy units in primary care

ObjetivoDescribir la atención domiciliaria que ofrecen los equipos móviles de rehabilitación-fisioterapia (EMRF) como respuesta a las necesidades de la población dependiente, las características que tiene su aplicación y las consecuencias que produce sobre el paciente y su independencia funcional.DiseñoEstudio descriptivo transversal desde 2004 hasta junio de 2007.EmplazamientoMedio comunitario. Los EMRF de atención primaria en Almería.ParticipantesEn total 1.093 pacientes incluidos en el programa.Mediciones principalesSe recogió sistemáticamente el estado de salud de los pacientes (proceso discapacitante principal, motivos de inclusión en el tratamiento, valoración funcional inicial y final e índice de Barthel), los datos sobre la atención fisioterapéutica y el n.o de sesiones.ResultadosUn 64,2% de la muestra fueron mujeres; la edad media fue de 78 años. El tiempo medio de espera para su valoración fue de 4 días y hubo una gran diversidad de procesos discapacitantes principales que han quedado descritos. Existió un elevado porcentaje de síntomas de grave deterioro motor, dolor y debilidad muscular. El 88,6% de los pacientes realizó tratamiento fisioterapéutico; el 11,1% de los pacientes fisioterapia y tratamiento ocupacional y el 0,3% de los pacientes tratamiento ortésico. El número medio de sesiones fue de 12,85. Se describe la variación en el índice de Barthel final tras la intervención realizada (cinesiterapia [61,9%]; combinada con electroterapia [10,2%]; cinesiterapia y educación al cuidador [14,5%], etc.).ConclusionesSe aporta información valiosa respecto a las características de la población geriátrica y dependiente así como la ayuda fisioterapéutica que viene recibiendo y cómo se lleva a cabo el proceso(AU)

ObjectiveTo describe the home care provided by mobile rehabilitation-physiotherapy teams as a response to the needs of the dependent population, the characteristics of their application, and the results they have on patients and their functional independence.DesignA descriptive, cross-sectional study from 2004 to June 2007.SettingCommunity setting. Mobile rehabilitation-physiotherapy teams from Primary Care in Almeria.ParticipantsA total of 1093 patients were included in the programme.Main measurementsData were collected on, the state of the patients’ health (primary disabling process, reasons for inclusion in the treatment, initial and final functional assessment and Barthel Index); details of physiotherapy treatment, and number of sessions.ResultsOf the total sample, the mean age was 78 years and 64.2% were female. The mean waiting time for their assessment was 4 days and there was a wide variety of primary disabling processes described. There was a high percentage of symptoms of severe motor deterioration, pain and muscle weakness. Physiotherapy treatment was given in 88.6%, physiotherapy and occupational therapy in 11.1%, and orthopaedic treatment in 0.3%, of the patients. The mean number of sessions was 12.85. The variation in the Barthel Index after the final therapy was given was, 61.9% for kinesiotherapy, 10.2% combined with electrotherapy, and 14.5% for kinesiotherapy and carer education.ConclusionsValuable information is provided as regards the characteristics of the geriatric and dependent population, as well as the physiotherapy help they are receiving, and also how the procedure is carried out(AU)

[Analysis of the activity of mobile rehabilitation-physiotherapy units in primary care]. / Análisis de la actividad en las unidades móviles de rehabilitación-fisioterapia en atención primaria.

OBJECTIVE: To describe the home care provided by mobile rehabilitation-physiotherapy teams as a response to the needs of the dependent population, the characteristics of their application, and the results they have on patients and their functional independence. DESIGN: A descriptive, cross-sectional study from 2004 to June 2007. SETTING: Community setting. Mobile rehabilitation-physiotherapy teams from Primary Care in Almeria. PARTICIPANTS: A total of 1093 patients were included in the programme. MAIN MEASUREMENTS: Data were collected on, the state of the patients' health (primary disabling process, reasons for inclusion in the treatment, initial and final functional assessment and Barthel Index); details of physiotherapy treatment, and number of sessions. RESULTS: Of the total sample, the mean age was 78 years and 64.2% were female. The mean waiting time for their assessment was 4 days and there was a wide variety of primary disabling processes described. There was a high percentage of symptoms of severe motor deterioration, pain and muscle weakness. Physiotherapy treatment was given in 88.6%, physiotherapy and occupational therapy in 11.1%, and orthopaedic treatment in 0.3%, of the patients. The mean number of sessions was 12.85. The variation in the Barthel Index after the final therapy was given was, 61.9% for kinesiotherapy, 10.2% combined with electrotherapy, and 14.5% for kinesiotherapy and carer education. CONCLUSIONS: Valuable information is provided as regards the characteristics of the geriatric and dependent population, as well as the physiotherapy help they are receiving, and also how the procedure is carried out.