Terapia de espelho na reabilitação do membro superior pós Acidente Vascular Cerebral

Author(s):  
Sónia Catarina Cabete de Freitas ◽  
Clara Maria Ângelo Rodrigues ◽  
Luís Filipe Picôas Pratas ◽  
Susana Isabel Faria de Almeida

Introdução: A perda da função motora dos membros superiores é um dos défices mais debilitantes após Acidente Vascular Cerebral (AVC). A Terapia de Espelho (TE) é uma abordagem promissora que visa melhorar a aprendizagem motora e promover a reorganização neural por meio de diferentes entradas aferentes e padrões de feedback visual. Objetivo: Identificar os ganhos obtidos pela intervenção do enfermeiro de reabilitação através de um protocolo de TE. Método. Trata-se de um estudo de caso, com um desenho experimental de caso único, onde foi selecio­nado um indivíduo do sexo masculino, 78 anos, hemiparesia à esquerda, devido a AVC isquémico, com boa capacidade cognitiva. Protocolo de intervenção de 15 sessões, com duração de 30 minutos, onde foi implementada a TE. Os ins­trumentos utilizados foram: Questionário Mini Mental State Examination (MMSE); Escala Motor Activity Log (MAL); Disabilities of the Arrm, Shouder and Hand (DASH) e a Escala de movimento da mão (MM). Resul­tados. Foi observada uma melhoria através do ganho da independência e habilidade motora no membro superior parético pós AVC, após intervenção com TE. Discussão:  O paciente avaliado evidenciou melhoria motora durante as atividades de vida diárias (AVD). Este resultado é corroborado por outros estudos de aplicação da TE e o uso da imagética motora, após AVC. Conclusão. A TE gerou efeitos positivos na função motora, do paciente avaliado.

Author(s):  
Jeice Sobrinho Cardoso ◽  
Izabelle Cristina da Cruz Miranda ◽  
Glenda Miranda Da Paixão

Introdução: O acidente vascular encefálico pode desencadear diversas sequelas que resultam em incapacidades funcionais no indivíduo. Os cuidados da Terapia Ocupacional objetivam retorno à independência, à autonomia e à participação social. Para isso, os profissionais utilizam diversos métodos e técnicas. Dentre as mais utilizadas estão o Conceito Bobath e a Terapia por Contensão Induzida (TCI). Objetivo: Este estudo objetivou comparar efeitos da terapia baseada no conceito Bobath e da TCI na capacidade funcional de sobreviventes de acidente vascular encefálico. Métodos: Utilizou-se abordagem quantitativa descritiva, do tipo pré-teste/pós-teste, com delineamento experimental de sujeito único. Utilizou-se como instrumentos de avaliação o Mini Mental State Examination (MMSE), a Escala de Avaliação de Fugl-Meyer (FMA/EFM), Wolf Motor Function Test (WMFT) e Motor Activity Log (MAL). Resultados: os dados revelam que não houve mudanças estatisticamente significativas do WMFT. No que diz respeito ao FMA/EFM, não houve mudanças estatisticamente significantes para os participantes 3 e 4, para o Participante 1houve diferenças entre admissão e Tratamento 1. No que diz respeito ao MAL, observou-se diferença estatisticamente relevante em todos os tempos avaliados. Conclusão: a terapia baseada no conceito Bobath e a TCI resultaram na melhora e manutenção do desempenho motor e da capacidade funcional por meio da execução de atividades de vida diária com o membro superior parético, sem diferenças significativas entre elas. AbstractIntroduction: Stroke can trigger several sequelae that result in functional disabilities. Occupational Therapy care aims at a return to independence, autonomy and social participation. For this, professionals use various methods and techniques. Among the most widely used are the Bobath Concept and Constraint-Induced Movement Therapy (CIMT). Objective: This study aimed to compare the effects of Bobath-based therapy and CIMT on the functional capacity of stroke survivors. Methods: it was used a qualitative descriptive approach, pretest / posttest, with a single subject experimental design. Mini Mental State Examination (MMSE) for cognitive screening only, Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT) and Motor Activity Log (MAL) were used as assessment tools. Results: data demonstrate that there were no statistically significant changes in WMFT. Regarding FMA, there were no statistically significant changes for patients 3 and 4, but for Participant 1, there were differences between admission and treatment 1. Regarding MAL, a statistically significant difference was observed in all patients in all times evaluated. Conclusion: therapy based on the Bobath concept and CIMT resulted in the improvement and maintenance of motor performance and functional capacity by performing activities of daily living with the paretic upper limb, without significant differences between them.Key words: Hemiplegia; Paresis; Stroke; Occupational Therapy; Rehabilitation. ResumenIntroducción: el accidente cerebrovascular puede desencadenar varias secuelas que resultan en discapacidades funcionales en el individuo. La atención en terapia ocupacional tiene como objetivo el retorno a la independencia, la autonomía y la participación social. Para esto, los profesionales utilizan varios métodos y técnicas. Entre los más utilizados están el Concepto Bobath y la Terapia de restricción-inducción de movimiento (CIMT). Objetivo: Este estudio tuvo como objetivo comparar los efectos de la terapia basada en el concepto  Bobath y la CIMT en la capacidad funcional de los sobrevivientes de un accidente cerebrovascular. Métodos: se utilizó un enfoque cualitativo descriptivo, como antes / después, con un diseño experimental de un solo sujeto. Se utilizó como instrumentos de evaluación: Mini Mental State Examination (MMSE) solo para detección cognitiva, Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT) y Motor Activity Log (MAL). Resultados: Los datos revelan que no hubo cambios estadísticamente significativos en WMFT. Con respecto a FMA /, no hubo cambios estadísticamente significativos para los participantes 3 y 4; para el participante 1, hubo diferencias entre el ingreso y el tratamiento 1. Con respecto a MAL, hubo una diferencia estadísticamente significativa en todos tiempos evaluados. Conclusión: la terapia basada en el concepto Bobath y la CIMT resultaron en un rendimiento motor y una capacidad funcional mejorados y mantenidos al realizar actividades de la vida diaria con la extremidad superior parética, sin diferencias significativas entre ellos.Palabras clave: Hemiplejía; Paresia, Accidente cerebrovascular; Terapia Ocupacional; Reabilitación.  


2009 ◽  
Vol 22 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Andreas Kaiser ◽  
Renate Gusner-Pfeiffer ◽  
Hermann Griessenberger ◽  
Bernhard Iglseder

Im folgenden Artikel werden fünf verschiedene Versionen der Mini-Mental-State-Examination dargestellt, die alle auf der Grundlage des Originals von Folstein erstellt wurden, sich jedoch deutlich voneinander unterscheiden und zu unterschiedlichen Ergebnissen kommen, unabhängig davon, ob das Screening von erfahrenen Untersuchern durchgeführt wird oder nicht. Besonders auffällig ist, dass Frauen die Aufgaben «Wort rückwärts» hoch signifikant besser lösten als das «Reihenrechnen». An Hand von Beispielen werden Punkteunterschiede aufgezeigt.


Diagnostica ◽  
2000 ◽  
Vol 46 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Herbert Matschinger ◽  
Astrid Schork ◽  
Steffi G. Riedel-Heller ◽  
Matthias C. Angermeyer

Zusammenfassung. Beim Einsatz der Center for Epidemiological Studies Depression Scale (CES-D) stellt sich das Problem der Dimensionalität des Instruments, dessen Lösung durch die Konfundierung eines Teilkonstruktes (“Wohlbefinden”) mit Besonderheiten der Itemformulierung Schwierigkeiten bereitet, da Antwortartefakte zu erwarten sind. Dimensionsstruktur und Eignung der CES-D zur Erfassung der Depression bei älteren Menschen wurden an einer Stichprobe von 663 über 75-jährigen Teilnehmern der “Leipziger Langzeitstudie in der Altenbevölkerung” untersucht. Da sich die Annahme der Gültigkeit eines partial-credit-Rasch-Modells sowohl für die Gesamtstichprobe als auch für eine Teilpopulation als zu restriktiv erwies, wurde ein 3- bzw. 4-Klassen-latent-class-Modell für geordnete Kategorien berechnet und die 4-Klassen-Lösung als den Daten angemessen interpretiert: Drei Klassen zeigten sich im Sinne des Konstrukts “Depression” geordnet, eine Klasse enthielt jene Respondenten, deren Antwortmuster auf ein Antwortartefakt hinwiesen. In dieser Befragtenklasse wird der Depressionsgrad offensichtlich überschätzt. Zusammenhänge mit Alter und Mini-Mental-State-Examination-Score werden dargestellt. Nach unseren Ergebnissen muß die CES-D in einer Altenbevölkerung mit Vorsicht eingesetzt werden, der Summenscore sollte nicht verwendet werden.


2012 ◽  
Vol 153 (12) ◽  
pp. 461-466 ◽  
Author(s):  
Magdolna Pákáski ◽  
Gergely Drótos ◽  
Zoltán Janka ◽  
János Kálmán

The cognitive subscale of the Alzheimer’s Disease Assessment Scale is the most widely used test in the diagnostic and research work of Alzheimer’s disease. Aims: The aim of this study was to validate and investigate reliability of the Hungarian version of the Alzheimer’s Disease Assessment Scale in patients with Alzheimer’s disease and healthy control subjects. Methods: syxty-six patients with mild and moderate Alzheimer’s disease and 47 non-demented control subjects were recruited for the study. The cognitive status was established by the Hungarian version of the Alzheimer’s Disease Assessment Scale and Mini Mental State Examination. Discriminative validity, the relation between age and education and Alzheimer’s Disease Assessment Scale, and the sensitivity and specificity of the test were determined. Results: Both the Mini Mental State Examination and the Alzheimer’s Disease Assessment Scale had significant potential in differentiating between patients with mild and moderate stages of Alzheimer’s disease and control subjects. A very strong negative correlation was established between the scores of the Mini Mental State Examination and the Alzheimer’s Disease Assessment Scale in the Alzheimer’s disease group. The Alzheimer’s Disease Assessment Scale showed slightly negative relationship between education and cognitive performance, whereas a positive correlation between age and Alzheimer’s Disease Assessment Scale scores was detected only in the control group. According to the analysis of the ROC curve, the values of sensitivity and specificity of the Alzheimer’s Disease Assessment Scale were high. Conclusions: The Hungarian version of the Alzheimer’s Disease Assessment Scale was found to be highly reliable and valid and, therefore, the application of this scale can be recommended for the establishment of the clinical stage and follow-up of patients with Alzheimer’s disease. However, the current Hungarian version of the Alzheimer’s Disease Assessment Scale is not sufficient; the list of words and linguistic elements should be selected according to the Hungarian standard in the future. Orv. Hetil., 2012, 153, 461–466.


2021 ◽  
Vol 2021 (7) ◽  
Author(s):  
Ingrid Arevalo-Rodriguez ◽  
Nadja Smailagic ◽  
Marta Roqué-Figuls ◽  
Agustín Ciapponi ◽  
Erick Sanchez-Perez ◽  
...  

Author(s):  
Said Dahbour ◽  
Maha Hashim ◽  
Ahmad Alhyasat ◽  
Anas Salameh ◽  
Abdallah Qtaishat ◽  
...  

2021 ◽  
Vol 10 (7) ◽  
pp. 1385
Author(s):  
Hyung Cheol Kim ◽  
Seong Bae An ◽  
Hyeongseok Jeon ◽  
Tae Woo Kim ◽  
Jae Keun Oh ◽  
...  

Cognitive status has been reported to affect the peri-operative and post-operative outcomes of certain surgical procedures. This prospective study investigated the effect of preoperative cognitive impairment on the postoperative course of elderly patients (n = 122, >65 years), following spine surgery for degenerative spinal disease. Data on demographic characteristics, medical history, and blood analysis results were collected. Preoperative cognition was assessed using the mini-mental state examination, and patients were divided into three groups: normal cognition, mild cognitive impairment, and moderate-to-severe cognitive impairment. Discharge destinations (p = 0.014) and postoperative cardiopulmonary complications (p = 0.037) significantly differed based on the cognitive status. Operation time (p = 0.049), white blood cell count (p = 0.022), platelet count (p = 0.013), the mini-mental state examination score (p = 0.033), and the Beck Depression Inventory score (p = 0.041) were significantly associated with the length of hospital stay. Our investigation demonstrated that improved understanding of preoperative cognitive status may be helpful in surgical decision-making and postoperative care of elderly patients with degenerative spinal disease.


2016 ◽  
Vol 31 (3) ◽  
pp. 263-272 ◽  
Author(s):  
I. Contador ◽  
F. Bermejo-Pareja ◽  
B. Fernández-Calvo ◽  
E. Boycheva ◽  
E. Tapias ◽  
...  

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