Maria Inês Paes Lourenção

The use of the comprehensive International Classification of Functioning, Disability and Health core set for stroke for chronic outpatients in three Brazilian rehabilitation facilities

Purpose: Stroke is a leading cause of death and disability in Brazil. The multiple aspects of disability in these patients require proportionally comprehensive tools for their assessment. The International Classification of Functioning, Disability and Health (ICF) core set for stroke intends to comprehensively describe the experience of such patients with their functioning. This study aimed to empirically validate the ICF core set for stroke by checking the frequency of problems in each of its categories, thus verifying content validity. Method: A cross-sectional study in which data were collected from clinical charts, physical examination, tests, and interviews with 132 stroke outpatients under rehabilitation and their caregivers. Categories were considered “not validated” if less than 20% of the sample would present some degree of problems in them. Results: Only 20 categories (14 body functions, 5 body structures, and 1 activity and participation) were considered not validated. Neuromusculoskeletal functions and mobility were the aspects of functioning most often described with problems. All environmental factors were qualified as facilitators or barriers and acted as modulators of disability. Conclusions: The comprehensive ICF core sets for stroke can be used by multidisciplinary teams to classify the life experience of stroke survivors, although efforts to enable and enhance reproducibility are needed to warrant its reliable routine use. Implications for Rehabilitation Stroke is a cause of multiple impairments and disability. Multidisciplinary approaches are indicated for rehabilitation in this condition. The International Classification of Functioning, Disability and Health (ICF) provides a model to understand human functioning. The ICF core set for stroke provides a comprehensive framework to describe functioning and needs of stroke survivors.

Poster 67 Guidelines: Breast Cancer Rehabilitation

deficits before surgery, and two of the patients had mild cognitive deficits. Patients suffered cranial neuropathies ranging from cranial nerves IV through X and XII. Program Description: The customized interdisplinary rehabilitation plan required the services of speech therapists, audiologists, physical therapists, occupational therapists, neuropsychologists, physiatrists, otolaryngologists, ophthalmologists and optometrists. Setting: Referral based tertiary cancer center. Results or Clinical Course: Each patient showed demonstrable gains in function with inpatient rehabilitation and good outcomes at discharge. Discussion: Intracranial epidermoid cysts are uncommon, slowgrowing brain tumors often found in the cerebellopontine angle. Due to their location, symptoms may present with a complex combination of headache, cerebellar dysfunction, and cranial nerve deficits affecting functional status. This is the first report of the rehabilitation of cerebellopontine angle epidermoid cyst patients. Conclusions: The findings suggest that a customized inpatient rehabilitation plan can result in functional gains. More research on the rehabilitation of these rare tumors is needed.

Poster 68 Guidelines on Therapeutic Exercises for Patients with Breast Cancer

Objective: Breast cancer is the most prevalent neoplasm among women. Treatment includes conservative or radical mastectomy, lymphadenectomy, radiotherapy, chemotherapy and hormonal therapy. The outcomes are mostly positive, especially in terms of survival rates. Rehabilitation plays an important role in providing Quality of Life improvements and recovery or prevention of disabilities. This study aims to answer the most common questions about rehabilitation techniques and effects in this group. Design: A multidisciplinary health team elaborated 13 questions about breast cancer rehabilitation selected treatments and outcomes. Secondly, research in Pubmed Database was performed. Forty five English-language studies identified as randomized controlled trials, prospective cohort studies, and nested case-control studies were selected. Multiple reviewers extracted details about statistical analyses, with adjustments for confounding and methodological quality. Differences were solved by consensus. Setting: Centro de Pesquisa do Instituto de Medicina Física e Reabilitação da Faculdade de Medicina da Universidade de São Paulo. Participants: Subjects of the selected articles. Interventions: Complex decongestive therapy, compression garment, pneumatic compression, early physical therapy, exercise, multidiciplinary approach (psychotherapy, occupational therapy, hydrotherapy, meditation). Main Outcome Measures: Lymphoedema improvement and prevention, Quality Of Life, prevention of recurrence of breast cancer, shoulder function. Results: Some techniques recommended in rehabilitation, such as manual drainage, pneumatic compression and hydrotherapy when isolated show no benefit over other combined therapies. Psychotherapy, early physical therapy, exercise and complex decongestive therapy show remarkable benefits improving lymphoedema, pain, function and Quality Of Life of breast cancer survivors. Conclusions: The study set the ground for the establishment of a guideline to breast cancer rehabilitation. However, there are still unanswered questions due to the lack of high quality studies on this subject, which may compromise the value of the best approaches so far.