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1.
Phys Ther ; 101(1)2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33508855

RESUMO

OBJECTIVE: Ultrasound elastography is an emerging diagnostic technology used to investigate the biomechanical properties of the musculoskeletal system. The purpose of this study was to systematically review the psychometric properties of ultrasound elastography techniques for evaluating muscle stiffness in people with neurological conditions. METHODS: A systematic search of MEDLINE, EMBASE, CINAHL, and Cochrane Library databases was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Using software, reviewers independently screened citations for inclusion. Peer-reviewed studies that evaluated in vivo muscle stiffness in people with neurological conditions and reported relevant psychometric properties were considered for inclusion. Twenty-one articles were included for final review. Data relevant to measurement technique, site, and neurological condition were extracted. The Consensus-Based Standards for the Selection of Health Measurement Instruments checklist was used to rate the methodological quality of included studies. The level of evidence for specific measurement outcomes was determined using a best-evidence synthesis approach. RESULTS: Reliability varied across populations, ultrasound systems, and assessment conditions (ie, joint/body positions, active/passive muscle conditions, probe orientation), with most studies indicating moderate to good reliability (ICC = 0.5-0.9, n = 13). Meta-analysis results showed a good overall correlation across studies (r = 0.78, 95% confidence interval = 0.64-0.86), with no between-group difference based on population (Q1 = 0.00). Convergent validity was demonstrated by strong correlations between stiffness values and measures of spasticity (n = 5), functional motor recovery or impairment (n = 5), and grayscale or color histogram pixel intensities (n = 3). Discriminant or known-groups validity was also established for multiple studies and indicated either significant between-group differences in stiffness values (n = 12) or within-group differences between more and less affected limbs (n = 6). Responsiveness was observed in all intervention studies reporting posttreatment stiffness changes (n = 6). CONCLUSIONS: Overall, ultrasound elastography techniques showed moderate reliability in evaluating in vivo muscle stiffness, good convergent validity with relevant clinical assessments, and good divergent validity in discriminating tissue changes within and between groups. IMPACT: Ultrasound elastography has clinical utility in assessing muscle stiffness, monitoring its temporal changes, and measuring the response to intervention in people with neurological conditions.


Assuntos
Técnicas de Imagem por Elasticidade/normas , Doenças Musculares/diagnóstico por imagem , Doenças Musculares/fisiopatologia , Doenças do Sistema Nervoso/diagnóstico por imagem , Doenças do Sistema Nervoso/fisiopatologia , Avaliação da Deficiência , Humanos , Doenças Musculares/reabilitação , Doenças do Sistema Nervoso/reabilitação , Psicometria , Reprodutibilidade dos Testes
2.
Am J Phys Med Rehabil ; 100(4): 321-326, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33480609

RESUMO

ABSTRACT: In the spring of 2020, coronavirus disease 2019 evolved into a worldwide pandemic, forcing traditional face-to-face healthcare to a standstill. Telemedicine was quickly adopted as a major tool for pediatric rehabilitation services. This article describes the national legislative response of the United States to the coronavirus disease 2019 pandemic and the opportunities and challenges of implementing telemedicine in pediatric rehabilitation outpatient settings, consultations, as well as physician and patient education. The feasibility of performing a remote pediatric musculoskeletal and neurological tele-evaluation is also discussed. Although challenges exist, telemedicine has demonstrated its potential and has proven to be a practical system. Future developments in technology and accessibility, in addition to support from government and third-party payers, have the potential to make telemedicine an effective and vital platform in a coordinated healthcare system.


Assuntos
/epidemiologia , Doenças do Sistema Nervoso/reabilitação , Doenças Neurodegenerativas/reabilitação , Tecnologia de Sensoriamento Remoto/estatística & dados numéricos , Telemedicina/organização & administração , Criança , Acesso aos Serviços de Saúde/organização & administração , Humanos , Telerreabilitação/organização & administração , Estados Unidos
3.
Tog (A Coruña) ; 17(2): 112-121, nov. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-198809

RESUMO

OBJETIVOS: el uso de la realidad virtual representa un enfoque metodológico prometedor como intervención terapéutica en neurorrehabilitación. En este estudio se analizó el uso de la RV en terapia ocupacional con pacientes neurológicos. MÉTODOS: se llevó a cabo un estudio descriptivo transversal con terapeutas ocupacionales de centros de neurorrehabilitación de la provincia de Alicante, entre febrero y mayo de 2017. La información se recogió online con un cuestionario de 36 preguntas. RESULTADOS: De 23 participantes, la mayoría eran mujeres (82.6%) y con edad media de 31.4 (DE: 4.1) años. La mitad (52.2%) usaba la realidad virtualcomo herramienta de tratamiento, principalmente con personas de 46-65 años (75.0%), con daño cerebral adquirido (75.0%) y alteraciones cognitivas (91.7%). Las áreas principales de intervención fueron: atención (83.3%), visión (75.0%), miembro superior (75.0%), comunicación verbal (66.7%), alimentación (50.0%), compras (41.7%) y participación social con amigos (41.7%). Los sistemas de RV más utilizados fueron la plataforma NeuronUp (50.0%) y el ordenador y/o tableta junto con los dispositivos Kinect y Wii (33.3%). CONCLUSIONES: Sólo la mitad de lo/as terapeutas ocupacionales usaban la realidad virtual como complemento al tratamiento convencional. Son necesarios más estudios sobre el uso de estas técnicas en terapia ocupacional con personas con afecciones neurológicas


OBJECTIVE: We aimed to analyze the use of virtual reality among occupational therapists working with neurological patients. Methods. A descriptive cross-sectional study was conducted on occupational therapists working in neurorehabilitation centers in the Alicante province between February and May 2017. The information was collected using an online questionnaire made up of 36 questions. RESULTS: Of the 23 participants, the majority of them were women (82.6%) with an average age of 31.4 years (SD: 4.1). Approximately half of them (52.2%) used virtual reality as a treatment tool, mainly with adults aged 46-65 (75.0%) affected by acquired brain damage (75.0%) and with cognitive alterations (91.7%). The intervention areas targeted were: attention (83.3%), vision (75.0%), upper limb mobility (75.0%), verbal communication (66.7%), eating (50.0%), shopping (41.7%), and social participation with friends (41.7%). The most used virtual reality systems in occupational therapy treatments were the NeuronUp platform (50.0%) and Xbox Kinect (R) / Nintendo Wii (R) (33.3%) used with a computer or a tablet. CONCLUSIONS: Only half of the occupational therapists in the study used virtual reality as a complementary tool for conventional treatment. Further studies exploring the use of these techniques in occupational therapy with people affected by neurological conditions are required


Assuntos
Humanos , Masculino , Feminino , Adulto , Terapia Ocupacional/métodos , Realidade Virtual , Centros de Reabilitação/organização & administração , Reabilitação Neurológica/métodos , Doenças do Sistema Nervoso/reabilitação , Terapia Ocupacional/instrumentação , Terapia Ocupacional/educação , Estudos Transversais , Serviços de Reabilitação , Reabilitação Neurológica/educação , Jogos de Vídeo , Inquéritos e Questionários
4.
Medicine (Baltimore) ; 99(34): e21805, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846817

RESUMO

BACKGROUND: Impaired physical mobility, most often seen in people with neurological disorders (i.e., stroke and spinal cord injury survivors), musculoskeletal diseases or frailty, is a limitation in independent and purposeful physical movement of the body or one or more extremities. The physical restrictions result in negative consequences on an individual's physical and psychosocial functions. This proposal describes a systematic review protocol to determine the effectiveness and approaches of sitting Tai Chi intervention for individuals with impaired physical mobility. Our review would inform stakeholders' decisions in integrating this complementary therapy into current rehabilitation services. METHODS: Randomized controlled trials or quasi-experimental studies that compared an intervention group receiving sitting Tai Chi with a control group among adult participants with impaired physical mobility resulting from any health condition(s) will be included. Outcomes of interest will include physical and psychosocial health outcomes. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PubMed, CINAHL, Scopus, Web of Science, AMED, PsycINFO, SPORDiscus, PEDro, WanFang Data and China National Knowledge Infrastructure will be searched from their inception to January 2020. Additional searches will be performed to identify studies that are being refereed, to be published, unpublished or ongoing. Two reviewers will select the trials and extract data independently. The risk of bias of the included studies will be assessed using the Cochrane risk-of-bias tools. The Grading of Recommendations, Assessment, Development and Evaluation will be used to assess evidence quality for each review outcome. Data synthesis will be performed using Review Manager 5.3. When a meta-analysis is possible, we will assess the heterogeneity across the studies by computing the I statistics. RESULTS: A high-quality synthesis of current evidence of sitting Tai Chi for impaired physical mobility will be stated from several aspect using subjective reports and objective measures of performance. CONCLUSION: This protocol will present the evidence of whether sitting Tai Chi is an effective intervention for impaired physical mobility. PROSPERO REGISTRATION NUMBER: CRD 42019142681.


Assuntos
Fragilidade/reabilitação , Limitação da Mobilidade , Doenças Musculoesqueléticas/reabilitação , Doenças do Sistema Nervoso/reabilitação , Tai Ji , Fragilidade/complicações , Fragilidade/psicologia , Humanos , Doenças Musculoesqueléticas/complicações , Doenças Musculoesqueléticas/psicologia , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/psicologia , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
8.
J Pak Med Assoc ; 70(Suppl 3)(5): S136-S140, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32515396

RESUMO

This paper provides the context of COVID-19 outbreak with special reference to hospital-based neurorehabilitation services in the UK and transferrable lessons for similar services globally. While the COVID-19 pandemic has created numerous challenges at all levels and forced us to confront our own vulnerabilities as individuals, teams, services, communities and on the global stage, it has also simultaneously offered us opportunities for transformation. Converting catastrophe into opportunity requires creativity, diligence, innovation, strategy and vision. This reflection serves to identify the challenges we encountered, the solutions we applied and the opportunities that we have taken. In the wake of an information avalanche, service and clinical practice challenge, service capacity challenge and above all, a unique and timely reminder of our own humanity and the inter-connectedness and fragility of human societies, we have endeavoured to identify and describe some crucial leadership facets, which are supporting our journey through this global health crisis.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Reabilitação Neurológica , Pandemias , Pneumonia Viral , Infecção Hospitalar , Assistência à Saúde , Pessoal de Saúde , Humanos , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/reabilitação , Doenças do Sistema Nervoso/terapia , Reabilitação Neurológica/organização & administração , Reabilitação Neurológica/estatística & dados numéricos , Reino Unido
10.
Artigo em Inglês | MEDLINE | ID: mdl-32429562

RESUMO

The introduction of robotic neurorehabilitation among the most recent technologies in pediatrics represents a new opportunity to treat pediatric patients. This study aims at evaluating the response of physiotherapists, patients and their parents to this new technology. The study considered the outcomes of technological innovation in physiotherapists (perception of the workload, satisfaction), as well as that in patients and their parents (quality of life, expectations, satisfaction) by comparing the answers to subjective questionnaires of those who made use of the new technology with those who used the traditional therapy. A total of 12 workers, 46 patients and 47 parents were enrolled in the study. Significant differences were recorded in the total workload score of physiotherapists who use the robotic technology compared with the traditional therapy (p < 0.001). Patients reported a higher quality of life and satisfaction after the use of the robotic neurorehabilitation therapy. The parents of patients undergoing the robotic therapy have moderately higher expectations and satisfaction than those undergoing the traditional therapy. In this pilot study, the robotic neurorehabilitation technique involved a significant increase in the patients' and parents' expectations. As it frequently happens in the introduction of new technologies, physiotherapists perceived a greater workload. Further studies are needed to verify the results achieved.


Assuntos
Doenças do Sistema Nervoso , Reabilitação Neurológica , Pediatria , Procedimentos Cirúrgicos Robóticos , Criança , Feminino , Hospitais Pediátricos , Humanos , Itália , Masculino , Doenças do Sistema Nervoso/reabilitação , Pais , Projetos Piloto , Qualidade de Vida , Inquéritos e Questionários
11.
Tog (A Coruña) ; 17(1): 18-25, mayo 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-196301

RESUMO

OBJETIVOS: bjetivo es hallar la posición más efectiva del terapeuta respecto al paciente para generar mayor aprendizaje motor por medio de la observación de la acción. MÉTODOS: diseñamos un modelo experimental simulando el entorno clínico de la terapia por observación de la acción y analizamos el aprendizaje de una tarea motora cotidiana desde diferentes perspectivas de observación en 60 personas sanas. RESULTADOS: obtuvimos diferencias de aprendizaje motor en los cuatro grupos estudiados. CONCLUSIONES: la perspectiva de observación en primera persona es mejor para adquirir habilidades motoras a corto plazo, aunque la observación en perspectiva opuesta puede obtener similares beneficios dependiendo de factores del contexto de la tarea, y la observación en perspectiva lateral, aunque es beneficiosa, obtiene menor aprendizaje que las anteriores


OBJECTIVE: To find the most effective position of the therapist with respect to the patient in order to generate greater motor learning through observing the action. METHODS: We designed an experimental model simulating the clinical environment of therapy by observation of the action and we analyzed the learning of a daily motor task from different observation perspectives in 60 healthy people. RESULTS: We obtained motor learning differences in the four groups studied. CONCLUSIONS: The perspective of first-person observation is better for acquiring short-term motor skills, although observation in opposite perspective can obtain similar benefits depending on factors of the task context, and observation in lateral perspective, although it is beneficial, obtains less learning than the previous ones


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Aprendizagem/fisiologia , Destreza Motora/fisiologia , Projetos Piloto , Terapia Ocupacional/educação , Posicionamento do Paciente/métodos , Terapia Diretamente Observada , Atividade Motora/fisiologia , Movimento (Física) , Terapia Ocupacional/métodos , Simulação de Paciente , Doenças do Sistema Nervoso/reabilitação , Análise de Variância
12.
Tog (A Coruña) ; 17(1): 55-64, mayo 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-196305

RESUMO

OBJETIVOS: valorar la eficacia del uso de la Tele-rehabilitación en la terapia ocupacional en pacientes con daño neurológico. MÉTODOS: se realizó una búsqueda a través de OTSeeker, Pubmed, Cochrane Library, Tripdatabase, International Journal of Telerehabilitation, The American Journal of Occupational Therapy, International Journal of Stroke, Journal of Telemedicine and Telecare, Clinical Rehabilitation y SAGE sobre artículos que hayan sido publicados entre los años 2009 y 2020 de la literatura inglesa y con un rango de edad de los y las pacientes variable. Fueron seleccionadas aquellas publicaciones donde se implicará el ámbito neurológico en el uso de la tele-rehabilitación. RESULTADOS: se evaluaron un total de 20 publicaciones, de las cuales 16 se referían a ensayos controlados aleatorizados, ensayos cuasi experimentales e informes de caso. Las 4 publicaciones restantes se referían a revisiones sistemáticas. En dichas publicaciones, se mostraron resultados positivos en componentes motores, cognitivos y emocionales. Además de que, la implementación de este método, no suponía un alto coste económico para los pacientes. CONCLUSIONES: Para mejorar nuestro entendimiento en este tema es necesario realizar un mayor número de estudios. Sin embargo, según los resultados mostrados, se puede evidenciar que el uso de la tele-rehabilitación en terapia ocupacional en pacientes con daño neurológico es una opción eficaz y viable como complemento a la terapia ocupacional convencional


OBJECTIVE: To evaluate the efficacy of Tele-rehabilitation in Occupational Therapy on patients with neurological damage. METHODS: Research was focused on publications made between 2009 and 2020, published in English literature and based on patients within a variable range of age. These include: OTSeeker, Pubmed, Cochrane Library, Tripdatabase, International Journal of Telerehabilitation, The American Journal of Occupational Therapy, International Journal of Stroke, Journal of Telemedicine and Telecare, Clinical Rehabilitation and SAGE. The publications were selected according to the involvement of the neurological field with the use of tele-rehabilitation. RESULTS: A total of 20 publications were evaluated, of which 16 referred to randomized controlled trials, quasi-experimental trials and case reports. The remaining 4 publications concerned systematic reviews. In these publications, positive results were shown in motor, cognitive and emotional components. In addition the implementation of this method did not imply a high economic cost for patients. CONCLUSIONS: In order to improve our understanding in this topic it is necessary to carry out a greater number of studies. However according to the results shown, it can be concluded that the use of tele-rehabilitation in occupational therapy in patients with neurological damage is an effective and viable option as a complement to conventional occupational therapy


Assuntos
Humanos , Telerreabilitação/métodos , Terapia Ocupacional/métodos , Resultado do Tratamento , Lesões Encefálicas/reabilitação , Acidente Vascular Cerebral/terapia , Telemedicina/métodos , Doenças do Sistema Nervoso/reabilitação , Doenças do Sistema Nervoso/terapia
13.
Phys Ther ; 100(5): 747-756, 2020 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-32339243

RESUMO

Beth E. Fisher, PT, PhD, FAPTA, is a physical therapist, educator, and scholar whose clinical career has been shaped by numerous observations and experiences of patients' remarkable potential to recover ideal movement capability. Currently, Dr Fisher is a Professor of Clinical Physical Therapy in the Division of Biokinesiology and Physical Therapy at the University of Southern California. She is Director of the Neuroplasticity and Imaging Laboratory, primarily using transcranial magnetic stimulation to investigate brain-behavior relationships during motor skill learning and motor control in both individuals without disabilities and individuals with neurologic disorders. Dr Fisher previously worked at Rancho Los Amigos Medical Center on the Adult Neurology and Brain Injury Services. During her years as a clinician and rehabilitation specialist, it was her greatest ambition to be a part of developing physical therapist interventions that would maximize neural and behavioral recovery in individuals with pathological conditions affecting the nervous system. Toward this goal, she has continued to consult and teach nationally and internationally on current concepts for the treatment of adults with neurological disorders. It has been her consistent clinical observation not only that patients are limited by impairments that result from their injury, but that movement abnormalities are in part the result of a patient's automatic, implicit tendency to "respond" to those impairments via compensation.


Assuntos
Lesões Encefálicas/reabilitação , Movimento/fisiologia , Doenças do Sistema Nervoso/reabilitação , Plasticidade Neuronal/fisiologia , Fisioterapeutas/tendências , Encéfalo/fisiopatologia , Humanos
14.
Neuron ; 105(4): 604-620, 2020 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-32078796

RESUMO

Stroke is one of the leading causes of long-term disability. Advanced technological solutions ("neurotechnologies") exploiting robotic systems and electrodes that stimulate the nervous system can increase the efficacy of stroke rehabilitation. Recent studies on these approaches have shown promising results. However, a paradigm shift in the development of new approaches must be made to significantly improve the clinical outcomes of neurotechnologies compared with those of traditional therapies. An "evolutionary" change can occur only by understanding in great detail the basic mechanisms of natural stroke recovery and technology-assisted neurorehabilitation. In this review, we first describe the results achieved by existing neurotechnologies and highlight their current limitations. In parallel, we summarize the data available on the mechanisms of recovery from electrophysiological, behavioral, and anatomical studies in humans and rodent models. Finally, we propose new approaches for the effective use of neurotechnologies in stroke survivors, as well as in people with other neurological disorders.


Assuntos
Estimulação Encefálica Profunda/métodos , Destreza Motora/fisiologia , Plasticidade Neuronal/fisiologia , Recuperação de Função Fisiológica/fisiologia , Córtex Sensório-Motor/fisiologia , Reabilitação do Acidente Vascular Cerebral/métodos , Estimulação Encefálica Profunda/instrumentação , Humanos , Doenças do Sistema Nervoso/diagnóstico por imagem , Doenças do Sistema Nervoso/fisiopatologia , Doenças do Sistema Nervoso/reabilitação , Reabilitação Neurológica/instrumentação , Reabilitação Neurológica/métodos , Córtex Sensório-Motor/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/instrumentação
15.
BMC Health Serv Res ; 20(1): 69, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000768

RESUMO

BACKGROUND: Following a neurological event, people's long-term health and well-being is hampered by a system that struggles to deliver person-centred communication and coordinated care and fails to harness individual and family capability to live well with the condition. We aimed to implement and evaluate a toolkit package to support these processes for people with long-term neurological conditions. METHODS: This is a multi-phased study drawing on the principles of participatory research. In this pilot phase, the toolkit package was introduced to clinicians, who introduced it to clients in four neurorehabilitation settings (inpatient and community-based). Individual and focus group interviews were carried out with clients (n = 10) and clinicians (n = 9). Data were categorised by the four components of Normalisation Process Theory (NPT), and data within each component was then coded inductively. This analysis was used to inform revisions to the toolkit package and wider implementation processes. RESULTS: There was widespread support for the principles underpinning the toolkit package from clients and clinicians. However, it was less clear how the client toolkit could support these principles in clinical practice which impacted buy-in. The flexibility of use of the client toolkit, which we encouraged, made it difficult for clinicians and clients to be clear about its purpose and for clinicians to operationalise in practice. Clinicians and clients identified a number of barriers that limited the time, energy and work users were able or prepared to invest, to the extent that uptake of the toolkit package was modest. Use of the toolkit package appeared more likely when clinicians perceived it to augment existing processes (e.g. goal setting) rather than detract from 'doing' therapy. This analysis was used to inform revisions to the toolkit package, including simplification of the client toolkit, development of videos with examples of use and a modular and reflective training package for clinical services. The refinements were intended to improve sense-making and minimise the cognitive barriers associated with implementation of a new intervention. CONCLUSION: Understanding how supporting the client toolkit could add value to the therapeutic encounter was necessary for clinicians to invest time and perceive the worth of the toolkit package. TRIAL REGISTRATION: ANZCTR: ACTRN12614000537651. Registered 21 May, 2014.


Assuntos
Comunicação , Doenças do Sistema Nervoso/reabilitação , Assistência Centrada no Paciente/organização & administração , Relações Médico-Paciente , Feminino , Grupos Focais , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Projetos Piloto , Pesquisa Qualitativa , Qualidade de Vida
16.
Phys Ther ; 100(2): 209-216, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-31595959

RESUMO

BACKGROUND: Clinical education is an integral component of physical therapy education. Both benefits and barriers exist in clinical education, but 1 commonly stated barrier includes the perception that students have a negative impact on clinical instructor productivity. OBJECTIVE: The purposes of this study were to evaluate the productivity of physical therapist clinical instructors in an academic medical center before, during, and after clinical education experiences, determine if there are differences in productivity during clinical education experiences across settings, and compare clinical instructor productivity with that of therapists who did not have a student during the same time frames. DESIGN: A retrospective design examined productivity across 3 years in acute care, inpatient rehabilitation, outpatient orthopedics, and outpatient neurology. Mean daily productivity was computed, normalized to an 8-hour day, and averaged for each week of the year. Data were analyzed using a repeated-measures ANOVA. Post-hoc comparisons were made within each setting to compare therapists with a student to those without. The Bonferonni-correction was used to control for multiple comparisons. RESULTS: Clinical instructor productivity was significantly increased in outpatient orthopedics and inpatient rehabilitation, and approached significance in outpatient neurology, but was not significant in acute care. The presence of a student made clinical instructors more productive but had no effect on the productivity of other therapists in that setting during the same time frame. LIMITATIONS: We studied only 1 academic medical center and could not account for clinical instructor factors such as years of experience or student factors such as year in their program. CONCLUSIONS: Our results indicate that having a student increases productivity of therapists in various settings. Future studies should examine the impact of clinical instructor experience and student characteristics and should expand to other settings.


Assuntos
Eficiência , Docentes/estatística & dados numéricos , Fisioterapeutas/estatística & dados numéricos , Estudantes de Ciências da Saúde/estatística & dados numéricos , Centros Médicos Acadêmicos , Assistência Ambulatorial/estatística & dados numéricos , Análise de Variância , Humanos , Pacientes Internados/estatística & dados numéricos , Doenças Musculoesqueléticas/reabilitação , Doenças do Sistema Nervoso/reabilitação , Fisioterapeutas/educação , Reabilitação/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Tempo
17.
Tumori ; 106(1): 12-24, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31452454

RESUMO

OBJECTIVE: This study reviews the scientific literature to identify and describe which assessment tools (ATs) are used in pediatric oncology and neuro-oncology rehabilitation and which development neuropsychomotor (DNPM) ATs were built for children with central nervous system (CNS) tumors. METHODS: A systematic review was performed searching PubMed, CINAHL, PEDro, Science Direct, and Catalog of National Institute of Tumors databases and specialized journals. The search covered 7 years (2010-2017) and used relevant keywords in different combinations. A further search was carried out on DNPM rehabilitation manuals and academic thesis. RESULTS: The review retrieved 35 eligible articles containing 63 ATs. The most common ATs were the Behavioral Rating Inventory of Executive Function (BRIEF) and the Wechsler Intelligence Scale for Children (WISC). Most of the ATs covered a single area of child development among behavioral/psychological, cognitive, and motor areas. A total of 159 ATs were found in manuals and thesis, and only 17 of them were already identified in the journal search. None of the ATs identified in both searches had been specifically developed for children with CNS tumor. CONCLUSION: The results highlight the need to develop and validate a global multidimensional AT for children with CNS tumor, overcoming the fragmentation of the assessment procedures and promoting standardized rehabilitation protocols.


Assuntos
Neoplasias do Sistema Nervoso Central/complicações , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/reabilitação , Reabilitação Neurológica , Testes Neuropsicológicos , Transtornos Psicomotores/etiologia , Transtornos Psicomotores/reabilitação , Neoplasias do Sistema Nervoso Central/diagnóstico , Neoplasias do Sistema Nervoso Central/terapia , Criança , Humanos , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/terapia , Transtornos Psicomotores/diagnóstico , Transtornos Psicomotores/terapia , Resultado do Tratamento
19.
NeuroRehabilitation ; 45(3): 311-322, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31796696

RESUMO

BACKGROUND: Individuals with extensive neuro-motor impairment and lack of speech tend to remain passive and isolated, and to rely on others for communication and leisure. While their problems are known, only limited evidence is available about intervention tools that could help them curb those problems. OBJECTIVE: This study was aimed at upgrading and assessing a smartphone-based technology package, which was recently developed to help those individuals to independently engage in basic communication and leisure. METHODS: The study included 11 non-ambulatory participants who had no speech or functional active communication. They were provided with (a) a Samsung A3 smartphone with Android 6.0 Operating System, which was fitted with WhatsApp Messenger and programmed via MacroDroid, and (b) cards fitted with radio frequency identification (RFID) tags. By bringing those cards in contact with the back of the smartphone, the participant could start a communication event (e.g., sending a message to a friend) or activate a leisure event (e.g., a song). The smartphone would automatically read to the participant any incoming messages. RESULTS: During the baseline (i.e., when a standard smartphone was available), the participants were unable to engage in communication or leisure. Once the aforementioned technology package was introduced, the participants spent between about 65 and 85% of their session time engaging in communication and leisure. CONCLUSIONS: The smartphone-based technology package seems to be a useful tool to support basic communication and leisure in individuals like those involved in this study.


Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Comunicação , Transtornos Motores/reabilitação , Doenças do Sistema Nervoso/reabilitação , Smartphone , Distúrbios da Fala/reabilitação , Adulto , Idoso , Idoso de 80 Anos ou mais , Auxiliares de Comunicação para Pessoas com Deficiência/tendências , Feminino , Humanos , Atividades de Lazer/psicologia , Masculino , Pessoa de Meia-Idade , Transtornos Motores/psicologia , Doenças do Sistema Nervoso/psicologia , Projetos Piloto , Smartphone/tendências , Fala/fisiologia , Distúrbios da Fala/psicologia
20.
Curr Sports Med Rep ; 18(12): 458-473, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31834178

RESUMO

The aims of this systematic review were to report on the feasibility of adaptive sports for individuals with acquired central neurological lesion; to analyze the effects of this approach according to the domains of the International Classification of Functioning, Health and Disability (ICF); and to emit guiding points for future research. Two authors searched PubMed, Scopus, Cochrane, Pedro, and SPORTdiscus for eligible trials. Data concerning demographics, outcome measures, results, and conclusions were extracted, and a qualitative synthesis was performed. Adaptive sports seem to be a feasible, efficient, and cost-effective complement to conventional rehabilitation. Significant effects were found on all domains of the ICF, except "environmental factors." Key factors, such as intervention volume, intensity, and type, play a determining role. This review is the first to expose the beneficial effects of adaptive sports practice among individuals with neurological lesions by relying on prospective evidence.


Assuntos
Terapia por Exercício , Doenças do Sistema Nervoso/reabilitação , Esportes para Pessoas com Deficiência , Pessoas com Deficiência , Humanos , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto
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