Instrumentos de avaliação do ajuste psicossocial à amputação, uso e satisfação com a prótese: uma revisão sistemática da literatura / Instruments for evaluation of psychosocial adjustment to amputation, use and satisfaction with the prosthesis: a systematic review of literature

O ajuste à amputação envolve tanto questões físicas quanto psicossociais e a satisfação com o membro artificial. Objetivo: Revisar sistematicamente a literatura acerca dos instrumentos que avaliam o ajuste psicossocial à amputação e uso da prótese e a satisfação com a prótese em pessoas com amputação de membro inferior. Métodos: Fonte de dados: Medline via Pubmed, Web of Science e Scopus. Critérios de elegibilidade: estudos originais que utilizaram questionários para avaliar o ajustamento psicossocial a amputação e uso da prótese e a satisfação com a prótese. Participantes: pessoas com amputação de membro inferior. Métodos de avaliação e síntese dos estudos: todas as análises foram realizadas por três avaliadores, de forma independente, sendo os resultados apresentados de forma descritiva, em tabelas. Resultados: Foram encontrados 239 artigos na busca inicial, sendo incluídos 12 artigos ao final da revisão. Nestes, foram identificados 14 questionários que avaliam o ajuste psicossocial e a satisfação com a prótese, porém, somente 5 são validados especificamente para a população amputada. Conclusão: A Trinity Amputation and Prosthesis Experience Scale (TAPES) e o Prosthesis Evaluation Questionnaire (PEQ) são os instrumentos mais utilizados, sendo sempre importante uma seleção criteriosa dos instrumentos a serem utilizados nas pesquisas e intervenções a fim de se obter dados válidos, confiáveis e comparáveis. Número de registro da revisão sistemática: CRD42019097279

The adjustment to amputation involves physical and psychosocial issues and the satisfaction with the artificial limb. Objective: To systematically review the literature about the instruments that assess psychosocial adjustment to amputation and use of the prosthesis and satisfaction with the prosthesis in people with lower limb amputation. Methods: Data sources: Medline via Pubmed, Web of Science and Scopus. Study eligibility criteria: Original studies that using questionnaires to evaluated the psychosocial adjustment to amputation and prosthesis use and about prosthesis satisfaction. Participants: people with lower limb amputation. Study appraisal and synthesis methods: all analyzes were performed independently by three evaluators, and the results were presented descriptively, in tables. Results: Were found 239 articles in the initial search, with 12 articles included at the end of the review. In these, 16 questionnaires were identified that assess the psychosocial adjustment and satisfaction with the prosthesis, however, only five are validated specifically for the amputated population. Conclusion: The Trinity Amputation and Prosthesis Experience Scale (TAPES) and the Prosthesis Evaluation Questionnaire (PEQ) are the most used instruments, being always important to carefully select the instruments to be used in research and interventions in order to obtain valid, reliable and comparable data. Systematic review registration number: CRD42019097279

Efeitos de um programa de exercícios físicos baseado no método Pilates solo sobre a atividade física, capacidade locomotora e qualidade de vida em homens com amputação de membro inferior / Effects of a physical exercise program based on the soil Pilates method on physical activity, locomotor capacity and quality of life in men with lower limb amputation

Objetivo: Avaliar os efeitos de um programa de exercícios físicos de 12 semanas baseado no método Pilates Solo sobre atividade física, equilíbrio, capacidade locomotora e qualidade de vida em homens com amputação unilateral de membro inferior. Método: Participaram do estudo 14 pessoas com amputação unilateral de membro inferior, divididos em 2 grupos: Grupo Intervenção ­ GI (participantes expostos ao protocolo de exercícios baseados no método Pilates Solo) e Grupo Controle ­ GC (participantes não expostos ao protocolo de exercícios baseados no método Pilates Solo). Foram aplicados os seguintes instrumentos: a) ficha para caracterização dos participantes; b) Physical Activity Scale for Individuals with Physical Disabilities (PASIPD); c) Escala de Equilíbrio de Berg; d) Medida Funcional para Amputados (MFA); e e) Short Form Health Survey (SF-36). Os dados foram analisados por meio da estatística descritiva e inferencial sendo considerados significativos os resultados com p menor ou igual a 0,05. Resultados: Com base nas análises foi possível observar diferença significativa no equilíbrio após o período experimental (p=0,008), a favor do grupo intervenção. Além disso, pode-se observar diferença significativa na média do grupo intervenção para equilíbrio e para aspectos físicos na qualidade de vida (SF-36), assim como o d de Cohen mostrou efeitos de grande magnitude sobre essas variáveis. Conclusão: Logo, os resultados apresentam efeitos positivos na prática do programa de exercícios físicos sobre o equilíbrio dinâmico e estático e na qualidade de vida de pessoas amputadas.

Objective: Evaluate the effects of a twelve week physical exercise program based on the Pilates Solo method about physical activity, balance, locomotor capacity, and quality of life in men with unilateral lower limb amputation. Method: The study included 14 people with unilateral lower limb amputation, divided in two groups: Intervention Group - IG (participants exposed to the exercise protocol based on the Pilates Solo method) and Control Group - CG (participants that were not exposed to the exercise protocol based on the Pilates Solo method). The following instruments were applied: a) form to characterize the participants; b) Physical Activity Scale for Individuals with Physical Disabilities (PASIPD); c) Berg's Balance Scale; d) Amputee Functional Measure; and e) Short Form Health Survey (SF-36). The data were analyzed using descriptive and inferential statistics, with results with p less than or equal to 0.05 being considered significant. Results: Based on the analysis, it was possible to observe a significant difference in balance after the experimental period (p=0.008), in favor of the intervention group. In addition, a significant difference can be observed in the mean of the intervention group for balance and for physical aspects of quality of life (SF-36), as well as Cohen's d showed effects of great magnitude on these variables. Conclusion: Therefore, the results show positive effects in the practice of the physical exercise program on the dynamic and static balance and on the quality of life of amputees.

Physical Activity Among People With Lower Limb Amputation in Brazil.

BACKGROUND: Limb loss affects quality of life, well-being, and autonomy. The World Health Organization has launched a global action plan to reduce physical inactivity and presented recommendations of physical activity for people living with disability. Knowledge of the characteristics of people with lower limb amputation regarding physical activity is important. Thus, the aim of this study was to identify the quantity and type of physical activity done by people with lower limb amputation. METHODS: The sample (N = 149) included adults aged 53.08 (17.24) years old with lower limb loss. Data collection was performed through the application of a sociodemographic, behavioral, and clinical data sheet and the Brazilian version of the Physical Activity Scale for Individuals with Physical Disabilities. RESULTS: The total Physical Activity Scale for Individuals with Physical Disabilities score was between 0 and 65.79 metabolic equivalents of task per hour per day, which suggests low practice of physical activities. The most frequently practiced activities (79.9%) were those that involved stationary behavior. Women carried out more domestic activities, and subjects who used lower limb prosthesis and those with traumatic amputation reported higher practice of physical activity. CONCLUSIONS: People living with lower limb amputation, from different regions of Brazil, have low levels of physical activity and mainly carry out activities of stationary behavior.

Validade e confiabilidade da versão brasileira da Trinity Amputation and Prosthesis Experience Scales - Revised (TAPES-R) / Validity and reliability of the brazilian version of Trinity Amputation and Prosthesis Experience Scales ­ Revised (TAPES-R)

Objetivo: Avaliar a validade e confiabilidade da versão brasileira da TAPES-R em uma população com amputação de membro inferior. Método: Participaram deste estudo transversal 102 pessoas com amputação de membro inferior, usuárias de prótese. Foram avaliadas as propriedades psicométricas (validade concorrente, grau de concordância (Índice de Kappa) e confiabilidade (ICC) intra e interobservador, além da consistência interna dos itens pelo alfa de Cronbach) da versão brasileira da TAPES-R. Para avaliação da validade concorrente foi utilizado o Prosthesis Evaluation Questionnaire (PEQ). Resultados: A TAPES-R se correlacionou com o PEQ, com exceção das subescalas de ajuste social e geral. O ICC interobservador variou de 0,38 a 0,88 na parte 1 e de 0,27 a 0,88 na parte 2, já o ICC intraobservador variou de 0,63 a 0,83 na parte 1 e de 0,27 a 0,79 na parte 2. O índice de Kappa variou de 0,18 a 0,66 na análise interobservador e de 0,25 a 0,69 na análise intraobservador. O Alfa de Cronbach variou de 0,75 a 0,89. Conclusão: A avaliação das propriedades psicométricas permite concluir que a TAPES-R é válida, confiável e apresenta uma boa consistência interna para ser aplicada em adultos brasileiros amputados de membro inferior.

Objective: Evaluate the validity and reliability of the Brazilian version of TAPES-R in people with lower limb amputation. Method: 102 people with lower limb amputation who used a prosthesis participated in this cross-sectional study. The psychometric properties (concurrent validity, degree of agreement (Kappa Index) and intra and interobserver reliability (ICC), in addition to the internal consistency of the items by Cronbach's alpha) of the Brazilian version of TAPES-R were evaluated. To assess concurrent validity, the Prosthesis Evaluation Questionnaire (PEQ) was used. Results: TAPES-R was correlated with PEQ, except for the subscales of social and general adjustment. The inter-observer ICC ranged from 0.38 to 0.88 in part 1 and from 0.27 to 0.88 in part 2, whereas the intra-observer ICC ranged from 0.63 to 0.83 in part 1 and 0.27 to 0.79 in part 2. The Kappa index varied from 0.18 to 0.66 in the inter-observer analysis and from 0.25 to 0.69 in the intra-observer analysis. Cronbach's alpha ranged from 0.75 to 0.89. Conclusion: The evaluation of psychometric properties allows us to verify that a TAPES-R is valid, reliable and has a good internal consistency to be applied to Brazilian adults with lower limb amputations.

Semantic equivalence in Brazilian Portuguese translation of the Trinity Amputation and Prosthesis Experience Scales-Revised.

BACKGROUND: The Trinity Amputation and Prosthesis Experience Scales-Revised assesses adjustment to amputation and to using a prosthesis and considers psychosocial adjustment, activity restriction, satisfaction with the prosthesis, and other aspects related to health and physical activities, including residual and phantom limb pain. OBJECTIVES: The aim of this study was to assess the semantic equivalence of the Trinity Amputation and Prosthesis Experience Scales-Revised when translated into Brazilian Portuguese. STUDY DESIGN: Qualitative study. METHODS: The process was conducted in five stages: translation of the questionnaire into Brazilian Portuguese; development of a first consensual version in Brazilian Portuguese; appraisal of the translation by an expert committee; back-translation; and semantics assessment of the instrument. For semantic evaluation, the translated and adapted Brazilian Portuguese versions were applied to a convenience sample of 10 individuals. RESULTS: The translated instrument showed a high degree of comprehension within the target population, as it was observed all questions from Part I and II were score 4 or higher on an Ordinal Scale ranging from 0 to 5. CONCLUSION: The Brazilian version of Trinity Amputation and Prosthesis Experience Scales-Revised has a satisfactory verbal comprehension and is now ready for assessment of its psychometric properties. CLINICAL RELEVANCE: The process of semantic evaluation of the Brazilian version of the Trinity Amputation and Prosthesis Experience Scales-Revised makes available to health professionals and researchers who work with people with amputations initial information on cross-cultural adaptation and degree of comprehension of this scale.

Psychosocial and physical adjustments and prosthesis satisfaction in amputees: a systematic review of observational studies.

Background: Adjustment to amputation is a complex process because it encompasses physical and psychosocial aspects as well as satisfaction with the artificial limb.Purpose: To review the scientific production on psychosocial and physical adjustments to amputation and prosthesis use as well as prosthetic satisfaction in people with lower limb amputation in the last 10 years.Methods: This review was conducted on the MEDLINE via Pubmed, Web of Science and Scopus databases. Original and observational studies published in the last 10 years were included, with topics related to adjustment to amputation and prosthesis use as well as prosthetic satisfaction in people with lower limb amputations.Results: A total of 1042 articles were identified in the initial search, but after analysing the criteria 16 articles were used for analysis in their entirety. Regarding psychosocial adjustments, higher rates of depression, anxiety and body image disorders were observed among people with amputations. Phantom and residual limb pain, gender, employment status and daily hours of prosthesis use may influence psychosocial adjustment. Physical adjustment may be influenced by the level of amputation, educational background, age, daily prosthesis use, ambulatory assistive devices and presence of comorbidities. The areas of greatest prosthetic dissatisfaction were colour and weight.Conclusion: Considering that most of the studies related to the satisfaction and adjustment of the prosthesis are cross-sectional studies, longitudinal studies should be conducted, since monitoring individuals over the years and verifying how these variables change over time may contribute to obtaining more data on the factors that influence prosthetic fitting and satisfaction.Implications for rehabilitationAdjustment to amputation and prosthesis use involves both physical and psychosocial issues, it is important that besides physical rehabilitation, psychological interventions and education and communication activities between the patient and the health professionals are carried out.The adaptation to the prosthesis and the recovery of walking capacity are important goals in the rehabilitation process and the knowledge of the physical and psychosocial factors associated with amputation and the use of the prosthesis can help the health team to provide better care to these subjects.Well-adjusted, comfortable and easy-to-use prostheses are of great importance as they enable the patient to perform their daily activities and maintain their independence.It is important to encourage the participation of the individual in both rehabilitation and choice of prosthesis.

Satisfação e ajuste à prótese de indivíduos com amputação de membro inferior / Satisfaction and adjustment to the prosthesis of individuals with lower limb amputation

OBJETIVOS: Avaliar a satisfação e o ajuste à prótese de indivíduos com amputação de membro inferior. MÉTODOS: Participaram 24 indivíduos com amputação de membro inferior com 46,1±17,5 anos e que utilizam prótese há 10,8±8,7 anos. Foi utilizada uma ficha para caracterização dos indivíduos e o questionário Prosthesis Evaluation Questionnaire (PEQ) para avaliar a satisfação e o ajuste à prótese. Os dados foram coletados em instituições que atendem pessoas amputadas nos estados do Rio Grande do Sul e Santa Catarina e analisados pela estatística descritiva e inferencial com nível de significância de 5%. RESULTADOS: Não houve diferença significativa nos resultados do PEQ entre os indivíduos quando comparados em relação ao nível de amputação e ao tempo que utilizam a prótese. Em relação aos escores obtidos entre os grupos com amputação vascular e traumática, houve diferença significativa na subescala de saúde do membro residual, com maiores escores e consequente melhor saúde do membro residual nos indivíduos com amputação de causa vascular, além de melhores escores na escala de satisfação nestes indivíduos. CONCLUSÕES: Foi possível concluir que indivíduos com amputação de causa vascular são mais satisfeitos com sua prótese, com a maneira como andam e como as coisas estão desde a amputação e também possuem melhor saúde do membro residual em relação a indivíduos com amputação traumática. Porém, o nível e o tempo de amputação parecem não influenciar na satisfação e no ajuste à prótese.

AIMS: Evaluate satisfaction and adjustment to the prosthesis of individuals with lower limb amputation. METHODS: Participants were 24 patients with lower limb amputation with 46,1±17,5 years and using the prosthesis for 10,8±8,7 years. A card was used to characterize the individuals and the Prosthesis Evaluation Questionnaire (PEQ) to evaluate satisfaction and adjustment to the prosthesis. Data were collected from institutions that serving amputees in the states of Rio Grande do Sul and Santa Catarina and analyzed by descriptive and inferential statistics at a 5% significance level. RESULTS: There was no significant difference in the results of the PEQ between individuals when compared to the level of amputation and time using the prosthesis. Regarding the scores between groups with vascular and traumatic amputation, was a significant difference in residual limb health subscale, with higher scores and consequently better health of the residual limb in amputees with vascular causes, besides better higher scores on the scale of satisfaction in these individuals. CONCLUSIONS: It was concluded that patients with a vascular cause of amputation are more satisfied with their prosthesis, with the way they walk and how things are from amputation and also have better health of the residual limb in relation to individuals with traumatic amputation. However, the level and time of amputation do not seem to influence the satisfaction and adjustment of the prosthesis.

Functionality and quality of life of children with disability / Funcionalidade e qualidade de vida de crianças com deficiência

INTRODUCTION: Preschool teachers are able to provide realistic information about functionality and quality of life of children with disabilities in regular classrooms OBJECTIVE: To analyze functionality and quality of life of children with disabilities included in public schools with early childhood education programs in Florianópolis, in the State of Santa Catarina, Brazil METHODS: Special education teachers, classroom teachers, physical education teachers, special education teaching assistants and classroom assistants for 2- to 5-year-old children with disabilities, who showed motor disabilities and were included in municipal public schools with early childhood education programs in Florianópolis. The instruments used were: the Pediatric Evaluation of Disability Inventory, the Pediatric Quality of Life Inventory version 4.0 and an identification form RESULTS: There were similarities between teachers' reports about functionality and quality of life of children with disabilities CONCLUSION: There are different academic backgrounds, professional categories and working hours. However, the reports of these teachers showed homogeneity of results, which indicates that they are attentive to the educational tasks and child care, and engaged in inclusive education, child development and well-being

INTRODUÇÃO: Professores da educação infantil são capazes de fornecer informações realistas acerca da funcionalidade e da qualidade de vida de crianças com deficiências incluídas nas classes regulares OBJETIVO: Analisar a funcionalidade e a qualidade de vida de crianças com deficiência inseridas na educação infantil da rede pública de ensino de Capital do Sul do Brasil MÉTODO: Foram selecionados professores de educação especial. professores de sala. professores de educação física. professores auxiliares de educação especial e auxiliares de sala de crianças com deficiência. entre dois e cinco anos de idade. que apresentam comprometimentos motores e estão inseridas na educação infantil da rede municipal de Florianópolis. Os instrumentos utilizados foram: Inventário de Avaliação Pediátrica de Incapacidade e o Questionário Pediátrico sobre Qualidade de Vida versão 4.0. além de uma ficha de identificação RESULTADOS: Houve semelhanças entre os relatos dos professores sobre funcionalidade e qualidade de vida das crianças CONCLUSÃO: Há diferentes formações acadêmicas. categorias profissionais e carga horária de trabalho. porém os relatos destes professores apresentaram certa homogeneidade. indicando que estão atentos às tarefas educativas e de cuidados destas crianças. promovendo o processo de inclusão. o desenvolvimento infantil e o bem estar geral da criança