Márcia Regina Garanhani

Alterações eletromiográficas dos músculos do tronco de pacientes com hemiparesia após acidente vascular encefálico

UNLABELLED Stroke is the main cause of chronic disability in adults, but few studies evaluated the trunk motor activity in affected subjects. OBJECTIVE To compare the myoelectrical activity of trunk muscle in hemiparetic and control subjects. METHOD Eight hemiparetic and eight control subjects were assessed during lower extremities flexion and trunk rotation in supine position; stand up and rise up upper extremities in seated position. RESULTS Paretic rectus abdominis presented a higher activation than control group (p=0.031) during lower extremities elevation. Obliquus externus abdominis showed a bilateral higher activation during lower extremities elevation than rotation activities (p=0.014 and p=0.002, respectively). There was no difference in extension activities comparison. CONCLUSION Trunk flexor muscles of hemiparetic subjects demonstrated motor alterations in rectus abdominis of paretic side and compensations were used with Obliquus externus.

Electromyographic activity of selected trunk muscles in subjects with and without hemiparesis during therapeutic exercise.

The purpose of this study was to evaluate the trunk muscles activity of hemiparetic and control subjects during selected therapeutic exercises with surface electromyography (sEMG). The sEMG evaluation included 12 subjects presenting hemiparesis after having suffered a unilateral stroke and 12 apparently healthy subjects. A 16-channel sEMG system was used; data were band pass filtered from 20 to 450Hz. The signal was normalized through reference voluntary contraction (RVC) and presented in percentage. The exercises used in the evaluations were trunk flexion and trunk extension. Rectus abdominis presented greater activation on the paretic side of the experimental group than on the corresponding side of the control group (P=0.035) (Cohens d¯=0.94). During leg elevation, the non-paretic obliquus externus abdominis showed greater activation than in other exercises (P=0.019) (Cohens d¯=0.75). No inter-group differences were found for either erectus spinae activity or contraction onset. Experimental group subjects showed muscle activity alterations, principally in the rectus abdominis, indicating the occurrence of compensatory strategies.

Physical therapy in peripheral facial paralysis: retrospective study.

UNLABELLED Peripheral facial paralysis requires specialized treatment. Physical therapy aims at reestablishing facial movements. The aim of this study was to describe and to analyze physical therapy results for individuals with peripheral facial paralysis. STUDY DESIGN Retrospective study. METHOD A retrospective study was carried out at the University Hospital, authorized by the Statistics and Medical File Services, from 1999 to 2003. Data are presented in descriptive form with mean and median values for numeric variables and frequency for categorical variables. RESULTS Twenty-three files were analyzed during four years. Females predominated and the average age was of 32.3 years (SD+/-16.5); 14 idiopathic and five trauma cases; 12 with total motor deficit and 11 with partial motor deficit; in the 12 cases that underwent final evaluation, seven had partial and five had total recovery. The physical therapy program used was kinesiotherapy and patient education. CONCLUSION In this study, individuals were similar to individuals in other populations. They were treated with kinesiotherapy, as suggested by the scientific literature and recovered.

Fisioterapia na paralisia facial periférica: estudo retrospectivo

Peripheral facial paralysis requires specialized treatment. Physical therapy aims at reestablishing facial movements. The aim of this study was to describe and to analyze physical therapy results for individuals with peripheral facial paralysis. STUDY DESIGN: Retrospective study. METHOD: A retrospective study was carried out at the University Hospital, authorized by the Statistics and Medical File Services, from 1999 to 2003. Data are presented in descriptive form with mean and median values for numeric variables and frequency for categorical variables. RESULTS: Twenty-three files were analyzed during four years. Females predominated and the average age was of 32.3 years (SD±16.5); 14 idiopathic and five trauma cases; 12 with total motor deficit and 11 with partial motor deficit; in the 12 cases that underwent final evaluation, seven had partial and five had total recovery. The physical therapy program used was kinesiotherapy and patient education. CONCLUSION: In this study, individuals were similar to individuals in other populations. They were treated with kinesiotherapy, as suggested by the scientific literature and recovered.

Cuidador de pessoa com acidente vascular encefálico: necessidades, sentimentos e orientações recebidas

Objectives: Understand the needs and feelings of the caregiver of individuals who have experienced a stroke, and identify the information provided to these caregivers by health professionals. Methods: This exploratory, descriptive qualitative approach used semistructured interviews to understand the experience of six caregivers, during the period from May to August, 2008. The data from these interviews were analyzed using discourse analysis. Results: Three categories were identified: the initial needs of the caregiver, the caregiver and his/her feelings, and the guidance received by the caregiver from health professionals. Needs of the caregivers were varied, but primarily concerned adaptive difficulties. Diverse feelings were identified, including ambivalence, and a range of intensity of those feelings was noted. Guidelines provided by health professionals ranged from a total absence of information, to guidance that was felt by caregivers to meet all of their needs. Conclusions: There is need for discussion regarding provision of standardized guidelines for caregivers, and a strategy to support caregivers and patients.Objectives: Understand the needs and feelings of the caregiver of individuals who have experienced a stroke, and identify the information provided to these caregivers by health professionals. Methods: This exploratory, descriptive qualitative approach used semistructured interviews to understand the experience of six caregivers, during the period from May to August, 2008. The data from these interviews were analyzed using discourse analysis. Results: Three categories were identified: the initial needs of the caregiver, the caregiver and his/her feelings, and the guidance received by the caregiver from health professionals. Needs of the caregivers were varied, but primarily concerned adaptive difficulties. Diverse feelings were identified, including ambivalence, and a range of intensity of those feelings was noted. Guidelines provided by health professionals ranged from a total absence of information, to guidance that was felt by caregivers to meet all of their needs. Conclusions: There is need for discussion regarding provision of standardized guidelines for caregivers, and a strategy to support caregivers and patients.

Caregivers of people with stroke: needs, feelings and guidelines provided

Objectives: Understand the needs and feelings of the caregiver of individuals who have experienced a stroke, and identify the information provided to these caregivers by health professionals. Methods: This exploratory, descriptive qualitative approach used semistructured interviews to understand the experience of six caregivers, during the period from May to August, 2008. The data from these interviews were analyzed using discourse analysis. Results: Three categories were identified: the initial needs of the caregiver, the caregiver and his/her feelings, and the guidance received by the caregiver from health professionals. Needs of the caregivers were varied, but primarily concerned adaptive difficulties. Diverse feelings were identified, including ambivalence, and a range of intensity of those feelings was noted. Guidelines provided by health professionals ranged from a total absence of information, to guidance that was felt by caregivers to meet all of their needs. Conclusions: There is need for discussion regarding provision of standardized guidelines for caregivers, and a strategy to support caregivers and patients.Objectives: Understand the needs and feelings of the caregiver of individuals who have experienced a stroke, and identify the information provided to these caregivers by health professionals. Methods: This exploratory, descriptive qualitative approach used semistructured interviews to understand the experience of six caregivers, during the period from May to August, 2008. The data from these interviews were analyzed using discourse analysis. Results: Three categories were identified: the initial needs of the caregiver, the caregiver and his/her feelings, and the guidance received by the caregiver from health professionals. Needs of the caregivers were varied, but primarily concerned adaptive difficulties. Diverse feelings were identified, including ambivalence, and a range of intensity of those feelings was noted. Guidelines provided by health professionals ranged from a total absence of information, to guidance that was felt by caregivers to meet all of their needs. Conclusions: There is need for discussion regarding provision of standardized guidelines for caregivers, and a strategy to support caregivers and patients.

Quality of life of primary caregivers of spinal cord injury survivors

Este estudo objetivou avaliar a qualidade de vida de cuidadores familiares de pacientes com Lesao da medula espinal (LM). Quatorze mulheres (sete cuidadoras familiares e sete controles) foram submetidas a avaliacao pelo questionario Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) e pelo questionario Caregiver Burden Scale (CBS). Utilizou-se o Teste de Mann-Whitney (p 0,05), caracterizada pela diferenca percentual de 62%, 66,7%, 55%, 50%, 57% e 63%, para tensao geral, isolamento, decepcao, envolvimento emocional, ambiente e escore global, respectivamente. O questionario CBS mostrou-se adequado para verificar a qualidade de vida dos cuidadores de pessoas com LM e o ato de cuidar produz um impacto negativo sobre a qualidade de vida destes.The aim of this study was to analyze quality of life of caregivers who are relatives of patients with spine cord injury (SCI). Fourteen women (seven caregivers and seven controls) were evaluated by the Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) and the Caregiver Burden Scale (CBS) Questionnaires. The data from both questionnaires were compared using the Mann-Whitney U testing procedure for differences between caregivers and controls (p<0.05). The results from SF-36 were not statistically significant between groups, however, for the CBS data, there were significant differences between groups (p>0.05), characterized by the percentage difference of 62%, 66.7%, 55%, 50%, 57% and 63% for tension, isolation, disappointment, emotional involvement, environment and overall score, respectively. The CBS questionnaire was more adequate for verifying quality of life of caregivers of SCI patients, and caregiving may have a negative impact on their quality of life.

Calidad de vida de cuidadores familiares de personas con lesión de medula espinal

Este estudo objetivou avaliar a qualidade de vida de cuidadores familiares de pacientes com Lesao da medula espinal (LM). Quatorze mulheres (sete cuidadoras familiares e sete controles) foram submetidas a avaliacao pelo questionario Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) e pelo questionario Caregiver Burden Scale (CBS). Utilizou-se o Teste de Mann-Whitney (p 0,05), caracterizada pela diferenca percentual de 62%, 66,7%, 55%, 50%, 57% e 63%, para tensao geral, isolamento, decepcao, envolvimento emocional, ambiente e escore global, respectivamente. O questionario CBS mostrou-se adequado para verificar a qualidade de vida dos cuidadores de pessoas com LM e o ato de cuidar produz um impacto negativo sobre a qualidade de vida destes.The aim of this study was to analyze quality of life of caregivers who are relatives of patients with spine cord injury (SCI). Fourteen women (seven caregivers and seven controls) were evaluated by the Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) and the Caregiver Burden Scale (CBS) Questionnaires. The data from both questionnaires were compared using the Mann-Whitney U testing procedure for differences between caregivers and controls (p<0.05). The results from SF-36 were not statistically significant between groups, however, for the CBS data, there were significant differences between groups (p>0.05), characterized by the percentage difference of 62%, 66.7%, 55%, 50%, 57% and 63% for tension, isolation, disappointment, emotional involvement, environment and overall score, respectively. The CBS questionnaire was more adequate for verifying quality of life of caregivers of SCI patients, and caregiving may have a negative impact on their quality of life.

A cadeira de rodas e seus componentes essenciais para a locomoção de pessoas com tetraplegia por lesão da medula espinhal

Objetivo: Compreender quais itens sao essenciais a cadeira de rodas (CR) na perspectiva da pessoa tetraplegica por lesao da medula espinhal (LME). Metodo: O estudo qualitativo foi com entrevista semi-estruturada e analise de discurso, bem como, checklist da CR em uso e do Sistema Unico de Saude (SUS). Resultados: No total foram dez entrevistados: nove homens e uma mulher, media de idade de 42,3 anos (± 9,23), dois advogados, um economista e demais aposentados. As causas da LME foram acidente automobilistico (60%), mergulho em aguas rasas (30%) e atropelamento (10%), respectivamente. O tempo de lesao foi em media 16,3 anos (± 7,14) e todos realizavam fisioterapia. Os numeros de CR, ate a adequada, foram duas a cinco e todos praticavam esporte adaptado ou lazer com CR. O checklist apontou itens insuficientes na CR do SUS e da analise dos discursos resultaram em quatro categorias: Itens, materiais e condicoes necessarias; A conquista da funcionalidade; Vantagens e desvantagens da CR; e Sentimentos vivenciados. A CR e essencial para a locomocao das pessoas com tetraplegia e conhecer modelos, experimentar e ter orientacoes sobre os itens adequados sao importantes para a aquisicao. Os itens adequados facilitam a aceitacao, melhor adaptacao, locomocao e autonomia. Conclusao: A cadeira do SUS mostrou-se insuficiente, o que leva ao abandono. A adquirida por funcionalidade, com itens essenciais, o que responde a individualidade e ao gosto do usuario, mostrou-se util e adequada apesar de seu elevado custo.

Qualidade de vida de cuidadores familiares de pessoas com lesão da medula espinal

Este estudo objetivou avaliar a qualidade de vida de cuidadores familiares de pacientes com Lesao da medula espinal (LM). Quatorze mulheres (sete cuidadoras familiares e sete controles) foram submetidas a avaliacao pelo questionario Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) e pelo questionario Caregiver Burden Scale (CBS). Utilizou-se o Teste de Mann-Whitney (p 0,05), caracterizada pela diferenca percentual de 62%, 66,7%, 55%, 50%, 57% e 63%, para tensao geral, isolamento, decepcao, envolvimento emocional, ambiente e escore global, respectivamente. O questionario CBS mostrou-se adequado para verificar a qualidade de vida dos cuidadores de pessoas com LM e o ato de cuidar produz um impacto negativo sobre a qualidade de vida destes.The aim of this study was to analyze quality of life of caregivers who are relatives of patients with spine cord injury (SCI). Fourteen women (seven caregivers and seven controls) were evaluated by the Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) and the Caregiver Burden Scale (CBS) Questionnaires. The data from both questionnaires were compared using the Mann-Whitney U testing procedure for differences between caregivers and controls (p<0.05). The results from SF-36 were not statistically significant between groups, however, for the CBS data, there were significant differences between groups (p>0.05), characterized by the percentage difference of 62%, 66.7%, 55%, 50%, 57% and 63% for tension, isolation, disappointment, emotional involvement, environment and overall score, respectively. The CBS questionnaire was more adequate for verifying quality of life of caregivers of SCI patients, and caregiving may have a negative impact on their quality of life.