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Introdução: Ocupações como tratamento, são umas das abordagens mais usadas na reabilitação do Acidente Vascular Encefálico (AVE); no entanto, pouco se sabe do seu impacto comparado a outras estratégias. Objetivo: Analisar o efeito de práticas baseadas em ocupações na reabilitação do AVE conduzidas por terapeutas ocupacionais brasileiros (TOBs). Métodos: Revisão sistemática baseada no Checklist PRISMA. A pergunta de pesquisa foi redigida a partir do acrônimo PICO. Termos consultados: Acidente Vascular Cerebral; Reabilitação; e Terapia Ocupacional. Os títulos identificados foram alimentados no Programa Rayyan, nas etapas de seleção e elegibilidade, com aplicação de critérios terminológicos das ocupações. A análise de viés foi feita pela Ferramenta de Colaboração Cochrane. O Teste Kappa calculou o índice de confiabilidade. Resultados: Confirmou-se que as Atividades de Vida Diária (AVDs) são as estratégias mais comuns também por TOBs. Há crescente interesse pela gameterapia nas intervenções dos TOBs. Foi encontrada consistência na condução terapêutica com desfechos favoráveis à recuperação pós-AVE, a partir das ocupações, mas com enviesamento metodológico. Conclusão: As evidências não são suficientes para afirmar categoricamente que as práticas baseadas em ocupações são mais relevantes para estabelecer a recuperação pós-AVE que outras abordagens conduzidas por TOBs. Prospero: CRD42020223565.
Introduction: Occupations, as a form of treatment, are one of the most commonly employed approaches in the rehabilitation of Cerebral Vascular Accident (CVA); though, little is known about their efficiency compared to other strategies. Objective: Investigate the effectiveness of occupations in Cerebral Vascular Accident rehabilitation carried out by Brazilian occupational therapists (BOTs). Methods: Systematic review based on PRISMA. The research question was formulated from the acronym PICO. Terms consulted: Cerebral Vascular Accident; Rehabilitation; and Occupational Therapy. The identified titles were exported to the Rayyan Program, during the selection and eligibility stages, applying terminological criteria of the occupations. Bias analysis was performed using the Cochrane Collaboration Tool. The Kappa test calculated the reliability index. Results: It was confirmed that Activities of Daily Living (ADLs) are the most common strategies also for BOTs. Interest in game therapy was shown in BOTs interventions. Consistency was found in rehabilitation with favorable outcomes for post-stroke recovery based on occupations, but methodological bias compromises the results. Conclusion: The results are not enough to definitively state that occupation-based practices are more relevant to establishing post-stroke recovery than other approaches carried out by BOTs. Prospero: CRD42020223565.
RESUMEN
Background/objective: Although many therapeutic approaches use energy conservation, only a few effectively report the steps involved. Thus, it is intended to identify energy conservation practices to be organized in flexible and adaptable stages. Methods: A scoping review was carried out, whose search strategies were applied in seven databases (CINAHL, Cochrane Library, Portal BVS, PsycINFO, PubMed, Scopus, and Web of Science) following guidelines by Arksey and O'Malley on the Rayyan software. Searches were carried out from January 2010 to December 2020. Inclusion of refered publications with different study designs, participation of adults with or by demands of energy conservation, joint protection, and control of fatigue and/or pain. Exclusion of productions without an occupational therapist or involving merely pharmacological or surgical therapeutic strategies. Results: 653 articles were identified, after the selection and eligibility steps, 30 articles were full review, 18 articles were included and 635 excluded. Energy conservation studies have been increasingly focusing on neurological and systemic diseases, especially regarding symptoms of fatigue and pain. The findings were arranged in six strategies whose interventions are essentially based on guidelines and setting goals for patients, client-centered approach. Merely supervised interventions are less frequent. The number of sessions is closed, but the duration of treatment is not yet. Conclusions: The signs of pain and fatigue are confirmed as indicators of energy conservation strategies, this delivery can be condensed from planning and organization, priorities, activity analysis, balance between activity and rest, outsourcing of tasks and physical/environmental adaptation. Trial Registration OSF: https://osf.io/rsyq4.
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Abstract Introduction The physical, social and occupational restrictions imposed by the COVID-19 pandemic have affected the health and well-being of the world population. Objective To identify the repercussions of the pandemic on the occupational participation of students, lecturers and technicians from three public universities in Northern Brazil, to compare the changes reported by participants in occupational participation before and during the pandemic, and to identify symptoms of depression, anxiety and stress self-reported. Method This is a Cross-sectional, descriptive and comparative study with a quantitative approach. One hundred and ninety-nine (n = 199) participants (students, lecturers and technicians) responded to an online questionnaire, the "Occupational Participation Checklist" and the Anxiety, Stress and Depression Scale (DASS-21). Data analysis were descriptive and also performed by applying the Wilcoxon and Mann-Whitney tests. Results During the pandemic, an increase in occupational participation was identified for all participants in domestic activities (p <0.001) and a decrease in work and study face to face (p <0.001). Students reported more symptoms of depression, anxiety and stress when compared to lecturers (p<0.001). Most students did not organise their time to fulfil their occupations with satisfaction. Such difficulties were associated with symptoms of depression, anxiety and stress, especially among the student's group (p<0.001). Conclusion This study provided preliminary evidence about differences in occupational participation before and during the Covid-19 pandemic. The organization of time and difficulties in occupational participation were associated to levels of anxiety, depression and stress, especially in the sample of students.
Resumo Introdução As restrições físicas, sociais e ocupacionais impostas pela pandemia de COVID-19 têm afetado a saúde, o bem-estar e a qualidade de vida da população mundial. Objetivo Identificar as repercussões da pandemia na participação ocupacional de estudantes, docentes e técnicos de três universidades públicas do Norte do Brasil, comparar as mudanças relatadas pelos participantes na participação ocupacional antes e durante a pandemia, e identificar sintomas de depressão, ansiedade e estresse. Método Estudo transversal, descritivo e comparativo com abordagem quantitativa. Cento e noventa e nove (n = 199) participantes (alunos, professores e técnicos), responderam (on-line) à "Lista de Verificação da Participação Ocupacional" e à Escala de Ansiedade, Estresse e Depressão (DASS-21). Realizou-se análise descritiva dos dados e aplicação dos testes de Wilcoxon e Mann-Whitney. Resultados Durante a pandemia, identificou-se aumento na participação ocupacional para todos os participantes nas atividades domésticas (p <0,001) e diminuição no trabalho ou estudos presenciais (p <0,001). Os alunos relataram mais sintomas de depressão, ansiedade e estresse em comparação com os professores (p<0,001). A maioria dos estudantes não organizou seu tempo para desempenhar, com satisfação, suas ocupações. Tais dificuldades foram associadas com sintomas de depressão, ansiedade e estresse, principalmente entre os estudantes (p <0,001). Conclusão Este estudo forneceu conclusões preliminares sobre as diferenças na participação ocupacional antes e durante a pandemia. A organização do tempo e as dificuldades no desempenho das ocupações foram relacionadas aos níveis de ansiedade, depressão e estresse, principalmente na amostra de estudantes.