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1.
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
2.
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 , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Artigo em Russo | MEDLINE | ID: mdl-31626175

RESUMO

At the present time, distant rehabilitation is a relevant direction in restorative medicine. The article considers existing projects in remote rehabilitation, including a self-rehabilitation method developed by academician K.V. Lyadov, the Guided Self-Rehabilitation Contracts system (GSC) etc. The authors present an original project of a remote rehabilitation website 'NeuroHouse' designed for the restoration of balance and gait functions, wrist fine motor skills and speech, spasticity management in patients with neurological diseases. The project combines proprietary rehabilitation methods and classical exercise therapy. This website will make it possible to implement the third ambulatory stage of medical rehabilitation at home.


Assuntos
Terapia por Exercício , Doenças do Sistema Nervoso , Neurologia , Telemedicina , Marcha , Humanos , Espasticidade Muscular , Doenças do Sistema Nervoso/reabilitação , Neurologia/tendências , Federação Russa
5.
Nervenarzt ; 90(12): 1261-1269, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31451849

RESUMO

BACKGROUND: Evidence for the effectiveness of work-related medical rehabilitation (WMR) for a successful return to work (RTW) is lacking for neurological diseases. The aim of this study was therefore to correlate the cross-indication screening instrument for the identification of the demand of work-related medical rehabilitation (SIMBO­C) with the individualized clinical anamnestic determination of severe restrictions of work ability (SRWA) as a required access criterion for admittance to neurological WMR. A further aim was to compare the rate of successful RTW in rehabilitants with and without WMR measures 6 months after inpatient rehabilitation. METHODS: On admission SRWA were routinely screened by an individualized clinical anamnestic determination with subsequent assignment to WMR or conventional rehabilitation. At the beginning of rehabilitation the SIMBO-C was applied and 6 months after the rehabilitation the RTW status was surveyed. RESULTS: Of the 80 rehabilitants 44 (55%) received WMR. On admission they showed a higher SIMBO-C score (41.3 ± 15.7 vs. 26.2 ± 18.6 points, p = 0.002), on discharge more often locomotor and psychomental disorders (55% vs. 36%, p = 0.10 and 46% vs. 22%, p = 0.03, respectively) and longer incapacitation times after rehabilitation of > 4 weeks (66% vs. 33%, p = 0.02) compared to those without WMR. At 6 months follow-up after discharge the 2 groups did not significantly differ with respect to successful RTW (61% vs. 66%, p = 0.69). The SIMBO-C (cut-off ≥ 30 points) showed a medium correlation with the individualized clinical anamnestic determination of SRWA (r = 0.33, p = 0.01). CONCLUSION: The applied neurological WMR concept accomplished a comparable RTW rate between rehabilitants with SRWA by a WMR and those without SRWA and conventional rehabilitation. The SIMBO-C should only be used in combination with the individualized anamnesis to identify SRWA.


Assuntos
Doenças do Sistema Nervoso , Neurologia , Humanos , Programas de Rastreamento , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/reabilitação , Neurologia/tendências , Retorno ao Trabalho , Inquéritos e Questionários
6.
Nurs Clin North Am ; 54(3): 357-366, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31331623

RESUMO

Transitions of care from acute hospitalization to postacute rehabilitation settings evolved as a function of cost-saving changes to the Medicare Prospective Payment System. Restricted criteria for inpatient rehabilitation facility admission limited access for patients with severe physical and cognitive deficits. Once used as a resource-intense supplement to hospital care, skilled nursing facilities have metamorphosed into rehabilitation settings with limited nursing staff, lower intensity of therapies, and decreased community discharge rates. A collaborative approach to care transitions, using acute and postacute health care providers, provides the opportunity to improve this process. Early physiatry consultation is a strategy for patients with neurologic disease.


Assuntos
Cuidados Críticos/normas , Doenças do Sistema Nervoso/reabilitação , Alta do Paciente/normas , Transferência de Pacientes/normas , Guias de Prática Clínica como Assunto , Reabilitação/normas , Cuidado Transicional/normas , Humanos , Estados Unidos
7.
Pediatr Phys Ther ; 31(3): 272-278, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31225831

RESUMO

PURPOSE: To report on the preliminary aquatic physical therapy core sets for children and youth with neurological disorders using the International Classification of Functioning, Disability and Health-children and youth version. METHODS: A formal and structured consensus process was developed, integrating the findings of preparatory studies: a systematic literature review, expert survey with 69 participants, and a qualitative study with 43 participants. RESULTS: Five preliminary aquatic physical therapy core sets were described: a Comprehensive Core Set (64 categories); a Common Brief (13 categories); and 3 age-specific Core Sets: infant (below 6 years, 18 categories), school-age (from 6 to <14 years, 22 categories), and youth (from 14 to 18 years, 19 categories). CONCLUSIONS: Consensus among aquatic physical therapists' expert opinions identified the relevant intervention categories available when treating children and youth with neurological disorders. This list of intervention categories can be used in practice, research, education, and health administration.


Assuntos
Doenças do Sistema Nervoso/reabilitação , Fisioterapeutas/psicologia , Modalidades de Fisioterapia , Água , Atividades Cotidianas , Adolescente , Criança , Pré-Escolar , Consenso , Avaliação da Deficiência , Pessoas com Deficiência , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Inquéritos e Questionários
8.
G Ital Med Lav Ergon ; 41(2): 125-131, 2019 05.
Artigo em Italiano | MEDLINE | ID: mdl-31170342

RESUMO

SUMMARY: The digitization of processes has become a necessity to make health management remain sustainable. Current organizational models do not enable the increasing efficiency in process governance required by the increasing demand for rehabilitation services. Vice versa, new technologies have an innovative potential for compensation of disability and for operations management. This is context in which the concept of a "comprehensive digital rehabilitation" also said "digital gym" is developed: as a governance system for the whole inpatient rehabilitation path. The author describes the fundamentals of the Maugeri clinical model for a "Digital Gym" and examines some methodological, clinical and organizational issue concerning: information technology, machine operation protocols, clinical evaluation, machine operator interaction, patient doctor interaction, personalization of care, operational changes linked to the electronic workschedule, and the important training needs.


Assuntos
Tecnologia Biomédica/tendências , Modelos Organizacionais , Doenças do Sistema Nervoso/reabilitação , Reabilitação Neurológica/organização & administração , Pessoas com Deficiência , Humanos , Doença dos Neurônios Motores/reabilitação
9.
G Ital Med Lav Ergon ; 41(2): 156-161, 2019 05.
Artigo em Italiano | MEDLINE | ID: mdl-31170347

RESUMO

SUMMARY: We present the clinical case of a 17-year-old boy who, after an auto-motorbike collision, suffered of bilateral condylar atlo-occipital dislocation with blood in the medullary canal and contusion of the C1-C3 spinal cord, hemothorax and pneumothorax, multiple costal fractures, fractures processes transverse L1 and right iliac wing and displaced fracture of the middle third of the right femur. In the emergency phase the patient, who was in a coma GCS: 3/15, was immediately intubated and taken to the Emergency Department and subsequently to Intensive Care Unit. He was also immediately subjected to chest drainage, reduction of femoral fracture and placement of external fixator and tracheostomy. Upon stabilization of the clinical picture, the patient was subjected to occipital-cervical stabilization with plates and screws and reduction of the fracture of the right femur with an intramedullary rod. Then the patient in hemodynamically stable and in alert condition, in spontaneous breath, was discharged and transferred to our Operative Unit of Intensive Neurorehabilitation. At the entrance, the doctor's evaluation, with the whole multidisciplinary team, enabled to identify the ICD-9 and ICF codes that best described the severity of the clinical picture: the patient showed tetraplegia, dysphonia and dysphagia, bearing a tracheal cannula in breath spontaneous with O2 supplementation, sequelae of multiple costal fractures and right femur, totally dependent on ADL. The rehabilitation intervention was aimed at promoting motor recovery in the 4 limbs, recovery of standing and walking, acquisition of ability to control daily life activities (ADL), recovery of physiological swallowing and removal of the tracheostomy tube. After long and slow physiotherapeutic training, the patient recovered the active motility at the crural and brachial level mainly at the proximal level, which however is not effective for ADL recovery. On the other hand, speech therapy allowed the passage to oral feeding and removal of the tracheostomy tube. Upon discharge, the re-evaluation of the ICF codes identified at the entrance indicated an improvement in the strength of the trunk muscles (b7305) with the possibility of performing transfers with assistance (d420), of dysphonia (b320) and of swallowing (b510) which led to the removal of the PEG and the tracheostomy tube; unfortunately severe deficiency of the muscular force at the distal brachial and crural level (b730, b7304) persists with severe disability in the activities of daily life (d455, d4551, d465, d429, d230).


Assuntos
Doenças do Sistema Nervoso/reabilitação , Reabilitação Neurológica/métodos , Traumatismos da Medula Espinal/reabilitação , Acidentes de Trânsito , Atividades Cotidianas , Adolescente , Avaliação da Deficiência , Humanos , Classificação Internacional de Doenças , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Masculino , Doenças do Sistema Nervoso/fisiopatologia , Equipe de Assistência ao Paciente/organização & administração
11.
Nervenarzt ; 90(10): 1031-1036, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31139851

RESUMO

BACKGROUND: Data on the long-term effects on quality of life of patients after severe stroke and discharge from early institutional rehabilitation are important for guiding the early rehabilitation phase and the further outpatient care. OBJECTIVE: Analysis of the outcome of patients following severe stroke 3 and 12 months after discharge from early neurological rehabilitation. METHODS: Analysis of the Asklepios Hamburg multicenter early stroke rehabilitation registry (ICD 10: I61, I60, I63 and OPS 8­552). Structured interviews with documentation of disabilities using the early rehabilitation Barthel index (ERBI), modified Rankin scale (mRS) and quality of life (12-item short form health survey, SF-12). Assessment of further treatment and complications 3 and 12 months after discharge from the early rehabilitation departments by telephone interviews. RESULTS: Out of 1045 treated stroke patients 270 were enrolled between October 2015 and November 2017 and 200 and 151 patients could be followed up after 3 and 12 months, respectively. There was a significant improvement (p < 0.001) in the median ERBI (151 patients at 12 months). Factors influencing a poorer functional outcome (higher mRS) at 12 months were a higher mRS at discharge (OR 5.43 [1.18, 25.09], p = 0.03) and age (per decade OR 1.5 [1.09, 2.02]; p = 0.01). Female sex reduced the risk for a poorer outcome after 12 months (OR 0.49 [0.25, 0.96]; p = 0.04). Quality of life (SF-12) was not different over time. The mental quality of life showed no differences (p = 0.32) compared to a historical, significantly less (p<0.001) handicapped stroke collective. CONCLUSION: The surviving severe stroke patients recovered significantly up to 12 months after discharge. The mental quality of life did not differ from that of a historical less handicapped collective.


Assuntos
Doenças do Sistema Nervoso , Qualidade de Vida , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Pessoas com Deficiência/estatística & dados numéricos , Humanos , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/reabilitação , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/patologia
12.
Biomedica ; 39(1): 22-32, 2019 03 31.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31021544

RESUMO

Se reporta el proceso de recuperación y rehabilitación neurológica y cognitiva de una mujer joven que desarrolló un síndrome de embolia grasa con repercusiones neurológicas, después de sufrir un politraumatismo. La paciente era una mujer de 21 años de edad con fractura cerrada de húmero y fémur izquierdos, que presentó un síndrome de embolia grasa, neumotórax izquierdo e hipertensión pulmonar, en las primeras 24 horas después de un accidente. Estuvo hospitalizada un mes y quedó con varios déficits neurológicos centrales, como infartos 'lacunares' y necrosis cortical laminar occipital, así como limitaciones en la bipedestación, la marcha, la visión y las funciones cognitivas. A partir del primer mes después del alta hospitalaria, se comenzó un proceso integral de rehabilitación neurológica y cognitiva en casa, y posteriormente, en una unidad médica de rehabilitación. Durante los primeros dos años después del accidente, la paciente recibió estimulación sensorial, sensoperceptiva y motora, así como rehabilitación motora y visual intensiva. Una vez se recuperó físicamente, se inició un proceso de rehabilitación neuropsicológica. Seis años después del accidente, la paciente terminó sus estudios universitarios y hoy está laboralmente activa. El proceso de rehabilitación neurológica es complejo, individual y difícil, aunque no imposible, y no se puede estandarizar un patrón de recuperación para todos los pacientes. Si bien existe la recuperación espontánea, la cual se da en los primeros seis meses, el caso aquí reportado demuestra que, en la fase crónica, la recuperación se puede lograr, pero requiere de evaluaciones y técnicas coordinadas de rehabilitación neurológica.


Assuntos
Transtornos Cognitivos/reabilitação , Embolia Gordurosa/reabilitação , Doenças do Sistema Nervoso/reabilitação , Transtornos Cognitivos/etiologia , Embolia Gordurosa/complicações , Feminino , Humanos , Doenças do Sistema Nervoso/etiologia , Adulto Jovem
15.
Gait Posture ; 70: 33-38, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30802642

RESUMO

BACKGROUND: The timed up and go (TUG) test is widely used for assessing treatments effectiveness on elderly mobility. Although the TUG test consists of different tasks (e.g. walking and turning), the total TUG duration (TTD) is usually the only outcome measure, with TTD shortening indicating the patient's improvement. RESEARCH QUESTION: Does TTD shortening reflect the improvement of each TUG tasks or does it reflect the improvement of only some of them? METHODS: This retrospective study recruited 120 elderly patients (mean, SD: 76.9, 6.6 years) admitted to inpatient rehabilitation because of an acute or chronic neurological disease (acute patients, AP; chronic patients, CP). TTD and TUG tasks duration was measured on admission and discharge (five trials/session) by means of the instrumental TUG test (ITUG). Likelihood ratios (LRs) were used for inferring TUG tasks improvement from TTD improvement. TTD and TUG tasks have improved if at least four measurements on discharge were shorter than the shortest measurement on admission. RESULTS: TTD improvement per se is not enough to claim that all the TUG tasks have improved (LR+AP = 1.32; LR+CP = 1.85). Conversely, if TTD has not improved, not even a single TUG task has improved (LR-AP = 0.13; LR-CP = 0.19). If TTD has improved, there is at least one TUG task that actually improved (LR+AP = 3.17; LR+CP = 9.54). The improvement of all TUG tasks can be only inferred in the (unusual) event of a large TTD shortening (AP: >39%, LR+AP = 6.26; CP: >30%, LR+CP = 9.0). SIGNIFICANCE: In most cases, TTD improvement is not associated with the improvement of all TUG tasks. Moreover, when TTD has improved there is at least a TUG task that has improved, but that remains unknown. To actually understand how treatments ameliorate patients' mobility, ITUG with TUG task duration measurement should be preferred to TTD.


Assuntos
Teste de Esforço/métodos , Doenças do Sistema Nervoso/reabilitação , Caminhada/fisiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Doenças do Sistema Nervoso/fisiopatologia , Equilíbrio Postural , Estudos Retrospectivos , Estudos de Tempo e Movimento
16.
Curr Neurol Neurosci Rep ; 19(1): 4, 2019 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-30649633

RESUMO

PURPOSE OF REVIEW: The goal of this paper is to critically examine the challenges to clinical practice in acute neurorehabilitation settings to provide evidence-based recommendations for conducting research on neurologic recovery. RECENT FINDINGS: Recent changes in health care have dramatically challenged post-acute care by reducing the length of stay and increasing transitions in care with resulting loss of continuity of care and follow-up. These challenges hinder research and undermine progress in neurorehabilitation. Based on recent evidence, a hub and spoke model is proposed to bridge and facilitate continuity of care from acute to subacute to community settings to meet these challenges head on and facilitate research on mechanisms of functional recovery from neurologic conditions.


Assuntos
Pesquisa Biomédica/métodos , Doenças do Sistema Nervoso/reabilitação , Reabilitação Neurológica/métodos , Pesquisa Biomédica/tendências , Humanos , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/fisiopatologia , Reabilitação Neurológica/tendências , Recuperação de Função Fisiológica/fisiologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/tendências
17.
Arch Phys Med Rehabil ; 100(6): 1184-1190, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30690011

RESUMO

The purpose of this paper is to discuss how knowledge of the biomechanics of walking can be used to inform the prescription of resistance exercises for people with mobility limitations. Muscle weakness is a key physical impairment that limits walking in commonly occurring neurologic conditions such as cerebral palsy, traumatic brain injury, and stroke. Few randomized trials to date have shown conclusively that strength training improves walking in people living with these conditions. This appears to be because (1) the most important muscle groups for forward propulsion when walking have not been targeted for strengthening, and (2) strength training protocols have focused on slow and heavy resistance exercises, which do not improve the fast muscle contractions required for walking. We propose a theoretical framework to improve exercise prescription by integrating the biomechanics of walking with the principles of strength training outlined by the American College of Sports Medicine to prescribe exercises that are specific to improving the task of walking. The high angular velocities that occur in the lower limb joints during walking indicate that resistance exercises targeting power generation would be most appropriate. Therefore, we propose the prescription of plyometric and ballistic resistance exercise, applied using the American College of Sports Medicine guidelines for task specificity, once people with neurologic conditions are ambulating, to improve walking outcomes. This new theoretical framework for resistance training ensures that exercise prescription matches how the muscles work during walking.


Assuntos
Terapia por Exercício/métodos , Doenças do Sistema Nervoso/fisiopatologia , Doenças do Sistema Nervoso/reabilitação , Caminhada/fisiologia , Fenômenos Biomecânicos , Humanos , Limitação da Mobilidade , Exercício Pliométrico , Treinamento de Resistência/métodos
18.
Rehabilitation (Stuttg) ; 58(4): 260-268, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-30049001

RESUMO

BACKGROUND: Most disorders in neurological and neurosurgical early rehabilitation (NNER) are associated with an increased pneumonia risk. Respiratory therapy aims to prevent respiratory complications. However, there are no studies showing an effect of respiratory muscle training on the incidence of pneumonia in NNER. METHOD: The study included 81 phase-B-patients receiving respiratory muscle training and 81 control patients. Routine data such as age, sex, diagnoses, and comorbidities, length of stay, information on ventilation and incidence of pneumonia were analyzed retrospectively. RESULTS: The development of pneumonia was associated with a longer duration of treatment, a higher number of ventilation hours, the presence of a tracheal canula, and a tendency to lower Early Rehabilitation Barthel-Index on admission. The incidence rate of nosocomial pneumonia was 20% in both study groups. The groups differed significantly in disease severity on admission, duration of treatment, number of dysphagia patients, and in therapy intensities of physio and speech therapy. CONCLUSION: A direct correlation between the respiratory muscle training and the incidence of pneumonia in the NNER could not be conclusively demonstrated due to the insufficient comparability of both study groups. Besides the duration of ventilation, the intensity of dysphagia therapy was the strongest factor influencing the pneumonia incidence.


Assuntos
Exercícios Respiratórios , Doenças do Sistema Nervoso/reabilitação , Reabilitação Neurológica/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pneumonia/epidemiologia , Estudos de Casos e Controles , Alemanha , Humanos , Incidência , Análise por Pareamento , Pneumonia/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento
19.
Int J Neurosci ; 129(4): 369-383, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30311823

RESUMO

PURPOSE: The primary focus of this review was to find out the effectiveness of robotics in improving upper extremity functions among people with neurological problems in the arena of physical rehabilitation. MATERIAL AND METHODS: Two reviewers independently scrutinized the included studies. The selected studies underwent quality assessment by Physiotherapy Evidence Database (PEDro) scale. Randomized Controlled Trial (RCT) having a score of four or more were included in the review. A search was conducted in PUBMED, MEDLINE, CINAHL, EMBASE, PROQUEST, science direct, Cochrane Library, PEDro and Google Scholar. RESULTS: A total of 202 studies were identified. After removal of duplication, inclusion and exclusion criteria's n = 23 studies were included in the review process. For analysis, only the primary outcome measures of the studies were taken into account. Studies finally included in analysis were n = 21. The included studies were 19 in stroke, 1 in cerebral palsy (CP) and 1 study in multiple sclerosis (MS). No RCTs were reportedly found in spinal cord injury (SCI), Parkinson and motor neuron disease (MND). CONCLUSIONS: Studies related to stroke showed a clear definiteness in the improvement of upper extremity functions. On the contrary, there still remains a need for quality trials in CP, MS to establish the efficacy of robotics in upper extremity rehabilitation.


Assuntos
Doenças do Sistema Nervoso/fisiopatologia , Doenças do Sistema Nervoso/reabilitação , Reabilitação Neurológica/instrumentação , Recuperação de Função Fisiológica/fisiologia , Robótica/instrumentação , Extremidade Superior/fisiopatologia , Humanos , Reabilitação Neurológica/métodos , Robótica/métodos
20.
Disabil Rehabil ; 41(2): 226-234, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29025283

RESUMO

OBJECTIVE: The aims were to (i) provide a German translation of the Melbourne Assessment 2 (MA2), a quantitative test to measure unilateral upper limb function in children with neurological disabilities and (ii) to evaluate its reliability and aspects of clinical utility. METHODS: After its translation into German and approval of the back translation by the original authors, the MA2 was performed and videotaped twice with 30 children with neuromotor disorders. For each participant, two raters scored the video of the first test for inter-rater reliability. To determine test-retest reliability, one rater additionally scored the video of the second test while the other rater repeated the scoring of the first video to evaluate intra-rater reliability. Time needed for rater training, test administration, and scoring was recorded. RESULTS: The four subscale scores showed excellent intra-, inter-rater, and test-retest reliability with intraclass correlation coefficients of 0.90-1.00 (95%-confidence intervals 0.78-1.00). Score items revealed substantial to almost perfect intra-rater reliability (weighted kappa kw = 0.66-1.00) for the more affected side. Score item inter-rater and test-retest reliability of the same extremity were, with one exception, moderate to almost perfect (kw = 0.42-0.97; kw = 0.40-0.89). Furthermore, the MA2 was feasible and acceptable for patients and clinicians. CONCLUSIONS: The MA2 showed excellent subscale and moderate to almost perfect score item reliability. Implications for Rehabilitation There is a lack of high-quality studies about psychometric properties of upper limb measurement tools in the neuropediatric population. The Melbourne Assessment 2 is a promising tool for reliable measurement of unilateral upper limb movement quality in the neuropediatric population. The Melbourne Assessment 2 is acceptable and practicable to therapists and patients for routine use in clinical care.


Assuntos
Reabilitação Neurológica/métodos , Psicometria/métodos , Extremidade Superior/fisiopatologia , Criança , Avaliação da Deficiência , Feminino , Alemanha , Humanos , Masculino , Doenças do Sistema Nervoso/fisiopatologia , Doenças do Sistema Nervoso/reabilitação , Pediatria/métodos , Reprodutibilidade dos Testes , Tradução , Resultado do Tratamento
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