Influence of manipulative skills on quality of life and activities of daily living in multiple sclerosis. / Influencia de la capacidad manipulativa en la calidad de vida y actividades de la vida diaria en la esclerosis múltiple.

INTRODUCTION: More than 50% of patients diagnosed with multiple sclerosis report problems with manipulative function and impairments in their daily lives due to this disorder. Therefore, the aim of the present study is to determine how pinch strength, prey strength and manipulative dexterity affect the quality of life and personal autonomy of people diagnosed with multiple sclerosis and to study whether there is a difference in these aspects between different types of multiple sclerosis. SUBJECTS AND METHODS: There was a total sample of 126 participants, of which 57 were controls and 69 cases. All of them were assessed with a Multiple Sclerosis Quality of Life-54 test, Nine-Hole Peg Test and Barthel Index. RESULTS: People with multiple sclerosis have worse pinch strength, prey strenght, manipulative dexterity, performance in basic activities of daily living and quality of life (p < 0.001). Prey strength is a conditioning factor for performance and quality of life in people with multiple sclerosis. As for the type of multiple sclerosis, relapsing-remitting multiple sclerosis presented better values (p < 0.001). CONCLUSIONS: The findings of this study point to the fact that patients diagnosed with multiple sclerosis have a decrease in prey strength, pinch strength, manipulative dexterity, quality of life and autonomy in activities of daily living compared to the healthy population.

TITLE: Influencia de la capacidad manipulativa en la calidad de vida y actividades de la vida diaria en la esclerosis múltiple.Introducción. Más de un 50% de los pacientes diagnosticados con esclerosis múltiple (EM) comunican problemas con la función manipulativa e impedimentos en su vida diaria a causa de esta alteración. Por ello, el objetivo del presente estudio es determinar la afectación que la fuerza de pinza, la fuerza de presa y la destreza manipulativa ejercen sobre la calidad de vida y la autonomía personal de las personas diagnosticadas de EM, y estudiar si existe diferencia de estos aspectos entre los distintos tipos de esta enfermedad. Sujetos y métodos. Se contó con una muestra total de 126 participantes, de los cuales 57 fueron controles, y 69, casos. A todos ellos se les evaluó con el Multiple Sclerosis Quality of Life-54, el Nine-Hole Peg Test, la dinamometría de pinza y de presa para la medición de la fuerza, y el índice de Barthel para la evaluación de las actividades básicas de la vida diaria. Resultados. Las personas con EM presentaron peores fuerza de pinza, fuerza de presa, destreza manipulativa, desempeño en actividades básicas de la vida diaria y calidad de vida (p < 0,001). La fuerza de presa es un factor condicionante en el desempeño de actividades básicas y calidad de vida en personas con EM. En cuanto al tipo de EM, el tipo remitente-recurrente presentó mejores valores (p < 0,001). Conclusiones. Los hallazgos de este estudio apuntan a que los pacientes diagnosticados con EM presentan una disminución en la fuerza de pinza, la fuerza de presa, la destreza manipulativa, la calidad de vida y la autonomía en las actividades de la vida diaria en comparación con la población sana.

Descripción de la afectación de la destreza y función manual en pacientes con distonía focal de la mano / Alterations in dexterity and manual function in patients with focal hand dystonia

Introducción: La distonía focal de la mano es un trastorno del movimiento cuya sintomatología produce una alteración en el desempeño de tareas que requieren un nivel de destreza alto. Actualmente no se dispone de un modelo de interpretación de la enfermedad y son escasos los estudios que identifican las dificultades de las personas con distonía al desempeñar las actividades de la vida diaria (AVD). Por todo ello, el objetivo del estudio es describir la destreza manipulativa y su influencia en las AVD de los pacientes con distonía focal de la mano.Material y métodoSe realizó un estudio observacional, transversal, tipo casos y controles. Se reclutaron 24 participantes: 12 pacientes y 12 sujetos control. Los pacientes fueron derivados por el Servicio de Neurología del Hospital Ramón y Cajal. Se obtuvieron datos sociodemográficos y clínicos retrospectivos en el grupo de casos. Posteriormente, se administraron pruebas de evaluación, en el siguiente orden: Nine Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT) y Jebsen-Taylor Test of Hand Function (JTTHF).ResultadosEn la muestra del estudio participaron un total de 24 personas, siete mujeres y 17 hombres, con una media de edad de 50,79 ± 14,40 años. Del total de participantes con distonía focal se observó que, aunque la mitad de la muestra no identificó signos de afectación neuromuscular, ni problemas psicoemocionales, un menor porcentaje de estos pacientes identificaron dificultades asociadas con el hombro derecho (25%) y el estado ansioso (33,3%).ConclusionesLos hallazgos encontrados en el presente trabajo señalan que la distonía focal de la mano afecta a la destreza manipulativa de estos pacientes, presentando una peor ejecución y requiriendo más tiempo para su ejecución. (AU)

Introduction: Focal hand dystonia is a movement disorder whose symptoms cause alterations in the performance of tasks requiring a high level of dexterity. Currently, there is no model for interpreting the disease and few studies have identified the difficulties of patients with dystonia in carrying out activities of daily living (ADL). This study aims to describe manipulative dexterity and its influence on ADLs in patients with focal hand dystonia.Materials and methodsWe performed an observational, cross-sectional, case-control study including 24 participants (12 patients with focal hand dystonia and 12 controls). The patients were referred by the neurology department of Hospital Ramón y Cajal. We gathered sociodemographic data, as well as retrospective clinical data for patients. We subsequently administered evaluation tests, in the following order: Nine-Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT), and Jebsen-Taylor Test of Hand Function (JTTHF).ResultsThe study sample included a total of 24 participants, 7 women and 17 men, with a mean age (standard deviation) of 50.79 (14.40) years. In the patient group, neuromuscular involvement or psycho-emotional problems were not detected in half of cases; smaller numbers of patients presented difficulties associated with the right shoulder (25%) and anxious state (33.3%).ConclusionsOur results indicate that focal hand dystonia affects manipulative dexterity in these patients, who showed poorer performance and required more time to complete the tasks. (AU)

Alterations in dexterity and manual function in patients with focal hand dystonia.

INTRODUCTION: Focal hand dystonia is a movement disorder whose symptoms cause alterations in the performance of tasks requiring a high level of dexterity. Currently, there is no model for interpreting the disease and few studies have identified the difficulties of patients with dystonia in carrying out activities of daily living (ADL). This study aims to describe manipulative dexterity and its influence on ADLs in patients with focal hand dystonia. MATERIALS AND METHODS: We performed an observational, cross-sectional, case-control study including 24 participants (12 patients with focal hand dystonia and 12 controls). The patients were referred by the neurology department of Hospital Ramón y Cajal. We gathered sociodemographic data, as well as retrospective clinical data for patients. We subsequently administered evaluation tests, in the following order: Nine-Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT), and Jebsen-Taylor Test of Hand Function (JTTHF). RESULTS: The study sample included a total of 24 participants, 7 women and 17 men, with a mean age (standard deviation) of 50.79 (14.40) years. In the patient group, neuromuscular involvement or psycho-emotional problems were not detected in half of cases; smaller numbers of patients presented difficulties associated with the right shoulder (25%) and anxious state (33.3%). CONCLUSIONS: Our results indicate that focal hand dystonia affects manipulative dexterity in these patients, who showed poorer performance and required more time to complete the tasks.

Sensibilidad y dolor en distonías focales de la mano / Sensitivity and pain in focal dystonia of the hand

Introducción: Considerando las evidencias acumuladas actualmente es importante estudiar la fisiopatología tanto sensorial como motora de las distonías focales para comprenderlas y mejorar su tratamiento. Por ello, los objetivos del presente estudio son evaluar las aferencias somatosensoriales de los pacientes con distonía focal o segmentaria con afectación del miembro superior, comprobar si se corresponde con la mano de más uso, analizar la tolerancia al dolor y examinar la posible relación con la percepción del dolor en los pacientes con distonía segmentaria de la mano.MétodosSe contó con una muestra total de 24 participantes: 12 pacientes con distonía focal de la mano y 12 sujetos sin distonía. Todos ellos fueron evaluados con un algómetro electrónico (Somedic AB®, Farsta, Suecia), con los monofilamentos de Semmes-Weinstein y con la escala visual analógica.ResultadosLos datos hallados muestran, en la población estudiada, una mayor afectación en la sensibilidad superficial comparada con el grupo control, tanto en la mano dominante como en la no dominante, así como presencia de dolor (p > 0,001). Además, el grupo de distonía focal obtuvo una correlación negativa entre el dolor percibido y en el umbral de tolerancia de dolor a la presión (rho = −0,83; p < 0,001).ConclusionesLas personas con distonía segmentaria de la mano presentan una alteración en la sensibilidad y manifiestan mayor dolor percibido que las personas sin distonía. Se requieren más estudios con una muestra mayor que detecten las implicaciones clínicas y cotidianas, tanto del dolor objetivo como subjetivo. (AU)

Introduction: A growing body of evidence highlights the importance of understanding both the sensory and the motor pathophysiology of focal dystonia in order to improve its treatment. This study aims to evaluate somatosensory afferences in patients with focal or segmental dystonia affecting the upper limbs, to analyse whether the dominant limb is more frequently affected, to analyse pain tolerance, and to examine the potential association with pain perception in patients with hand dystonia.MethodsWe recruited 24 participants: 12 patients with focal hand dystonia and 12 individuals without dystonia. All participants were evaluated with a digital algometer (Somedic SenseLab AB®, Farsta, Sweden), a Semmes-Weinstein monofilament test, and the visual analogue scale for pain.ResultsAccording to our data, patients showed greater impairment in surface sensitivity than controls, both in the dominant and the non-dominant hands, as well as greater presence of pain (P > .001). Furthermore, the dystonia group showed a negative correlation between perceived pain and pressure pain tolerance threshold (rho = −0.83; P < .001).ConclusionsPatients with focal hand dystonia presented alterations in sensitivity and more severe perceived pain than individuals without dystonia. Future studies with larger samples should aim to analyse the clinical implications and everyday impact of both objective and subjective pain. (AU)

Sensitivity and pain in focal dystonia of the hand.

INTRODUCTION: A growing body of evidence highlights the importance of understanding both the sensory and the motor pathophysiology of focal dystonia in order to improve its treatment. This study aims to evaluate somatosensory afferences in patients with focal or segmental dystonia affecting the upper limbs, to analyse whether the dominant limb is more frequently affected, to analyse pain tolerance, and to examine the potential association with pain perception in patients with hand dystonia. METHODS: We recruited 24 participants: 12 patients with focal hand dystonia and 12 individuals without dystonia. All participants were evaluated with a digital algometer (Somedic SenseLab AB®, Farsta, Sweden), a Semmes-Weinstein monofilament test, and the visual analogue scale for pain. RESULTS: According to our data, patients showed greater impairment in surface sensitivity than controls, both in the dominant and the non-dominant hands, as well as greater presence of pain (P > .001). Furthermore, the dystonia group showed a negative correlation between perceived pain and pressure pain tolerance threshold (rho = -0.83; P < .001). CONCLUSIONS: Patients with focal hand dystonia presented alterations in sensitivity and more severe perceived pain than individuals without dystonia. Future studies with larger samples should aim to analyse the clinical implications and everyday impact of both objective and subjective pain.

Alterations in dexterity and manual function in patients with focal hand dystonia. / Descripción de la afectación de la destreza y función manual en pacientes con distonía focal de la mano.

INTRODUCTION: Focal hand dystonia is a movement disorder whose symptoms cause alterations in the performance of tasks requiring a high level of dexterity. Currently, there is no model for interpreting the disease and few studies have identified the difficulties of patients with dystonia in carrying out activities of daily living (ADL). This study aims to describe manipulative dexterity and its influence on ADLs in patients with focal hand dystonia. MATERIALS AND METHODS: We performed an observational, cross-sectional, case-control study including 24 participants (12 patients with focal hand dystonia and 12 controls). The patients were referred by the neurology department of Hospital Ramón y Cajal. We gathered sociodemographic data, as well as retrospective clinical data for patients. We subsequently administered evaluation tests, in the following order: Nine-Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT), and Jebsen-Taylor Test of Hand Function (JTTHF). RESULTS: The study sample included a total of 24 participants, 7 women and 17 men, with a mean age (standard deviation) of 50.79 (14.40) years. In the patient group, neuromuscular involvement or psycho-emotional problems were not detected in half of cases; smaller numbers of patients presented difficulties associated with the right shoulder (25%) and anxious state (33.3%). CONCLUSIONS: Our results indicate that focal hand dystonia affects manipulative dexterity in these patients, who showed poorer performance and required more time to complete the tasks.

Sensitivity and pain in focal dystonia of the hand. / Sensibilidad y dolor en distonías focales de la mano.

INTRODUCTION: A growing body of evidence highlights the importance of understanding both the sensory and the motor pathophysiology of focal dystonia in order to improve its treatment. This study aims to evaluate somatosensory afferences in patients with focal or segmental dystonia affecting the upper limbs, to analyse whether the dominant limb is more frequently affected, to analyse pain tolerance, and to examine the potential association with pain perception in patients with hand dystonia. METHODS: We recruited 24 participants: 12 patients with focal hand dystonia and 12 individuals without dystonia. All participants were evaluated with a digital algometer (Somedic SenseLab AB®, Farsta, Sweden), a Semmes-Weinstein monofilament test, and the visual analogue scale for pain. RESULTS: According to our data, patients showed greater impairment in surface sensitivity than controls, both in the dominant and the non-dominant hands, as well as greater presence of pain (P>.001). Furthermore, the dystonia group showed a negative correlation between perceived pain and pressure pain tolerance threshold (rho=-0.83; P<.001). CONCLUSIONS: Patients with focal hand dystonia presented alterations in sensitivity and more severe perceived pain than individuals without dystonia. Future studies with larger samples should aim to analyse the clinical implications and everyday impact of both objective and subjective pain.

[Efficacy of interventions with video games consoles in stroke patients: a systematic review]. / Eficacia de la intervencion con videoconsolas en pacientes con ictus: revision sistematica.

INTRODUCTION: In recent years video games and games consoles have been developed that are potentially useful in rehabilitation, which has led to studies conducted to evaluate the degree of efficacy of these treatments for people following a stroke. AIM: To analyse the literature available related to the effectiveness of applying video games consoles in the functional recovery of the upper extremities in subjects who have survived a stroke. PATIENTS AND METHODS: A review of the literature was conducted in the CINHAL, Medline, PEDro, PsycArticles, PsycInfo, Science Direct, Scopus and Web of Science databases, using the query terms 'video game', 'stroke', 'hemiplegia', 'upper extremity' and 'hemiparesis'. After applying the eligibility criteria (clinical trials published between 2007 and 2017, whose participants were adults who had suffered a stroke with involvement of the upper extremity and who used video games), the scientific quality of the selected studies was rated by means of the PEDro scale. Eleven valid clinical trials were obtained for the systematic review. RESULTS: The studies that were selected, all of which were quantitative, presented different data and the inferential results indicated different levels of significance between control and experimental groups (82%) or between the different types of treatment (18%). CONCLUSIONS: The use of video games consoles is a useful complement for the conventional rehabilitation of the upper extremities of persons who have survived a stroke, since it increases rehabilitation time and enhances the recovery of motor functioning. Nevertheless, homogeneous intervention protocols need to be implemented in order to standardise the intervention.

TITLE: Eficacia de la intervencion con videoconsolas en pacientes con ictus: revision sistematica.Introduccion. En los ultimos años se han desarrollado videoconsolas y videojuegos que son potencialmente utiles para la rehabilitacion, lo que ha llevado a valorar el grado de eficacia de estos tratamientos para las personas tras un ictus. Objetivo. Analizar la bibliografia disponible relacionada con la efectividad de la aplicacion de videoconsolas en la recuperacion funcional del miembro superior en sujetos supervivientes a un ictus. Pacientes y metodos. Se ha realizado una busqueda bibliografica en las bases de datos CINHAL, Medline, PEDro, PsycArticles, PsycInfo, Science Direct, Scopus y Web of Science, utilizando como terminos de busqueda 'video game', 'stroke', 'hemiplegia', 'upper extremity' y 'hemiparesis'. Aplicados los criterios de inclusion (ensayos clinicos publicados entre 2007 y 2017, cuyos participantes fueron adultos con ictus con afectacion en la extremidad superior y que utilizaron videojuegos), se valoro la calidad cientifica de los estudios seleccionados mediante la escala PEDro. Se han obtenido 11 ensayos clinicos validos para la revision sistematica. Resultados. Las investigaciones, todas ellas cuantitativas, seleccionadas presentan datos diferentes, y los resultados inferenciales indican distontos niveles de significacion entre los grupos control y experimentales (82%) o entre los diferentes tipos de tratamiento (18%). Conclusiones. El uso de las videoconsolas es un complemento eficaz para la rehabilitacion convencional del miembro superior de personas supervivientes a un ictus al incrementar el tiempo de rehabilitacion y potenciar la recuperacion de la funcion motora. No obstante, se requiere la implantacion de protocolos de intervencion homogeneos con el fin de estandarizar la intervencion.

Outcomes of a multicomponent intervention on occupational performance in persons with unilateral acquired brain injury.

Complications after unilateral acquired brain injury (ABI) can affect various areas of expertise causing (depending on the location of the lesion) impairment in occupational performance. The aim of this study was to analyze and compare the concepts of occupational performance and functional independence, both before and after a multicomponent intervention including occupational therapy, in persons with unilateral brain damage. This was a longitudinal quasi-experimental pretest post-test study in a sample of 58 patients with unilateral brain injury (28 with traumatic brain injury and 30 with ischemic stroke). The patients' level of independence was measured using the short version of the International Classification of Functioning, Disability and Health. We also measured quality of performance using the Assessment of Motor and Process Skills. The findings of this study showed that patients with injury in the right hemisphere improved more than those with left hemisphere damage (p<0.001). All the patients with ABI, especially those with right-sided injury, derived benefit from the multicomponent intervention, except in the area of motor skills. More research is needed on the specific techniques that might address such skills.

Disability, quality of life, personality, cognitive and psychological variables associated with fatigue in patients with multiple sclerosis.

OBJECTIVE: To examine the associations between function, quality of life, personality, cognitive and psychological outcomes with fatigue in patients with MS. METHODS: One hundred and eight patients (54% women) with definite MS participated. MS-related fatigue was assessed with the Fatigue Impact Scale (FIS). Demographic and clinical data (weight, height, medication and history of pain), specific disease outcomes (Functional Assessment of Multiple Sclerosis/FAMS), general disease outcomes (Beck Depression Inventory/BDI-II, and Short-Form Health Survey 36/SF-36) and personality (NEO Five-Factor Inventory/NEOFFI) were assessed. Correlation and regression analyses were performed to determine associations between variables. RESULTS: A significant positive correlation existed between the FIS and EDSS (r=0.190; P<0.05). Significant negative correlations between the FIS with specific disease (FAMS mobility: r=-0.333, P<0.01; FAMS symptoms: r=-0.443, P<0.01; FAMS emotional well-being: r=-0.412, P<0.01; FAMS general contentment: r=-0.325, P<. 01; and, FAMS thinking/fatigue: r=-0.706, P<0.01); general disease (all domains SF36: -0.508

Análisis del movimiento de la extremidad superior hemiparética en pacientes con accidente cerebrovascular: estudio piloto / Movement analysis of upper extremity hemiparesis in patients with cerebrovascular disease: a pilot study

Introducción: Consecuentemente a la lesión neurofisiológica, los pacientes con ictus presentan limitaciones motoras principalmente en el hemicuerpo contralateral al hemisferio lesionado. El objetivo de este trabajo es cuantificar las estrategias motoras de compensación que ocurren en la extremidad superior afectada en pacientes con ictus durante la actividad de beber agua de un vaso.Material y métodos: Cuatro pacientes con ictus y cuatro sujetos controles, sin patología y diestros. El análisis del movimiento se realizó usando el sistema VICONmotion System® y el equipo de electromiografía de superficie Aurion ZeroWire®. Se analizaron los movimientos articulares del codo, el hombro y el tórax. Se realizó un análisis cualitativo de la secuencia de activación muscular. Resultados: Se observó una disminución de las amplitudes articulares en el plano sagital del codo y el hombro durante la actividad de beber en el grupo de casos; sin embargo, las amplitudes articulares del tronco y el hombro en el plano frontal fueron mayores con respecto a los sujetos controles. En cuanto a la secuencia de activación muscular, deltoides anterior, medio y posterior, se contrajeron en el grupo de pacientes conjuntamente durante la tarea, mientras que el trapecio superior mantuvo su activación durante toda la actividad. Conclusiones: El análisis cuantitativo del movimiento ofrece información cuantitativa acerca de las estrategias de compensación que realizan los pacientes con ictus, y por tanto, su relevancia clínica es importante (AU)

Introduction: As a result of neurophysiological injury, stroke patients have mobility limitations, mainly on the side of the body contralateral to the lesioned hemisphere. The purpose of this study is to quantify motor compensation strategies in stroke patients during the activity of drinking water from a glass. Material and methods: Four male patient with cerebrovascular disease and four right-handed, healthy male control subjects. The motion analysis was conducted using the Vicon Motion System® and surface electromyography equipment ZeroWire Aurion®. We analysed elbow, shoulder and trunk joint movements and performed a qualitative analysis of the sequence of muscle activation. Results: Trunk, shoulder and elbow movements measured in the stroke patient along the sagittal plane decreased during the drinking from a glass activity, while the movements in the shoulder in the coronal plane and trunk increased. As for the sequence of muscle activation, anterior, middle and posterior deltoid all contracted in the patient group during the task, while the upper trapezius activation remained throughout the activity. Conclusions: Quantitative analysis of movement provides quantitative information on compensation strategies used by stroke patients, and is therefore, clinically relevant (AU)

[Movement analysis of upper extremity hemiparesis in patients with cerebrovascular disease: a pilot study]. / Análisis del movimiento de la extremidad superior hemiparética en pacientes con accidente cerebrovascular: estudio piloto.

INTRODUCTION: As a result of neurophysiological injury, stroke patients have mobility limitations, mainly on the side of the body contralateral to the lesioned hemisphere. The purpose of this study is to quantify motor compensation strategies in stroke patients during the activity of drinking water from a glass. MATERIAL AND METHODS: Four male patient with cerebrovascular disease and four right-handed, healthy male control subjects. The motion analysis was conducted using the Vicon Motion System(®) and surface electromyography equipment ZeroWire Aurion(®). We analysed elbow, shoulder and trunk joint movements and performed a qualitative analysis of the sequence of muscle activation. RESULTS: Trunk, shoulder and elbow movements measured in the stroke patient along the sagittal plane decreased during the drinking from a glass activity, while the movements in the shoulder in the coronal plane and trunk increased. As for the sequence of muscle activation, anterior, middle and posterior deltoid all contracted in the patient group during the task, while the upper trapezius activation remained throughout the activity. CONCLUSIONS: Quantitative analysis of movement provides quantitative information on compensation strategies used by stroke patients, and is therefore, clinically relevant.

Eficacia de un programa intensivo de terapia ocupacional para niños amputados / Efficacy of an intensive occupational therapy programme for amputated children

Objetivo: Analizar si los niños con prótesis mioeléctricas pueden mejorar sus destrezas motoras necesarias para la realización de las actividades de la vida diaria (AVD) de manera independiente. Material y método: Se realizó un programa estructurado de terapia ocupacional, basado en actividades de coordinación motora fina y gruesa, así como un refuerzo constante de las AVD, durante 6 días en 10 niños amputados (4 chicos y 6 chicas) usuarios de prótesis mioeléctricas, con edades comprendidas entre 4-0 años. Se administró el Assessment of Process and Motor Skills (AMPS) para evaluar las destrezas motoras al inicio y al finalizar la estancia en el campamento. Resultados: En la primera valoración y en la segunda obtuvieron respectivamente los siguientes resultados por destrezas: alcanza (2,0-1,4), se inclina (1,8-1,2), manipula (2,1-1,6), coordina (2,3-2,0), mueve (2,1-1,7), posiciona (2,0-1,7), camina (1,2-1,1), transporta (1,7-1,6). Todos los participantes mejoraron en las habilidades referidas a la posición corporal, obtener y sujetar objetos, y movilización de si mismos y de los objetos. Conclusiones: Los programas intensivos de terapia ocupacional en los niños usuarios de prótesis mioeléctricas son eficaces, ya que mejoran la calidad en la realización de las AVD lo que redunda en la mejora de la autoestima y en la calidad de vida de los niños (AU)

Objective: To analyse myoelectric prostheses in amputated children on fulfilling activities of daily life (ADL) independently. Material and method: A structured occupational therapy programme was performed, based on fine and gross motor coordination activities as well as constant reinforcement of ADL for 6 days in 10 amputated children (4 boys and 6 girls) using myoelectric prostheses, aged within 4-0 years. The Assessment of Process and Motor Skills (AMPS) was administered to evaluate motor skills at the start and at the end of stay in the camp. Results: The following results were obtained in the first and the second assessment, by skills, respectively: reaches (2.0-1.4), bends (1.8-1.2), manipulates (2.1-1.6), coordinates (2.3-2.0), moves (2.1-1.7), positions (2.0- 1.7), walks (1.2-1.1), carries (1.7-1.6). All participants improved their skills referring to body position, obtaining and holding objects and moving themselves and objects. Conclusion: Invasive occupational therapy programmes in children using myoelectric prostheses are effective, as they improve quality in fulfilling ADL, leading to an improved self-esteem and quality of life of children (AU)

[The origins of occupational therapy in Spain]. / Origen de la terapia ocupacional en España.

INTRODUCTION: Occupational therapy is a young discipline in many aspects, but since ancient times an important number of reports have appeared in the health sciences literature and in the early days of neurology and psychiatry that can shed light on the origins and the fundamental principles that underlie this profession today. We have gathered examples that show how the philosophy and the clinical practice of the procedures used in occupational therapy stem from the process of humanising medical care. AIMS: After analysing the information currently available to us on the history of the influence of humanism on the development of medicine in Spain, the authors believe they have found enough evidence to identify the precursors of occupational therapy at that point in history. DEVELOPMENT: Our study examines facts that appear to situate the earliest evidence of occupational therapy at the origins of Spanish neurology and psychiatry in the 15th century, and which were later to have such a powerful influence on the birth of certain aspects of Pinel's moral treatment. CONCLUSIONS: If we accept 'moral treatment' as being one of the main forerunners of occupational therapy, and if we take into account that the humanitarian way patients were dealt with in Spanish neurological and psychiatric institutions and hospitals in the 15th century had a notable influence on the principles that regulated that 'moral treatment', then it is reasonable to state that the earliest evidence of occupational therapy is to be found in the development of humanisation within Spanish medical care.

Origen de la terapia ocupacional en España / The origins of occupational therapy in Spain

La terapia ocupacional es una disciplina joven en muchos aspectos, pero desde la Antigüedad existe un notable número de referencias en la literatura de las ciencias de la salud y en los comienzos de la neurología y la psiquiatría, que nos acercan a los orígenes y a los principales fundamentos que hoy en día mueven esta profesión. Se han recogido ejemplos que ilustran que la filosofía y la práctica clínica de la intervención de la terapia ocupacional nace del proceso de humanización de la asistencia médica. Objetivo. Analizando la información que existe sobre la historia de la influencia del humanismo en la evolución de la medicina en España, los autores creen haber encontrado indicios suficientes para situar los orígenes precursores de la terapia ocupacional en ese momento histórico. Desarrollo. Se estudian hechos que parecen localizarlos primeros rastros de la terapia ocupacional en el origen de la neurología y la psiquiatría españolas en el siglo XV, y que han tenido una gran influencia después en el nacimiento de algunos aspectos del tratamiento moral de Pinel. Conclusiones. Si aceptamos que el ‘tratamiento moral’ es uno de los principales antecesores de la terapia ocupacional, y si consideramos que el trato humanitario, dispensado en las instituciones y hospitales neurológicos y psiquiátricos españoles del siglo XV, influyó notablemente en los principios que regulaban el ‘tratamiento moral’, podemos afirmar que en el desarrollo de la humanizaciónen la asistencia médica española se encuentran los primeros esbozos de la terapia ocupacional (AU)

Occupational therapy is a young discipline in many aspects, but since ancient times an important number of reports have appeared in the health sciences literature and in the early days of neurology and psychiatry that can shed light on the origins and the fundamental principles that underlie this profession today. We have gathered examples that show how the philosophy and the clinical practice of the procedures used in occupational therapy stem from the process of humanising medical care. Aims. After analysing the information currently available to us on the history of the influence of humanism on the development of medicine in Spain, the authors believe they have found enough evidence to identify the precursors of occupational therapy at that point in history. Development. Our study examines facts that appear to situate the earliest evidence of occupational therapy at the origins of Spanish neurology and psychiatry in the 15th century, and which were later to have such a powerful influence on the birth of certain aspects of Pinel’s moral treatment. Conclusions. If we accept ‘moral treatment' as being one of the main forerunners of occupational therapy, and if we take into account that the humanitarian way patients were dealt with in Spanish neurological and psychiatric institutions and hospitals in the 15th century had a notable influence on the principles that regulated that ‘moral treatment’, then it is reasonable to state that the earliest evidence of occupational therapy is to be found in the development of humanisation within Spanish medical care (AU)

[Occupational therapy in neurology]. / Terapia ocupacional en Neurología.

AIMS: To review the fundamentals of occupational therapy (OT) and to present its possible contributions in the field of neurological rehabilitation. DEVELOPMENT: As its name suggests, OT is a form of treatment that makes use of occupations. Furthermore, occupation is a purpose itself, since OT seeks to adapt the individual to the occupation and the occupation to the individual. The postulates on which OT rests are: 1. The occupational nature of human beings, 2. Human dignity, and 3. A dual therapeutic approach both focal and global. OT acts not only on the individual but also on the environment surrounding him or her. Neurology is one of the most important fields of application for OT, as patients suffering from neurological illnesses are often limited in their ability to perform activities of daily living. OT attempts to diminish or compensate for cognitive, perceptive or motor deficiencies so that the neurological patient may reach the highest degree of functioning and independence. Although up to now the efficiency of OT has not been evaluated in a systematic way, there are some studies that support its clinical usefulness in certain neurological disorders, such as cerebrovascular diseases, dementias and multiple sclerosis. CONCLUSION: OT can increase the independence and quality of life of neurological patients. New studies are needed to prove the efficacy of OT in different disorders and to analyse its financial implications.

Terapia ocupacional en Neurología / Occupational therapy in Neurology

Objetivo. Revisar los fundamentos de la terapia ocupacional (TO) y dar a conocer sus posibles aportaciones en el ámbito de la rehabilitación neurológica. Desarrollo. La TO es una forma de tratamiento cuyo instrumento es la ocupación. Además, la ocupación es una finalidad en sí misma, ya que la TO busca adaptar el individuo a la ocupación y la ocupación al individuo. Los postulados sobre los que se basa la TO son: 1. La naturaleza ocupacional del hombre, 2. La dignidad humana, y 3. Un abordaje terapéutico dual, tanto focal como global. La TO actúa, no sólo sobre el individuo, sino también sobre su entorno. La Neurología es uno de los campos de aplicación más importantes de la TO, ya que los pacientes con enfermedades neurológicas a menudo sufren limitaciones en la ejecución de las actividades de la vida diaria. La TO trata de disminuir o compensar las deficiencias cognitivas, perceptivas o motoras para que el paciente neurológico alcance el mayor grado posible de funcionalidad y de autonomía. Aunque de momento no se ha evaluado la eficacia de la TO de forma sistemática, existen estudios que avalan su utilidad clínica en algunas afecciones neurológicas, como las enfermedades cerebrovasculares, las demencias y la esclerosis múltiple. Conclusión. La TO puede incrementar la independencia y la calidad de vida de los pacientes neurológicos. Se necesitan nuevos estudios que demuestren la eficacia de la TO en distintas enfermedades y que analicen sus implicaciones económicas (AU)

Terapia ocupacional en los programas de rehabilitación cardíaca / Occupational therapy in the cardiac rehabilitation programs

Las enfermedades cardiovasculares pertenecen al grupo de las enfermedades crónicas, procesos que durante este siglo ocupan los primeros lugares como causa de morbilidad y mortalidad en los países desarrollados; a diferencia de lo que sucede actualmente en los países en desarrollo donde las enfermedades transmisibles siguen constituyendo el mayor problema sanitario. Después de numerosos estudios epidemiológicos acerca de los efectos beneficiosos del ejercicio físico sobre la cardiopatía isquémica, los Programas de Rehabilitación Cardíaca fueron reconocidos y recomendados por la OMS en los años cincuenta. Estos programas consisten en un conjunto de actuaciones multifactoriales cuya finalidad es reducir la mortalidad y la morbilidad. Además, se centran en mejorar la calidad de vida de los pacientes y hacen posible que éstos puedan reincorporarse a la sociedad de una forma más rápida. A diferencia de otros tipos de programas más simples en cuanto a los profesionales que los integran, los programas transdisciplinarios aseguran la eficacia y la continuidad de los pacientes en ellos. En este artículo de revisión nos centramos en el papel significativo que juega la Terapia Ocupacional y en las técnicas terapéuticas que utiliza en cada una de las fases de la Rehabilitación Cardíaca, dirigidas a reconstruir la vida cotidiana del paciente y sus planes de vida (AU)