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1.
Cien Saude Colet ; 21(10): 3161-3170, 2016 Oct.
Artigo em Português, Inglês | MEDLINE | ID: mdl-27783789

RESUMO

The present qualitative study was conducted in the second semester of 2014 via interviews with 12 doctors and 13 nurses working as managers at a large hospital that serves as a reference center for urgent and emergent care in the Zona da Mata region of Minas Gerais State, Brazil. The study sought to identify the criteria that doctors and nurses use to discharge individuals with disabling neurological injury with instructions related to accessing physical rehabilitation programs. Thematic content analysis was used to examine data. The results show that the participating hospital managers still have difficulties providing adequate referrals to specialized rehabilitation services and that their patients' autonomy and independence for self-care are impaired as a result. We concluded that in addition to involving relatives and other caregivers in the discharge of patients with a neurological injury that impairs their self-care abilities, managers should assess the accessibility of the patient's home and make adequate referrals to rehabilitation services in the community in light of the poor dispersal of information about what is available within the Care for People with Disability Network.


Assuntos
Pessoas com Deficiência/reabilitação , Alta do Paciente , Encaminhamento e Consulta , Traumatismos do Sistema Nervoso/reabilitação , Adulto , Idoso , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos do Sistema Nervoso/complicações
2.
Ciênc. saúde coletiva ; 21(10): 3161-3170, Out. 2016. tab
Artigo em Português | LILACS | ID: lil-797021

RESUMO

Resumo Trata-se de pesquisa de abordagem qualitativa realizada no segundo semestre de 2014, mediante entrevistas com 12 médicos e 13 enfermeiros gestores atuantes em Hospital de grande porte, referência na área de urgência e emergência para a Zona da Mata Mineira. Buscou identificar os critérios utilizados por médicos e enfermeiros para o preparo da alta de pessoas com lesão neurológica incapacitante e indicação para acesso a programa de reabilitação física. Para o tratamento dos dados, utilizou-se a técnica de Análise de Conteúdo, modalidade temática. Os resultados mostram que os gestores hospitalares ainda encontram dificuldades para proceder ao encaminhamento adequado dessas pessoas para serviços especializados de reabilitação, o que compromete a autonomia e independência para o autocuidado. Conclui-se que os gestores além de envolver cuidadores e familiares no preparo da alta de pessoas com lesão neurológica que resulta em incapacidades para o autocuidado, deveriam avaliar as condições de acessibilidade em seus domicílios e fazer encaminhamentos adequados para serviços de reabilitação disponíveis na comunidade, a despeito da pouca divulgação acerca dos fluxos da Rede de Cuidados da Pessoa com Deficiência.


Abstract The present qualitative study was conducted in the second semester of 2014 via interviews with 12 doctors and 13 nurses working as managers at a large hospital that serves as a reference center for urgent and emergent care in the Zona da Mata region of Minas Gerais State, Brazil. The study sought to identify the criteria that doctors and nurses use to discharge individuals with disabling neurological injury with instructions related to accessing physical rehabilitation programs. Thematic content analysis was used to examine data. The results show that the participating hospital managers still have difficulties providing adequate referrals to specialized rehabilitation services and that their patients’ autonomy and independence for self-care are impaired as a result. We concluded that in addition to involving relatives and other caregivers in the discharge of patients with a neurological injury that impairs their self-care abilities, managers should assess the accessibility of the patient’s home and make adequate referrals to rehabilitation services in the community in light of the poor dispersal of information about what is available within the Care for People with Disability Network.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Pessoas com Deficiência/reabilitação , Alta do Paciente , Encaminhamento e Consulta , Traumatismos do Sistema Nervoso/reabilitação , Avaliação da Deficiência , Traumatismos do Sistema Nervoso/complicações
3.
Neurol Med Chir (Tokyo) ; 56(1): 33-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26538291

RESUMO

To improve the activities of daily living of patients with injury to the central nervous system, physical therapy starting from the acute phase of the injury is important. Recently, the efficacy of physical therapy using a hybrid assistive limb (HAL) robot suit was reported. However, individual differences exist in the effects of HAL. We investigated factors predicting the effects of HAL in 15 patients at our institution with central nervous system injury, primarily due to stroke, who underwent training using HAL during the acute phase. Patients were classified as either "with HAL suitability" or "without HAL suitability" based on scores from 10-m walking speed, gait, satisfaction, and pain. In both groups, Brunnstrom stage before HAL intervention, Fugl-Meyer assessment (FMA), stroke impairment assessment set (SIAS), and functional independence measure (FIM) were evaluated. Although motor function items did not differ significantly, FIM cognitive function items (P = 0.036), visuospatial perception items on SIAS (P = 0.0277), and pain items on SIAS (P = 0.0122) differed significantly between groups. These results indicated that training using HAL does not involve pain in patients with central nervous system injury during the acute phase, and exhibits positive effects in patients without pain and with high communication ability and visuospatial perception function. When conducting HAL intervention, incorporating functional assessment scores (FIM and SIAS), including peripheral items, may be useful to predict the suitability of HAL.


Assuntos
Extremidades/fisiopatologia , Traumatismos do Sistema Nervoso/reabilitação , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Robótica , Adulto Jovem
4.
Neurotherapeutics ; 13(2): 382-94, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26671658

RESUMO

Pathological neural activity could be treated by directing specific plasticity to renormalize circuits and restore function. Rehabilitative therapies aim to promote adaptive circuit changes after neurological disease or injury, but insufficient or maladaptive plasticity often prevents a full recovery. The development of adjunctive strategies that broadly support plasticity to facilitate the benefits of rehabilitative interventions has the potential to improve treatment of a wide range of neurological disorders. Recently, stimulation of the vagus nerve in conjunction with rehabilitation has emerged as one such potential targeted plasticity therapy. Vagus nerve stimulation (VNS) drives activation of neuromodulatory nuclei that are associated with plasticity, including the cholinergic basal forebrain and the noradrenergic locus coeruleus. Repeatedly pairing brief bursts of VNS sensory or motor events drives robust, event-specific plasticity in neural circuits. Animal models of chronic tinnitus, ischemic stroke, intracerebral hemorrhage, traumatic brain injury, and post-traumatic stress disorder benefit from delivery of VNS paired with successful trials during rehabilitative training. Moreover, mounting evidence from pilot clinical trials provides an initial indication that VNS-based targeted plasticity therapies may be effective in patients with neurological diseases and injuries. Here, I provide a discussion of the current uses and potential future applications of VNS-based targeted plasticity therapies in animal models and patients, and outline challenges for clinical implementation.


Assuntos
Doenças do Sistema Nervoso/reabilitação , Traumatismos do Sistema Nervoso/reabilitação , Estimulação do Nervo Vago/métodos , Humanos , Doenças do Sistema Nervoso/terapia , Plasticidade Neuronal , Traumatismos do Sistema Nervoso/terapia
5.
J Hand Ther ; 28(2): 101-4; quiz 105, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25835256

RESUMO

STUDY DESIGN: Literature review. PURPOSE: The corticospinal system (CS) and peripheral nervous system (PNS) are common sites of damage during the early stages of life. The prenatal or immediately prenatal period is the most common time for damage to occur. Here we briefly review the basic features of the development of the CS and the PNS and the clinical consequences of injury to or improper development of these systems on upper extremity (UE) function. RESULTS: The proper development of both the CS and PNS is necessary to achieve adequate function of the (UE). Injury or improper development of these systems can lead to upper extremity dysfunction and limit participation in activities of daily living. CONCLUSIONS: Both the PNS and CS play major roles in the proper functioning of the UE. A better understanding of their roles and common developmental disorders is needed to move rehabilitation of motor impairments forward.


Assuntos
Sistema Nervoso Periférico/crescimento & desenvolvimento , Tratos Piramidais/crescimento & desenvolvimento , Traumatismos do Sistema Nervoso/complicações , Traumatismos do Sistema Nervoso/fisiopatologia , Extremidade Superior/fisiologia , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Traumatismos do Sistema Nervoso/reabilitação
6.
Disabil Rehabil Assist Technol ; 10(2): 132-40, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24369043

RESUMO

PURPOSE: The objectives of this study were to (1) describe the sociodemographic profile of service dog users, their physical disabilities, main occupations, living environment, and use of technical aids in daily life and (2) evaluate the impact of service dogs on wheelchair travel and picking up objects. METHOD: Sociodemographic and clinical data were collected and various mobility tests were conducted in the service dog users' home environment (n = 199). RESULTS: The service dog users had injuries to the central or peripheral nervous system (55%), spinal cord (33%), or musculoskeletal or orthopedic system (12%). In the wheelchair travel on flat terrain test (n = 67), users travelled a longer distance in a shorter time, improving their average speed to 1.28 m/s with the service dog compared to 0.75 m/s without (p < 0.001). In a wheelchair propelling up a slope, 42% improved with the service dog (n = 60). Mounting a threshold/curb in a wheelchair, 41% improved with the service dog (n = 39). In a test where walkers and wheelchair users picked up three objects off the ground, 44% improved with the service dog (n = 164). CONCLUSION: Service dogs significantly improved wheelchair travel speed and distance on flat and ascending terrain, mounting a threshold/curb and picking up objects off the ground. Implications for Rehabilitation For people with motor impairments: Service dogs are most often used as a technical aid to pick up objects (96%), open doors (36%) and pull the wheelchair during travel (34%). Clients' performance in significant travel in a wheelchair (on flat terrain, on an upslope, mounting a threshold) improved with the service dog compared to their own performance without the dog. Clients' grasping performance (picking up three significant objects off the ground) improved with the service dog compared to their own performance without the dog.


Assuntos
Atividades Cotidianas , Cães , Traumatismos do Sistema Nervoso/reabilitação , Cadeiras de Rodas , Adolescente , Adulto , Idoso , Animais , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Quebeque , Fatores Socioeconômicos , Adulto Jovem
7.
Neuroscientist ; 20(6): 639-51, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25193343

RESUMO

Brain-computer interface (BCI) has proven to be a useful tool for providing alternative communication and mobility to patients suffering from nervous system injury. BCI has been and will continue to be implemented into rehabilitation practices for more interactive and speedy neurological recovery. The most exciting BCI technology is evolving to provide therapeutic benefits by inducing cortical reorganization via neuronal plasticity. This article presents a state-of-the-art review of BCI technology used after nervous system injuries, specifically: amyotrophic lateral sclerosis, Parkinson's disease, spinal cord injury, stroke, and disorders of consciousness. Also presented is transcending, innovative research involving new treatment of neurological disorders.


Assuntos
Interfaces Cérebro-Computador , Encéfalo/fisiopatologia , Traumatismos do Sistema Nervoso/reabilitação , Esclerose Amiotrófica Lateral/reabilitação , Interfaces Cérebro-Computador/tendências , Transtornos da Consciência/reabilitação , Humanos , Doença de Parkinson/reabilitação , Processamento de Sinais Assistido por Computador , Traumatismos da Medula Espinal/reabilitação , Reabilitação do Acidente Vascular Cerebral
8.
Eur J Phys Rehabil Med ; 49(6): 829-36, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24185691

RESUMO

BACKGROUND: In recent years we have witnessed a rapidly-growing tendency to seek neurorehabilitation abroad. AIM: This study aimed at better understanding this practice through a analysis of the authorizations for pediatric neurorehabilitation services issued by Italian Regions. DESIGN: Descriptive retrospective survey study. SETTING: Outpatient. POPULATION: Italian children travelling abroad for neurorehabilitation. METHODS: We analyzed the number of authorizations granted in the 2008-2011 period by local health agencies of Italian regions to children aged 0-18 years applying for neurorehabilitation services abroad. Information was obtained from the Ministry of Health database management systems. RESULTS: Our analysis showed an extreme variability across Italian regions. This is probably suggestive of an unbalanced offer of pediatric neurorehabilitation services across regions, different mechanisms used to control the phenomenon. CONCLUSION: Our study looked specifically at the practice of neurorehabilitation abroad in order to encourage further and larger studies, even at international level. A greater integration of health systems with common policies is to be achieved in order to control this phenomenon in a field as sensitive as pediatric neurorehabilitation. CLINICAL REHABILITATION IMPACT: Our study, which is the only study so far focusing on pediatric neurorehabilitation, looked specifically at the practice of health tourism in order to encourage further and larger studies, even at international level. Health tourism is a critical issue for all Western welfare systems which are under a pressure to cut health-related expenses.


Assuntos
Turismo Médico/estatística & dados numéricos , Doenças do Sistema Nervoso/reabilitação , Traumatismos do Sistema Nervoso/reabilitação , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Itália/epidemiologia , Itália/etnologia , Estudos Retrospectivos
9.
World Neurosurg ; 79(3-4): 568-75, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23022982

RESUMO

OBJECTIVE: To review the sparse literature that exists on the topic of head injury assessment and management outside high-income settings and attempt to: 1) identify strengths and weaknesses of the currently published clinical data relating to head injuries in lower-income countries; and 2) consider specific objectives for future head injury research in the resource-limited setting. If levels of excellence in neurosurgery are to be sustainably achieved outside high-income countries, there must be good systems of research and audit in place both to identify where development is needed and to evaluate the efficacy of development projects already in progress. METHODS: We performed a MEDLINE search of publications between 1980 and 2010 by using the search terms head injuries/craniocerebral trauma/neurotrauma and developing world/developing nations. Information was extracted and compared between publications by using our local head injury evaluation and audit database (OxHEAD) as a quality standard. RESULTS: The issue of traumatic brain injury management in low-income countries is underrepresented in the international literature relative to the scale of the problem. However, epidemiologic data generally are better reported than data relating to in-hospital care and follow-up, which suffers as a result of heterogeneous data collection and categorization techniques. CONCLUSION: The use of standardized scoring systems and outcome measures is likely to improve the comparability of data between studies. A multicenter collaborative approach towards data collection in resource-limited settings may be the most efficient and productive strategy for future research.


Assuntos
Traumatismos do Sistema Nervoso/terapia , Lesões Encefálicas/epidemiologia , Lesões Encefálicas/terapia , Administração de Caso , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/reabilitação , Traumatismos Craniocerebrais/terapia , Países em Desenvolvimento , Seguimentos , Geografia , Escala de Coma de Glasgow , Hospitalização , Humanos , Renda , Neurocirurgia/estatística & dados numéricos , Traumatismos do Sistema Nervoso/epidemiologia , Traumatismos do Sistema Nervoso/reabilitação
10.
Expert Rev Neurother ; 12(8): 901-5, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23002933

RESUMO

The 9th Global College of Neuroprotection and Neuroregeneration annual meeting was held in cooperation with the 5th International Association of Neurorestoratology and the 4th International Spinal Cord Injury Treatment and Trial Symposium in the beautiful city of Xi'an, Shaanxi Province, China, between 4 and 7 May 2012. This trilateral conference was held in the pleasing ambience of the Sofitel Hotel Complex in Renmin Square, Xi'an. Top Chinese government dignitaries including the National Deputy Health Minister, Vice Governor of Shaanxi Province, Vice President of Xi'an Jiaotong University and Party Secretary of the Medical Association inaugurated the congress. More than 1000 delegates from across the world, including approximately 600 medical researchers from China, participated in this meeting. The theme of this meeting was 'neurorestoration and neurorepair' using stem cell treatment, antibodies and pharmacotherapy, as well as nanomedicine and neurorehabilitation. Preclinical and clinical research was presented and discussed. Use of nanomedicine to enhance neurorepair or diagnosis of neurological diseases in clinical situations was the new attraction in this trilateral meeting. More than 50 leading experts in neuroprotection and neurorestoratology presented their cutting edge research in the area. New features included the Youth Forum in which 12 young scientists presented their innovative results, and more than 30 platform presentations were included. Thus, the trilateral conference of the Global College of Neuroprotection and Neuroregeneration, the International Association of Neurorestoratology and the International Spinal Cord Injury Treatment and Trial Symposium was extremely successful from both the scientific and social perspectives.


Assuntos
Sistema Nervoso Central/lesões , Nanomedicina/métodos , Medicina Regenerativa/métodos , Reabilitação/métodos , Transplante de Células-Tronco , Traumatismos do Sistema Nervoso/reabilitação , Traumatismos do Sistema Nervoso/terapia , Animais , Sistema Nervoso Central/efeitos dos fármacos , Sistema Nervoso Central/fisiologia , Humanos , Nanomedicina/tendências , Regeneração Nervosa , Fármacos Neuroprotetores/uso terapêutico , Medicina Regenerativa/tendências , Reabilitação/tendências , Transplante de Células-Tronco/tendências , Engenharia Tecidual/métodos , Engenharia Tecidual/tendências , Traumatismos do Sistema Nervoso/tratamento farmacológico
11.
Am J Occup Ther ; 66(4): 488-93, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22742699

RESUMO

Occupational therapists have many intervention tools available for working with clients having a neurological injury; however, some of the most innovative and effective methods have not gained acceptance by many clinicians. Emerging research and new technologies provide occupational therapists with a multitude of treatment strategies and novel devices, but incorporation of those tools into clinical practice appears to be limited by the time necessary to learn about the intervention, educational requirements associated with implementation, or lack of awareness regarding the evidence supporting the use of such tools. Strategies to combat this trend include educating clinicians on evidence-based methods for neurological rehabilitation, aligning academics with practitioners to translate evidence into practical treatment strategies, and accepting that occupational therapy can use these innovations as a means toward state-of-the art, occupation-based practice.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Terapia Ocupacional , Traumatismos do Sistema Nervoso , Difusão de Inovações , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Humanos , Planejamento de Assistência ao Paciente , Traumatismos do Sistema Nervoso/reabilitação
12.
Br J Surg ; 99 Suppl 1: 75-86, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22441859

RESUMO

BACKGROUND: Traumatic leg amputation commonly affects young, active people and leads to poor long-term outcomes. The aim of this review was to describe common causes of disability and highlight therapeutic interventions that may optimize outcome after traumatic leg amputation. METHODS: A comprehensive search of MEDLINE, Embase and Cumulative Index to Nursing and Allied Health Literature databases was performed, using the terms 'leg injury', 'amputation' and 'outcome'. Articles reporting outcomes following traumatic leg amputation were included. RESULTS: Studies demonstrated that pain, psychological illness, decreased physical and vocational function, and increased cardiovascular morbidity and mortality were common causes of disability after traumatic leg amputation. The evidence highlights that appropriate preoperative management and operative techniques, in conjunction with suitable rehabilitation and postoperative follow-up, can lead to improved treatment outcome and patient satisfaction. CONCLUSION: Patients who undergo leg amputation after trauma are at risk of poor long-term physical and mental health. Clinicians involved in their care have many opportunities to improve their outcome using a variety of therapeutic variables. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.


Assuntos
Amputação Traumática/reabilitação , Pessoas com Deficiência , Traumatismos da Perna/reabilitação , Dor Pós-Operatória/etiologia , Atividades Cotidianas , Amputação Traumática/psicologia , Antibioticoprofilaxia/métodos , Bandagens , Doenças Cardiovasculares/etiologia , Aconselhamento , Desbridamento/métodos , Emprego , Nível de Saúde , Humanos , Transtornos do Humor/etiologia , Dor Pós-Operatória/prevenção & controle , Procedimentos Cirúrgicos Reconstrutivos , Reoperação/métodos , Irrigação Terapêutica/métodos , Traumatismos do Sistema Nervoso/reabilitação , Infecção dos Ferimentos/prevenção & controle
13.
Clin Neurol Neurosurg ; 114(5): 460-70, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22326716

RESUMO

Advances in technology in recent decades have contributed to rapid developments in non-invasive methods for imaging human anatomy, and advanced imaging methods are now one of the primary tools for clinical diagnosis after neurological trauma or disease. Here we review the current and upcoming capabilities of one of the most rapidly developing methods, magnetic resonance imaging (MRI). The underlying theory is introduced so that the reasons for the strengths, weaknesses, and future expectations of this method, can be explained. Current techniques for imaging anatomical changes, inflammation, and changes in white matter, axonal integrity, blood flow and function, are reviewed. Applications for specific purposes of assessing traumatic injury in the brain or spinal cord, and for multiple-sclerosis are also presented, and are used as examples of how the advanced techniques are being used in practice.


Assuntos
Imagem por Ressonância Magnética/métodos , Sistema Nervoso/patologia , Traumatismos do Sistema Nervoso/diagnóstico , Algoritmos , Axônios/patologia , Lesões Encefálicas/patologia , Imagem de Tensor de Difusão , Humanos , Processamento de Imagem Assistida por Computador , Inflamação/patologia , Esclerose Múltipla/patologia , Bainha de Mielina/patologia , Rede Nervosa/patologia , Perfusão , Recuperação de Função Fisiológica , Traumatismos do Sistema Nervoso/patologia , Traumatismos do Sistema Nervoso/reabilitação
14.
Clin Neurol Neurosurg ; 114(5): 436-40, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22300890

RESUMO

The adult human nervous system is an incredibly complex set of thousands to tens of thousands of connections between a hundred billion neurons that develops via an intricate spatial-temporal process and is shaped by experience. In addition, any one anatomical arrangement of neural circuits is usually capable of multiple physiological states. Following neurological injury, a new anatomy, and consequently a new spectrum of physiology, emerges within this nervous system with its mix of both injured and uninjured parts. It is this new combination of neural components that determines the extent to which natural functional recovery can occur and the extent to which clinical interventions can further that recovery. Detecting the new anatomy and physiology of the injured human nervous system is difficult but not impossible and some methods can track over time changes in neural structure or, more often, functions that correlate with neurological improvement. The goal of restorative neurology is to make best use of this new anatomy and physiology to facilitate neurological recovery. While we are still learning about how neurorehabilitation interventions generate functional recovery, we can begin to test hypothesis regarding the underlying mechanisms of neural plasticity and attempt to augment those processes.


Assuntos
Neurologia/tendências , Traumatismos do Sistema Nervoso/patologia , Traumatismos do Sistema Nervoso/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Rede Nervosa/fisiopatologia , Plasticidade Neuronal , Recuperação de Função Fisiológica , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos do Sistema Nervoso/reabilitação
15.
Acta fisiátrica ; 18(3)set. 2011.
Artigo em Português | LILACS | ID: lil-663385

RESUMO

Introdução: na última década, dentre os acidentes automobilísticos, observa-se um número crescente envolvendo motocicletas, veículo que ganha cada vez mais aceitação e aprovação da população. Nestes acidentes, as lesões neurológicas mais freqüentes são o traumatismo cranioencefálico (TCE), seguido de lesão medular (LM), ambas de grande importância devido à gravidade das seqüelas que provocam. Objetivos: identificar o perfil dos pacientes vítimas de acidentes de tráfego com motocicletas no Centro de Reabilitação e Readaptação Dr. Henrique Santillo (CRER), tipo de lesão neurológica, incapacidades adquiridas, reinserção laboral e capacidade para conduzir veículos após o trauma. Pacientes e métodos: realizou-se uma análise descritiva dos prontuários dos pacientes internados no CRER, no período de 2007 a 2010, selecionando apenas as vítimas de acidente motociclístico, assim como da atual situação produtiva dos mesmos através de contato telefônico no período de 01-07-2011 a 20-07-2011, utilizando formulário previamente elaborado. Resultados: houve predomínio de homens jovens economicamente ativos, sendo que a maioria não retornou sua vida laboral (86%) e está usufruindo de benefício previdenciário (79,6%). Conclusão: faz-se primordial a elaboração de estratégias para prevenção e controle dos traumas por motos, assim como medidas que estimulem a reinserção desses indivíduos incapacitados.


Introduction: in the last decade, among automobile accidents, it was observed that a growing number involved motorcycles, a vehicle that is beingmore and more accepted and approved by the population. In these accidentsthe most frequent neurological lesions are cranioencephalic trauma (CET), followed by medullary lesion (ML), both of great importance due to the gravity of their after-effects. Objectives: to identify the profile of the patients who are victims of motorcycle accidents at the Dr. Henrique Santillo Rehabilitation and Readaptation Center (CRER), their type of neurologicallesion, any acquired disabilities, their reinsertion into the job market, andtheir capacity to drive vehicles after the trauma. Patients and methods: a descriptive analysis of the medical history forms of patients admitted at CRER, from 2007 to 2010, selecting only the victims of motorcycle accidents, as well as the current productive situation of these victims through telephone contact between July 1st, 2011 and July 20th, 2011, utilizing apreviously-prepared form. Results: there was a predominance of youngmales economically active, the majority of whom did not return to work (86%) and are enjoying social welfare benefits (79.6%). Conclusion: The need to prepare strategies to prevent and control motorcycle traumas is evident, as well as measures that stimulate the reinsertion of these disabled individuals into the work market.


Assuntos
Humanos , Masculino , Feminino , Acidentes de Trânsito/prevenção & controle , Perfil de Saúde , Motocicletas , Lesões Encefálicas Traumáticas/reabilitação , Traumatismos da Medula Espinal/reabilitação , Traumatismos do Sistema Nervoso/reabilitação , Epidemiologia Descritiva , Registros Médicos , Centros de Reabilitação
16.
Prog Brain Res ; 192: 59-68, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21763518

RESUMO

Robotic technology can provide innovative responses to the severe challenges of providing cost-effective care to restore sensory-motor function following neurological and biomechanical injury. It may be deployed at several points on a continuum of care, to provide precisely controlled sensory-motor therapy to ameliorate disability and promote recovery of function, or to provide assistance to compensate for functions that cannot be recovered, or to replace limbs lost irretrievably. This chapter reviews recent progress using robotic technology to capitalize on neural plasticity and promote recovery after neurological injury such as stroke (cerebral vascular accident), research on brain-computer interfaces as a source of control signals for assistive technologies, and research on high-performance multiple-degree-of-freedom upper-extremity prosthetic limbs.


Assuntos
Plasticidade Neuronal/fisiologia , Recuperação de Função Fisiológica/fisiologia , Robótica/métodos , Reabilitação do Acidente Vascular Cerebral , Traumatismos do Sistema Nervoso/reabilitação , Análise Custo-Benefício , Humanos , Próteses e Implantes , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/fisiopatologia , Traumatismos do Sistema Nervoso/fisiopatologia , Interface Usuário-Computador
17.
J Biomech ; 44(1): 128-33, 2011 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-20855074

RESUMO

The use of body weight support (BWS) systems during locomotor retraining has become routine in clinical settings. BWS alters load receptor feedback, however, and may alter the biomechanical role of the ankle plantarflexors, influencing gait. The purpose of this study was to characterize the biomechanical adaptations that occur as a result of a change in limb load (controlled indirectly through BWS) and gait speed during treadmill locomotion. Fifteen unimpaired participants underwent gait analysis with surface electromyography while walking on an instrumented dual-belt treadmill at seven different speeds (ranging from 0.4 to 1.6m/s) and three BWS conditions (ranging from 0% to 40% BWS). While walking, spatiotemporal measures, anterior/posterior ground reaction forces, and ankle kinetics and muscle activity were measured and compared between conditions. At slower gait speeds, propulsive forces and ankle kinetics were unaffected by changing BWS; however, at gait speeds ≥ approximately 0.8m/s, an increase in BWS yielded reduced propulsive forces and diminished ankle plantarflexor moments and powers. Muscle activity remained unaltered by changing BWS across all gait speeds. The use of BWS could provide the advantage of faster walking speeds with the same push-off forces as required of a slower speed. While the use of BWS at slower speeds does not appear to detrimentally affect gait, it may be important to reduce BWS as participants progress with training, to encourage maximal push-off forces. The reduction in plantarflexor kinetics at higher speeds suggests that the use of BWS in higher functioning individuals may impair the ability to relearn walking.


Assuntos
Articulação do Tornozelo/fisiologia , Modalidades de Fisioterapia , Caminhada/fisiologia , Adulto , Fenômenos Biomecânicos , Peso Corporal , Eletromiografia , Feminino , Marcha/fisiologia , Humanos , Masculino , Traumatismos do Sistema Nervoso/fisiopatologia , Traumatismos do Sistema Nervoso/reabilitação , Suporte de Carga/fisiologia , Adulto Jovem
19.
PM R ; 1(3 Suppl): S67-72, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19627975

RESUMO

OBJECTIVE: This self-directed learning module highlights select spine and neurological injuries in athletes and performing arts injuries. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on sports-induced concussion, stingers and transient myelopathy, and buttock pain in athletes, and hand dystonia and hand numbness in musicians. The goal of this article is to facilitate the learner's ability to diagnose and treat spine and neurologic injuries in athletes and performing artists.


Assuntos
Traumatismos em Atletas/reabilitação , Traumatismos da Coluna Vertebral/reabilitação , Medicina Esportiva , Traumatismos do Sistema Nervoso/reabilitação , Humanos
20.
J Neuroeng Rehabil ; 6: 20, 2009 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-19531254

RESUMO

There is increasing interest in using robotic devices to assist in movement training following neurologic injuries such as stroke and spinal cord injury. This paper reviews control strategies for robotic therapy devices. Several categories of strategies have been proposed, including, assistive, challenge-based, haptic simulation, and coaching. The greatest amount of work has been done on developing assistive strategies, and thus the majority of this review summarizes techniques for implementing assistive strategies, including impedance-, counterbalance-, and EMG- based controllers, as well as adaptive controllers that modify control parameters based on ongoing participant performance. Clinical evidence regarding the relative effectiveness of different types of robotic therapy controllers is limited, but there is initial evidence that some control strategies are more effective than others. It is also now apparent there may be mechanisms by which some robotic control approaches might actually decrease the recovery possible with comparable, non-robotic forms of training. In future research, there is a need for head-to-head comparison of control algorithms in randomized, controlled clinical trials, and for improved models of human motor recovery to provide a more rational framework for designing robotic therapy control strategies.


Assuntos
Manipulações Musculoesqueléticas/métodos , Robótica/métodos , Traumatismos do Sistema Nervoso/reabilitação , Algoritmos , Eletromiografia/métodos , Humanos
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