bluuebunny/crossref_metadata_2025 huggingface dataset:
Retorno ao trabalho em amputados dos membros inferiores
Authors: Guarino Priscila , Chamlian Therezinha Rosane , Masiero Danilo
Published: June 2022

O retorno ao trabalho deve ser incentivado, pois proporciona bem estar, melhora da auto-estima e do convívio social, além de dar mais um sentido a vida. Objetivo: Verificar a situação atual de trabalho e o uso de próteses de membros inferiores em amputados atendidos no Lar Escola São Francisco - Centro de Reabilitação – UNIFESP, São Paulo. Métodos: Estudo retrospectivo dos pacientes atendidos de 1999 a 2005, com amputação de membros inferiores, com idade acima de 18 anos, que estivessem trabalhando ou estudando na época da amputação. A amostra foi composta por 78 amputados, 61 homens e 17 mulheres, com média de idade de 46,3 anos. Cinqüenta por cento eram transfemurais e 34,6% transtibiais. A vasculopatia foi a mais prevalente das causas de amputação (62,8%). Cinquenta e um pacientes (65,4%) tinham grau de instrução fundamental. Realizada entrevista, por telefone, no período de dezembro de 2006 e janeiro de 2007. Resultados: Sessenta e quatro por cento dos pacientes estavam em uso de prótese de membro inferior no momento da entrevista. A taxa de retorno ao trabalho foi de 10,2%, sendo todos para a mesma ocupação pré-amputação. Conclusão: Baixa taxa de retorno ao trabalho de amputados de membros inferiores reabilitados com próteses. Alguns fatores, tais como, idade avançada na época da amputação e baixo nível de instrução podem ser responsáveis por estes resultados. Outros estudos precisam ser realizados para melhor análise desta situação.
The use of the International Classification of Functioning, Disability and Health in the physical therapy assessment of individuals with musculoskeletal disorders of the lower limbs and lumbar region
Authors: Sabino George Schayer , Coelho Cecília Martins , Sampaio Rosana Ferreira
Published: June 2022

The structure and contents of the International Classification of Functioning, Disability and Health (ICF) can contribute to the physical therapists’ clinical practice management and systematization. Although promising, its use is still limited, especially due to the complexity of its application. The aim of this study was to analyze the difficulties related to the use of the ICF to codify activities/ participation of patients with musculoskeletal disorders in the lower limbs and lumbar region, evaluated by a physical therapist. Methods: Reports of patients related to the activities/participation that were altered due to musculoskeletal disorders were used. Data were obtained from the charts and grouped into categories for subsequent coding. Results: Five ICF domains were used to describe the altered activities/participation (mobility, self-care, domestic life, major life areas and community, social and civic life) and four difficulties related to the coding process were identified: (1) multiple codes related to some activities/participation; (2) inaccurate code to detail one activity/participation (run distance); (3) “unspecified” code used for the classification of “getting into the car”; (4) generic codes attributed to activities/participation that refer to sports. Discussion: The possibility of choosing several codes to describe the same condition due to the overlap and interrelation of activities/participation can make the classification process inconsistent in some situations. The absence of detailing concerning some activities/participation can restrict the precision of categorization and data documentation. Conclusion: The ICF allowed the characterization of the health status of individuals, but presented some issues that must be considered in order to obtain its improvement.
Developing Human Functioning and Rehabilitation Research from a comprehensive perspective
Authors: Stucki Gerold , Reinhardt Jan Dietrich , Grimby Gunnar , Melvin John
Published: June 2022

By creating the International Classification of Functioning, Disability and Health (ICF) the World Health Organization (WHO) prepared the ground for a comprehensive understanding of Human Functioning and Rehabilitation Research, integrating the biomedical perspective on impairment with the social model of disability. This new understanding poses a number of old and new challenges related to the enhancement of adequate research capacity. Here we will summarize approaches to address these challenges with respect to three areas: the organization of Human Functioning and Rehabilitation Research into distinct scientific fields, the development of suitable academic training programs and the building of university centers and collaboration networks.
Reabilitação profissional como política de inclusão social
Authors: Maeno Maria , Takahashi Mara Alice Conti , Lima Mônica Angelim Gomes de
Published: June 2022

Este artigo faz uma breve análise de aspectos históricos e institucionais da reabilitação profissional no Brasil, e propõe desafios conceituais e estruturais a serem superados, condição necessária para que seja construída uma política de inclusão social nessa área. Aborda o uso da Classificação Internacional de Funcionalidade, Incapacidade e Saúde – CIF, criada Organização Mundial de Saúde (OMS), no ano de 2001, como ferramenta na reabilitação profissional.
Tutela jurídica da saúde dos empregados de frigoríficos: considerações dos serviços públicos
Authors: Sarda Sandro Eduardo , Ruiz Roberto Carlos , Kirtschig Guilherme
Published: June 2022

O presente artigo pretende abordar as condições de trabalho nas empresas de abate e processamento de carnes (frigoríficos), setor econômico que apresenta alta prevalência de doenças ocupacionais. A prevenção de doenças ocupacionais por meio da redução dos riscos inerentes ao trabalho encerra valor jurídico fundante de todo o modelo de proteção à saúde dos trabalhadores. Não obstante, o elevado patamar que os direitos à vida, à saúde e ao meio ambiente equilibrado ocupam na Constituição Federal e a existência de verdadeira sinergia de fatores de risco à saúde dos trabalhadores (repetitividade, monotonia, pressão de tempo, frio, ritmo excessivo, jornadas exaustivas, posturas inadequadas) as empresas do setor não vem adotando as medidas preconizadas no ordenamento jurídico, gerando um elevado contingente de trabalhadores lesionados, sobretudo jovens empregados. O presente artigo tem por objetivo realizar uma descrição das condições de trabalho em duas empresas do setor. Esta análise foi realizada a partir dos dados do INSS, dos autos de infração lavrados por Auditores do Trabalho e demais provas existentes nos inquéritos civis instaurados pelo Ministério Público do Trabalho. Conclui-se que a realidade encontrada é caracterizada pelo descumprimento das normas de proteção a saúde dos trabalhadores preconizada na Constituição Federal.
Link between the King’s Health Questionnaire and the International Classification of Functioning, Disability and Health, for the evaluation of patients with urinary incontinence after gynecological oncology surgery
Authors: Castaneda Luciana , Plácido Tiago
Published: June 2022

Uterine cervix tumors are the second most common type of tumor among women in the world. In Brazil, 18,680 new cases were estimated for 2008. The treatment of choice for this type of cancer involves surgery, chemotherapy, and radiotherapy that encourage healing but, on the down side, impairments develop such as urinary incontinence. This incontinence appears as an early and common complication of the surgical treatment and involves deterioration in the quality of life, generating levels of morbidity, affecting psychological, occupational, domestic, physical, and sexual areas. To asses the quality of life in patients with incontinence there are several questionnaires in the scientific literature. Among them, the King’s Health Questionnaire (KHQ) is the most widely used as a research tool. In addition to accessing quality of life, the World Health Organization is advocating the use of the International Classification of Functioning, Disability and Health (ICF) as a tool for statistics, research, clinical and social policies, to provide a common language for the conditions related to health. The objective of this study is to establish a correlation between the KHQ and the ICF. The KHQ was correlated by two separate professionals, and followed by a discussion and conclusion of the coded domains. Twelve categories were found for body functions (b), 22 for activities and participation (d), and 4 for environmental factors (e), however, 7 significant concepts of the questionnaire could not be linked to the ICF. The KHQ has focused predominantly on issues related to activity and participation. This is a pilot study that needs more evidence to conclude its findings.
Pharmacology of vasoactive drugs
Authors: Muri Estela Maris Freitas , Sposito Maria Matilde de Mello , Metsavaht Leonardo
Published: June 2022

Peripheral vascular diseases (PVDS) are characterized as a circulation problem in the veins, arteries, and lymphatic system. The main therapy consists of changes in lifestyle such as diet and physical activity. The pharmacological therapy includes the use of vasoactive drugs, which are used in arteriopathies and venolymphatic disorders. The goal of this study was to research the scientific literature on the use and pharmacology of vasoactive drugs, emphasizing the efficacy of their local actions and administration.
Physical and rehabilitation medicine in the XXI century: challenges and opportunities
Authors: Faria Filipa
Published: June 2022

This paper addresses some of the issues that are shaping rehabilitation nowadays, such as changes in demographics and epidemiology of diseases, raising patients’ expectations, increasing costs of rehabilitation care and also the difficulties in establishing boundaries between PMR, other medical specialties and rehabilitation professionals. Some contextual changes which have occurred in the last years in concepts, mentalities and policies related to disability and rehabilitation will be pointed out, as well as the benefits of technological evolution as a tool for enhancing social inclusion of people with disabilities. The recently created network for continued and integrated care, which is being set up in Portugal, will be referred, as a response to the need of providing integrated services. These changes may represent opportunities to enlarge PMR field of intervention and to confirm its role on promoting social understandings of disability. Finally, some new perspectives for rehabilitation on the edge of the 21st are suggested.
The effect of surgical exposure of nerves and muscles in neurophysiologic tests on rats
Authors: Stipp-Brambilla Elisangela Jeronymo , Romão Adriana Maria , Garbino José Antonio , Salgado Manoel Henrique , Viterboz Fausto
Published: June 2022

The neurophysiologic study in the modality of electroneuromyography (ENMG) determined and quantified the components in the motor ambit. The main data supplied by the examination was from the motor and sensory nerve conduction studies and by electromyography. However, many factors can interfere with the nervous response to electrostimulation, such as: age, gender, temperature, humidity, and other things. The aim of this work was to verify the effect of surgical exposure of the sciatic, common fibular, tibial, and cranial tibial muscle nerves in a neurophysiologic test on rats. Twenty (20) Wistar male rats were utilized, with approximately 80 days of age, divided into two groups. In the normal group the exam was made without the surgical exposure of the fibular nerve. In the surgical group the common fibular nerve was exposed. With the experimental model utilized, it was concluded that the neurophysiologic test done on animals with nerves and muscles surgically exposed is viable, since the alteration in animal temperature did not interfere significantly with the values of the electrophysiological parameters observed. In addition, the exposure of nerves and muscles allows stimulation of an exact point on the target nerve.
Techniques of proprioceptive evaluation of the anterior cruciate knee ligament
Authors: Alonso Angélica Castilho , Brech Guilherme Carlos , Greve Julia Maria D’Andréa
Published: June 2022

The increasing interest in sports activities, combined with the knee’s anatomical vulnerability and complexity, justifies the increasing number of patients with ligament injuries, especially the anterior cruciate ligament (ACL). What then would be the best way to evaluate the knee proprioception? The objective of this study was to identify the techniques of proprioceptive evaluation of the anterior cruciate knee ligament (ACL), and to determine whether a better technique is available. The method was to review the literature, including only those studies published in indexed scientific journals that referred to evaluation tools and/or knee proprioception measurement. The discussion of the different methods of evaluating ACL proprioception, according to the literature, included: morphological anatomical studies; neurophysiologic evaluation, and clinical evaluation which was divided into three types: a) sense of static position; b) kinesthetic posture; and c) postural balance. Although proprioception is important to the final results of a treatment involving ligament injury, its evaluation is still a problem. The conclusion was that the ideal method should have high sensitivity and specificity, in addition to good reproducibility and accuracy. There is lack of consensus in literature regarding the best evaluation technique and the results are also contradictory, despite the balance evaluation being a modern technique used in major research centers, it was not possible to isolate the proprioceptive system from other systems: visual and vestibular.
Adaptação da pessoa após acidente vascular encefálico e seu cuidador: ambiente domiciliar, cadeira de rodas e de banho
Authors: Garanhani Márcia Regina , Alves Jaqueline Frazão , Fugisawa Dirce Shizuko , Garanhani Mara Lúcia
Published: June 2022

O acidente vascular encefálico causa incapacidade funcional. O envolvimento dos familiares influencia na recuperação dos pacientes e as barreiras arquitetônicas no domicílio dificultam a acessibilidade. O estudo qualitativo procurou identificar as dificuldades das pessoas após o acidente vascular encefálico em relação às barreiras arquitetônicas, ao manuseio da cadeira de rodas e de banho, por meio de entrevista semi-estruturada e roteiro de medidas de acessibilidade. Nove pacientes e seus cuidadores foram entrevistados e da análise dos discursos emergiram três categorias empíricas: acessibilidade andando, acessibilidade com a cadeira de rodas e de banho e o papel das orientações. As principais barreiras encontradas foram os corredores estreitos e circulação interna inadequada. As barreiras arquitetônicas dificultam o uso da cadeira de rodas e de banho no domicílio, sobrecarregando os cuidadores. O conhecimento da realidade destas pessoas facilita programas de orientações de atividades de vida diária centradas na realidade.
O estresse na reabilitação: a síndrome da adaptação geral e a adaptação do indivíduo à realidade da deficiência
Authors: Chagas Maria Inês Orsoni
Published: June 2022

O presente artigo explora a idéia de que o ser humano possui em seu DNA a capacidade para a adaptação às mudanças drásticas que ocorrem na vida, propiciando-lhe a sobrevivência em situações adversas, neste contexto, a aquisição de seqüelas incapacitantes. E se a isso estiver somada a resiliência, enquanto capacidade de transcender à crise com vantagens pode ocorrer uma retomada do desenvolvimento e uma melhora na qualidade de vida do indivíduo, a despeito das seqüelas.
Ground reaction forces analyses during the gait of healthy individuals with and without the use of a calcaneus insole
Authors: Kleiner Ana Francisca Rozin , Carmo Aline Araujo do , Kletecke Regina , Burgos Danielle , Souza Marcio Ferreira de , Barros Ricardo Machado Leite de
Published: June 2022

The foot forms the base of propulsion and balance during the gait. It is well known that excessive or prolonged pronation and supination changes the gait’s mechanical movement. Hence, the use of corrective insoles is recommended when calcaneus alterations (valgus and varun) are present. Objetive: The main purpose of this article was to analyze the effects of a calcaneus insole on normal individuals on the Ground Reaction Force variables. Method: The experiment used ten adults (31.9 ± 6,7 years, 65.9 ± 15.4 kg and 1.7 ± 0.1 m) and registered no apparent changes in gait or pathologies that have an effect on the locomotor system. The following gait conditions were analyzed and compared: barefoot, using a sport shoe, and using the sport shoe with insole. The variables analyzed were vertical, medial lateral, and anterior-posterior dynamic ground reaction forces. An ANOVA one-way was used in order to compare the three different conditions. Statistically significant differences were revealed between the conditions of barefoot and sport shoe with insole for the vertical GRF during initial contact Fz1 (F2,59 = 3.4; p < 0.0406) and for the GRF anterior-posterior in the terminal stance phase Fy2 (F2,59 = 3.63; p < 0.0332). Results: These results indicated that the use of an insole increased the vertical impact on the locomotor system during the response to load phase, probably because of its greater stiffness compared to the barefoot or sport shoe trials. The insole also changed the GRF anterior-posterior during the terminal stance that corresponded with the acceleration/propulsion gait phase. Conclusion: Just based on the analysis of the dynamic variables, it was concluded that the use of insoles did not induce any significant increase in lateral forces that would indicate the reduction of excessive pronation or supination during the response load phase. The use of an insole produced a significant dynamic effect on the pronation/supination only in the propulsive gait phase.
Study on the characteristics of pain in patients with spinal cord injury
Authors: Rodrigues Adriana Vieira , Vidal Wesley Araújo Sampaio , Lemes Joseane Andréa , Gôngora Carolina Spagnuolo , Neves Thalita Correa , Santos Suhaila Mahmoud Smaili , Souza Roger Burgo de
Published: June 2022

Aside from the loss of functionality after a spinal cord injury (SCI) pain is considered one of the most disabling complications experienced in the rehabilitation process, even with the significant advances in understanding the physiopathology and treatment of the pain, the approach to this symptom is still precarious in spinal cord injury. Objective: To describe the characteristics of pain in this population and to associate the pain between variables such as the type of injury, the interference in the daily living activities (DLA), and its onset. Method: It is a descriptive cross-sectional study and was conducted on 77 patients with spinal cord injuries; the survey was applied using a semi-structured interview. Mean and standard deviation and absolute and relative frequencies were calculated, and for the association between qualitative variables we used the Chisquare test (χ²). Results: The mean age was 38.26 ± 12.43 years, 84.4% of which were men, and 80.5% were paraplegics. Thirty-one were caused by motor vehicle crashes and twenty-nine were by gunshot; 61% of them were fully disabled. As for the pain, 44.2% reported severe pain and 29.8% moderate, 50.6% felt no pain above the lesion, but 58.4% felt it below. Thirty-nine patients reported feeling burning pain, 40% reported that the pain came in the first year after SCI. Pain intensity was 5.44 ± 3.18 points, with 5.20 ± 3.07 in men and 6.75 ± 3.54 in women; for tetraplegic individuals it was 4.13 ± 3.18 and with 5.76 ± 3.12 in the paraplegics. For 27 patients the pain worsened if they remained in the same position, improved to 22 by performing physiotherapy, and to 21 with a change in position. For 68.8% of the patients the pain did not interfere with their DLAs. Twenty-eight used analgesics. It was significantly mentioned that the presence of pain below the lesion interferes with the DLAs (p = 0.04) and appears in the first year after injury above and below the lesion (p = 0.05 and p = 0.01), respectively. Conclusion: Pain was prevalent in those with injured spinal cords, more evident in women, and for the majority arose in the first year after injury and interferes with their DLA. Physiotherapy and a change of position decreased the pain. Therefore, orientations and interventions by the multidisciplinary team should be immediate after the injury, because the prevention or reduction of this complication will lead to an improved quality of life and the re-adaptation of the patient to their family and social life.
Effectiveness of back school in patients with chronic nonspecific low back pain
Authors: Vieira Adriane , Braga Rafaela de Macedo , Bartz Patrícia Thurow , Candotti Claudia Tarragô
Published: June 2022

Spinal pains affect 70% to 80% of the adult population at some point in life and are considered one of the most common reasons for early retirement for total or partial disability. The treatments’ high cost and the lack of efficiency of conventional therapeutic practices are at the root of the Back School’s creation. Objective: The purpose of this study was to perform a systematic review of literature over the last ten years to verify the effectiveness of the Back School with those who suffer from chronic nonspecific low back pain. Method: The search was conducted in the computerized databases of Medline, Embase, and Lilacs. The search’s criteria for the three databases were randomized articles about the Back School’s effectiveness over the last ten years. The methodological quality of the selected studies in this review was evaluated using a set composed of nine criteria. Overall, five studies were included in this review, four being considered of high quality. Results: Two of the study’s considered articles come from Brazil, demonstrating the interest this country’s researchers have for this approach to chronic nonspecific low back pain. Every study analyzed presented positive results for the effectiveness of the Back School in the short and medium-term. Conclusion: With this research we conclude that the Back School programs have been considered as an important tool, not just in the treatment, but also in the prevention of chronic nonspecific low back pain. However, more studies are needed to assess the referred tool in the long-term and with methodological standardized procedures.
Functional electrical stimulation in upper extremity recovery of hemiparetic patients after stroke
Authors: Soares Antonio Vinicius , Poluceno Leila , Cremonini Caroline da Rosa , Ponsoni Priscila Baracho , Domenech Susana Cristina , Borges Júnior Noé Gomes
Published: June 2022

The rehabilitation of the upper limb of hemiparetic patients by stroke is a major challenge. Among the various therapeutic resources used, functional electrical stimulation (FES) has been a popular avenue explored in treatment programs for these patients. Objective: To evaluate the effects of FES on wrist and finger extensors in a specific task (ST). Methods: We conducted a pre-experimental study (pre and post-tests) with eight chronic patients with a mean age of 63.4 years (± 6.1). The evaluation parameters were for manual mobility by the hand movement scale (EMM), grip strength by dynamometry (Din), dexterity of the upper limb by the box and blocks test (CB) and the 9-pin and holes test (9PB), spasticity by the modified Ashworth scale (MAS), and functional independence by the Barthel index (BI). The ST chosen was performing the movement of reaching and grasping plastic bottles of different sizes with the affected upper limb in different combinations of positions for a total maximum of 54 repetitions per session. FES was used to assist the hand in grabbing and holding the object during the ST. There was a mean of 20 sessions with attendance twice a week. Results: The results showed improvement in all parameters, the difference was statistically significant in all the tests, except for Din. Conclusion: In this sample, FES in the proposed ST resulted in improved performance in the upper limb function of patients undergoing treatment.
Self-care practice for bowel functioning in a group of patients with spinal cord injury
Authors: Campoy Laura Terenciani , Rabeh Soraia Assad Nasbine , Nogueira Paula Cristina , Vianna Patrícia Carla , Miyazaki Margareth Yuri
Published: June 2022

This was a descriptive and exploratory study. Objective: To characterize individuals with spinal cord injuries (SCI) treated at a rehabilitation center in a tertiary hospital in the interior of São Paulo state, and to identify their self-care practices related to bowel management. Method: After being approved by the Research Ethics Committee and receiving consent from the participants, the data was collected through an interview and by analyzing their medical records. Thirty individuals were interviewed, most of whom were male, single, had a complete secondary education, and a mean age of 35 years. Results: The main cause for the SCI was automobile accident with a prevalence of cervical injuries. The most common self-care practices were nutritional management followed by abdominal massage. Regarding the bowel problems, fecal impaction predominated followed by fecal incontinence. Conclusion: The bowel rehabilitation program should be instituted for individuals with SCI as early as possible to minimize complications.
Thalidomide-induced sensory polyneuropathy and electrophysiological study of the sural nerve as a screening diagnosis: a case report
Authors: Yamamoto Rodrigo Luiz , Chung Tae Mo , Oliveira Eduardo Freire de , Ramos Arquimedes de Moura , Nunes Lucas Martins de Exel , Nunes Jose Alcyr Exel
Published: June 2022

Polyneuropathy is a common clinical condition with debilitating symptoms whose treatment depends on etiology. There are numerous possible causes of this type of disorder and the etiological diagnosis is not always easy. In this case report we describe a case of a patient with multiple myeloma who developed purely sensory polyneuropathy, confirmed by electrophysiological study, induced by thalidomide.
The Relationship between the Functional Independence Measure and the International Classification of Functioning, Disability, and Health Core Set for stroke
Authors: Fréz Andersom Ricardo , Vignola Bruna Antinori Passeggio , Kaziyama Helena Hideko Seguchi , Spezzano Luisa Carmen , Filippo Thais Raquel Martins , Imamura Marta , Rosa Chennyfer Dobbins Paes da , Battistella Linamara Rizzo
Published: June 2022

The Functional Independence Measure (FIM) is one of many instruments available for assessing the functionality of stroke patients. However, with the approval of the International Classification of Functioning, Disability, and Health (ICF), the Core Set that was developed for stroke patients, a new tool for understanding functionality and disability of these patients is available. Objective: To establish a relationship between the FIM and the ICF Core Set for stroke. Four researchers of different healthcare backgrounds, all working in the field of rehabilitation, considered the descriptions of the activities of the FIM and the definitions of the ICF categories. Method: They selected the categories of the ICF Core Set for stroke, which could be related to the tasks assessed by the FIM. Once the relationship was established, the researchers came to a consensus for the inclusion or exclusion of those categories. Results: From the 130 second-level categories used in the Core Set, 27 (20.8%) were related to the activities of FIM, eight (29.6%) regarded the bodily functions component (b), 17 (63%) concerned activity and participation (d), and two (7.4%) considered environmental factors (e). As for the 10 categories that are part of the Brief Core Set for stroke, only five were related to the activities of FIM. Conclusion: The FIM is focused on the individual, while the ICF is concerned not only with the dysfunctions and disabilities of the patient, but also considers these factors within social activities, as well as environmental influences, either as a facilitator or a barrier to functional independence.
Analysis of postural control after the application of functional electrical stimulation in stroke patients
Authors: Costa Thais Delamuta Ayres da , Barbosa Alessandra Ferreira , Oliveira Maria Fernanda Pauletti , Castro Pedro Cláudio Gonsales de , Ayres Denise Vianna Machado , Moreira Maria Cecília dos Santos , Lopes José Augusto Fernandes , Goroso Daniel Gustavo
Published: June 2022

Strokes cause the main neurological impairments in adults around the world. They can result in neuromotor and cognitive deficits. Among the neuromotor deficits there is spasticity; this affects the planning of movements and posture control. The postural control system is essential for functional independence in daily life activities and is, therefore, one of the main goals to achieve in rehabilitation programs. These programs have various therapeutic elements aimed at providing stimulus to the individual, which help them control their movements and stance more efficiently. Among these techniques is neuromuscular electrical stimulation, which contributes to decreasing spasticity and other benefits. When used for functional tasks it is called Functional Electrical Stimulation (FES). Objective: The purpose of this study was to verify the response of the postural control in two individuals with hemiparesis by stroke after the application of the FES over a short period time. Method: The experimental protocol had four phases. A: pre-FES; B: Immediately after the application of FES; C: 45 minutes after the application of FES; D: 90 minutes after application of FES. In each phase, the participants were positioned on a force platform and made three attempts to do the chosen task: touching the fingertip-to-floor test. Results: The software Matlab 7.0 provided the variable center-of-pressure velocities along the mediolateral (Vmx) and anteroposterior (Vmy) axes. In this way it was possible to see that, even when the participants showed a reduction in Vmx and Vmy, it was by less than 1%. Conclusion: This may indicate postural regulatory activity similar to before the application of FES, and even less postural regulatory activity when the centerof- pressure velocities were greater at the start, even 90 minutes after the application of FES.
Physiotherapeutic intervention in the outpatient care of persons with Down syndrome at the Institute of Physical Medicine and Rehabilitation at HC FMUSP
Authors: Almeida Munique Dias de , Moreira Maria Cecilia dos Santos , Tempski Patricia Zen
Published: June 2022

Down Syndrome (SD) is the most common chromosomopathy in humans. It is known that, if properly stimulated, these people have the potential for full social inclusion. The objective of this study is to show the work done with this population by the Physiotherapy service provided by the multiprofessional team at the Clinic for the Care of Persons with DS at the Institute of Physical Medicine and Rehabilitation at HC FMUSP. This clinic develops therapeutic activities for persons up to 18 years of age. The work is carried out in models, which are subdivided into: a DS General Stimulation Model which serves patients up to three years of age whose objectives are focused on the acquisition of motor marks, essential for neuropsychomotor development; a DS Child Development Model which helps children from four to eleven years of age that focuses on the development of more advanced motor skills, strength, posture, improvement of mobility, balance, and proprioception to optimize cerebellar activity and the consequent enhancement of static and dynamic balance; a DS Adolescent Model for those aged twelve to eighteen; and a DS Adult Model starting at age nineteen aimed at orthopedic and postural restoration in addition to providing health guidance. Physiotherapeutic monitoring is fundamental within the clinic for the care of a person with DS, for it stimulates the motor development of these children, along with the multiprofessional team and the family, respecting their time and favoring their potentials, in addition to acting to educate the family on health so as to prevent problems and promote the health of the person with DS and their nuclear family.
Um estudo do processo expressivo de afásicos sob enfoque da psicologia junguiana
Authors: Vergueiro Paola Vieitas , Wahba Liliana Liviano , Conforto Adriana Bastos , Masini Maria Lucia Hage , Fuso Simone Freitas
Published: June 2022

Este artigo descreve uma pesquisa exploratória em que se aplica técnica expressiva plástica a afásicos de expressão, vítimas de acidente vascular cerebral isquêmico (AVCI) no hemisfério esquerdo. Objetivo: Investigar os resultados da intervenção realizando estudos de caso com base no método clínico e análise qualitativa, com enfoque teórico da psicologia junguiana. Método: Utiliza testes antes e depois da intervenção, como critério externo: a técnica projetiva HTP - House-Tree-Person, aponta mudanças de personalidade condizentes com as observadas no processo; o teste de percepção emocional International Affective Picture System - IAPS, e seu sistema de registro de respostas Self-Assessment Manikin - SAM, auxilia a lançar hipóteses sobre a transformação emocional dos participantes; o European Brain Injury Questionnaire - EBIQ, fornece substratos para discutir a transformação da visão dos sujeitos sobre seus próprios problemas. Mediante o método do Discurso do Sujeito Coletivo identifica etapas do processo expressivo com conteúdos comuns ao grupo atendido. Resultados: Os resultados dos estudos de caso, do DSC e dos instrumentos de avaliação revelam que, ao final, os participantes, sem exceção, mostraram-se fortalecidos, mais próximos da sua própria realidade e enriquecidos no contato consigo mesmos e com o mundo externo. Conclusão: Os instrumentos de avaliação o confirmam, assinalando o valor terapêutico da técnica proposta e sugerindo que esta forma de intervenção pode ser útil no processo de reabilitação de afásicos.
Ansiedade, depressão e desesperança em pacientes amputados de membros inferiores
Authors: Sabino Stephanie Di Martino , Torquato Richelle Maitê , Pardini Adriana Cristina Guimarães
Published: June 2022

Amputação consiste na retirada de um membro, total ou parcialmente, por cirurgia ou trauma. A causa mais frequente de amputações é vascular (75% em membros inferiores), seguida por traumas (20%) e tumores (5%). Após a amputação, o paciente geralmente passa por uma série de reações emocionais. Dentre as mais comuns, pacientes amputados podem apresentar quadros de ansiedade, depressão e desesperança. Objetivo: Verificar a incidência de Ansiedade, Depressão e Desesperança em pacientes com amputação de membros inferiores que chegaram ao Centro de Reabilitação. Método: Participaram desta pesquisa 31 pacientes no período de maio a agosto de 2011. Os pacientes foram submetidos à realização de um questionário de caracterização da amostra e as escalas Beck de Ansiedade, Depressão e Desesperança. Resultados: Os pacientes que tinham companheiro apresentaram menores níveis de Ansiedade e Desesperança e os pacientes que saíam semanalmente apresentaram menores pontuações na escala de depressão. Conclusão: Os pacientes com amputação de membros inferiores apresentaram boas estratégias de enfrentamento ou estão em processo de negação de sua condição atual, ou ainda aliviados pela melhora do quadro álgico.
Prevalence of musculoskeletal pain among nursing surgery teams
Authors: Vidor Cristiane da Rocha , Mahmud Mahmud Ahmad Ismail , Farias Leonardo Fontanive , Silva César Augusto , Ferrari Juliana Nery , Comel João Carlos , Zanini Maurice , Nery Rosane Maria , Santos Antônio Cardoso dos , Stefani Marco Antônio
Published: June 2022

Among the health professions, nursing, in particular, has been affected by musculoskeletal disorders. The WMSD produce changes in the lives of these workers, impossible of them held daily activities and labour. Objective: Investigating the prevalence of musculoskeletal pain and associated with the quality of life in nursing professionals who work in surgery teams. Method: Cross-sectional study conducted between March 2011 and January 2012 in a tertiary university hospital in southern Brazil. We evaluated 110 workers nursing teams. It was excluded workers on sick leave, vacation or other absence during the period of data collection. The musculoskeletal pain was assessed using the Nordic Musculoskeletal symptoms questionnaire the quality of life was assessed by the Medical Outcomes Study 36 - Item Short-Form Survey (SF-36). The relationship between musculoskeletal pain and quality of life were analyzed by the U of Mann-Whitney test, using a significance level of 95%. Results: The prevalence of musculoskeletal pain found in this study was 91.81%. With respect to anatomic regions, it was considered the complaints of musculoskeletal pain retroactive twelve months ago, where there was the predominance of neck pain (56%) and shoulders (56%). When we consider sick leaving for musculoskeletal pain we found the prevalence of low back pain (34%). The group who reported no musculoskeletal pain showed better indices of quality of life in the areas of physical functioning, physical aspect, bodily pain, vitality, social and mental health aspect. Conclusion: the higher prevalence of musculoskeletal pain in the neck and shoulder regions. Moreover, the largest number of sick leaves occurs because of the prevalence of low back pain among nursing staff of the surgical teams. The pain influenced the quality of life affecting six of the areas assessed.
Balance quantification with videogame: pilot study
Authors: Barbosa Alessandra Ferreira , Costa Thais Delamuta Ayres da , Oliveira Maria Fernanda Pauletti , Castro Pedro Claudio Gonsales de , Moreira Maria Cecília dos Santos , Goroso Daniel Gustavo , Lopes José Augusto Fernandes , Ayres Denise Vianna Machado , Battistella Linamara Rizzo
Published: June 2022

Seventh generation video games (VG) propose various balancing tests to asses the stability of the user. However, the parameters used to provide the score of these tests are not reported in the literature, nor is their relationship to clinical practice and user functionality. Objective: The objective of this study was to correlate the scores obtained by the balance platform of the Wii video game with kinetic variables provided by a force platform in simultaneous measurements. Methods: This pilot study included two subjects with stroke and two with traumatic brain injury. The kinetic variables analyzed were: area, movement speed, and root mean square of center of pressure (COP) position in the medial-lateral and anterior-posterior directions, and were processed in Matlab 7.0® and correlated with the score provided by the console (balancing tests: Single-leg test - SL - and Steadiness test - ST -) using the Pearson and Spearman correlation coefficients, both with p < 0.05. Results: A moderate correlation was found between the SL score and RMSy (r = 0.5839). When comparing the ST score to the variables: area (r = 0.8164), RMSx (r = -0.6418) and RMSy (r = -0.8094) the correlation was moderate to strong. Conclusion: No correlation was found between the console tests and the movement speed of the center of pressure measured on the force platform. It is concluded that the score of VG presented significant correlation with the kinetic variables, but the method is not practical for being employed in a clinical evaluation.
Changes of the gait parameters and sensory-motor deficit associated with peripheral diabetic neuropathy
Authors: Martinelli Alessandra Rezende , Mantovani Alessandra Madia , Nozabieli Andrea Jeanne Lourenço , Ferreira Dalva Minonroze Albuquerque , Fregonesi Cristina Elena Prado Teles
Published: June 2022

Peripheral nervous system impairment with sensory and motor loss, as observed in diabetic neuropathy, might induce severe effects on balance control and gait in this population. Objective: To evaluation the performance of the gait and the sensory-motors changes, due of the peripheral diabetic neuropathy (PDN). Method: Participated twenty four individuals with PDN and twenty eight healthy individuals without glycemic alterations indicative of diabetes. Participants were subjected to confirm the clinical diagnosis of diabetic neuropathy through the tactile sensitivity of the soles of the feet with monofilament test. Subsequently, ankle angular variation in static condition and during the gait was investigated through kinematics. The ankle muscle strength was investigated using a digital dynamometer. Results: Diabetic neuropathy group showed greater duration in double support and full support periods of gait than control group with impairment in balance control. Diabetic neuropathy group showed reduces muscle strength of plantiflexors and dorsiflexors. Conclusion: The losses sensory-motors deriving from PDN may imply in impairment in gait performance, with consequent loss of balance.
Validação da acelerometria para medida do gasto energético: revisão sistemática
Authors: Daniel Christiane Riedi , Battistella Linamara Rizzo
Published: June 2022

Objetivo: Examinar a qualidade dos estudos de validação da acelerometria comparados com o consumo máximo de oxigênio (VO2máx) e como objetivo secundário apresentar as principais características dos estudos inseridos e os principais modelos de acelerômetros testados. Método: Após pesquisa na base de dados MedLine, LILACS, Embase e CLINAHL com os descritores “Oxygen Consumption” OR “Energy Metabolism” AND “Accelerometry” AND “Validation Studies”, os dois autores realizaram a seleção dos artigos de acordo com título, leitura do resumo e do texto completo. Após a inclusão dos artigos, estes tiveram sua qualidade avaliada pela ferramenta QUADAS-2 que avalia o risco de viés e a preocupação com a aplicabilidade do teste. Resultados: Foram selecionados 11 trabalhos que se ajustaram aos critérios de inclusão. A análise QUADAS-2 mostrou que para o risco de viés houve problemas com a sua identificação principalmente no que diz respeito ao teste proposto e o padrão-ouro, em relação à aplicabilidade na maioria dos estudos o risco foi baixo. O acelerômetro mais utilizado foi o Actgraph e SenseWear Armband Pro3 que foi testado em 3 estudos. Conclusão: Conclui-se através desta revisão sistemática que são necessárias mais informações a respeito da metodologia proposta nos estudos para classificação da qualidade dos mesmos e que a acelerometria é uma alternativa válida para medida do gasto energético em condições de atividades livres e controladas independente do tipo de acelerômetro.
Chronic failure in the treatment of chronic pain? The silent influence of the personality and its disorders
Authors: Solano João Paulo Consentino
Published: June 2022

Patients with non-oncologic chronic pain conditions commonly present with psychiatric symptoms and disorders. In a sample of non-oncologic chronic pain patients referred for psychiatric consultation, personality disorders were found more frequently than any other diagnosis, including major depression. Borderline and narcissistic personality disorders were the most common psychiatric diagnoses in the group. This paper debates such findings along with a literature review carried out using the keywords chronic pain, borderline personality disorder, and narcissistic personality disorder. Diagnostic criteria for the personality disorders are shown, as well as some “soft signs” that may indicate the disorder. Two vignettes exemplify each of the personality disorders; finally, some recommendations are offered to ease the clinical management of such patients by multi-professional teams for chronic pain patients.
Clinical and epidemiological characteristics of adolescent patients with osteosarcoma
Authors: Castro Juliana Ramiro Luna , Silva Cíntia Maria Torres Rocha , Barroso Karoline Sampaio Nunes , Lopes Jaqueline Pereira
Published: June 2022

Osteosarcoma (OS) is a malignant neoplasia that affects the bone tissue with no known cause. It most commonly affects the appendicular skeleton, mainly the femur and tibia bones, in children and adolescents. The surgery treatment consists of a resection of the tumor or amputation of the affected limb, associated with chemotherapy. The earlier it is diagnosed and treated, and the smaller it is, the better the prognosis will be. Objective: The main objective of this study was to present the clinical characteristics and epidemiology of adolescent patients from the Ceará Cancer Hospital (HCC) in the city of Fortaleza. Clinical and epidemiologic data about these patients, who ranged from the age of 10 to 19 years old, was investigated in order to fulfill our objectives with this study. Method: A retrospective cohort study was developed gathering information from patients’ charts from the above-mentioned hospital from the period of January 2006 to December 2007. The data was collected through a semi-structured form that consisted of questions that appraised both the clinical and epidemiological characteristics of the patients, as well as the demographic data. After selecting 29 cases, only 26 were used for the analysis due to either incomplete information, abandonment of treatment, or hospital transference. Results: Our results show that Osteosarcoma was found to be more frequent in male patients (57.7%), in patients between 10 and 15 years old (73.1%), in afro-descendant patients (50%), and in patients that came from more rural areas (73.1%). This study also shows that 30.8% of the patients presented a family history of cancer. The symptom that these patients seemed to have in common was pain (24 patients), followed by an increase of local volume (20 patients), and previous trauma (8 patients). The femur bone was affected in 65.4% of the cases, with occurrence of metastasis (76.9%), almost always during the diagnosis and with the majority (15 patients) to the lungs. The treatment consisted of chemotherapy (96.2%) associated with the surgical resection (69.2%) and amputation (73.1%) or limb replacement. Other treatments such as Physical Therapy were prescribed in 42.3% of the cases, mostly during post-surgery (23.1%), and generally just to treat the complications. Conclusion: This study suggests that the common profile of a patient with Osteosarcoma is male, afro-descendant, coming from the more rural areas and presenting a family history of cancer. In conclusion, this study suggests the importance of knowledge about both clinical and epidemiological characteristics of Osteosarcoma patients, so that there is more regard from health professionals concerning multidisciplinary teamwork at the time of the diagnosis.