RESUMO
PROPÓSITO: El principal objetivo de este estudio fue describir el proceso y evaluar la eficacia de terapia ocupacional con abordaje de integración sensorial para 3 niños con dificultades de procesamiento sensorial, con el fin de ayudar a desarrollar modelos de practica apropiados en planificación e implementación de la intervención de terapia ocupacional. MÉTODO: Se utilizó un diseño de estudio de casos múltiples. Todos los participantes eran estudiantes de la misma escuela y fueron remitidos a terapia ocupacional debido a dificultades en escritura, torpeza motora y participación en clase. Los participantes recibieron sesiones individuales de 45 minutos de duración. La duración media de la intervención fue de 27 sesiones realizadas una vez por semana en el transcurso del año lectivo. Los niños fueron evaluados antes y después de la intervención con entrevistas a padres y maestros, observaciones clínicas y pruebas estandarizadas. RESULTADOS: Luego de la intervención se observaron mejores resultados en habilidades de desempeño de las evaluaciones estandarizadas Bruininks-Oseretsky Test of Motor Proficiency, Segunda Edición (BOT™-2) y Prueba de Desarrollo de la Percepción Visual - Tercera Edición (DTVP-3). Además, se observó mejora en la calidad de la escritura y la participación en los juegos de motricidad gruesa en todos los niños. CONCLUSIÓN: Los resultados de este estudio se adhieren a la literatura en el sentido de que la terapia ocupacional bajo un marco de integración sensorial parece ser un método efectivo para mejorar las habilidades de desempeño y la participación funcional de los niños con desafíos de procesamiento sensorial.
PURPOSE: The main purpose of this study was to describe the process and evaluate the effectiveness of occupational therapy under a sensory integration framework for 3 children with sensory processing challenges, in order to help develop models of good practice in planning and implementation of occupational therapy intervention. METHOD: A Multiple Case Study design was utilized. All participants were students at the same school and were referred to occupational therapy because of concerns with handwriting, clumsiness and class participation. Participants received individual, 45 minutes long intervention sessions. The mean length of intervention was 27 sessions delivered 1 time per week over the course of the academic year. Children were evaluated before and after intervention with parent/teacher interviews, clinical observations and standardized tests. RESULTS: After the intervention all participants obtained higher scores for performance skills in the standardized tests Bruininks-Oseretsky Test of Motor Proficiency, Second Edición (BOT™-2) and Developmental Test of Visual Perception Third Edition (DTVP-3). Furthermore, improved handwriting quality and participation on gross motor games was reported for all participants. CONCLUSION: The results of this study adhere to the literature in that occupational therapy under a sensory integration framework seems to be an effective method for enhancing performance skills and functional participation of children with sensory processing challenges.
Assuntos
Humanos , Masculino , Feminino , Criança , Desempenho Psicomotor , Estudantes , Terapia Ocupacional/métodos , Transtornos de Sensação/reabilitação , Instituições AcadêmicasRESUMO
La presente revisión se centra en proporcionar una visión general de la literatura que identifica estudios enfocados en definir los patrones de procesamiento sensorial en niños menores de 3 años y los enfoques de intervención identificados en esta población. Durante la última década ha existido un crecimiento constante de la literatura relacionada con el procesamiento sensorial en los niños pequeños, sin embargo, la información disponible entre las diferentes publicaciones es aún limitada y segmentada. En esta revisión se recopilaron 15 artículos sobre los patrones de procesamiento sensorial en los niños pequeños y 10 artículos relacionados con los enfoques de intervención para un total de 25 artículos publicados entre 2007 y 2017. Del análisis de la información obtenida acerca de los patrones de procesamiento sensorial, surgieron los siguientes temas: el diagnóstico y los factores de riesgo, el tipo de disfunción del procesamiento sensorial y el impacto funcional. Entre los temas que surgieron al analizar los enfoques de intervención, se destaca la importancia de la familia como un tema general que abarca subtemas de intervención, tales como: estrategias sensoriales, capacitación de los padres e intervenciones grupales. Si bien es necesario continuar desarrollando investigaciones que amplíen nuestro conocimiento en relación con estos temas en general, la evidencia apoya la efectividad de la intervención temprana.
La presente revisión se centra en proporcionar una visión general de la literatura que identifica estudios enfocados en definir los patrones de procesamiento sensorial en niños menores de 3 años y los enfoques de intervención identificados en esta población. Durante la última década ha existido un crecimiento constante de la literatura relacionada con el procesamiento sensorial en los niños pequeños, sin embargo, la información disponible entre las diferentes publicaciones es aún limitada y segmentada. En esta revisión se recopilaron 15 artículos sobre los patrones de procesamiento sensorial en los niños pequeños y 10 artículos relacionados con los enfoques de intervención para un total de 25 artículos publicados entre 2007 y 2017. Del análisis de la información obtenida acerca de los patrones de procesamiento sensorial, surgieron los siguientes temas: el diagnóstico y los factores de riesgo, el tipo de disfunción del procesamiento sensorial y el impacto funcional. Entre los temas que surgieron al analizar los enfoques de intervención, se destaca la importancia de la familia como un tema general que abarca subtemas de intervención, tales como: estrategias sensoriales, capacitación de los padres e intervenciones grupales. Si bien es necesario continuar desarrollando investigaciones que amplíen nuestro conocimiento en relación con estos temas en general, la evidencia apoya la efectividad de la intervención temprana.
Assuntos
Humanos , Criança , Sensação , Desenvolvimento Infantil , Terapia Ocupacional/métodos , Transtornos de Sensação/reabilitaçãoRESUMO
AIM: The aim of this study was to verify the effects of a multisensory exercise programme on the cognition and functionality of institutionalized older adults. METHODS: Forty-five volunteers were randomly allocated to 2 groups, the multisensory exercise programme (n = 24) and the control group that received no treatment (n = 21). The programme consisted of 3 50-min sessions of progressive exercises per week for 16 weeks that challenged their strength, balance, coordination, multisensory stimulation, and flexibility in different tasks. Cognition (Montreal Cognitive Assessment), balance (Berg Scale), mobility (Timed Up and Go), and functional performance (Physical Performance Test) were measured preintervention and postintervention. Statistical analyses were performed using Student's t test and 2-way ANOVA. RESULTS: The multisensory exercise programme showed statistically significant improvements (p < .05) on cognition (effect size [ES]: 0.92), balance (ES: 0.77), mobility (ES: 0.51), and functional performance (ES: 0.86) as compared with the control group, which showed no statistical significant differences at the postintervention time point. CONCLUSIONS: The multisensory exercise programme improved the cognition and functionality of institutionalized older adults. The introduction of a motor and multisensory-based approach in care routines may improve residents' health and engagement to the environment.
Assuntos
Acidentes por Quedas/prevenção & controle , Terapia Cognitivo-Comportamental/métodos , Terapia por Exercício/métodos , Avaliação Geriátrica/métodos , Transtornos de Sensação/reabilitação , Atividades Cotidianas , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Método Duplo-Cego , Feminino , Humanos , Masculino , Equilíbrio Postural/fisiologia , Valores de Referência , Medição de Risco , Fatores Sexuais , Instituições de Cuidados Especializados de Enfermagem , Resultado do TratamentoAssuntos
Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/patologia , Transtornos de Sensação/etiologia , Transtornos de Sensação/patologia , Infecção por Zika virus/complicações , Infecção por Zika virus/patologia , Adulto , Progressão da Doença , Fenômenos Eletrofisiológicos , Feminino , Marcha Atáxica/etiologia , Marcha Atáxica/reabilitação , Humanos , Exame Neurológico , Doenças do Sistema Nervoso Periférico/reabilitação , Fenótipo , Recuperação de Função Fisiológica , Transtornos de Sensação/reabilitaçãoRESUMO
Virtual reality therapy (VRT) has clinical indications in rehabilitation programs for the elderly; however, there is still no consensus on the recovery of body balance. The objective of this review was to summarize the effects of physical therapy interventions with VRT in the rehabilitation of balance in the elderly. The studies were identified via a systematic search in the databases PubMed, SciELO, LILACS and PEDro from 2010 onward. Clinical trials with interventions that involved VRT in the elderly were included in the study and were subjected to methodological quality analysis using the PEDro scale. A random effects meta-analysis of the studies that analyzed balance using the Berg Balance Scale and the Timed Up and Go (TUG) test was performed. Ten articles met the inclusion criteria, which presented variability in relation to the types of interventions used (70%) and the outcomes analyzed (60%). The mean duration of the interventions was 13.90 (± 5.08) weeks, with at least two weekly sessions (± 0.73). There were positive results in relation to improvements in both dynamic and static balance (70% of the studies), mobility (80%), flexibility (30%), gait (20%) and fall prevention (20%). A summary of the meta-analysis showed mean effects on the Berg scale (standardized mean difference [SMD]: -0.848; 95% CI: -1.161; - 0.535) and the TUG test (SMD: 0.894; 95% CI: 0.341; 1.447). Individually, virtual reality is promising in rehabilitation programs for the elderly. The overall measures were sufficient to show beneficial effects of the therapy on balance in the elderly.
Assuntos
Equilíbrio Postural , Transtornos de Sensação/reabilitação , Terapia de Exposição à Realidade Virtual/métodos , Idoso , HumanosRESUMO
INTRODUCTION: Hearing loss changes the functionality and body structure a disability that limits activity and restricts the participation of the individual in situations of daily life. It is believed that capoeira can help people with visual disabilities to minimize these deficits. BSE is a low specificity scale that evaluates objectively and functionally aspects of balance and risk of falls in the elderly and children, including the effect of environment on balance function. OBJECTIVE: The objective of the research is to analyze deaf children and adolescents prior to and post-practice of capoeira using the Berg Balance Scale (BBS). METHODS: Quantitative, clinical and observational studies. Twenty five deaf children between 10 and 16 years old of both genders were assessed. BBS was applied in two stages: before starting capoeira and after 6 months of training. The one-hour classes were held once a week for quantitative evaluation purposes. The subjects were divided and evaluated in two groups (10-13 years old and 14-16 years old). RESULTS: There was a significant statistical difference in BBS scores. The general group and the group of 10-13 years old (p = 0.0251) showed an increase in scores after practicing capoeira (p = 0.0039). There were no statistically significant differences in the group from 14 to 16 years of age (p = 0.0504). CONCLUSION: Using the Berg Balance Scale, it was possible to observe an improvement in the balance of the group of children and adolescents who practiced capoeira, and consequently, a decrease in the risk of falling.
Assuntos
Acidentes por Quedas , Surdez/fisiopatologia , Artes Marciais , Equilíbrio Postural , Transtornos de Sensação/reabilitação , Adolescente , Criança , Feminino , Humanos , Masculino , Transtornos de Sensação/fisiopatologia , Sensibilidade e EspecificidadeRESUMO
Objetivo Optimizar el programa de Orientación Vocacional de la Fundación IDEAL dirigido a los beneficiarios en condición de discapacidad con el fin de favorecer un desempeño satisfactorio en la labor productiva del taller institucional y en el cotidiano de sus vidas para una futura reinserción laboral. Material y Métodos Estudio de tipo descriptivo transversal. Se seleccionaron a conveniencia 20 personas del proceso de orientación vocacional-laboral de la Fundación que desarrollaban una actividad laboral en el taller productivo. Se efectuó la caracterización de esta muestra mediante la batería basada en el formato institucional de Habilidades y Destrezas, se analizaron los puestos laborales de los talleres y se realizó la evaluación ocupacional de estos trabajadores adoptando las categorías propuestas por la Metodología Integral de Evaluación Ocupacional (MIEO). Partiendo de las categorías del formato institucional se establece una comparación entre las habilidades individuales de los beneficiarios y las demandas de su puesto laboral. Resultados La metodología de evaluación derivada del formato institucional de Habilidades y Destrezas ostenta limitaciones en su implementación. La mayoría de los beneficiarios despliegan buen rendimiento laboral en las actividades del taller, respondiendo a los requerimientos de percepción sensorial, motricidad y procesos mentales pero asumen malas prácticas de cuidado de la salud. Discusión Se debe favorecer la diversificación de actividades a las que tienen acceso los beneficiarios, prevaleciendo la realización individual con opciones que trasciendan lo laboral. Las consideraciones de orden productivo han llevado a los usuarios de la Fundación a adoptar prácticas que ponen en riesgo su salud y bienestar.
Objective Optimizing the IDEAL foundation's vocational guidance program for its disabled beneficiaries to promote their satisfactory performance in the institutional workshop and in their daily lives, aimed at their future re insertion into the labor market. Methods This was a cross-sectional descriptive study involving 20 handicapped people from the IDEAL foundation's vocational guidance program who had been assigned a workshop activity. This sample was characterized by using a battery of tests based on IDEAL's institutional format called Abilities and Skills. Workplace in IDEAL's workshop and occupational evaluation of the workers was analyzed using the integral occupational evaluation methodology (MIEO) categories proposed by the Latin-American Professional Rehabilitation Group (GLARP) as part of their Handicapped Disabled People's Standardized Integration Project. Users' individual abilities were compared to the requirements of their workplaces, based on the institutional format's categories. Results The evaluation methodology based on the institutional Abilities and Skills format had limitations, thereby hampering its implementation. Most users performed well regarding their assigned work shop activities, responding well to sensory-perception, motor function and mental processing requirements; however, they engaged in poor healthcare habits. Discussion Diversification of the activities to which the users/beneficiaries have access should be encouraged, promoting individual performance by providing options offering a wider scope than just that of the labor market/workplace. Production-related considerations have led the workshop's users to adopt practices endangering their health and putting their welfare at risk.
Assuntos
Adulto , Humanos , Pessoas com Deficiência , Reabilitação Vocacional , Oficinas de Trabalho Protegido , Educação Vocacional/organização & administração , Orientação Vocacional/organização & administração , Aptidão , Colômbia , Estudos Transversais , Avaliação da Deficiência , Eficiência , Fundações , Destreza Motora , Transtornos dos Movimentos/reabilitação , Saúde Ocupacional , Transtornos de Sensação/reabilitaçãoRESUMO
We tested the short-term effects of a nonrigid tool, identified as an "anchor system" (e.g., ropes attached to varying weights resting on the floor), on the postural stabilization of blindfolded adults with and without intellectual disabilities (ID). Participants held a pair of anchors-one in each hand, under three weight conditions (250 g, 500 g and 1,000 g), while they performed a restricted balance task (standing for 30 s on a balance beam placed on top of a force platform). These conditions were called anchor practice trials. Before and after the practice trials, a condition without anchors was tested. Control practice groups, who practiced blocks of trials without anchors, included individuals with and without ID. The anchor system improved subjects' balance during the standing task, for both groups. For the control groups, the performance of successive trials in the condition without the anchor system showed no improvement in postural stability. The individuals with intellectual disability, as well as their peers without ID, used the haptic cues of nonrigid tools (i.e., the anchor system) to stabilize their posture, and the short-term stabilizing effects appeared to result from their previous use of the anchor system.
Assuntos
Terapia por Exercício/instrumentação , Deficiência Intelectual/reabilitação , Equilíbrio Postural , Transtornos de Sensação/reabilitação , Adulto , Estudos de Casos e Controles , Sinais (Psicologia) , Feminino , Humanos , Deficiência Intelectual/complicações , Masculino , Desempenho Psicomotor , Transtornos de Sensação/complicações , Percepção do TatoRESUMO
The present study examined the effectiveness of a training method to enhance balance in people with PD, which could potentially reduce their risk for falls. Specifically, we investigated whether the benefits of the self-controlled use of a physical assistance device for the learning of a balance task, found previously in healthy adults, would generalize to adults with PD. Twenty-eight individuals with PD were randomly assigned to one of two groups, a self-control and a yoked (control) group. The task required participants to stand on a balance platform (stabilometer), trying to keep the platform as close to horizontal as possible during each 30-s trial. In the self-control group, participants had a choice, on each of 10 practice trials, to use or not to use a balance pole. Participants in the yoked group received the same balance pole on the schedule used by their counterparts in the self-control group, but did not have a choice. Learning was assessed one day later by a retention test. The self-control group demonstrated more effective learning of the task than the yoked group. Questionnaire results indicated that self-control participants were more motivated to learn the task, were less nervous, and less concerned about their body movements relative to yoked participants. Possible reasons for the learning benefits of self-controlled practice, including a basic psychological need for autonomy, are discussed.
Assuntos
Retroalimentação Psicológica , Destreza Motora/fisiologia , Doença de Parkinson/reabilitação , Tecnologia Assistiva/estatística & dados numéricos , Transtornos de Sensação/reabilitação , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Feminino , Seguimentos , Humanos , Aprendizagem , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Satisfação do Paciente , Autonomia Pessoal , Equilíbrio Postural/fisiologia , Estudos Prospectivos , Valores de Referência , Medição de Risco , Transtornos de Sensação/etiologia , Transtornos de Sensação/fisiopatologia , Resultado do Tratamento , Caminhada/fisiologiaRESUMO
OBJECTIVE: Optimizing the IDEAL foundation's vocational guidance program for its disabled beneficiaries to promote their satisfactory performance in the institutional workshop and in their daily lives, aimed at their future re insertion into the labor market. METHODS: This was a cross-sectional descriptive study involving 20 handicapped people from the IDEAL foundation's vocational guidance program who had been assigned a workshop activity. This sample was characterized by using a battery of tests based on IDEAL's institutional format called Abilities and Skills. Workplace in IDEAL's workshop and occupational evaluation of the workers was analyzed using the integral occupational evaluation methodology (MIEO) categories proposed by the Latin-American Professional Rehabilitation Group (GLARP) as part of their Handicapped Disabled People's Standardized Integration Project. Users' individual abilities were compared to the requirements of their workplaces, based on the institutional format's categories. RESULTS: The evaluation methodology based on the institutional Abilities and Skills format had limitations, thereby hampering its implementation. Most users performed well regarding their assigned work shop activities, responding well to sensory-perception, motor function and mental processing requirements; however, they engaged in poor healthcare habits. DISCUSSION: Diversification of the activities to which the users/beneficiaries have access should be encouraged, promoting individual performance by providing options offering a wider scope than just that of the labor market/workplace. Production-related considerations have led the workshop's users to adopt practices endangering their health and putting their welfare at risk.
Assuntos
Pessoas com Deficiência , Reabilitação Vocacional , Oficinas de Trabalho Protegido , Educação Vocacional/organização & administração , Orientação Vocacional/organização & administração , Adulto , Aptidão , Colômbia , Estudos Transversais , Avaliação da Deficiência , Eficiência , Fundações , Humanos , Destreza Motora , Transtornos dos Movimentos/reabilitação , Saúde Ocupacional , Transtornos de Sensação/reabilitaçãoRESUMO
UNLABELLED: Central Nervous System disorders may cause important functional unbalance in the maintenance of balance and posture. There is no effective rehabilitation for these symptoms until now. OBJECTIVE: The aim of this paper is to evaluate the use of tongue electrotactile stimulation on patients with central imbalance using BrainPort. MATERIALS AND METHODS: This is a prospective case series study. We evaluated 8 patients with central imbalance, 6 men and 2 women, with mean age of 67.75 years. The patients were submitted to Computed Dynamic Posturography (CDP) and then received 18 sessions of electrotactile stimulation by BrainPort® device for 20 minutes, twice a day. Then they were submitted to a new CDP test and to a self-perception scale to assess symptom remission, partial improvement and no improvement at all. RESULTS: 75% of the patients reported being more stable. There was no improvement in the balance control of the mass center in these patients. CONCLUSION: The patients were able to use the electrotactile stimulus to improve their balance control.
Assuntos
Biorretroalimentação Psicológica/métodos , Equilíbrio Postural , Transtornos de Sensação/reabilitação , Doenças Vestibulares/reabilitação , Idoso , Estimulação Elétrica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Transtornos de Sensação/etiologia , Resultado do Tratamento , Doenças Vestibulares/etiologiaRESUMO
Central Nervous System disorders may cause important functional unbalance in the maintenance of balance and posture. There is no effective rehabilitation for these symptoms until now. OBJECTIVE: The aim of this paper is to evaluate the use of tongue electrotactile stimulation on patients with central imbalance using BrainPort. MATERIALS AND METHODS: This is a prospective case series study. We evaluated 8 patients with central imbalance, 6 men and 2 women, with mean age of 67.75 years. The patients were submitted to Computed Dynamic Posturography (CDP) and then received 18 sessions of electrotactile stimulation by BrainPort® device for 20 minutes, twice a day. Then they were submitted to a new CDP test and to a self-perception scale to assess symptom remission, partial improvement and no improvement at all. RESULTS: 75 percent of the patients reported being more stable. There was no improvement in the balance control of the mass center in these patients. CONCLUSION: The patients were able to use the electrotactile stimulus to improve their balance control.
As lesões do Sistema Nervoso Central (SNC) determinam importantes prejuízos funcionais na manutenção do equilíbrio e da postura. A reabilitação vestibular e a fisioterapia oferecem benefícios limitados nesses casos. OBJETIVO: Avaliar a resposta de pacientes portadores de desequilíbrio de origem central à estimulação eletrotáctil da língua por meio do BrainPort®. CASUÍSTICA E MÉTODO: O estudo é prospectivo e configura uma série de casos. Foram avaliados 8 pacientes portadores de desequilíbrio de origem central, 6 homens e 2 mulheres com média de idade de 67,75 anos. Os pacientes foram submetidos à posturografia dinâmica computadorizada (PDC) e submetidos ao treinamento pelo BrainPort®. em duas sessões diárias de 20 minutos, perfazendo um total de 18 sessões. Foram então reavaliados pela PDC e a uma escala análogo visual, que compreendeu remissão dos sintomas, melhora parcial e sem melhora. RESULTADO: 75 por cento dos pacientes referiram melhora subjetiva. Não houve diferença significante nos parâmetros avaliados da PDC, mas foi observada a melhora do controle postural do centro de massa nesses mesmos pacientes. CONCLUSÃO: Os pacientes puderam utilizar o estímulo eletrotáctil para melhorar o seu controle postural.
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Biorretroalimentação Psicológica/métodos , Equilíbrio Postural , Transtornos de Sensação/reabilitação , Doenças Vestibulares/reabilitação , Estimulação Elétrica/métodos , Estudos Prospectivos , Transtornos de Sensação/etiologia , Resultado do Tratamento , Doenças Vestibulares/etiologiaRESUMO
The current concerns with quality of life, population aging, limitations imposed by balance disturbance in the elder population and the alternative treatment through the vestibular rehabilitation had justified this study. The objective was to analyze in perspective the application of the Cawtome & Cooksey protocol for vestibular rehabilitation results in aged institutionalized people with complains of balance alterations and probability of fall, aiming the improvement of quality of life and that elders could perceive the limitations imposed by the balance disturbance. A hybrid methodology was used, searching an integration of quantitative and qualitative data associating the experimental to the phenomenological in a population of 30 elders with complains of balance alterations living in an asylum. The evaluation instruments had been the Berg Scale, Dizziness Handicap Inventory (DHI) and speech analysis. As conclusion, it was evidenced that, within the population studied, the vestibular rehabilitation was effective regarding the improvement of symptoms of balance alteration in relation to quality of life, probability of fall as well as the security and independence feelings of the elders.
Assuntos
Percepção , Equilíbrio Postural , Qualidade de Vida , Transtornos de Sensação/reabilitação , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Institucionalização , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
As atuais preocupações com qualidade de vida (QV), envelhecimento da população, limitações impostas pelos distúrbios do equilíbrio na população idosa e a alternativa de tratamento por meio da reabilitação vestibular (RV) justificaram este estudo. Nele, objetivou-se analisar, perspectivamente, os resultados da aplicação do protocolo de Cawtome & Cooksey para RV, em idosos institucionalizados, com queixas de alterações de equilíbrio e probabilidade de queda (PQ), visando à melhoria da QV e à percepção desses idosos sobre as limitações impostas pelos distúrbios do equilíbrio. Utilizou-se uma metodologia híbrida, buscando a integração de dados quantitativos e qualitativos, associando-se o estudo experimental ao fenomenológico, em uma população de trinta idosos asilados com queixas de alterações do equilíbrio. Os instrumentos de avaliação foram a Escala de Berg, Dizziness Handicap Inventory (DHI) e análise de conteúdo. Como conclusão do estudo, constatou-se que, na população estudada, a RV foi efetiva quanto à melhora dos sintomas de alteração do equilíbrio em relação à QV, à PQ e aos sentimentos de segurança e independência dos idosos.
The current concerns with quality of life, population aging, limitations imposed by balance disturbance in the elder population and the alternative treatment through the vestibular rehabilitation had justified this study. The objective was to analyze in perspective the application of the Cawtome & Cooksey protocol for vestibular rehabilitation results in aged institutionalized people with complains of balance alterations and probability of fall, aiming the improvement of quality of life and that elders could perceive the limitations imposed by the balance disturbance. A hybrid methodology was used, searching an integration of quantitative and qualitative data associating the experimental to the phenomenological in a population of 30 elders with complains of balance alterations living in an asylum. The evaluation instruments had been the Berg Scale, Dizziness Handicap Inventory (DHI) and speech analysis. As conclusion, it was evidenced that, within the population studied, the vestibular rehabilitation was effective regarding the improvement of symptoms of balance alteration in relation to quality of life, probability of fall as well as the security and independence feelings of the elders.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Equilíbrio Postural , Qualidade de Vida , Transtornos de Sensação/reabilitação , Institucionalização , Estudos ProspectivosRESUMO
The present study investigated the influence of a regular Physical Therapy program with emphasis on proprioceptive stimulation, on the center pressure trajectory and muscle adjustments necessary to maintain balance on orthostatic position. After medical assessment, 29 subjects (63.06 +/- 2.84 years) were submitted to electromyographic and baropodometric evaluation and, subsequently, to a program of 12 weeks of physical therapy intervention focusing on proprioceptive stimulation. The oscillation of the pressure center (Pressure platform-MatScanTekscan) was evaluated concomitantly to electromyographic signal envelopment and median frequency assessment of anterior tibial and gastrocnemius muscles (signal conditioner module--MCS 1000-V2-LYNX ). The Wilcoxon test was used for comparison of means, with the significance level of 5%. The pressure center trajectory unipodal position with open eyes (UO) decreased significantly after physical therapy intervention. In this position, there was a reduction of the electromyographic signal envelopment and an increase on median frequency of the gastrocnemius muscle, while the anterior tibial muscle showed increased median frequency after intervention. For the unipodal position with closed eyes (UC), the anterior tibial muscle showed significant electromyographic signal envelopment decrease and increase of median frequency, which also increased for the gastrocnemius muscle. It is concluded that the physical therapy intervention promoted decrease of body oscillation, recruitment improvement and adjustment of the gastrocnemius and anterior tibial muscles, contributing to the postural balance improvement in orthostatic position on senior population.
Assuntos
Eletromiografia , Músculo Esquelético/fisiopatologia , Estimulação Luminosa , Equilíbrio Postural/fisiologia , Transtornos de Sensação/reabilitação , Estimulação Elétrica Nervosa Transcutânea , Idoso , Estudos de Coortes , Tontura/etiologia , Tontura/fisiopatologia , Tontura/prevenção & controle , Feminino , Humanos , Perna (Membro) , Masculino , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Transtornos de Sensação/fisiopatologiaRESUMO
Esta comunicación analiza: 1) Los aspectos multifactoriales de la etiología de las alteraciones del equilibrio en el adulto mayor: 2) Los test validados para su evaluación. 3) El abordaje multidisciplinario de su terapéutica y rehabilitación. 4) Se describe el sistema del equilibrio como un sistema de control y el valor de la posturografía para la evaluación y el seguimiento clínico de estos pacientes.
This communication analyze: 1) The multiple factors involved in the etiology of the balance disorders in the elderly population: 2) The validated test for the assessment of this pathology, 3) The description of the balance system as a control system and the value of the posturography for the evaluation and follow up of these patients. 4) The necessary multidisciplinary approach for the treatment and rehabilitation.
Assuntos
Humanos , Idoso , Doenças Vestibulares/fisiopatologia , Doenças Vestibulares/terapia , Transtornos de Sensação/fisiopatologia , Transtornos de Sensação/terapia , Acidentes por Quedas/prevenção & controle , Terapia por Exercício , Doenças Vestibulares/reabilitação , Equilíbrio Postural/fisiologia , Postura/fisiologia , Transtornos de Sensação/reabilitação , Transtornos Cognitivos/complicações , Vertigem/fisiopatologiaRESUMO
OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. METHOD: Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. RESULTS: Clinically resting tremors and subjective postural instability were the motor complaints most frequently associated with complaints of vertigo in 12 cases (100%); in the vestibular exam, all the patients presented abnormalities, frequently from the uni and bilateral peripheral vestibular deficiency syndromes in 10 cases (83.3%); there was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. CONCLUSION: The VR following the Cawthorne and Cooksey protocol were shown to be useful in managing subjective complaints of several aspects evaluated in this protocol.
Assuntos
Doença de Parkinson/reabilitação , Doenças Vestibulares/reabilitação , Idoso , Terapia por Exercício , Feminino , Avaliação Geriátrica , Humanos , Masculino , Doença de Parkinson/complicações , Equilíbrio Postural , Transtornos de Sensação/complicações , Transtornos de Sensação/reabilitação , Inquéritos e Questionários , Vertigem/reabilitação , Doenças Vestibulares/complicações , Testes de Função VestibularRESUMO
OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. METHOD: Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. RESULTS: Clinically resting tremors and subjective postural instability were the motor complaints most frequently associated with complaints of vertigo in 12 cases (100 percent); in the vestibular exam, all the patients presented abnormalities, frequently from the uni and bilateral peripheral vestibular deficiency syndromes in 10 cases (83.3 percent); there was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. CONCLUSION: The VR following the Cawthorne and Cooksey protocol were shown to be useful in managing subjective complaints of several aspects evaluated in this protocol.
OBJETIVO: Avaliar a eficácia dos exercícios de reabilitação vestibular (RV) por meio de avaliação pré e pós-aplicação da versão brasileira do questionário Dizziness Handicap Inventory (DHI). MÉTODO: Estudou-se 12 pacientes e realizaram-se os seguintes procedimentos: anamnese, avaliação otorrinolaringológica, vestibular e aplicação do DHI pré e pós RV. RESULTADOS: Do ponto de vista clínico, o tremor de repouso e a instabilidade postural subjetiva foram às queixas motoras mais freqüentes associadas às queixas de vertigem em 12 casos (100 por cento); no exame vestibular, todos os pacientes apresentaram anormalidades, com freqüência das síndromes vestibulares periféricas deficitárias uni e bilaterais em 10 casos (83,3 por cento); houve melhora significativa dos aspectos físico, funcional e emocional do DHI após a realização da RV. CONCLUSÃO: A RV seguindo o protocolo de Cawthorne e Cooksey mostrou-se útil no manejo de queixas subjetivas de diversos aspectos avaliados neste protocolo.