Autor: Anatomia e UTI | Publicado: 2014-08-18T11:34:00-07:00

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A
FISIOTERAPIA NA SÍNDROME DA IMOBILIDADE



O QUE É A
SÍNDROME DA IMOBILIDADE?



A
Síndrome da Imobilidade é comum em idosos, e consiste no estado em que o
indivíduo vivencia limitações físicas do movimento, decorrente de alterações
que ocorrem naquele que se encontra acamado há um longo período de tempo. Os
efeitos da imobilização são definidos como uma redução na capacidade funcional
dos sistemas cardiorrespiratório, vascular, endócrino, gastrointestinais,
urinário, muscular, esquelético e neurológico. Sendo que estas complicações
podem ser aumentadas dependendo dos fatores pré-existentes de cada paciente,
como por exemplo, a idade ou uma doença debilitante.



COMO É
DIAGNOSTICADA?



Um
paciente é considerado portador da síndrome&nbsp;da Imobilidade quando
apresenta uma das características do critério maior, ou seja, déficit cognitivo
médio a grave, além de múltiplas contraturas. E também apresentar pelo menos
duas características do critério menor: sinais de sofrimento cutâneo ou úlcera
de pressão, dificuldades na deglutição (disfagia) leve ou grave, incontinência
urinária e fecal, e alterações na fala.



Muitos
fatores físicos, psicológicos e ambientais podem causar imobilidade em pessoas
idosas, como: artrites, osteoporose, fraturas, doença de paget, doença de Parkinson,
neuropatias periféricas, sequelas de acidente vascular cerebral, insuficiência
cardíaca grave, doença coronariana instável (anginas), claudicação (doença
vascular periférica), doença pulmonar obstrutiva crônica (DPOC), dor crônica,
desnutrição grave, etc.

Considera-se
que de 7 a 10 dias seja um período de repouso, de 12 a15 dias já é considerada
imobilização e a partir de 15 dias é considerado decúbito de longa duração.
Para cada semana de imobilização completa no leito um paciente pode perder de
10 a 20% de seu nível inicial de força muscular. Por volta de 4 semanas, 50% da
força inicial pode estar perdida.



QUAIS SÃO
OS ACOMETIMENTOS DECORRENTES DA SÍNDROME?



- Sistema
Musculoesquelético: Osteoporose, atrofias, contraturas etc;

- Sistema
Tegumentar: Úlceras de pressão, edema, alterações sensitivas, micoses etc;

-Sistema
Cardiovascular: Trombose venosa profunda, embolia pulmonar, Isquemia arterial
aguda dos membros inferiores;

-Sistema respiratório:
Pneumonia e outras doenças estruturais.

-Sistema
urinário: Incontinência urinária, Infecção do trato urinário.
-Sistema digestivo: Desnutrição, Constipação, disfagia, distúrbio neuropsíquico.



 

  
 


COMO A
FISIOTERAPIA PODE AJUDAR?&nbsp;



- Estimulando a movimentação no leito e a&nbsp;independência&nbsp;nas
atividades.
- Estimulando a deambulação (caminhada).
- Prevenindo complicações pulmonares.
- Auxiliando na resolução de patologias pulmonares já instaladas.
- Promovendo um padrão respiratório mais eficaz.
- Evitando complicações circulatórias (vasculares).
- Reduzindo a dor.
- Mantendo força muscular e a amplitude de movimentos com exercícios. Ex: Isométricos,
metabólicos, ativos-resistidos e passivos.
- Evitando encurtamentos musculares, atrofias e contraturas.
- Melhorando mobilidade e flexibilidade, coordenação e habilidade.
- Promovendo o relaxamento.
- Prevenindo e tratando o edema (inchaço) que pode ocorrer como consequência da
patologia de cirurgias ou da imobilização no leito.
- Promovendo a reeducação postural.
- Promovendo a conscientização corporal.
- Prevenindo as escaras (desde a fase aguda hospitalar, realizando mudanças de
decúbito de 2/2hs).



Diante de
tantas alterações constata-se que a Síndrome do Imobilismo é de grande
sofrimento tanto para os pacientes quanto aos familiares. Fato é que desde 1860
o repouso no leito foi reconhecido como modalidade terapêutica a fim de poupar
os "humores ou energia, a partir daí passou a ser adotado de forma abusiva
para muitos processos mórbidos. O conceito de "repouso necessita ser
atualizado e desmistificado de tal forma que permita a mobilização precoce no
pós-operatório e reabilitação geriátrica de modo a deixar o idoso no leito
somente o tempo necessário e se necessário. A fisioterapia tem papel
fundamental nesse paciente e visa prevenir que o idoso fique restrito ao leito
e possa fazer com que possa manter-se útil e ativo.



Publicado
por: Talita Dias em http://pt.scribd.com/doc/127793707/A-FISIOTERAPIA-NA-SINDROME-DA-IMOBILIDADE
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   UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/>
  
  <w:LsdException Locked="false" Priority="34" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/>
  <w:LsdException Locked="false" Priority="29" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Quote"/>
  <w:LsdException Locked="false" Priority="30" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 1"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 1"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 2"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 2"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 2"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/>
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   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 2"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 2"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 3"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 3"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 4"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 4"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 5"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 5"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 6"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 6"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
  <w:LsdException Locked="false" Priority="19" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
  <w:LsdException Locked="false" Priority="21" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
  <w:LsdException Locked="false" Priority="31" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
  <w:LsdException Locked="false" Priority="32" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
  <w:LsdException Locked="false" Priority="33" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>
  
  
 
<![endif]--><!--[if gte mso 10]>

 /* Style Definitions */
 table.MsoNormalTable
 {mso-style-name:"Tabela normal";
 mso-tstyle-rowband-size:0;
 mso-tstyle-colband-size:0;
 mso-style-noshow:yes;
 mso-style-priority:99;
 mso-style-parent:"";
 mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
 mso-para-margin:0cm;
 mso-para-margin-bottom:.0001pt;
 mso-pagination:widow-orphan;
 font-size:10.0pt;
 font-family:"Calibri","sans-serif";}

<![endif]-->