Influência da queixa funcional dos membros superiores no uso real e na intensidade da prática durante a fisioterapia em pacientes pós-acidente vascular encefálico

• Autor(a) principal: Silva, Maria Liliane da
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/302
• topic: Acidente vascular cerebral – Queixa funcional; Acelerometria; Extremidade superior; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL

Introduction: After stroke, upper limbs are affected and bring functional limitations to patients. The functional complaint of the patient may influence physiotherapy and actual use Objective: To identify the influence of upper limb functional complaint in physiotherapy and in actual use, both on the paretic and non-paretic sides in post-stroke individuals. Additionally, it is intended to observe the intensity of the practice and type of intervention proposed in physical therapy according to the patient's complaint. Methods Article 1: Patients with hemiparesis due to stroke were recruited in rehabilitation centers, clinics and / or clinics. From the functional complaint, as determined by The Canadian Occupational Performance Measure (COPM), patients were divided into two groups: with and without upper limb functional complaint. Socio-demographic, clinical and functional data were collected. A physiotherapy session was filmed and an accelerometer on each upper limb was placed. Filming was analyzed and all interventions were categorized according to the International Classification of Functioning, Disability and Health (CIF). Body structure and function interventions were described when the activity did not have a specific functional objective and interventions of activity and participation were those with functional objectives of the upper limb. The intensity of the practice (repetitions and time) was counted and the asymmetry obtained by the accelerometry was calculated. Descriptive and inferential analyzes (General Linear Model) were performed comparing the intensity of practice and type of intervention between the groups. Methods Article 2: the same procedures of evaluation and separation of groups of patients were performed. A pair of accelerometers were positioned on each upper limb and remained for 72 hours. Instructions on maintaining the accelerometer and an activity diary was delivered to the patient. The asymmetry between the upper limbs was calculated. Descriptive and inferential analyzes (General Linear Model) were performed comparing the asymmetry between the groups. Results Article 1: The presence of complaining of upper limbs influences the intensity of upper limb practice during physiotherapy. Both groups perform more non-spontaneous activities in the paretic upper limb and spontaneous to the non-paretic upper limb. Interventions related to body structure and function are performed in both upper limbs in the upper limb complaint group. Results article 2: The functional complaint influenced only the asymmetry in the actual use. There is a relationship between the severity of sensorimotor impairment and the increase in asymmetry between the upper limbs, especially in the upper limbs complaint group. Conclusion: The presence of functional complaints of upper limbs influences the intensity of practice and the actual use of upper limbs in post-stroke patients.