Percepciones sobre la rehabilitación durante la pandemia por COVID-19 de las personas con discapacidad motora / People's perceptions with motor disabilities of rehabilitation during the COVID-19 pandemic

Antecedentes y objetivo: La Organización Mundial de la Salud declaró a la infección por COrona VIrus Disease 19 (COVID-19) como pandemia y recomendó, como medida preventiva, el distanciamiento social. Esto afectó a todos los tratamientos médico-clínicos, incluidos los relacionados con el proceso de rehabilitación física. El objetivo fue describir las percepciones sobre el proceso de rehabilitación debido a las modificaciones experimentadas por las personas con discapacidad motora de un hospital de rehabilitación durante la pandemia por COVID-19. Pacientes y métodos: Diseño cualitativo. La muestra elegida fue por conveniencia y el análisis de datos fue por análisis temático, el cual permite identificar, analizar y reportar temas relevantes. Las entrevistas se realizaron a pacientes atendidos en la División de Kinesiología. Criterios de inclusión: adultos> 18 años, diagnóstico de discapacidad motora, en tratamiento kinésico ≥ 1 mes de forma ambulatoria, con alta temprana de internación o internados en el momento de la realización del estudio y firma del consentimiento informado. Criterios de exclusión: alta kinésica por motivos diferentes a la COVID-19 y diagnóstico de enfermedad psiquiátrica. Resultados: La muestra se compuso de 16 participantes. El 31,2% era de sexo femenino. Doce presentaron diversas alteraciones neurológicas y 4, secuelas de amputación. Se identificaron 4 temas principales: importancia de la rehabilitación, modificaciones/interrupción del tratamiento, actividades de la vida diaria y telerrehabilitación. Conclusiones: Se describieron las percepciones sobre el proceso de rehabilitación y el impacto en las modificaciones experimentadas en las personas con discapacidad motora. Destacamos la importancia de la telerrehabilitación como un recurso alternativo.(AU)

Background and objective: The World Health Organization declared COrona VIrus Disease 19 (COVID-19) a pandemic and recommended social distancing as a preventive measure. This affected all medical–clinical treatments, including those related to the physical rehabilitation process. The objective was to describe the perceptions about the rehabilitation process due to the modifications experienced by people with motor disabilities in a rehabilitation hospital during the COVID-19 pandemic. Patients and methods Qualitative design. The sample chosen was for convenience and the data analysis was by thematic analysis, which allows to identify, analyze and report themes. The interviews were conducted with patients seen in the physiotherapy división of the hospital. Inclusion criteria: adults >18 years old, diagnosis of motor disability, undergoing physical treatment ≥1 month on an outpatient basis, with early discharge from hospitalization or hospitalization at the time of the study and signing of the informed consent. Exclusion criteria: physical discharge for reasons other than COVID-19 and diagnosis of psychiatric illness. Results: The sample consisted of 16 participants. 31.2% were female. Twelve presented various neurological alterations and 4 amputation effects. Four main themes were identified: importance of rehabilitation, treatment modifications/interruption, activities of daily living and tele-rehabilitation. Conclusions: Perceptions about the rehabilitation process and the impact on the modifications experienced in people with motor disabilities were described. We highlight the importance of tele-rehabilitation as an alternative resource.(AU)

[People's perceptions with motor disabilities of rehabilitation during the COVID-19 pandemic]. / Percepciones sobre la rehabilitación durante la pandemia por COVID-19 de las personas con discapacidad motora.

BACKGROUND AND OBJECTIVE: The World Health Organization declared COrona VIrus Disease 19 (COVID-19) a pandemic and recommended social distancing as a preventive measure. This affected all medical-clinical treatments, including those related to the physical rehabilitation process. The objective was to describe the perceptions about the rehabilitation process due to the modifications experienced by people with motor disabilities in a rehabilitation hospital during the COVID-19 pandemic. PATIENTS AND METHODS: Qualitative design. The sample chosen was for convenience and the data analysis was by thematic analysis, which allows to identify, analyze and report themes. The interviews were conducted with patients seen in the physiotherapy división of the hospital. INCLUSION CRITERIA: adults >18 years old, diagnosis of motor disability, undergoing physical treatment ≥1 month on an outpatient basis, with early discharge from hospitalization or hospitalization at the time of the study and signing of the informed consent. EXCLUSION CRITERIA: physical discharge for reasons other than COVID-19 and diagnosis of psychiatric illness. RESULTS: The sample consisted of 16 participants. 31.2% were female. Twelve presented various neurological alterations and 4 amputation effects. Four main themes were identified: importance of rehabilitation, treatment modifications/interruption, activities of daily living and tele-rehabilitation. CONCLUSIONS: Perceptions about the rehabilitation process and the impact on the modifications experienced in people with motor disabilities were described. We highlight the importance of tele-rehabilitation as an alternative resource.

Propiedades psicométricas de instrumentos observacionales para evaluar habilidades en silla de ruedas en sujetos con lesión medular espinal: revisión sistemática / Psychometric properties of observational instruments to evaluate wheelchair skills in persons with a spinal cord injury: A systematic review

El 60% de las personas con lesión medular es completamente dependiente de una silla de ruedas; existe una gran variedad de instrumentos que evalúan las habilidades en la misma, pero no son específicos para esta población. Objetivo Identificar, evaluar, comparar y resumir las propiedades psicométricas de instrumentos que evalúen habilidades en silla de ruedas en sujetos con lesión medular. Se realizó una revisión sistemática y se incluyeron instrumentos observacionales que evaluaron habilidades en silla de ruedas en sujetos con lesión medular espinal. Se identificaron 11 artículos que evaluaron 8 instrumentos. La mayoría de los mismos reportaron actividades según la Clasificación internacional del funcionamiento, de la discapacidad y de la salud. La fiabilidad fue la propiedad psicométrica más evaluada. El Queensland Evaluation of Wheelchair Skills y el Adapted Manual Wheelchair Circuit presentaron los mejores grados de confianza en la evidencia; su utilización orientaría a seleccionar estrategias terapéuticas pertinentes (AU)

A total of 60% of people with a spinal cord injury are completely dependent on a wheelchair. There is a wide variety of instruments that assess wheelchair skills, but they are not specific for this population. Objective To identify, assess, compare and summarize the psychometric properties of instruments that assess wheelchair skills in persons with a spinal cord injury. A systematic review was conducted and observational instruments were included that assessed wheelchair skills in persons with spinal cord injury. Eleven articles were identified that evaluated eight instruments. Most of them reported activities according to the International Classification of Functioning, Disability and Health. Reliability was the most frequently evaluated psychometric property. The Queensland Evaluation of Wheelchair Skills and the Adapted Manual Wheelchair Circuit had the best degrees of confidence in the evidence, and their application could guide the selection of pertinent therapeutic strategies (AU)

[Psychometric properties of observational instruments to evaluate wheelchair skills in persons with a spinal cord injury: A systematic review]. / Propiedades psicométricas de instrumentos observacionales para evaluar habilidades en silla de ruedas en sujetos con lesión medular espinal: revisión sistemática.

A total of 60% of people with a spinal cord injury are completely dependent on a wheelchair. There is a wide variety of instruments that assess wheelchair skills, but they are not specific for this population. OBJECTIVE: To identify, assess, compare and summarize the psychometric properties of instruments that assess wheelchair skills in persons with a spinal cord injury. A systematic review was conducted and observational instruments were included that assessed wheelchair skills in persons with spinal cord injury. Eleven articles were identified that evaluated eight instruments. Most of them reported activities according to the International Classification of Functioning, Disability and Health. Reliability was the most frequently evaluated psychometric property. The Queensland Evaluation of Wheelchair Skills and the Adapted Manual Wheelchair Circuit had the best degrees of confidence in the evidence, and their application could guide the selection of pertinent therapeutic strategies. PROSPERO registration: CRD42020161430.

Validación del Timed up and go test como predictor de riesgo de caídas en sujetos con artritis reumatoide. Parte I: confiabilidad y aplicabilidad clínica / Validation of the timed up and go test as a predictor of the risk of falls in persons with rheumatoid arthritis. Part I: reliability and clinical applicability

Introducción. Los sujetos con artritis reumatoide (AR) tienen un elevado riesgo de caídas. Se necesitan herramientas para determinar qué pacientes tienen mayor riesgo de caerse. El Timed up and go test (TUG) es utilizado para predecir el riesgo de caídas, pero es imprescindible que se estudien sus propiedades psicométricas. El objetivo es establecer la confiabilidad intra e interobservador, test-retest y aplicabilidad clínica del TUG a la velocidad habitual y máxima-segura en sujetos con diagnóstico de AR. Material y método. Estudio observacional, prospectivo y longitudinal. Se estableció la confiabilidad intra e interobservador y test-retest del TUG con el coeficiente de correlación intraclase. Se construyeron gráficos de Bland-Altman para la concordancia intra e interobservador. Resultados. La confiabilidad intraobservador fue CCI 0,98 (IC 95%: 0,96-0,99) y CCI 0,99 (IC 95%: 0,98-0,99) a velocidad habitual y máxima CCI 0,97 (IC 95%: 0,95-0,98) y CCI 0,99 (IC 95%: 0,99-0,99). La confiabilidad interobservador a velocidad habitual obtuvo CCI 0,99 (IC 95% 0,98-0,99) y a velocidad máxima CCI 0,99 (IC 95% 0,99-0,99). La confiabilidad test-retest a velocidad habitual CCI 0,77 (IC 95%: 0,61-0,87) y a máxima CCI 0,91 (IC 95%: 0,83-0,95). El 23% reportó mínima dificultad para comprender el test. La mediana del tiempo de administración fue 90 segundos. Conclusión. El estudio permitió establecer la confiabilidad intra e interobservador, test-retest y aplicabilidad clínica del TUG test a velocidad habitual y máxima segura en sujetos con AR (AU)

Introduction. Persons with rheumatoid arthritis (RA) have a high risk of falls. There is a need for tools that identify at-risk patients. The Timed Up and Go test (TUG) is used to predict the risk of falls but it is essential to study its psychometric properties. The aim of this study was to establish intra- and interobserver reliability, test-retest reliability and the clinical applicability of the TUG test in persons with a diagnosis of RA. Material and method. Observational, prospective, longitudinal study. intra- and interobserver reliability and the test-retest reliability of the TUG were established with intraclass correlation coefficients (ICC). Bland-Altman plots were constructed for intra- and interobserver reliability. Results. The intraobserver reliability ICC for the two assessors was 0.98 (95% CI 0.96-0.99) and 0.99 (95% CI 0.98-0.99), and was 0.97 (95% CI 0.95-0.98) at normal speed and 0.99 (95% CI 0.99-0.99) at maximal speed. The interobserver reliability ICC at normal speed was 0.99 (95% CI 0.98-0.99) and 0.99 (95% CI 0.99-0.99) at maximal speed. The test-retest reliability ICC was 0.77 (95% CI 0.61-0.87) at normal speed and 0.91 (95% CI 0.83-0.95) at maximal speed. A total of 23% of the participants reported minimal difficulty in understanding the test. The average administration time was 90seconds. Conclusion. This study identifies the intra- and interobserver reliability, test-retest reliability and the clinical applicability of the TUG test at normal and maximal speed in RA patients (AU)

[Hand fine motor skills and use of both hand and arm in subjects after a stroke: a systematic review]. / Herramientas de evaluacion del uso fino de la mano y uso de la mano y el brazo en sujetos con secuela de ictus: revision sistematica.

INTRODUCTION: In clinical practice it is important to be able to assess the function of the upper limb of the patient who has suffered a stroke. There is currently no systemic review that could identify assessment tools for the 'fine use of the hand' and 'use of both hand and arm'. AIMS: Primary, to identify observational tools which can assess the fine use of the hand and the use of both hand and arm in patients with stroke sequels. Secondary, to analyze the bias risk in the included articles, describing and categorizing the clinical utility, validity and reliability. PATIENTS AND METHODS: A search was carried in Medline, LILACS, SciELO and Open Grey, which included articles published until October 2015. Studies that validate assessing tools of the upper limb in subjects with a stroke sequel which evaluate the fine use of the hand and the use of both hand and arm were included. RESULTS: Eleven tools in evaluate observational haven been selected, which assess the fine use of the hand and the use of hand and arm. CONCLUSIONS: In every case both validity and reliability have been reported, but clinical utility has been less considered for assessment. The studies that researched these tools showed a high risk of bias in their development. ARAT-19 showed a lower bias risk, but when it has to do with applicability and the reference trial is taken into account, the level of concern is high.

TITLE: Herramientas de evaluacion del uso fino de la mano y uso de la mano y el brazo en sujetos con secuela de ictus: revision sistematica.Introduccion. En la practica clinica resulta importante poder evaluar la funcion de la extremidad superior paretica del paciente que ha sufrido un ictus. No hay una revision sistematica que identifique herramientas de evaluacion del 'uso fino de la mano' o el 'uso de la mano y el brazo'. Objetivos. Como objetivo primario, identificar las herramientas observacionales que evaluan el uso fino de la mano o el uso de la mano y el brazo en pacientes con secuela de ictus. Secundariamente, analizar el riesgo de sesgo de los articulos incluidos, describir y categorizar la validez, fiabilidad y utilidad clinica. Pacientes y metodos. Se realizo una busqueda en Medline, LILACS, SciELO y Open Grey hasta octubre de 2015. Se incluyeron estudios de validacion de herramientas de evaluacion del miembro superior en sujetos con secuela de ictus, que evaluen el uso fino de la mano o el uso de la mano y el brazo. Resultados. Se han seleccionado 11 herramientas que evaluan el uso fino de la mano y el uso de la mano y el brazo. Conclusiones. Si bien se comunicaron la fiabilidad, la validez y la utilidad clinica, esta ultima fue menos evaluada. Los estudios que investigaron estas herramientas presentaron alto riesgo de sesgo, en particular en la eleccion de la prueba de referencia. La herramienta ARAT-19 fue la que presento un menor riesgo de sesgo, pero cuando se evaluo la aplicabilidad, esta presento una preocupacion alta para la prueba de referencia.