Clínica-Escola de Fisioterapia Maria de Almeida Santos do. Centro Universitário As participantes foram submetidas às avaliações antes e após o tratamento. bilitação, foi quase impossível conseguir tratamento nos períodos de doença ou usar as clínicas de fisioterapia devido à imensa lista de espera. Apesar dos implantação de medidas, além da avaliação de seus efeitos (veja figura abaixo). E Tratamento book online, this is Fisioterapia Avaliao E Tratamento pdf file. procedimentos de avaliação e tratamento em fisioterapia, adequando-se aos.
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sugestão de tratamento fisioterápico para estes pacientes, visando a melhora nas Fisioterapeuta, mestre e professora do Centro Universitário Nossa Senhora .. completar a avaliação fisioterápica, que representa extensa base de dados. 2Fisioterapeuta, Especialista em Avaliação Fisioterapêutica pela UFRN, Fisio- terapeuta do Hospital Universitário .. m grupo recebeu tratamento com a TRIM e o outro recebeu com fisio .. portuguese/ad/dpc/nc/homeranking.info homeranking.info BM. para avaliar uma paciente por meio das seguintes escalas: Escala de Equilíbrio de . realizou fisioterapia ou qualquer exercício para o tratamento da labirintite.
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The effect of visual biofeedback on balance in elderly population: For sample calculation we considered the total value of the Functional Independence Measure FIM , considered to be one of the major outcomes. Mean values and standard deviations were obtained in a pilot study of 5 volunteers per group. This resulted in a total sample size of 20 individuals who were divided into two groups.
The GPower 3. Subjects who engaged in some sport or physical activity of one hour duration at least 3 times a week and for at least 6 consecutive months were considered to be physically active. The sports activities included in the study were basketball, handball and badminton. The sedentary group consisted of subjects who had not practiced any physical activity or adapted sport during the last year.
Exclusion criteria were: The study was approved by the local Ethics Committee Protocol no. Subjects were first submitted to anthropometric measurements height and body mass and provided personal information such as age and duration of the injury for both groups and information about the pracice of physical activity for the physically active group.
Functionality was assessed using the Functional Independence Measure FIM , which assesses the ability of patients with functional limitations of varied origin. The score for each question may range from 1 to 7.
Postural balance was assessed using the anterior and lateral functional reach test. The participant was instructed to adopt the following position: A measuring tape positioned at the height of the acromion was fixed parallel to the floor. The subject was then instructed to bend forward as much as possible without losing balance or shift the position of the wheelchair.
Figure 1. The participant keeps his arms extended by the side of the chair as close as possible to his body so that the distance between his hand and the floor can be measured at rest measure 1. Next, he is asked to perform lateral bending of the trunk as much as possible and the maximum distance of his hand from the floor is measured measure 2. Figure 2. The types of reach were measured in three attempts and the mean of the three attempts was calculated.
The subject was allowed to familiarize himself with the movement before the beginning of the tests.
The Shapiro-Wilk test was used to determine data normality. For data with normal distribution, the Student t-test was used to determine differences between groups regarding anamnesis data, functional reach tests and FIM domains sphincter control, locomotion, communication, social cognition, and total score. Data with non-normal distribution were analyzed by the Kruskal-Wallis test followed by the Mann-Whitney post-hoc test in order to determine differences between active and sedentary subjects.
Table 1 presents the characterization of the study sample. The physical activities practiced by the PASI group were: Mean time of physical activity was 7. The results obtained for the self-care, sphincter control, transfer, locomotion, communication and social cognition subscales of the FIM questionnaires are presented in Figure 3.
The score varies for each domain due to the number of questions present. The score ranges from 6 to 42 points for Self-care, from 2 to 14 points for Sphincter control, from 3 to 21 points for Transfer, from 2 to 14 points for Locomotion and for Communication, and from 3 to 21 points for Social cognition.
Figure 4 illustrates the total mean FIM values for the two groups studied.
The present anamnesis data agree with those reported in several other studies of individuals with spinal cord injury. The age range of the participants at the time of spinal injury was years and the mean age was years, in agreement with the literature, which points out that the occurrence of spinal cord trauma is highest between 15 and 40 years of age and among men.
The best score for the active group was obtained for the subitems related to self-care, sphincter control and transfer, as well as for the final FIM score.
These results suggest that individuals who regularly practice adapted physical exercise such as basketball, handball and badminton are more independent, mainly regarding motor aspects. Our results support those reported by Silva et al.
Since all subjects studied here have complete spinal cord injury, they have no motor or sensory control of the perineal region. However, the question of the FIM regarding sphincter control also assesses the number of urinary and fecal losses daily, monthly or weekly , the use of some instrument for aid, or dependency on a person during bladder or intestinal emptying, among other things..
Thus, physically active subjects with spinal injury were found to be more cautious and disciplined at the times scheduled for bladder emptying and all reported a lower loss, a fact that resulted in a better FIM score. In the present study we did not detect any cognitive change among the subjects with spinal injury evaluated. All showed the same score 7 points for the locomotion domain points which assesses locomotion on flat or slightly inclined surfaces and stair climbing, since they all reported the same difficulties.
According to Vall et al. For this reason, in the present study we applied the complete FIM questionnaire since the impact of physical exercise also on social aspects represents relevant information for this population. However, we did not observe an impact of physical activity on the social life of the subjects. The sitting functional reach test 14 represents a clinical assessment of postural control that measures the maximum reach distance. It is a reliable test that can be used also for subjects with spinal cord injury.
According to a battery of tests applied to persons with spinal cord injury in , forward and lateral reach is part of the daily activities for which these individuals have greatest difficulty, a fact showing the importance of the assessment of these movements.
In the present study the active group showed greater forward and bilateral functional reach than the sedentary group, suggesting that continuous physical exercise promotes better trunk control. According to Santos et al. Patients with spinal cord injury, because of the loss of muscle activation below the level of the injury, use new patterns of muscle activation employing intact muscles in order to adapt and to maintain postural control and stability during routine activities.
However, a different pattern of muscle activation was observed iin forward reach tasks in the subjects with spinal injury compared to uninjured persons.
In the present study we suggest that physical activity can be of help for the improvement of these new motor patterns among subjects with spinal cord injury, thus contributing to a better postural control and to greater functional independence.
In addition, only some sport modalities basketball, handball and badminton were included, while it would be interesting to compare trunk control between various modalities. We conclude that subjects with spinal cord injury who perform physical exercise have greater functional independence regarding motor, self-care and transfer functions, as well as better trunk control as determined by the forward and lateral functional reach tests.
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