RESUMO
Introducción. El 01 marzo de 2022 y con la presencia la subsecretaria de Salud Pública se llevó a cabo la oficialización del Plan Nacional de Rehabilitación 2021-2030 del Departamento de Rehabilitación y Discapacidad del Ministerio de Salud de Chile (MINSAL). Mediante esta iniciativa, el MINSAL buscó proporcionar una guía para la organización de los servicios de rehabilitación en toda la red asistencial a través de la regulación y administración de "Servicios de Medicina Física y Rehabilitación", desconociendo otras formas de organización y las intervenciones orientadas hacia la recuperación funcional de los usuarios realizadas por los profesionales de salud que no están integrados en dichos servicios. Ante las protestas de nuestro gremio, el ministerio decidió someter a consulta pública el mencionado documento. En este artículo se deja de manifiesto la visión parcial de conceptos respecto de discapacidad, rehabilitación e inclusión y se señalan algunas imprecisiones contenidas en este documento. Además, resulta evidente el marcado enfoque biomédico del plan propuesto, que se centra en el médico fisiatra, sin reconocer otras formas de organización por parte de los profesionales del equipo multidisciplinario en rehabilitación, especialmente los kinesiólogos. Finalmente, en opinión de los autores, la implementación de una política pública como la que se pretende imponer con el plan nacional, podría generar nuevas barreras de acceso a los servicios profesionales de los miembros del equipo de rehabilitación, en vez de organizar adecuadamente los recursos ya existentes en la red pública.
Introduction. On March 1, 2022, in the presence of the Sub-secretary of Public Health, the official launch of the National Rehabilitation Plan 2021-2030 was held by the Department of Rehabilitation and Disability of the Ministry of Health of Chile (MINSAL). Through this initiative, MINSAL aimed to guide the organization of rehabilitation services throughout the healthcare network, through the regulation and administration of "Physical Medicine and Rehabilitation Services," disregarding other forms of organization and interventions focused on the functional recovery of users carried out by healthcare professionals who are not integrated into these services. In response to the protests from our professional community, the ministry has decided to subject the mentioned document to public consultation. This article highlights the partial understanding of concepts related to disability, rehabilitation, and inclusion, and identifies certain inaccuracies contained in this document. Furthermore, the pronounced biomedical approach of the proposed plan is evident, focuses on physiatrists, neglecting to recognize other forms of organization by professionals in the multidisciplinary rehabilitation team, particularly physical therapists. Finally, in the authors' opinion, the implementation of a public policy such as the one intended to be imposed with the national plan may create new barriers to accessing professional services provided by members of the rehabilitation team, instead of adequately organizing the existing resources in the public network.
RESUMO
BACKGROUND: A low hand grip strength is a prognostic factor both in healthy people and hospitalized subjects. Local normal hand grip strength values are needed to define cutoff points of abnormality. AIM: To measure handgrip strength in Chilean people aged 20 to 70 years and propose normal values for healthy people in this age range. MATERIAL AND METHODS: Handgrip strength was measured using a JAMAR hydraulic dynamometer in 436 males and 465 females aged 20 to 70 years and who were free of disease. They were recruited from waiting rooms in several public and private hospitals and outpatient clinics, under self-evaluation of inclusion criteria. RESULTS: The variability of the handgrip strength in women was smaller in than men. Tables containing handgrip strength values by age and sex and the ranges between three standard deviations were prepared. CONCLUSIONS: This study contributes with normal handgrip strength values in Chile to be used for the diagnosis and management of various conditions, such sarcopenia, obesity, oncological patients, Intensive Care Unit acquired weakness (ICU-aw) and weaning of mechanical ventilation.
Assuntos
Força da Mão/fisiologia , Adulto , Fatores Etários , Idoso , Chile , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Dinamômetro de Força Muscular , Padrões de Referência , Valores de Referência , Fatores Sexuais , Estatísticas não Paramétricas , Adulto JovemRESUMO
Background: A low hand grip strength is a prognostic factor both in healthy people and hospitalized subjects. Local normal hand grip strength values are needed to define cutoff points of abnormality. Aim: To measure handgrip strength in Chilean people aged 20 to 70 years and propose normal values for healthy people in this age range. Material and Methods: Handgrip strength was measured using a JAMAR hydraulic dynamometer in 436 males and 465 females aged 20 to 70 years and who were free of disease. They were recruited from waiting rooms in several public and private hospitals and outpatient clinics, under self-evaluation of inclusion criteria. Results: The variability of the handgrip strength in women was smaller in than men. Tables containing handgrip strength values by age and sex and the ranges between three standard deviations were prepared. Conclusions: This study contributes with normal handgrip strength values in Chile to be used for the diagnosis and management of various conditions, such sarcopenia, obesity, oncological patients, Intensive Care Unit acquired weakness (ICU-aw) and weaning of mechanical ventilation.
