ABSTRACT
O acidente vascular encefálico (AVE) pode causar dependência nas atividades de vida diária dos indivíduos e, para minimizar esses danos, é fundamental que o acesso aos serviços de reabilitação seja imediato e ininterrupto. OBJETIVO: Investigar o acesso à reabilitação fisioterapêutica de indivíduos após o AVE. MATERIAIS E MÉTODOS: Este estudo trata-se de uma revisão integrativa da literatura, na qual foi realizada uma busca on-line nas bases de dados Scielo, Pubmed, Lilacs, PEDro, Cochrane e Scopus De forma complementar, foram realizadas buscas secundárias nas listas de referências dos estudos analisados. A pesquisa restringiu artigos publicados entre os anos de 2009 a 2019, escritos nos idiomas português, inglês e espanhol, com descritores específicos. No total foram identificados 129 artigos, dos quais 7 foram selecionados para análise nesta revisão após aplicar os critérios de inclusão e exclusão. RESULTADOS: Com base no que foi revelado pela pesquisa, mais da metade dos indivíduos entrevistados não foram encaminhados aos serviços de fisioterapia, sendo que as principais barreiras relatadas foram a dificuldade de acesso físico-financeiro aos serviços e de dar continuidade ao tratamento. Outro dado de destaque é o pequeno percentual de usuários com problemas neurológicos identificados na rede de fisioterapia ambulatorial. CONCLUSÃO: De maneira geral, o acesso a reabilitação fisioterapêutica foi classificado como insuficiente na maioria dos estudos analisados. É nessa perspectiva que se percebe a importância da reorganização dos serviços de saúde, ressaltando a necessidade da inserção do profissional Fisioterapeuta nas Equipes de Saúde da Família.
Stroke can cause dependence on the activities of daily living of individuals and, to minimize these damages, it is essential that access to rehabilitation services be immediate and uninterrupted. OBJECTIVE: To investigate the access to physical therapy rehabilitation of individuals after a stroke. MATERIALS AND METHODS: This study is an integrative literature review, in which an online search was performed in the databases Scielo, Pubmed, Lilacs, PEDro, Cochrane and Scopus In a complementary way, secondary searches were carried out in the lists references of the analyzed studies. The research restricted articles published between the years 2009 to 2019, written in Portuguese, English and Spanish, with specific descriptors. In total, 129 articles were identified, of which 7 were selected for analysis in this review after applying the inclusion and exclusion criteria. RESULTS: Based on what was revealed by the research, more than half of the interviewed individuals were not referred to physiotherapy services, and the main barriers reported were the difficulty of physical and financial access to services and to continue treatment. Another highlight is the small percentage of users with neurological problems identified in the outpatient physiotherapy network. CONCLUSION: In general, access to physical therapy rehabilitation was classified as insufficient in most of the studies analyzed. It is in this perspective that the importance of the reorganization of health services is perceived, emphasizing the need for the insertion of the professional Physiotherapist in the Family Health Teams.
Subject(s)
Stroke , Rehabilitation , Physical Therapy SpecialtyABSTRACT
BACKGROUND: Studies have demonstrated that the combination of Nintendo Wii (NW) with Conventional Exercises (CE) was effective in the rehabilitation of patients with Parkinson's Disease (PD), but there are no studies comparing the effects of this combination on both techniques isolated. OBJECTIVE: To investigate if the effects of the combination of NW to CE are superior to isolated techniques in the rehabilitation of balance, gait, functional mobility and improvement of the quality of life of individuals with PD. METHODS: 45 patients with PD were divided into three groups, NW alone, CE alone and NW plus EC. The sessions occurred for 50 minutes, twice a week and evaluations administered before and after the 2-month intervention. RESULTS: Significant differences were found in the pre and post intervention analyzes of all the outcomes in the three groups, but there was no difference between the groups. The effect size was evaluated, in which the NW plus CE group had a greater magnitude of the therapeutic effect. CONCLUSION: The NW plus CE was statistically as effective as each intervention alone in the rehabilitation of patients with PD, however, the use of this combination provided a magnitude of the therapeutic effect superior to the other groups.
Subject(s)
Exercise Therapy/methods , Neurological Rehabilitation/methods , Parkinson Disease/rehabilitation , Play Therapy/methods , Video Games , Aged , Female , Gait , Humans , Male , Middle Aged , Postural Balance , Quality of Life , Single-Blind MethodABSTRACT
Background. Motor imagery (MI) consists of the mental simulation of repetitive movements with the intention of promoting the learning of a motor skill. It seems to be an additional useful tool for motor-based therapy to potentiate the rehabilitation of the upper limb function of post-stroke individuals. Objective. To investigate whether MI combined with motor-based therapy is effective in recovering motor deficits of upper limbs from post-stroke individuals. Method. A systematic review of the literature was performed in the PEDro, LILACS, Cochrane, SCOPUS, Medline/PubMed and SciELO databases. Randomized controlled trials (RCTs) investigating the efficacy of MI associated with motor-based therapy compared with isolated motor-based therapy were included. The included outcomes were gross motor function and functional activities of the upper limb of post-stroke individuals. The physiotherapy evidence database scale was applied for evaluation of methodological quality. Results. Four RCTs were included, with a total of 104 participants, with methodological quality varying from moderate to high. There was a statistically significant improvement in upper limb motor function in all studies. Gross motor function was higher in MI associated with motor-based therapy compared to controls, but only in one study there was superiority in the results of functional activities of the upper limb. Conclusion. There is evidence showing that MI associated with motor-based therapy is an effective tool in improving the motor function of upper limbs of post-stroke individuals. However, more studies are needed to establish criteria for frequency and duration of intervention, and what better type of MI should be used.
Subject(s)
Imagery, Psychotherapy/methods , Recovery of Function , Stroke Rehabilitation/methods , Upper Extremity , Humans , Motor Skills , Movement , Physical Therapy ModalitiesABSTRACT
OBJECTIVE: To evaluate in the follow-up the sensory-motor recovery and quality of life patients 2 months after completion of the Nintendo Wii console intervention and determine whether learning retention was obtained through the technique. METHODS: Five hemiplegics patients participated in the study, of whom 3 were male with an average age of 54.8 years (SD = 4.6). Everyone practiced Nintendo Wii therapy for 2 months (50 minutes/day, 2 times/week, during 16 sessions). Each session lasting 60 minutes, under a protocol in which only the games played were changed, plus 10 minutes of stretching. In the first session, tennis and hula hoop games were used; in the second session, football (soccer) and boxing were used. For the evaluation, the Fulg-Meyer and Short Form Health Survey 36 (SF-36) scales were utilized. The patients were immediately evaluated upon the conclusion of the intervention and 2 months after the second evaluation (follow-up). RESULTS: Values for the upper limb motor function sub-items and total score in the Fugl-Meyer scale evaluation and functional capacity in the SF-36 questionnaire were sustained, indicating a possible maintenance of the therapeutic effects. CONCLUSION: The results suggest that after Nintendo Wii therapy, patients had motor learning retention, achieving a sustained benefit through the technique.
