RESUMO
OBJECTIVE: To describe a coordinated interdisciplinary approach to the treatment of functional neurological symptom (conversion) disorder (FNSD), mixed symptoms, including motor dysfunction, in a rehabilitation setting. DESIGN: Adult patient was admitted with worsening neurological symptoms in the absence of contributory clinical pathology. Interdisciplinary diagnostic and treatment approach included physiatry, neuro- and rehabilitation- psychology, occupational, physical, recreational, and speech therapy. Providers coordinated care and delivered psychologically informed therapies consistent with the standards appropriate to the setting. RESULTS: Diagnosis of FNSD was made 5 weeks after admission. The patient achieved symptom remission at 13 weeks after admission. He remained symptom free at 6 months postdischarge. IMPLICATIONS: Rehabilitation settings are uniquely suited to the treatment of FNSD.
Assuntos
Transtorno Conversivo/psicologia , Transtorno Conversivo/reabilitação , Equipe de Assistência ao Paciente , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Ocupacional , Modalidades de Fisioterapia , Psicoterapia , Terapia Recreacional , Fonoterapia , Resultado do TratamentoRESUMO
During the past decade, our understanding of biomechanics and its importance in rehabilitation has advanced significantly. The kinetic chain, a concept borrowed from engineering, has helped us better understand the underlying physiology of human movement. This understanding, in turn, has facilitated the development of new and more rational rehabilitation strategies. The kinetic chain concept has application in a wide spectrum of clinical conditions, including musculoskeletal medicine, sports medicine, and neurorehabilitation, as well as prosthetics and orthotics. The purpose of this review is to provide insights into the biomechanics related to the concept of kinetic chains, with a specific focus on closed kinetic chains and its clinical applications in rehabilitation.