RESUMO
AIMS: The World Health Organization points out that, by 2030, two billion people will need at least one assistive product. 3D printing can be used to meet the demands when dispensing these products. PURPOSE: This review aims to map the use of 3D printing in the manufacture of orthoses and prostheses for people with physical disability at rehabilitation centers. METHODS: Publications that deal with the use of 3D printing for the manufacture of orthoses and prostheses were used, preferably studies from 2012 to 2022. RESULTS: The majority of studies, 56.25%, were quantitative and 46.25% were evaluative research. None of the studies were characterized as developed at rehabilitation centers. 75% of them had the participation of people with physical disability. The use of 3D printing was, for the most part, for the development of assistive technologies for the upper limbs at 56.25%, while 31.25% were for the lower limbs. CONCLUSION: The assistive products developed were orthoses and prostheses for the wrist, hands, fingers, upper limbs, writing devices, sockets, knees, and feet. Although there were positive results in their performance, some limitations related to strength, stiffness, and resistance were observed.
Assuntos
Pessoas com Deficiência , Aparelhos Ortopédicos , Impressão Tridimensional , Desenho de Prótese , Centros de Reabilitação , Humanos , Pessoas com Deficiência/reabilitação , Membros ArtificiaisRESUMO
STUDY DESIGN: Mixed-method approach. OBJECTIVES: To develop and assess the content validity of a semi-structured interview that captures the lived experience of using a manual wheelchair among individuals with SCI in the real world, the Wheelchair Mobility Activity Log (WC-MAL). SETTING: SCIR-Group (UDESC)/Brazil. METHODS: Developing the WC-MAL comprised five steps: (1) defining the construct-based on the International Classification of Functioning, Disability and Health (ICF); (2) identifying relevant activities from other assessment instruments and interviews with the end-users (14 Individuals with SCI and 13 rehabilitation professionals); (3) Selecting the items - activities were linked to ICF codes and grouped into sets; (4) developing the scoring scales based on interviews with the end-users; and, (5) evaluating content validity in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The content validity ratio (CVR) for each item and scale and the overall instrument content validity index (CVI) were calculated. RESULTS: From an initial draft of 295 activities identified, a set of 222 activities was linked to the ICF domain of "Mobility (d4)" and further refined to generate the 23 items in the WC-MAL. Three scales were developed to assess Frequency (how often), Performance (how well), and Assistance (assistance needed) levels. The items and scales showed a CVR superior to the critical value established (≥0.64). The general CVI value was 0.96. CONCLUSION: The WC-MAL is a promising clinical instrument with adequate content validity to assess the spontaneous use of the manual wheelchair in the real world among individuals with SCI.
Assuntos
Traumatismos da Medula Espinal , Cadeiras de Rodas , Humanos , Traumatismos da Medula Espinal/reabilitação , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Atividades Cotidianas , Avaliação da Deficiência , Entrevistas como Assunto , Pessoas com Deficiência/reabilitação , BrasilRESUMO
To evaluate the effectiveness of a home exercise program called Home Exercise Booklet for People Living with Human T Lymphotropic Virus 1 (HTLV-1). This is a methodological study of content validation with expert judges. A questionnaire with a Likert scale was applied, containing 16 items referring to the content domain. Descriptive statistics were used to obtain the content validity index. In total, 46 judges participated, 24 physiotherapists (PG) and 22 professionals from other health areas specializing in methodological studies and HTLV-1 (EG). In the validation process, each evaluator judged the technology and scored their considerations. In the end, we obtained the following results for the Content Validity Index (CVI): PG CVI: 94.3%, GE CVI: 93.4%. Although the index was sufficient to consider the technology validated, modifications were made to the second and final version of the booklet, considering the judges' observations and suggestions, which we consider relevant. The technology proved to be valid for use with the target audience. The development and validation of this product provides support to help prevent functional decline in people living with HTLV-1; standardize guidelines for physiotherapy professionals who monitor these issues; start a home exercise program aimed at other comorbidities; open the possibility of creating and validating home exercise programs with other comorbidities.
Assuntos
Terapia por Exercício , Vírus Linfotrópico T Tipo 1 Humano , Humanos , Terapia por Exercício/métodos , Inquéritos e Questionários , Feminino , Infecções por HTLV-I/prevenção & controle , Masculino , Adulto , Pessoas com Deficiência/reabilitação , Pessoa de Meia-Idade , Exercício FísicoRESUMO
BACKGROUND: Health disparities in osteoarthritis (OA) outcomes exist both in the occurrence and treatment of functional limitation and disability for Mexican Americans. Although the effect of self-management of chronic illness is well established, studies demonstrate little attention to self-management of function or disability, despite the strong potential effect on both and, consequently, on patients' lives. OBJECTIVE: The purpose of this study pilot was to develop and test key variable relationships for a measure of disability self-management among Mexican Americans. METHODS: In this sequential, two-phased, mixed-methods, biobehavioral pilot study of Mexican American women and men with OA, a culturally tailored measure of disability self-management was created, and initial relationships among key variables were explored. RESULTS: First, a qualitative study of 19 adults of Mexican American descent born in Texas (United States) or Mexico was conducted. The Mexican American Disability Self-Management Scale was created using a descriptive content analysis of interview data. The scale was tested and refined, resulting in 18 items and a descriptive frequency of therapeutic management efforts. Second, correlations between study variables were estimated: Disability and function were negatively correlated. Disability correlated positively with social support and activity effort. Disability correlated negatively with disability self-management, pain, and C-reactive protein. Function was positively correlated with age, pain, and depression. Liver enzymes (alanine transaminase) correlated positively with pain and anxiety. DISCUSSION: This mixed-methods study indicates directions for further testing and interventions for disability outcomes among Mexican Americans.
Assuntos
Pessoas com Deficiência , Americanos Mexicanos , Osteoartrite , Autogestão , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pessoas com Deficiência/estatística & dados numéricos , Pessoas com Deficiência/reabilitação , Americanos Mexicanos/estatística & dados numéricos , Americanos Mexicanos/psicologia , Osteoartrite/etnologia , Osteoartrite/terapia , Projetos Piloto , Pesquisa Qualitativa , Autocuidado/estatística & dados numéricos , Autocuidado/métodos , Autocuidado/psicologia , Autogestão/métodos , TexasRESUMO
PURPOSE: Wheelchair users and people with disabilities have limited access to physical exercise due to various factors, including medical follow-up and training facilities. Although tele-exercise guided by experts has become a viable option, there is limited knowledge about the acute performance decrement (APD) resulting from remote training methods. The current cross-sectional study aimed to: (1) assess the APD of muscle resistance strength after three synchronous tele-exercise training methods in wheelchair users and (2) compare the training loads associated with each training method. MATERIALS AND METHODS: Eighteen male and female wheelchair users who participated in tele-exercise strength practices were recruited. The participants performed a maximum resistance strength test by synchronous tele-assessment (push-up test, PUT) at baseline and immediately after three training methods: high-intensity interval training (HIIT), moderate-intensity continuous training (MICT) and sprint interval training (SIT). The primary outcome was the APD, which was measured by the percentage decrease in the number of repetitions of the PUT immediately after the training methods. RESULTS: APD was observed for all three training methods, with no significant differences between them (-34.8%, -29.9% and -38.0% for MICT, SIT and HII, respectively), and presented a non-significant correlation with the training loads. HIIT had a significantly higher training load than MICT and SIT. CONCLUSIONS: APD occurred in all training sessions, but did not correlate with training load, indicating that it is not an appropriate metric for comparison. Findings provide insight into APD response and highlight the need to consider multiple metrics when comparing training protocols.
Synchronous moderate-intensity continuous training (MICT), sprint interval training (SIT) and high-intensity interval training tele-exercises provided similar acute performance decrement in wheelchair users and people with disabilities.High-intensity interval training showed a higher training load compared to MICT and SIT performed remotely.Acute performance decrement did not correlate with the training load.
Assuntos
Pessoas com Deficiência , Cadeiras de Rodas , Humanos , Masculino , Feminino , Pessoas com Deficiência/reabilitação , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Força Muscular/fisiologia , Telerreabilitação , Treinamento Resistido/métodos , Terapia por Exercício/métodos , Treinamento Intervalado de Alta IntensidadeRESUMO
PURPOSE: To link the concepts measured by the Grocery Shelving Task Test (GST) to the codes and qualifiers of the activity and participation component of the International Classification of Functioning, Disability and Health (ICF). METHODS: The linkage was performed by two professionals who applied the 10 standardized binding rules. The linking process was performed through the model of extraction and identification of the concepts that were found in each item of the GST Test. RESULTS: The GST test includes 1 domain of the activity and participation component (d4 mobility). The link with the qualifiers allowed quantifying the impairment of the limitations of activities in the postoperative period, being observed that 21.27% of the sample did not present any problem, 61.70% presented the qualifier "0.1" (mild problem), 8.50% had a moderate problem (qualifier '0.2') and 8.50% had a severe problem (qualifier '0.3'). No complete impairment was observed in any study participant. DISCUSSION: The linking of the GST to the ICF codes and qualifiers allowed quantifying the functional impairment in the postoperative period of breast cancer, allowing a comprehensive and standardized view, and being a guiding tool for treatment plans.
Assuntos
Neoplasias da Mama , Pessoas com Deficiência , Humanos , Feminino , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Avaliação da Deficiência , Neoplasias da Mama/cirurgia , Pessoas com Deficiência/reabilitação , Atividades CotidianasRESUMO
Con el propósito de facilitar los procesos de prescripción y entrega, el Departamento de Rehabilitación y Discapacidad, de la División de Prevención y Control de Enfermedades disponibiliza en el presente listado, las AATT actualmente vigentes a través de la compra centralizada con CENABAST, el cual regirá hasta el año 2025.
Assuntos
Reabilitação , Reabilitação/instrumentação , Cadeiras de Rodas , Bengala , Chile , Pessoas com Deficiência/reabilitação , Deambulação com AuxílioRESUMO
IMPORTANCE: Outcomes research on the impact of seating and mobility services delivered using a short-term medical mission (STMM) model is limited. OBJECTIVE: To evaluate the impact of seating and mobility services on the occupational performance of individuals with disabilities in El Salvador. DESIGN: One-group retrospective pretest-posttest. SETTING: Clinical (El Salvador). PARTICIPANTS: Individuals with disabilities in El Salvador. OUTCOMES AND MEASURES: Survey and the standardized Wheelchair Outcome Measure (WhOM) for those who received a wheelchair as their mobility device. METHOD: Participants rated satisfaction with performance of preferred in-home and out-of-home occupations on the WhOM before and after receiving seating and mobility services. RESULTS: For most survey questions assessing the impact on activities of daily living, more than 86% of the respondents selected agree or strongly agree. Nearly half of the respondents reported that questions regarding work and education were not applicable. Participants' WhOM scores (n = 86) demonstrated a statistically significant improvement in performance satisfaction for both in-home (p < .001; d > 1) and out-of-home (p < .001; d > 1) occupations after they received services, with a huge effect size (d > 2). CONCLUSIONS AND RELEVANCE: The findings suggest that seating and mobility services provided by rehabilitation professionals in El Salvador improved occupational performance for people with disabilities. Compared with STMMs that solely provide equipment, the findings emphasize the importance of professional service provision with education and training as best practice. What This Article Adds: Seating and mobility services delivered through a STMM model may improve occupational performance for individuals with disabilities. However, STMMs should be carefully planned in collaboration with in-country partners, provide customized seating systems, and include education and training from licensed rehabilitation professionals.
Assuntos
Pessoas com Deficiência , Tecnologia Assistiva , Cadeiras de Rodas , Humanos , Atividades Cotidianas , El Salvador , Estudos Retrospectivos , Pessoas com Deficiência/reabilitaçãoRESUMO
Introdução: a assistência à pessoa com deficiência no Brasil vem sendo ampliada ao longo dos anos, a partir do avanço das discussões sobre os Direitos Humanos e legislações publicadas pelo Ministério da Saúde. Objetivo: analisar a produção assistencial de um Centro Especializado em Reabilitação. Métodos: trata-se de estudo observacional, descritivo, transversal, realizado com dados secundários de produção ambulatorial do período de abril de 2019 a março de 2020. Resultados: foi possível observar maior número de usuários assistidos na modalidade auditiva, posteriormente na modalidade física, intelectual e visual. Houve maior proporção de atendimentos multidisciplinares na modalidade intelectual e física; ao sexo feminino, exceto na modalidade intelectual; e a crianças, exceto na modalidade auditiva. Quanto às equipes mínimas, na modalidade auditiva, o fonoaudiólogo foi o profissional que realizou maior número de atendimentos; na física, o fisioterapeuta; na intelectual, o fisioterapeuta, seguido pelo fonoaudiólogo e terapeuta ocupacional; na reabilitação visual, o terapeuta ocupacional. Houve diferença com significância estatística quando comparadas as modalidades visual e intelectual em relação ao sexo; e o número de atendimentos por especialidades quando comparado à faixa etária. Conclusão: o estudo retrata a estrutura e oferta de atendimentos multidisciplinares realizados para as pessoas com deficiência que frequentam um serviço especializado em reabilitação. (AU)
Introduction: assistance to people with disabilities in Brazil has been expanded over the years, from the advancement of discussions on Human Rights, and legislation published by the Ministry of Health. Objective: to analyze the care production of a Specialized Center in Rehabilitation. Methods: this is an observational, descriptive, cross-sectional study, conducted with secondary data of outpatient production from April 2019 to March 2020. Results: it was possible to observe a greater number of users assisted in the auditory modality, later in the physical, intellectual and visual modality, there was a higher proportion of multidisciplinary care in the intellectual and physical modality; female gender, except in the intellectual modality; and children, except in the auditory mode. As for the minimum teams, in the auditory modality the speech therapist was the professional who performed the highest number of consultations; in physics the physiotherapist; in the intellectual the physiotherapist, followed by the speech therapist and occupational therapist; in visual rehabilitation the occupational therapist. There was a statistically significant difference when comparing the visual and intellectual modalities in relation to gender; and the number of visits by specialties when compared to age group. Conclusion: the study portrays the structure and offer of multidisciplinary care provided to people with disabilities, who attend a specialized service in rehabilitation. (AU)
Introducción: la asistencia a las personas con discapacidad em Brasil se ha ampliado a lo largo de los años, a partir del avance de las discusiones sobre Derechos Humanos y la legislación publicada por el Ministerio de Salud. Objetivo: analizar la producción asistencial de un Centro Especializado em Rehabilitación. Métodos: se trata de un estúdio observacional, descriptivo, transversal, realizado con datos secundarios de producción ambulatoria de abril de 2019 a marzo de 2020. Resultados: fue posible observar un mayor número de usuários atendidos en la modalidade auditiva, posteriormente en la modalidade física, intelectual y visual, hubo una mayor proporción de atención multidisciplinaria en la modalidade intelectual y física; género femenino, excepto en la modalidade intelectual; y niños, excepto em el modo auditivo. En cuanto a los equipos mínimos, en la modalidade auditiva el logopeda fue el profesional que realizó mayor número de consultas; em física el fisioterapeuta; em el intelectual el fisioterapeuta, seguido por el logopeda y el terapeuta ocupacional; em rehabilitación visual el terapeuta ocupacional. Hubo uma diferencia estadísticamente significativa al comparar las modalidades visuales e intelectuales em relación con el género; y el número de visitas por especialidades em comparación con el grupo de edad. Conclusión: el estúdio retrata la estructura y la oferta de atención multidisciplinaria prestada a las personas con discapacidad, que asisten a un servicio especializado em rehabilitación. (AU)
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Pessoas com Deficiência/reabilitação , Serviços de Saúde para Pessoas com Deficiência/estatística & dados numéricos , Terapia Ocupacional , Modalidades de Fisioterapia , Ciências da Nutrição , Fonoaudiologia , Política de Saúde , Pesquisa sobre Serviços de SaúdeRESUMO
The access of People with Disabilities (PwD) to specialized care services was analyzed on the basis of the availability-accommodation and adequacy dimensions. This is a case study with a qualitative approach and triangulation of sources based on documentary research, data from the Health Information Systems and semi-structured interviews with managers, health professionals and PwD. There was an expansion of rehabilitation services in Recife, although it was not possible to analyze the production capacity of such services. The findings point to the existence of architectural and urban barriers and insufficient resources in the services studied. Furthermore, there is a long waiting time for specialized care and difficult access to assistive technologies. It was also observed that professionals have low qualifications to meet the needs of PwD and a process of permanent education in different levels of complexity has not been instituted for workers. The conclusion drawn is that the institution of the Municipal Policy of Comprehensive Health Care for the PwD was insufficient to guarantee access to health services with continuity of care, considering the permanence of the fragmentation of the care network, thus violating the right to health of this segment.
Analisou-se, a partir das dimensões disponibilidade-acomodação e adequação, o acesso das Pessoas com Deficiência (PcD) aos serviços de atenção especializada. Trata-se de estudo de caso de abordagem qualitativa com triangulação de fontes a partir de pesquisa documental, dados dos Sistemas de Informações em Saúde e entrevistas semiestruturadas com gestores, profissionais de saúde e PcD. Observou-se a ampliação de serviços de reabilitação no Recife, embora não tenha sido possível analisar a capacidade de produção de tais serviços. Os achados apontam para a existência de barreiras arquitetônicas e urbanísticas e insuficiência de recursos nos serviços estudados. Ademais, há um longo tempo de espera para atenção especializada e um difícil acesso às tecnologias assistivas. Pôde-se observar ainda que os profissionais têm baixa qualificação para atender às necessidades das PcD e não se tem instituído um processo de educação permanente para os trabalhadores dos diversos níveis de complexidade. Conclui-se que a instituição da Politica Municipal de Atenção Integral à Saúde da PcD não foi suficiente para garantir o acesso aos serviços de saúde com continuidade do cuidado, considerando a permanência da fragmentação da rede de atenção, ferindo, assim, o direito à saúde deste segmento.
Assuntos
Pessoas com Deficiência , Humanos , Pessoas com Deficiência/reabilitação , Acessibilidade aos Serviços de Saúde , Serviços de Saúde , Escolaridade , Instalações de Saúde , Pesquisa QualitativaRESUMO
The complex epidemiological profile of Brazil, the aging population and the proportion of individuals with disabilities have led to a substantial increase in the demand for rehabilitation. The spatiotemporal distribution of the offer of physiotherapy, speech therapy and occupational therapy in the Brazilian public healthcare system from 2007 to 2019 was analyzed for the five macro-regions of the country. Data from the National Register of Health Establishments and census estimates from the Brazilian Institute of Geography and Statistics were used. Indicators of the offer of professionals in these fields services and relative changes in the offer were calculated. The spatial distribution of the relative change in the offer was also determined. A regression model with inflection points was adopted for the analysis of the temporal trend. A growing temporal trend was found in the offer of the three professionals in Brazil as a whole and in all regions of the country, but with a slowdown in growth. Differences were observed in the offer among the regions of the country, revealing healthcare inequality that needs to be overcome. The present findings can assist in planning to expand access to rehabilitation services in the country.
O complexo perfil epidemiológico do país, o envelhecimento populacional e a proporção de pessoas com deficiência apontam para o aumento substancial da demanda por reabilitação. Nesse contexto, foi analisada a distribuição espaço-temporal da oferta de profissionais de fisioterapia, fonoaudiologia e terapia ocupacional no Sistema Único de Saúde (SUS) de 2007 a 2019 nas cinco regiões do Brasil. Foram utilizados dados do Cadastro Nacional de Estabelecimentos em Saúde, as estimativas censitárias do Instituto Brasileiro de Geografia e Estatística e calculados os indicadores da oferta potencial de profissionais e sua evolução relativa. Foi realizada a distribuição espacial da evolução relativa da oferta potencial de profissionais. Para a análise da tendência temporal, adotou-se o modelo de regressão por pontos de inflexão. Houve tendência temporal crescente na oferta potencial das três categorias profissionais no Brasil e em todas as regiões, mas com uma desaceleração do crescimento. Observaram-se diferenciais entre as profissões e as regiões do país, representando um quadro de desigualdade de oferta que precisa ser superado. Resultados que podem subsidiar o controle social e o planejamento nacional para a ampliação do acesso aos serviços de reabilitação.
Assuntos
Atenção à Saúde , Pessoas com Deficiência , Humanos , Idoso , Brasil , Pessoas com Deficiência/reabilitação , Análise Espaço-Temporal , Modalidades de FisioterapiaRESUMO
Objetivo: mapear evidências na literatura científica sobre o comprometimento de saúde no pós-alta de pacientes tratados por Hanseníase e fatores relacionados. Materiais e Método: revisão de escopo realizada a partir das bases de dados CINAHL, LILACS, MEDLINE, PUBMED, SCOPUS e Web of Science em março de 2021, norteados pela estratégia mnemônica que auxilia na identificação do Problema, Conceito e Contexto propostos pelo Instituto Joanna Briggs, sistematizados por meio do fluxograma PRISMA-ScR e registrados na Open Science Framework (osf.io/vmdc6). Foram incluídos estudos sobre a temática publicados até fevereiro de 2021 no cenário nacional e internacional. Resultados: dos dez artigos incluídos na amostra final, nove evidenciaram algum grau de comprometimento funcional, demonstrando fragilidades no acompanhamento desde o diagnóstico até o período pós-alta. Conclusões: evidencia-se acometimentos com maior frequência sobretudo de ordem física, que impactam diretamente a funcionalidade nas atividades de vida diária e social dessas pessoas. As fragilidades no monitoramento pós-alta foram relacionadas ao déficit de profissionais capacitados, ao desconhecimento de técnicas de avaliação e classificação do grau de incapacidade, à carência na oferta de educação em saúde, à dificuldade de acesso aos serviços de saúde, ao atraso no tratamento dos episódios reacionais e reabilitação biopsicossocial e à ausência da sistematização do cuidado.(AU)
Objective: to map evidence in the scientific literature on the post-discharge health impairment of patients treated for leprosy and related factors. Materials and Method: scope review carried out from the CINAHL, LILACS, MEDLINE, PUBMED, SCOPUS and Web of Science databases in March 2021, guided by the mnemonic strategy that helps to identify the Problem, Concept and Context proposed by the Joanna Institute Briggs, systematized through the PRISMA-ScR flowchart, and registered in the Open Science Framework (osf.io/vmdc6). Studies on the subject published until February 2021 in the national and international scenario were included. Results: of the ten articles included in the final sample, nine showed some degree of functional impairment, demonstrating weaknesses in follow-up from diagnosis to the post-discharge period. Conclusions: there is evidence of more frequent involvement, especially of a physical nature, which directly impact the functionality of these people's daily and social activities. Weaknesses in post-discharge monitoring were related to the lack of trained professionals, lack of knowledge of assessment techniques and classification of the degree of disability, lack of health education provision, difficulty in accessing health services, delay in treatment of reactional episodes and biopsychosocial rehabilitation and the absence of systematization of care.(AU)
Objetivo: mapear en la literatura científica las evidencias sobre el deterioro de la salud post-alta en pacientes tratados por lepra y factores relacionados. Materiales y Métodos: revisión de alcance realizada a partir de las bases de datos CINAHL, LILACS, MEDLINE, PUBMED, SCOPUS y Web of Science en marzo de 2021, guiada por la estrategia mnemotécnica que ayu-da a identificar el Problema, Concepto y Contexto propuesta por el Instituto Joanna Briggs, sistematizada a través del flujograma PRISMA-ScR y registrada en el Open Science Framework (osf.io/vmdc6). Fueron incluidos estudios sobre el tema, publicados hasta febrero de 2021, en el escenario nacional e internacional. Resultados: de los diez artículos incluidos en la muestra final, nueve mostraron algún grado de deterioro funcional, demostrando debilidades en el seguimiento desde el diagnóstico hasta el período posterior al alta. Conclusiones: se evidencia con mayor frecuencia ataques sobre todo de orden físico que impactan directamente en la funcionalidad en las actividades de la vida diaria y social de las personas. Fragilidades en el seguimiento postoperatorio relacionadas con el déficit de profesionales capacitados, el desco-nocimiento de las técnicas de evaluación y clasificación del grado de incapacidad, la carencia en la oferta de educación en salud, la dificultad de acceso a los servicios de salud, el retraso en el tratamiento de los episodios reaccionarios y la rehabilitación biopsicosocial y la ausencia de...(AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Enfermagem em Reabilitação , Doenças Negligenciadas/complicações , Qualidade de Vida , Fatores Socioeconômicos , Educação em Saúde , Pessoas com Deficiência/reabilitaçãoRESUMO
Objetivo: compreender a percepção dos usuários de programa de reabilitação física sobre suas experiências no enfrentamento de barreiras de acessibilidade e mobilidade urbana para comparecer nos atendimentos em Centro Especializado de Reabilitação. Método:estudo descritivo, abordagem qualitativa, realizado na região Metropolitana I do Rio de Janeiro, Brasil. Dados coletados através de entrevistas semiestruturadas, analisados à luz da análise de conteúdo, abordagem temática. Resultados: da análise emergiram quatro categorias que evidenciaram reiteradas experiências desafiadoras no percurso de suas residências para agendamentos no programa de reabilitação, se deparando com ambientes de mobilidade urbana inadequados à circulação de pessoas com algum tipo de deficiência ou mobilidade reduzida. Considerações Finais: os participantes experimentam situações constrangedoras que os fazem se sentir impotentes, desmotivados, frustrados e com baixa autoestima, requerendo das equipes de reabilitadoras a adoção de estratégias acolhedoras de atendimentos para que não comprometam o alcance de metas planejadas no programa de reabilitação.
Objective: to understand the perception of users of a physical rehabilitation program about their experiences in facing barriers to accessibility and urban mobility to attend consultations at a Specialized Rehabilitation Center. Method: descriptive study, qualitative approach, in the Metropolitan Region I of Rio de Janeiro, Brazil. Data collected through semi-structured interviews, analyzed in the light of content analysis, thematic approach. Results: from the analysis, four categories emerged that showed repeated challenging experiences in the course of their residences for scheduling in the rehabilitation program, facing urban mobility environments unsuitable for the circulation of people with some type of disability or reduced mobility. Final Considerations: participants experience embarrassing situations that make them feel powerless, unmotivated, frustrated and with low self-esteem, requiring rehabilitation teams to adopt welcoming strategies for care so that they do not compromise the achievement of goals planned in the rehabilitation program.
Objetivo: comprender la percepción de los usuarios de un programa de rehabilitación física sobre sus experiencias frente a las barreras de accesibilidad y movilidad urbana para asistir a consultas en un Centro Especializado de Rehabilitación. Método: estudio descriptivo, abordaje cualitativo, realizado en la Región Metropolitana I de Río de Janeiro, Brasil. Datos recolectados a través de entrevistas semiestructuradas, analizados a la luz del análisis de contenido, abordaje temático. Resultados: del análisis surgieron cuatro categorías que evidenciaron reiteradas experiencias desafiantes en el transcurso de sus residencias para la inserción en el programa de rehabilitación, frente a ambientes de movilidad urbana no aptos para la circulación de personas con algún tipo de discapacidad o movilidad reducida. Consideraciones Finales: los participantes viven situaciones bochornosas que los hacen sentir impotentes, desmotivados, frustrados y con baja autoestima, requiriendo que los equipos de rehabilitación adopten estrategias acogedoras de atención para que no comprometan el logro de las metas previstas en el programa de rehabilitación.
Assuntos
Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Centros de Reabilitação/estatística & dados numéricos , Barreiras ao Acesso aos Cuidados de Saúde , Mobilidade Urbana , Pessoas com Deficiência/reabilitação , Pesquisa Qualitativa , Limitação da Mobilidade , Discriminação SocialRESUMO
Introduction: Introduction: Participation is the dynamic and complex interaction between the individual's health condition, bodily functions, activities that can be carried out and environmental factors. Measuring it helps to understand the impact of disability. Objectives: Describe the activities and participation in subjects with neurological pathologies, discharged from hospitalization for rehabilitation. Secondly, to compare the clinical-demographic characteristics and the participation among wheelchair users with respect to non-users. Material and method: Observational, prospective, cross-sectional, multicenter study. Based on a survey of people over 18 years of age with pathologies of neurological origin discharged from rehabilitation from 6 centers in Argentina. Results: 282 people responded, 69% men with an average age of 50 years and discharged 22 months ago. The most common diagnosis was cerebrovascular accident. The self-perception of participation was 49 out of 90, and those who do not use a wheelchair report a higher level of participation. The greatest satisfaction was in areas of interpersonal relationships. 50% require assistance to use transportation in the community. 61% neither work nor study, nor do they engage in sports activities (65%). 61% of wheelchair users cannot go to places in the community because they are inaccessible. Conclusion: Less participation in community activities was observed, mainly due to architectural barriers and difficulties in using transport in wheelchair users. The family occupies a central place so that they can integrate into the community.
Introducción: La participación es la interacción dinámica y compleja entre la condición de salud del individuo, las funciones corporales, las actividades que puede realizar y los factores ambientales. Medirla ayuda a comprender el impacto de la discapacidad. Objetivos: Describir las actividades y participación en sujetos con patologías neurológicas, dados de alta de internación para rehabilitación. Secundariamente comparar las características clínico-demográficas y la participación entre usuarios de silla de ruedas respecto a personas no usuarias. Material y método: Estudio observacional, prospectivo, transversal, multicéntrico. Basado en una encuesta a mayores de 18 años con patologías de origen neurológico dados de alta de rehabilitacion de 6 centros de Argentina. Resultados: Respondieron 282 personas, 69% hombres con una media de edad de 50 años y dados de alta hace 22 meses. El diagnóstico más frecuente fue el accidente cerebrovascular. La autopercepción de la participación fue de 49 sobre 90, y los que no utilizan silla de ruedas refieren mayor nivel de participación. La mayor satisfacción fue en áreas de relaciones interpersonales. El 50% requiere de asistencia para utilizar los transportes en la comunidad. El 61% no trabaja ni estudia, así como tampoco realizan actividades deportivas (65%). Al 61% de los usuarios de silla de ruedas no pueden ir a lugares de la comunidad por ser inaccesibles. Conclusión: Se observó menor participación en actividades comunitarias, principalmente por barreras arquitectónicas y por dificultades para usar el transporte en usuarios de silla de ruedas. La familia ocupa un lugar central para que puedan integrarse en la comunidad.
Assuntos
Pessoas com Deficiência , Cadeiras de Rodas , Adolescente , Adulto , Argentina , Estudos Transversais , Pessoas com Deficiência/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
BACKGROUND: The classification of health problems of persons with Mucopolysaccharidosis (MPS) based on the International Classification of Functioning, Disability and Health (ICF) may contribute to better understanding the disease impacts. The ICF is a useful tool to describe disabilities and functioning, especially in diseases with multisystemic involvement. AIM: To identify and classify the health needs of persons with non-neuronopathic MPS according to the ICF. DESIGN: A cross-sectional study. SETTING: Department of Physical Therapy (Federal University, Brazil). POPULATION: Persons with non-neuronopathic MPS. METHODS: Semi-structured interviews covering all components of the ICF were conducted to know the patients' perspectives of their health problems (patient-reported outcomes). The speeches were transcribed verbatim and analyzed by researchers to identifying meaningful concepts. Then, the concept units were linked to ICF components and the magnitude of the problem to ICF qualifiers. Data are shown by descriptive statistics and separated into two groups: children and adolescents, and adults. RESULTS: A total of 60 different ICF categories were used to classify participants' functioning. A total of 28 and 51 categories was necessary to classify the health problems of children and adults, respectively. Additionally, 16 categories related to contextual factors were used, of which eight and 12 were identified as facilitators by children, adolescents, and adults, respectively. The main problems were related to supportive functioning of arms or legs (b7603), pain in the body part (b2801), respiratory functions (b440), and voice functions (b310). Limitations in the activity and participation component were related to walking (d450), fine hand use (d440), washing oneself (d510), and dressing (d540). Recreation and leisure (d920) was restricted to approximately half of the studied population. CONCLUSIONS: People with MPS face impairments of body structures and functions, activity limitations and restrictions to participation. Environmental factors may be act as facilitators of these problems. CLINICAL REHABILITATION IMPACT: The ICF is a useful tool to classify the health problems of people with non-neuropathic MPS. The planning of rehabilitation programs needs to covers all components of functioning to provide a biopsychosocial model of care. The ICF categories may direct health professionals to more effective targets.
Assuntos
Pessoas com Deficiência , Mucopolissacaridoses , Atividades Cotidianas , Adolescente , Adulto , Criança , Estudos Transversais , Avaliação da Deficiência , Pessoas com Deficiência/reabilitação , Humanos , Classificação Internacional de Funcionalidade, Incapacidade e SaúdeRESUMO
PURPOSE: The literature review presents a conceptual participatory design through accessibility technology solutions, considering the design experience to be an essential factor in communication processes. Technologies must assess a wide range of disabilities based on characterisations that helps daily activities. This work includes collaboration concepts to assist in the development of accessible technology. Collaborative design requires the fostering of communication between actors involved in the design process. METHODS: This work implemented with a protocol of guidelines developed by a group of experts in disability research. The relevant literature is included and assessed based on three categories: accessibility, assistive technologies, and participatory design. RESULTS: A knowledge gap can be identified: the development of assistive technology processes should enhance the voice of participants and consider their ideas, desires and needs. CONCLUSIONS: Multidisciplinary communication is necessary to identify problems and propose solutions, and it is essential that people with disabilities collaborate with experts from a range of disciplines to identify problem-solving patterns.Implications for rehabilitationA participatory design can develop a holistic understanding of the participant's motivation and rehabilitation needs. This has provided a grounded basis to offer information about the assistive technology design.A participatory work provides information about the technology design which may finally result in a better understanding of rehabilitation, other types of home-based healthcare or the gamification for rehabilitation.The rehabilitation professionals can explore requirements of a customised technology for users, which allows to transfer knowledge about disabilities and skills in rehabilitation to people with disabilities, their families and communities.The notion of a research problem in rehabilitation can be re-evaluated through a participatory design process that attempts to capture the subjective experiences of persons with disability.
Assuntos
Pessoas com Deficiência , Tecnologia Assistiva , Comunicação , Pessoas com Deficiência/reabilitação , Humanos , Comunicação Interdisciplinar , TecnologiaRESUMO
SUMMARY: Sports results of table tennis players with disabilities depend on the functionality level, but also on morphological characteristics. There is an increased risk of obesity in these athletes with disability due to a reduced level of locomotor functionality. The hitherto practice showed that leading table tennis players with disabilities in Serbia did not have an additional kinesiology treatment implemented as part of their training process, which would encourage both strengthening and flexibility of muscle groups relevant for the efficacy of table tennis game, and reduction of body mass and voluminosity. The goal of this paper is to apply an additional kinesiology treatment and determine its effect of on the morphological characteristics of leading table tennis players with disabilities. Eight representatives, table tennis players with disabilities, both male and female, aged between 23 and 52, were included in the additional kinesiology treatment that lasted for nine months. The measures of longitudinal skeleton dimensionality, body mass and volume, subcutaneous adipose tissue and body mass index were analyzed. In order to establish the effects of kinesiology treatment Student's t-test was used, while the results were processed by means of a statistical package SPSS, version 14.0. The values were estimated at p < 0.05 significance level. Male respondents demonstrated statistically significant changes in biceps skinfold (p = 0.05). In the case of female respondents no statistically significant difference was observed in anthropometric space. The additional kinesiology treatment indicates a trend towards reduced voluminosity and body mass of both male and female respondents, but not at a statistically significant level, which is probably the result of an insufficient number of respondents. Continued additional kinesiology treatment should be included in the training process of male and female table tennis players with disabilities, which has not been the case up until now.
RESUMEN: Los resultados deportivos de los jugadores de tenis de mesa con discapacidad dependen del nivel de funcionalidad, pero también de las características morfológicas. Existe un mayor riesgo de obesidad en estos atletas con discapacidad debido a un nivel reducido de funcionalidad locomotora. La práctica hasta ahora mostró que los principales jugadores de tenis de mesa con discapacidades en Serbia no cuentan con un tratamiento de kinesiología adicional, implementado como parte de su proceso de entrenamiento, que fomentaría tanto el fortalecimiento como la flexibilidad de los grupos musculares relevantes para el juego de tenis de mesa, y la reducción de masa corporal y voluminosidad. El objetivo de este trabajo fue aplicar un tratamiento kinesiológico adicional y determinar su efecto sobre las características morfológicas de los principales jugadores de tenis de mesa con discapacidad. Ocho representantes, jugadores de tenis de mesa con discapacidad, tanto hombres como mujeres, con edades entre 23 y 52 años, fueron incluidos en el tratamiento adicional de kinesiología que tuvo una duración de nueve meses. Se analizaron las medidas de dimensionalidad esquelética longitudinal, masa y volumen cor- poral, tejido adiposo subcutáneo e índice de masa corporal. Para establecer los efectos del tratamiento kinesiológico se utilizó la prueba t de Student, mientras que los resultados se procesaron mediante el paquete estadístico SPSS, versión 14.0. Los valores se estimaron a un nivel de significación p < 0,05. Los hombres encuestados demostraron cambios estadísticamente significativos en el pliegue cutáneo del bíceps (p = 0,05). En el caso de las mujeres encuestadas no se observó diferencia estadísticamente significativa en el espacio antropométrico. El tratamiento de kinesiología adicional indica una tendencia hacia la reducción de la voluminosidad y la masa corporal de los encuestados masculinos y femeninos, pero no a un nivel estadísticamente significativo, lo que probablemente sea el resultado de un menor número de encuestados. El tratamiento kinesiológico continuo debe incluirse en el proceso de formación de los jugadores de tenis de mesa con discapacidad, lo que no ha sido el caso hasta el momento.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tênis , Antropometria , Pessoas com Deficiência/reabilitação , Modalidades de FisioterapiaAssuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Isolamento Social , Estado Terminal/mortalidade , Estado Terminal/psicologia , Estado Terminal/reabilitação , Estado Terminal/epidemiologia , Pessoas com Deficiência/psicologia , Pessoas com Deficiência/reabilitação , Estados Unidos/epidemiologia , Mortalidade , Avaliação das Necessidades , Avaliação da Deficiência , Estudos Observacionais como Assunto , Vida Independente/estatística & dados numéricos , Transição do Hospital para o Domicílio/normas , Transição do Hospital para o Domicílio/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde , Unidades de Terapia Intensiva/estatística & dados numéricosRESUMO
A smart environment is an assistive technology space that can enable people with motor disabilities to control their equipment (TV, radio, fan, etc.) through a human-machine interface activated by different inputs. However, assistive technology resources are not always considered useful, reaching quite high abandonment rate. This study aims to evaluate the effectiveness of a smart environment controlled through infrared oculography by people with severe motor disabilities. The study sample was composed of six individuals with motor disabilities. Initially, sociodemographic data forms, the Functional Independence Measure (FIMTM), and the Canadian Occupational Performance Measure (COPM) were applied. The participants used the system in their domestic environment for a week. Afterwards, they were reevaluated with regards to occupational performance (COPM), satisfaction with the use of the assistive technology resource (QUEST 2.0), psychosocial impact (PIADS) and usability of the system (SUS), as well as through semi-structured interviews for suggestions or complaints. The most common demand from the participants of this research was 'control of the TV'. Two participants did not use the system. All participants who used the system (four) presented positive results in all assessment protocols, evidencing greater independence in the control of the smart environment equipment. In addition, they evaluated the system as useful and with good usability. Non-acceptance of disability and lack of social support may have influenced the results.