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1.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(3): 180-182, 2020 Mar 12.
Artigo em Chinês | MEDLINE | ID: mdl-32164083

RESUMO

A recent epidemic of pneumonia cases in Wuhan China was caused by a novel coronavirus with strong infectivity, the 2019 novel coronavirus (2019-nCoV). The article provides the pulmonary rehabilitation (PR) methods in the principle of 4S (simple, safe, satisfy, save) for patients with pneumonia caused by the novel coronavirus, shows how to establish a ventilative and convectional PR environment to prevent the spread of virus through droplets, how to guide the patients to carry out PR, how to carry out respiratory muscle training, effective cough, expectoration, sneeze, general exercise, digestive function rehabilitation and psychological rehabilitation, and how to clean and disinfect the PR environment.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus , Pneumonia Viral/reabilitação , Reabilitação/métodos , Sistema Respiratório/fisiopatologia , China , Infecções por Coronavirus/complicações , Infecções por Coronavirus/reabilitação , Tosse , Humanos , Pneumonia Viral/complicações , Pneumonia Viral/virologia , Respiração Artificial , Mecânica Respiratória
2.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 37(1): 174-178, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32096392

RESUMO

Human motion recognition (HAR) is the technological base of intelligent medical treatment, sports training, video monitoring and many other fields, and it has been widely concerned by all walks of life. This paper summarized the progress and significance of HAR research, which includes two processes: action capture and action classification based on deep learning. Firstly, the paper introduced in detail three mainstream methods of action capture: video-based, depth camera-based and inertial sensor-based. The commonly used action data sets were also listed. Secondly, the realization of HAR based on deep learning was described in two aspects, including automatic feature extraction and multi-modal feature fusion. The realization of training monitoring and simulative training with HAR in orthopedic rehabilitation training was also introduced. Finally, it discussed precise motion capture and multi-modal feature fusion of HAR, as well as the key points and difficulties of HAR application in orthopedic rehabilitation training. This article summarized the above contents to quickly guide researchers to understand the current status of HAR research and its application in orthopedic rehabilitation training.


Assuntos
Aprendizado Profundo , Movimento , Ortopedia , Reabilitação/métodos , Humanos
3.
Biosci. j. (Online) ; 36(1): 266-275, jan./feb. 2020. ilus, graf, tab
Artigo em Inglês | LILACS | ID: biblio-1049248

RESUMO

This study aimed to evaluate the influence of Integrated Continuous Care on the functional independence of the elderly. This cohort study included participants aged 60 years or older who had experienced a disabling event or disease, and were admitted to rehabilitation in a Brazilian Integrated Continuous Care Unit. The functional gain was evaluated by the Barthel index.Fifty-nine elderly individuals admitted due to a disabling event or disease at the ICCU were assisted from March 2014 to February 2015. Since twenty-two of these were excluded, only 37 participants were evaluated. The mean age of the elderly that were included was 70.41 years (± 1.40) and most of them presented an ischemic stroke diagnosis (64.9%). The total functional gain was 24.05 (± 3.84) points, with an average stay of 32.32 (± 2.18) days. When compared with the degree of dependence on the admission and at discharge, total or severe dependence was identified in 62.2% on admission and mild dependence or total independence was identified in 54.1% at discharge, with a significant decrease in the percentage of the elderly with total dependence between admission and discharge (McNemar test, p = 0.001). At hospital discharge, 70.3% of the elderly had better individual performance in their Activities of Daily Living than at hospital admission and none of them got worse. The multi-professional team-based approach in the Integrated Continuous Care assistance model favors the elderly with gain in functionality and independence. The social network involvement of the elderly lead to their empowerment and co-responsibility along with their family/caregiver in pursuit of the therapeutic goals established together.


Investigar a influência dos Cuidados Continuados Integrados na independência funcional de idosos. Este estudo de coorte incluiu participantes com 60 anos ou mais que sofreram algum evento ou doença incapacitante e que foram internados para reabilitação em Unidade Brasileira de Cuidados Continuados Integrados. O ganho funcional foi avaliado pelo índice de Barthel. Cinquenta e nove idosos admitidos por um evento ou doença incapacitante na UCCI foram atendidos de março de 2014 a fevereiro de 2015. Como vinte e dois deles foram excluídos, apenas 37 participantes foram avaliados. A média de idade dos pacientes incluídos foi de 70,41 anos (± 1,40) e a maioria apresentou AVC isquêmico como diagnóstico (64,9%). O ganho funcional total foi de 24,05 (± 3,84) pontos, com tempo médio de permanência de 32,32 (± 2,18) dias. Quando comparados o grau de dependência na admissão e na alta, a dependência total ou grave foi identificada em 62,2% na admissão e a dependência leve ou independência total foi identificada em 54,1% na alta, com uma diminuição significativa no percentual de pacientes com dependência total entre admissão e alta (teste de McNemar, p = 0,001). Na alta hospitalar, 70,3% dos pacientes apresentaram melhor desempenho individual em suas Atividades de Vida Diária do que no momento da admissão hospitalar e nenhum paciente piorou. A abordagem multiprofissional baseada em equipe no modelo assistencial do Cuidado Integrado Contínuo beneficia o idoso, com ganho de funcionalidade e independência. O envolvimento do paciente na rede social leva ao empoderamento e corresponsabilidade deste e da família/cuidador na busca dos objetivos terapêuticos estabelecidos em conjunto.


Assuntos
Reabilitação , Idoso , Atividades Cotidianas , Resultado do Tratamento , Assistência ao Paciente
4.
Rehabilitation (Stuttg) ; 59(1): 10-16, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31096290

RESUMO

BACKGROUND: Early retirements make up a large portion of indirect costs of illness caused by chronic back pain. METHODS: Claims data from statutory health insurance and German Pension Fund provide the basis for analysis. Cox-Regression was performed for duration to early retirement, whereby beside sociodemographic and treatment characteristics, the effect of rehabilitation was considered. RESULTS: Early retirement started on average 7.1 month later through rehabilitation. Therefore, rehabilitants made € 8,432.60 higher payments to statutory health insurance and German Pension Fund per rehabilitant. Based on the total number of 21,262 early retirees with orthopedic indications, this can save € 180.7 million. The timing of the early retirement was also affected by age and sickness benefits in the previous month. Savings by avoiding entry into early retirement have not yet been taken into account in this model. CONCLUSION: Rehabilitants receive later pensions due to reduced ability, which allow for more contributions to statutory health insurance and German Pension Fund. This indicates that medical rehabilitation is an economic and effective treatment.


Assuntos
Administração Financeira , Reabilitação , Aposentadoria , Alemanha , Humanos , Renda , Pensões , Reabilitação/economia
5.
Rehabilitation (Stuttg) ; 59(1): 34-41, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-30743284

RESUMO

OBJECTIVE: The study explores barriers impeding the access to pediatric rehabilitation and potential for optimization from the pediatricians' perspective. METHODS: Semi-structured expert interviews (N=25) and focus groups (N=3) with pediatricians were conducted and analyzed according to the method of Meuser & Nagel. The results were discussed within an expert group consisting of representatives of the statutory pension insurance and the professional association of pediatricians. RESULTS: Barriers appear due to information deficits regarding carrier-oriented access criteria. A perceived time-consuming application, high refusal rates with insufficient reasons and a lack of feedback from the carrier to the physician inhibit the application motivation. Mentioned improvements refer to a direct feedback of the application decision to the physician, case-specific reasons for refusal, physician oriented information as well as an increased presence of rehabilitation at pediatric congresses and medical trainings. CONCLUSION: To strengthen the role of rehabilitation in pediatric care improved information and knowledge in the allocation and submission of rehabilitation applications of primary care physicians is needed as well as an enhanced communication between rehabilitation carriers and physicians.


Assuntos
Acesso aos Serviços de Saúde , Pediatras , Reabilitação , Criança , Grupos Focais , Alemanha , Humanos
7.
São Paulo; s.n; 2020. 232 p.
Tese em Português | LILACS | ID: biblio-1052693

RESUMO

Deficiência e incapacidade são intrínsecas a condição humana. Grande parte das pessoas, em algum momento das suas vidas, irão experimenta-las de forma definitiva, momentânea ou intermitente. A identificação desses indivíduos é complexa. Depende do conceito compreendido pela sociedade e pelo poder público. Uma das lacunas ainda existentes nos sistemas de saúde, são as ações voltadas para as pessoas com deficiência, desde o seu acompanhamento na atenção primária à saúde, atenção especializada, hospitalar e reabilitação. Visando organizar o sistema de saúde para responder as necessidades de saúde decorrentes destas questões, o Ministério da Saúde instituiu, em 2012, a Rede de Cuidado à Pessoa com Deficiência (RCPD). Objetivo: Analisar o processo de implementação de política de atenção à saúde da pessoa com deficiência física no contexto da constituição uma rede regional de atenção à saúde considerando diferentes concepções de deficiência. Método: Estudo de caso de abordagem quantitativa e qualitativa. Utilizada triangulação de dados para analise de documentos (atas de colegiados de gestão e normativas), dados primários e secundários (população, profissionais e estabelecimentos de saúde e, financiamento). Dados primários coletados por meio de questionários e entrevistas estruturadas com gestores, prestadores e sociedade dos níveis estadual, regional e municipal na região de saúde de São José do Rio Preto, estado de São Paulo. Dados quantitativos analisados por estatística descritiva e qualitativos por analise de conteúdo. Resultados: Foram entrevistados 37 informantes chave. Deficiência é compreendida substancialmente através do modelo médico, sendo o corpo o principal alvo de intervenção ou através de modelo de caridade, tratados como indivíduos que dependem da sociedade para sobrevir. Os implementadores da política na prática cotidiana apresentam poder de modular a política conforme suas próprias crenças. Serviços não estão articulados em rede. Não existem processos de regulação assistencial consistentes que visem ampliar o acesso e potencializar a equidade, sobretudo em instituições filantrópicas contratualizadas pelo Estado. Estas atuam de forma independente as diretrizes elaboradas pelos colegiados de gestão e pelos formuladores da política. O cuidado é centrado em serviços de atenção especializada, não existindo, por parte da atenção primária à saúde, efetiva participação no cuidado. Recursos humanos são escassos, com baixa capacidade técnica. Conclusão: Deficiência é ainda compreendida como problema do corpo. Serviços de saúde atuam de forma isolada. O Estado normatiza a política mas esta, não se concretiza na vida real, pelo não alinhamento técnico e organizacional e pelo seu baixo poder de regular a RCPD.


Disabilities are intrinsic to the human condition. Most people, at some point in their lives, will experience them permanently, momentarily or intermittently. The identification of these individuals is complex, it depends on the concept understood by society and the government. One of the gaps that still exist in health systems, are the actions aimed at people with disabilities, since their monitoring in primary health care, specialized care, hospital care and rehabilitation. In order to organize the health system to answer the needs arising from these issues, the Ministry of Health instituted, in 2012, the Care Network for People with Disabilities (CNPD). Objective: To analyze the process of implementing a health care policy for people with physical disabilities in the context of the constitution of a regional health care network considering different concepts of disability. Method: Case study with a quantitative and qualitative approach. Data triangulation was used through document analysis, primary and secondary data (population, health professionals and establishments, and financing). Primary data collected through questionnaires and structured interviews with managers, providers and society at the state, regional and municipal levels in the health region of São José do Rio Preto, state of São Paulo. Quantitative data analyzed by descriptive statistics and qualitative data by content analysis. Results: 37 key informants were interviewed. Disability is substantially understood through the medical model, with the body being the main target of intervention or through the charity model, treated as individuals who depend on society to survive. Policy implementers have the power to modulate policy according to their own beliefs. Services are not organized in networks. There are no consistent regulation processes that aim to expand access and enhance equity, especially in philanthropic institutions contracted by the State. These act independently of the guidelines developed by management collegiate bodies and policy makers. Care is centered on specialized care services, without effective participation of primary health care. Human resources are scarce, with low technical capacity. Conclusion: Disability is still understood as a problem of the body. Health services operate in isolation. The State regulates the policy, but it does not materialize in real life, due to the lack of technical and organizational alignment and its low power to regulate CNPD.


Assuntos
Política Pública , Reabilitação , Pessoas com Deficiência , Assistência à Saúde , Sistemas Nacionais de Saúde
9.
Maturitas ; 132: 40-48, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31883662

RESUMO

BACKGROUND: The accessibility, low cost and motivation generated by exergames has fostered its rapid expansion as a rehabilitation technique. OBJECTIVE: To estimate the effectiveness of rehabilitation programs using IVGT in improving walking capacity of people aged 60 years and over. MATERIALS AND METHODS: The electronic data research following the PRISMA Statement (Scopus, Cochrane, Web of Science, OT Seeker, National Guideline Clearinghouse, Trip Database, CSIC Spanish National Research Council) was completed in September 2018. The results of randomized clinical trials using exergames for rehabilitation of walking capacity were combined. The calculations have followed the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the quality of the evidence. RESULTS: We obtained data from 14 trials, including 11 meta-analysis studies. The size of exergames effects on walking capacity is moderate, but significant (SMD -0.56; 95 % CI: -0.90, -0.21; p = 0.002). Effectiveness was greater to recover the ability to transfer from one position or place to another (SMD -1.02; CI 95 %: -1.70, -0.35; P = 0.003). The intervention protocols, their duration and intensity varied considerably. The lack of masking, the allocation concealment, the absence of assessor blinding were the main causes of bias so the final grade of evidence has been low for walking and very low for transfers. CONCLUSIONS: Positive clinical effects of exergames have been found to improve walking capacity, but the quality of evidence to refute its effectiveness is weak with risk of bias. Further research is needed in order to know the actual magnitude of its effect.


Assuntos
Tolerância ao Exercício , Limitação da Mobilidade , Jogos de Vídeo , Realidade Virtual , Caminhada/fisiologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Reabilitação/métodos
10.
Rev. bras. cir. plást ; 34(4): 561-566, oct.-dec. 2019. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-1047928

RESUMO

Introdução: O couro cabeludo é uma área de difícil reconstrução devido à sua pouca elasticidade e por sobrepor-se a uma estrutura rígida e convexa. Existem diferentes técnicas cirúrgicas para reparação dos defeitos, que podem ser produto de diversas etiologias, como: traumas, deformidades e consequência de doenças, principalmente oncológicas, como é o caso do paciente apresentada neste trabalho. O angiossarcoma cutâneo é um tumor vascular maligno raro e extremamente agressivo, que afeta principalmente idosos. É caracterizado clinicamente pelo aparecimento de placas eritêmato-violáceas e de rápida evolução. O tratamento depende da extensão da doença. A maioria dos casos são tratados com ampla ressecção cirúrgica e reconstrução. O objetivo é relatar um caso de reconstrução de grande defeito do couro cabeludo depois de uma dissecção oncológica, realizado no Hospital Central do Exército (HCE) - RJ. Métodos: O caso foi tratado com enxerto autólogo e uso de matriz dérmica, em 2 tempos cirúrgicos, até a total cobertura da área lesionada. Resultados: Obteve-se resultado satisfatório após as cirurgias de enxertia de pele na área ressecada. Conclusão: O enxerto autólogo, juntamente a matriz dérmica mostrou-se uma opção viável na reconstrução do couro cabeludo.


Introduction: It is difficult to reconstruct the scalp due to its poor elasticity and presence of layers over a rigid convex structure. Different surgical techniques are used to repair defects that may develop due to several etiologies, such as trauma, deformities, and disease sequelae, especially cancer, as noted in the present case. Cutaneous angiosarcoma, a rare and extremely aggressive malignant vascular tumor that mainly develops in elderly individuals, is clinically characterized by the onset of rapidly evolving erythematous purple plaques. The treatment depends on disease extent. Most patients are treated with wide surgical resection and reconstruction. The objective is to report a case of reconstruction of a major scalp defect after an oncologic dissection performed at the Hospital Central do Exército in Rio de Janeiro. Methods: An autologous graft and dermal matrices were applied during two surgical periods till the damaged area was fully covered. Results: Satisfactory results were obtained after performing skin grafting surgery in the resected area. Conclusion: The autologous graft and dermal matrix proved to be a viable option for scalp reconstruction.


Assuntos
Humanos , Masculino , Idoso , História do Século XXI , Reabilitação , Couro Cabeludo , Neoplasias Cutâneas , Procedimentos Cirúrgicos Reconstrutivos , Hemangiossarcoma , Neoplasias de Tecido Vascular , Reabilitação/métodos , Reabilitação/psicologia , Couro Cabeludo/cirurgia , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/terapia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Hemangiossarcoma/cirurgia , Hemangiossarcoma/terapia , Neoplasias de Tecido Vascular/cirurgia , Neoplasias de Tecido Vascular/terapia
11.
Rev. bras. cir. plást ; 34(4): 497-503, oct.-dec. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047912

RESUMO

Introdução: A úlcera plantar por hanseníase é uma lesão no pé resultante da falta de sensibilidade plantar. O objetivo é descrever o tratamento realizado em portadores de úlceras plantares por hanseníase. Métodos: Estudo de prontuários de portadores de úlcera plantar atendidos no Hospital Sarah em Brasília, de 2006 a 2016, quanto ao sexo, idade, etiologia, localização e tratamento. Resultados: Foram atendidos 27 pacientes, 17(62,96%) homens e 10 (37,04%) mulheres, procedentes de Goiás e DF, na faixa etária de 41 a 60 anos (40,74%). Todos necessitaram de um ou mais procedimentos cirúrgicos. Conclusão: Observou-se maior frequência no sexo masculino, grau avançado, localizadas no primeiro artelho. Todos necessitaram de procedimentos cirúrgicos e não cirúrgicos, evoluindo com cicatrização completa da ferida, amputação transtibial em um caso e de artelhos em sete casos, e 90% dos casos apresentaram recorrência da úlcera após um ano.


Introduction: Leprosy-induced plantar ulcers result from a lack of plantar sensitivity. Objective: This study aimed to describe the treatment provided to patients with leprosy-induced plantar ulcers. Methods: We retrospectively reviewed the medical records of patients with plantar ulcers treated at Sarah Hospital in Brasilia from 2006 to 2016 and collected information about sex, age, etiology, location, and treatment. Results: A total of 27 patients (17 [62.96%] men, 10 [37.04%] women; 40.74% were aged 41­60 years) were treated from Goiás and the Federal District. All required ≥1 surgical procedure. Conclusion: A higher frequency of advanced grade was observed in men, primarily on the first toe. All needed surgical and non-surgical procedures and achieved complete wound healing. Transtibial amputation was required in 1 case and toe amputation in 7 cases; 90% patients developed ulcer recurrence after 1 year.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , História do Século XXI , Reabilitação , Terapêutica , Tratamento Terciário , Registros Médicos , Úlcera do Pé , Hanseníase , Reabilitação/métodos , Reabilitação/estatística & dados numéricos , Terapêutica/métodos , Terapêutica/estatística & dados numéricos , Tratamento Terciário/métodos , Tratamento Terciário/estatística & dados numéricos , Registros Médicos/normas , Registros Médicos/estatística & dados numéricos , Úlcera do Pé/cirurgia , Úlcera do Pé/complicações , Úlcera do Pé/terapia , Hanseníase/cirurgia , Hanseníase/complicações , Hanseníase/terapia
12.
Artigo em Russo | MEDLINE | ID: mdl-31884769

RESUMO

The purpose of the study is to design and to prove rehabilitation process management for musculoskeletal system disorders with the use of on line communication technology between patients and medical institution. MATERIAL AND METHODS: Medical and sociological study used sampling of 381 patients involved in hip-and-knee joint replacement program before the surgery and in rehabilitation period with the use of specially designed and implemented at the base of the V. I. Razumovsky Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University interactive system of monitoring and feedback (SMF). THE RESULTS: The implementation of developed criteria of SMF performance confirmed its demand among the patients. It was revealed that more than 91% of them are ready for active rehabilitation after surgery and all the participants of the study consider as acceptable the distant communication with medical specialists. The performed trial test established that for the period of interaction with SMF patients have changed their attitude to the ways of communication preferring those which suppose on line communication. CONCLUSION: The developed organizational technology being patient-focused provided acceptable quality of informational interaction for health services access at the base of active feedback, interactivity and customization. It is shown that aged but able-bodied patients are impressionable for such practice, so using of on line communication influencing labor and social activity prolongation being both factor and instrument of health services accessibility.


Assuntos
Ortopedia , Traumatologia , Comunicação , Acesso aos Serviços de Saúde , Humanos , Reabilitação , Universidades
13.
J Rehabil Med ; 51(11): 847-853, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31663599

RESUMO

OBJECTIVE: Rehabilitation services play an important role in optimizing functional ability and societal integration for people with disabilities. The Madagascar Rehabilitation Programme (2011-2013) resulted from a global training partnership and led to 8 doctors achieving a university diploma in rehabilitation medicine. This paper describes a 2014 evaluation of the programme methods, results and learning points. METHODS: A combination of qualitative methods was used for the evaluation, based on a Theory of Change model, with informants from Madagascar and the UK. RESULTS: Malagasy trainees and UK volunteers gained new theoretical knowledge and practical skills. For Madagascar, it led to changes in working practice and the formation of a national rehabilitation association. Key to its success was the strong collaboration between Malagasy and UK professionals, with support from the University and Ministry of Health in Madagascar, and the UK partners. Having a clear common vision ensured the programme met the needs of the Malagasy clinicians. CONCLUSION: Rehabilitation is increasingly recognized as an important focus for international development. Successful rehabilitation training programmes can be achieved at modest costs with global health partnerships. The combination of factors that enabled this programme to be a success is reproducible in other contexts.


Assuntos
Pessoas com Deficiência/educação , Pessoas com Deficiência/reabilitação , Saúde Global/normas , Reabilitação/métodos , Humanos , Madagáscar
14.
Pediatr Phys Ther ; 31(4): 370-372, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31568386

RESUMO

The outbreak of Zika in Brazil almost 3 years ago had harmful medical, financial, and social consequences for children and their families. It also significantly increased the statistics of Brazilian children with disabilities being followed up in rehabilitation centers. Actions promoting the use of the International Classification of Functioning, Disability and Health (ICF) framework are encouraged in view of the complex health needs identified in this population, which cover all areas of functioning, and gain special relevance when it comes to a vulnerable context. This perspective article discusses the challenges related to the implementation of the ICF in rehabilitation services for children with congenital syndrome.


Assuntos
Avaliação da Deficiência , Crianças com Deficiência/reabilitação , Microcefalia/reabilitação , Reabilitação/classificação , Reabilitação/métodos , Infecção por Zika virus/reabilitação , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino
15.
J Rehabil Med ; 51(11): 834-840, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31583419

RESUMO

OBJECTIVE: To describe a project to develop guideline implementation tools (GItools) for rehabilitation guidelines, and a collaboration between a guideline producer and a healthcare organization to implement guidelines into care pathways. DESIGN: Descriptive case study. METHODS: A national guideline organization in Finland launched a 3-year project in 2015 to implement rehabilitation recommendations. Usability of the GItools was evaluated and improved, based on literature, workshops and surveys. An implementation plan guided the production of the GItools. An implementation plan was developed to integrate the shoulder disorders guideline into a care pathway at Päijät-Häme district rehabilitation unit. The implementation plan was produced in 3 facilitated workshops, which included brainstorming, snowballing, prioritizing and short lectures. RESULTS: Twenty implementation plans and 119 different GItools for 22 guidelines were developed. The GItools, in particular patient material, were perceived as useful for the facilitation of guideline implementation. Four seminars and 14 sessions of continuous medical education were arranged. A plan was developed and executed for the implementation of the shoulder disorders guideline. CONCLUSION: It is feasible for a guideline producer to systematically include GItools into rehabilitation guidelines. This implementation project was an example of a successful collaboration between a guideline producer and a healthcare organization.


Assuntos
Fidelidade a Diretrizes/normas , Reabilitação/métodos , Humanos
16.
Rev Sci Instrum ; 90(9): 094101, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31575258

RESUMO

Robotic therapy is a useful method applied during rehabilitation of stroke patients (to regain motor functions). To ensure active participation of the patient, assistance-as-needed is provided during robotic training. However, most existing studies are based on a predetermined desired trajectory, which significantly limits the use of this method for more complex scenarios. In this paper, artificial intelligence (AI) agents are introduced to enhance the robot so that a knee exoskeleton can be autonomously controlled. A new assist-as-needed (AAN) method is proposed, where the subjects and agents cooperatively control movements. An electromyographic (EMG)-controlled knee exoskeleton with an interesting screen game is developed. Two different AI agents, modular pipeline and deep Q-network, are introduced; both can control the exoskeleton to play the screen game independently. The human-robot cooperative control is studied with two different assistant strategies, i.e., fixed assistant ratio and AAN. Eight healthy subjects participated in the initial experiment, and four assistant modes were studied. The game scores obtained by the two agents were significantly higher than those obtained by healthy subjects (EMG control), indicating that using the agents to assist stroke rehabilitation is possible. The AAN method demonstrated a better performance than the fixed assistant ratio method, indicated by the higher integral muscle activation level and participant score. Compared to a fully active control (EMG control) and fully fixed guidance (AI control), human-robot cooperative control had significantly higher integral muscle activation levels, i.e., the subjects were more involved and motivated during training. Using AI agents to power rehabilitation robots is a promising way to realize AAN rehabilitation.


Assuntos
Inteligência Artificial , Exoesqueleto Energizado , Articulação do Joelho , Robótica/instrumentação , Adulto , Eletromiografia , Feminino , Humanos , Aprendizado de Máquina , Masculino , Músculos/fisiologia , Reabilitação/instrumentação , Adulto Jovem
18.
Int J Med Inform ; 132: 103982, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31605883

RESUMO

BACKGROUND: Previous research has studied the effects of games in pediatric wards, but none of it has focused on the impact of the hospital's school staff on the psychosocial state of the children nor on the gameplay itself. OBJECTIVES: To present the Tangibot application and evaluate its impact on the children's psychosocial state in the short term and the impact of the teacher on their psychosocial state, communications and coordination during the activity. METHODS: A study was conducted in a hospital classroom with 20 participants, who participated twice in the game: one with the teacher playing along and another without her. An observational scale was used by two evaluators in order to assess the impact on the children. RESULTS AND CONCLUSIONS: The study revealed that the teacher has an impact on the children's communication and coordination procedures but has no impact on the psychosocial state of the participants. The teacher's impact was found to be positive about communications. Dialogue management significantly improves when the communication includes the teacher, which means speaking turns are observed more consistently. Information pooling also improves, and the participants ask the teacher more questions. Consensus is also reached more often and more easily, but this does not reflect on the performance, as the time management is evidently worse when the teacher is present, as is also the joint task orientation. On the other hand, it was found that the teacher does not have an impact on the psychosocial state of the participants during the game, and that it is the game itself which changes their state over time. In the case of affection, which reflects the participants' emotions of joy or boredom, their state improved significantly after a few minutes of play. The same thing occurred for physical activity, interest in the activity and interaction between peers, which increased in value in the first part of the game, although physical activity and interaction were reduced towards the end. No changes were found throughout the game in the number of complaints, nervousness or satisfied comments, which remained very low for all these aspects, showing that the game distracted them from their various symptoms. Based on these results, future work will explore the effects of gamification on the overall hospitalization perception, with special focus on the social opportunities during the hospital stay, to provide ways for the children to meet others during their treatment, to make the experience less painful and reduce their feelings of isolation. Some game strategies should also be evaluated to determine the ones that provide the best opportunities to improve the children's hospital experience.


Assuntos
Comunicação , Hospitalização/estatística & dados numéricos , Reabilitação/métodos , Interface Usuário-Computador , Jogos de Vídeo/estatística & dados numéricos , Criança , Pré-Escolar , Comportamento Cooperativo , Feminino , Teoria do Jogo , Humanos , Masculino , Ensino
19.
Artigo em Russo | MEDLINE | ID: mdl-31626165

RESUMO

AIM: Diabetes mellitus (DM) type 2 leads to the progression of cognitive impairment. The authors compared different types of cognitive rehabilitation in patients with type 2 diabetes. MATERIAL AND METHODS: One hundred and twenty patients with type 2 diabetes were examined and randomized into 4 groups: the computerized training group, the exercise therapy group, the akatinol memantine group and the control group. The duration of rehabilitation was 6 months. All patients underwent general clinical examination and neuropsychological testing. RESULTS AND CONCLUSION: All patients had impaired cognitive functions, especially in visual-constructive skills, speech, abstraction, and memory. Treatment with akatinol memantine was most effective compared to computerized training and exercise therapy. With the exception of the control group, all groups, in particular the exercise therapy group, showed the improvement in carbohydrate metabolism.


Assuntos
Disfunção Cognitiva , Diabetes Mellitus Tipo 2 , Terapia por Exercício , Terapia Assistida por Computador , Cognição , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/reabilitação , Disfunção Cognitiva/terapia , Diabetes Mellitus Tipo 2/complicações , Humanos , Memantina/uso terapêutico , Testes Neuropsicológicos , Reabilitação/métodos
20.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1368-1375, out.-dez. 2019. il
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1021865

RESUMO

Objective: The study's main purpose has been to analyze the Brazilian scientific productions that used the Pediatric Evaluation of Disability Inventory (PEDI) in investigations focused on children diagnosed with disabilities. Methods: It is an integrative literature review which was carried out from July to August 2017 in the following data sources: MEDLINE (PubMed), Virtual Health Library (VHL) and Web of Science, in English, Portuguese and Spanish languages. Results: The use of PEDI contributed to the identification of individual disabilities and the most impaired functions in children, providing data that allows the planning of interventions for parents, professionals, and caregivers. Furthermore, it has revealed the benefits of physical activities for functional performance, as well as the effects of the guidelines transmitted by health professionals to children with developmental disorders. Conclusion: PEDI has been proved to be relevant as it contributes with evidence to the evolution of the child with disabilities, identifies the commitments and allows the redirection of the actions of professionals and caregivers


Objetivo: Analisar as produções científicas brasileiras que utilizaram o Inventário de Avaliação Pediátrica de Incapacidade (PEDI) em estudos voltados para crianças diagnosticadas com deficiência. Metodologia: Trata-se de revisão integrativa da literatura, realizada entre julho e agosto de 2017 nas seguintes fontes: MEDLINE (PubMed), Biblioteca virtual em saúde (BVS) e Web of sience nos idiomas inglês, português e espanhol. Resultados: A utilização do PEDI contribuiu para identificação de incapacidades individuais e das funções mais comprometidas em crianças, fornece dados que permitem o planejamento de intervenções para pais, profissionais e cuidadores. Além disso, permitiu revelar os benefícios das atividades físicas para o desempenho funcional assim como os efeitos das orientações realizadas por profissionais de saúde para crianças com desvios de desenvolvimento. Conclusão: O PEDI têm-se mostrado relevante por contribuir com evidências sobre a evolução da criança com incapacidades, identificar os comprometimentos e permitir redirecionamento das ações de profissionais e cuidadores


Objetivo: Analizar las producciones científicas brasileñas que utilizaron el Inventario deEvaluación Pediátrica de Discapacidad en estudios centrados en niños diagnosticados con discapacidad. Método: Se trata de una revisión integradora de la literatura, efectuada entre julio y agosto de 2017 en las siguientes fuentes: MEDLINE (PubMed), Biblioteca Virtual en Salud (BVS) y Web of Science enlos idiomas inglés, portugués y español. Resultados: La utilización del PEDI contribuyó a la identificación de discapacidades individuales y de las funciones más comprometidas en niños, suministra datos que permiten la planificación de intervenciones redireccionando las acciones de padres, profesionales y cuidadores, además de haber permitido revelar los beneficios de las actividades físicas para el desempeño funcional, así como los efectos de las orientaciones transmitidas por profesionales de salud para niños con desviaciones de desarrollo. Conclusión: El PEDI se ha mostrado relevante por contribuir con evidencias sobre la evolución del niño con discapacidades, identificar los compromisos y permitir la redirección de las acciones de profesionales y cuidadores


Assuntos
Humanos , Criança , Crianças com Deficiência/reabilitação , Crianças com Deficiência/estatística & dados numéricos , Equipamentos e Provisões/normas , Reabilitação/tendências
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