Melhora da independência funcional após internação para reabilitação de pacientes com sequela de Acidente Vascular Cerebral
DOI:
https://doi.org/10.34024/rnc.2022.v30.12363Palavras-chave:
Acidente Vascular Cerebral, Reabilitação, Avaliação da deficiênciaResumo
Introdução. O Acidente Vascular Cerebral (AVC) é uma das principais causas de incapacidade; e a reabilitação intensiva tem papel importante na melhora da funcionalidade. Objetivo. Comparar a independência funcional de pacientes com sequela de AVC antes e após a internação para reabilitação, relacionando com características sociodemográficas e clínicas. Método. Estudo longitudinal, retrospectivo. Foram coletados dados sociodemográficos, clínicos e a Medida da Independência Funcional (MIF) na admissão e alta, de prontuários de 167 pacientes com diagnóstico de AVC internados para reabilitação em um centro de referência, entre julho de 2016 a dezembro de 2018. Resultados. A maior parte era do sexo masculino, com idade maior ou igual a 60 anos. Os pacientes tiveram melhora no escore total, domínios motor e cognitivo da MIF após internação para reabilitação (p<0,001). Houve diminuição do número de pacientes com dependência modificada e aumento com independência completa, principalmente em indivíduos do sexo masculino, com idade inferior a 60 anos, tempo de internação maior que 30 dias e tempo de AVC menor ou igual a 180 dias (p<0,001). Conclusão. A internação para reabilitação melhora a independência funcional de pacientes com sequela de AVC.
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GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019;18:439-58. https://doi.org/10.1016/S1474-4422(19)30034-1
Brant LCC, Nascimento BR, Passos VMA, Duncan BB, Bensenõr IJM, Malta DC, et al. Variações e diferenciais da mortalidade por doença cardiovascular no Brasil e em seus estados, em 1990 e 2015: estimativas do Estudo Carga Global de Doença. Rev Bras Epidemiol 2017;20(Suppl 1):116-28. https://doi.org/10.1590/1980-5497201700050010
Bensenor IM, Goulart AC, Szwarcwald CL, Vieira MLFP, Malta DC, Lotufo PA. Prevalence of stroke and associated disability in Brazil: National Health Survey – 2013. Arq Neuropsiquiatr 2015;73:746-50. https://doi.org/10.1590/0004-282X20150115
Faria-Fortini I, Basílio ML, Scianni AA, Faria CDCM, Teixeira-Salmela LF. Performance and capacity-based measures of locomotion, compared to impairment-based measures, best predicted participation in individuals with hemiparesis due to stroke. Disabil Rehabil 2018;40:1791-8. https://doi.org/10.1080/09638288.2017.1312570
Motta E, Natalio MA, Waltrick PT. Intervenção fisioterapêutica e tempo de internação em pacientes com Acidente Vascular Encefálico. Rev Neurocienc 2008;16:118-23. https://doi.org/10.34024/rnc.2008.v16.8648
Bleyenheuft Y, Gordon AM. Precision grip in congenital and acquired hemiparesis: similarities in impairments and implications for neurorehabilitation. Front Hum Neurosci 2014;8:459. https://doi.org/10.3389/fnhum.2014.00459
Barbay M, Taillia H, Nedelec-Ciceri C, Arnoux A, Puy L, Wiener E, et al. Vascular cognitive impairment: Advances and trends. Rev Neurol (Paris) 2017;173:473-80.
https://doi.org/10.1016/j.neurol.2017.06.009.
Klamroth-Marganska V. Stroke Rehabilitation: Therapy Robots and Assistive Devices. Adv Exp Med Biol 2018;1065:579-87. https://doi.org/10.1007/978-3-319-77932-4_35
Tanlaka E, King-Shier K, Green T, Seneviratne C, Dukelow S. Inpatient Rehabilitation Care in Alberta: How Much Does Stroke Severity and Timing Matter? Can J Neurol Sci 2019;46:691-701. https://doi.org/10.1017/cjn.2019.276
Mang CS, Campbell KL, Ross CJ, Boyd LA. Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor. Phys Ther 2013;93:1707-16. https://doi.org/10.2522/ptj.20130053
Daly JJ, McCabe JP, Holcomb J, Monkiewicz M, Gansen J, Pundik S. Long-Dose Intensive Therapy Is Necessary for Strong, Clinically Significant, Upper Limb Functional Gains and Retained Gains in Severe/Moderate Chronic Stroke. Neurorehabil Neural Repair 2019;33:523-37. https://doi.org/10.1177/1545968319846120
Filippo TRM, Alfieri FM, Daniel CR, Souza DR, Battistella LR. Modelo de reabilitação hospitalar após acidente vascular cerebral em país em desenvolvimento. Acta Fisiátr 2017;24:44-7. https://doi.org/10.5935/0104-7795.20170009
Kamo T, Momosaki R, Suzuki K, Asahi R, Azami M, Ogihara H, et al. Effectiveness of Intensive Rehabilitation Therapy on Functional Outcomes After Stroke: A Propensity Score Analysis Based on Japan Rehabilitation Database. J Stroke Cerebrovasc Dis 2019;28:2537-42. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.06.007
Jorge LL, Brito AMDND, Marchi FHG, Hara ACP, Battistella LR, Riberto M. New rehabilitation models for neurologic inpatients in Brazil. Disabil Rehabil 2015;37:268-73. https://doi.org/10.3109/09638288.2014.914585
Horn SD, DeJong G, Smout RJ, Gassaway J, James R, Conroy B. Stroke rehabilitation patients, practice, and outcomes: is earlier and more aggressive therapy better? Arch Phys Med Rehabil 2005;86(Suppl 2):S101-14.
https://doi.org/10.1016/j.apmr.2005.09.016
Wang H, Camicia M, Terdiman J, Mannava MK, Sidney S, Sandel ME. Daily treatment time and functional gains of stroke patients during inpatient rehabilitation. PM R 2013;5:122-8. https://doi.org/10.1016/j.pmrj.2012.08.013
Bindawas SM, Vennu V, Moftah E. Improved functions and reduced length of stay after inpatient rehabilitation programs in older adults with stroke: A systematic review and meta-analysis of randomized controlled trials. NeuroRehabilitation 2017;40:369-90. https://doi.org/10.3233/NRE-161425
Hong I, Goodwin JS, Reistetter TA, Kuo YF, Mallinson T, Karmarkar A, et al. Comparison of Functional Status Improvements Among Patients With Stroke Receiving Postacute Care in Inpatient Rehabilitation vs Skilled Nursing Facilities. JAMA 2019;2:e1916646. https://doi.org/10.1001/jamanetworkopen.2019.16646
Mutai H, Furukawa T, Wakabayashi A, Suzuki A, Hanihara T. Functional outcomes of inpatient rehabilitation in very elderly patients with stroke: differences across three age groups. Top Stroke Rehabil 2018;25:269-75. https://doi.org/10.1080/10749357.2018.1437936
Riberto M, Miyazaki MH, Jucá SSH, Sakamoto H, Pinto PPN, Battistella L. Validação da versão brasileira da Medida de Independência Funcional. Acta Fisiátr 2004;11:72-6. https://doi.org/10.5935/0104-7795.20040003
Ricci NA, Kubota MT, Cordeiro RC. Concordância de observações sobre a capacidade funcional de idosos em assistência domiciliar. Rev Saúde Púb 2005;39:655-62. https://doi.org/10.1590/S0034-89102005000400021
Muzaffar T, Kaleem M. Rehabilitation of post stroke patients with a focus on neuroplasticity. Neurorehabil Neural Repair 2018;32(4‐5):415. https://doi.org/10.1177/1545968318765498
Boyd LA, Vidoni ED, Wessel BD. Motor learning after stroke: is skill acquisition a prerequisite for contralesional neuroplastic change? Neurosci Lett 2010;482:21-5.
https://doi.org/10.1016/j.neulet.2010.06.082
Kim JS, Lee KB, Roh H, Ahn MY, Hwang HW. Gender differences in the functional recovery after acute stroke. J Clin Neurol 2010;6:183-8. https://doi.org/10.3988/jcn.2010.6.4.183
Gall SL, Donnan G, Dewey HM, Macdonell R, Sturm J, Gilligan A, et al. Sex differences in presentation, severity, and management of stroke in a population-based study. Neurology 2010;74:975-81. https://doi.org/10.1212/WNL.0b013e3181d5a48f
Phan HT, Blizzard CL, Reeves MJ, Thrift AG, Cadilhac DA, Sturm J, et al. Sex Differences in Long-Term Quality of Life Among Survivors After Stroke in the INSTRUCT. Stroke 2019;50:2299-306. https://doi.org/10.1161/STROKEAHA.118.024437
Cruz KCTD, Diogo MJDE. Avaliação da capacidade funcional de idosos com acidente vascular encefálico. Acta Paul Enferm 2009;22:666-72. https://doi.org/10.1590/S0103-21002009000500011
Rabadi MH, Rabadi FM, Edelstein L, Peterson M. Cognitively impaired stroke patients do benefit from admission to an acute rehabilitation unit. Arch Phys Med Rehabil 2008;89:441-8. https://doi.org/10.1016/j.apmr.2007.11.014
Daly JJ, McCabe JP, Holcomb J, Monkiewicz M, Gansen J, Pundik S. Long-Dose Intensive Therapy Is Necessary for Strong, Clinically Significant, Upper Limb Functional Gains and Retained Gains in Severe/Moderate Chronic Stroke. Neurorehabil Neural Repair 2019;33:523-37. https://doi.org/10.1177/1545968319846120.
Bundy DT, Nudo RJ. Preclinical Studies of Neuroplasticity Following Experimental Brain Injury. Stroke 2019;50:2626-33. https://doi.org/10.1161/STROKEAHA.119.023550
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Copyright (c) 2022 Juliana Araújo de Morais, Isadora Tavares Almeida, Francyelle Sales de Oliveira Perdigão, Francine Aguilera Rodrigues da Silva, Rayne Ramos Fagundes, Cejane Oliveira Martins Prudente

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Aceito: 2021-11-10
Publicado: 2022-01-25