Background/objective Although many therapeutic approaches use energy conservation, only a few effectively report the steps involved. Thus, it is intended to identify energy conservation practices to be organized in flexible and adaptable stages. Methods A scoping review was carried out, whose search strategies were applied in seven databases (CINAHL, Cochrane Library, Portal BVS, PsycINFO, PubMed, Scopus, and Web of Science) following guidelines by Arksey and O’Malley on the Rayyan software. Searches were carried out from January 2010 to December 2020. Inclusion of refered publications with different study designs, participation of adults with or by demands of energy conservation, joint protection, and control of fatigue and/or pain. Exclusion of productions without an occupational therapist or involving merely pharmacological or surgical therapeutic strategies. Results 653 articles were identified, after the selection and eligibility steps, 30 articles were full review, 18 articles were included and 635 excluded. Energy conservation studies have been increasingly focusing on neurological and systemic diseases, especially regarding symptoms of fatigue and pain. The findings were arranged in six strategies whose interventions are essentially based on guidelines and setting goals for patients, client-centered approach. Merely supervised interventions are less frequent. The number of sessions is closed, but the duration of treatment is not yet. Conclusions The signs of pain and fatigue are confirmed as indicators of energy conservation strategies, this delivery can be condensed from planning and organization, priorities, activity analysis, balance between activity and rest, outsourcing of tasks and physical/environmental adaptation. Trial Registration, OSF https://osf.io/rsyq4.
ResumoAinda há carência por mais estudos qualificados que possibilitem o debate sobre limitações, benefícios e possíveis melhorias na conduta de Terapia Ocupacional na reabilitação. Objetivouse evidenciar a eficácia de abordagens específicas da Terapia Ocupacional baseadas no treino de Atividades Vida Diária, complementadas pela Cinesioatividade. Estudo quantitativo, caso único, paciente do sexo femino hemiparética à esquerda por isquemia encefálica. Os Procedimentos foram aprovados pelo comitê de ética e pesquisa com seres humanos através do parecer nº 1.337.714, comitê de ética em pesuisa do Instituto de Ciências da Saúde da Universidade Federal do Pará, e ocorreram ao longo de 20 sessões, duas vezes por semana, duração de 40 a 60 minutos por sessão. Avaliações em três tempos: admissão (1ª sessão), reavaliação (10ª sessão) e alta (20ª sessão). Testes físicos apontaram a resposta ao tratamento: percepção tátil (estesiômetro), grau de força muscular e amplitude articular de movimento. A Medida de Independência Funcional promoveu inferências sobre a recuperação de habilidades funcionais. Os dados gerados foram plotados no Programa Graph Pad, Prism – 6.0, análise de variância, pós-teste de Tukey, índice de significância: p 0,05. Gráficos em coluna (média ± desvio padrão). Os testes físicos conseguiram evidenciar ganhos importantes aos componentes de desempenho ocupacional como a percepção tátil, a força muscular e a ADM. Isso também representou recuperação de habilidades funcionais prejudicadas pelo AVE, validada pela medida de independência funcional. Conclui-se que a relevância na associação de diferentes abordagens e prática específica da Terapia Ocupacional promovem importantes ganhos físicos e funcionais no decorrer da reabilitação. Abstract There is still a lack of qualified studies that allow the debate on limitations, benefits and possible improvements in the conduct of Occupational Therapy in rehabilitation. The objective of this study was to demonstrate the efficacy of specific approaches to Occupational Therapy based on activities of daily living, supplemented by kinesioactivity. Quantitative study, single case, female patient presenting left hemiparesis due to brain ischemia. Procedures approved by research ethics committee ICS-UFPA number 1.337.714, occurred over 20 sessions, twice a week, duration of 40 to 60 minutes per session. Three-time assessments: admission (1st session), re-evaluation (10th session) and discharge (20th session). Physical tests indicated the response to the treatment: tactile perception, degree of muscle strength and range of motion. The Functional Independence Measure promoted inferences about the recovery of functional abilities. The data generated were plotted in the Graph Pad Program, Prism - 6.0, Analysis of Variance, Tukey post - test, significance index: p 0.05. Column graphs. Physical tests were able to show important gains to occupational performance components such as tactile perception, muscle strength and range of motion. This also represented recovery of functional abilities impaired by the stroke, validated by Functional Independence Measure. The relevance of the association of different approaches and specific practice of Occupational Therapy promotes important physical and functional gains in the course of rehabilitation.Keywords: Activities of daily living; Kinesioactivity; Occupational Therapy; Rehabilitation; Stroke.
Introdução. Sobreviventes de Acidente Vascular Cerebral (AVC) podem ser reabilitados pela Terapia Ocupacional (TO) tradicional ou associada a procedimentos que carecem de exploração, como a Prática Mental (PM). Objetivo. Investigar a eficácia do treinamento de Atividades de Vida Diária (AVDs), mentalmente executadas, como complemento à reabilitação tradicional. Método. Em uma Instituição Federal de Ensino Superior, pacientes sobreviventes de AVC foram distribuídos em: controle (GC) e prática mental (GPM), admissão pelo Mini Exame do Estado Mental e teste baseado no Questionário Revisado de Movimento Imaginário (MIQ-RS). Avaliações e registros: Escala de Força Muscular (MRC), Estesiômetro e Medida de Independência Funcional (MIF). Tratamento: 20 sessões, uma hora de duração (50 minutos fundamentados em AVDs e 10 minutos de PM para o GPM ou de relaxamento para o GC). Resultados. Os testes físicos demonstram recuperação de Componentes dos Desempenho Ocupacional testados no GPM. A MIF atesta ganho funcional e sugere celeridade na reabilitação no GPM. Conclusão. a PM de AVDs, aliada ao programa de reabilitação tradicional, promoveu ganhos físico-funcionais.
Muscular atrophy is a progressive degeneration characterized by muscular proteolysis, loss of mass and decrease in fiber area. Tendon rupture induces muscular atrophy due to an intrinsic functional connection. Local inhibition of nitric oxide synthase (NOS) by Nω-nitro-L-arginine methyl ester (L-NAME) accelerates tendon histological recovery and induces functional improvement. Here we evaluate the effects of such local nitrergic inhibition on the pattern of soleus muscle regeneration after tenotomy. Adult male Wistar rats (240 to 280 g) were divided into four experimental groups: control (n=4), tenotomized (n=6), vehicle (n=6), and L-NAME (n=6). Muscular atrophy was induced by calcaneal tendon rupture in rats. Changes in muscle wet weight and total protein levels were determined by the Bradford method, and muscle fiber area and central core lesion (CCL) occurrence were evaluated by histochemical assays. Compared to tenotomized (69.3±22%) and vehicle groups (68.1%±17%), L-NAME treatment induced an increase in total protein level (108.3±21%) after 21 days post-injury. A reduction in fiber areas was observed in tenotomized (56.3±1.3%) and vehicle groups (53.9±3.9%). However, L-NAME treatment caused an increase in this parameter (69.3±1.6%). Such events were preceded by a remarkable reduction in the number of fibers with CCL in L-NAME-treated animals (12±2%), but not in tenotomized (21±2.5%) and vehicle groups (19.6±2.8%). Altogether, our data reveal that inhibition of tendon NOS contributed to the attenuation of atrophy and acceleration of muscle regeneration.
Introduction The physical, social and occupational restrictions imposed by the COVID-19 pandemic have affected the health and well-being of the world population. Objective To identify the repercussions of the pandemic on the occupational participation of students, lecturers and technicians from three public universities in Northern Brazil, to compare the changes reported by participants in occupational participation before and during the pandemic, and to identify symptoms of depression, anxiety and stress self-reported. Method This is a Cross-sectional, descriptive and comparative study with a quantitative approach. One hundred and ninety-nine (n = 199) participants (students, lecturers and technicians) responded to an online questionnaire, the “Occupational Participation Checklist” and the Anxiety, Stress and Depression Scale (DASS-21). Data analysis were descriptive and also performed by applying the Wilcoxon and Mann-Whitney tests. Results During the pandemic, an increase in occupational participation was identified for all participants in domestic activities (p <0.001) and a decrease in work and study face to face (p <0.001). Students reported more symptoms of depression, anxiety and stress when compared to lecturers (p<0.001). Most students did not organise their time to fulfil their occupations with satisfaction. Such difficulties were associated with symptoms of depression, anxiety and stress, especially among the student's group (p<0.001). Conclusion This study provided preliminary evidence about differences in occupational participation before and during the Covid-19 pandemic. The organization of time and difficulties in occupational participation were associated to levels of anxiety, depression and stress, especially in the sample of students.
Resumo As metodologias ativas configuram-se como rompimento do ensino centrado na transmissão hierárquica do conhecimento do docente ao aluno, colaborando para o aperfeiçoamento do processo de ensino-aprendizagem centrado no discente. O objetivo deste estudo foi investigar as contribuições de uma disciplina baseada nas metodologias ativas ao desenvolvimento acadêmico, pessoal, profissional e ao aprendizado significativo de alunos-monitores, tanto em termos de conhecimentos científicos no estudo de temas em Ciências do Movimento quanto de iniciação à pesquisa. A pesquisa da qual deriva esse artigo usou metodologia qualitativa de abordagem narrativa, pela qual investigamos o desenvolvimento de alunos-monitores por meio de relatos de si e da experiência vivida ao participarem de uma disciplina de introdução à metodologia científica e ao estudo das Ciências do Movimento. Assumimos, para a análise dos dados construídos, a Análise Textual Discursiva (ATD), evidenciando pesquisa e reflexão sobre o aprendizado dos alunos-monitores durante a disciplina “Experimentando ciências: o corpo humano em movimento”. Os dados foram coletados por meio de questionário, via Google Forms. Com base na análise textual discursiva, emergiram as seguintes categorias: i) reflexões sobre o desenvolvimento pessoal e acadêmico; ii) construção de conhecimento científico; iii) postura crítica ao aprendizado e conduta/perspectiva profissional. Concluímos que, por meio da estratégia pedagógica utilizada na disciplina, centrada nas metodologias ativas, tendo em vista a iniciação à pesquisa, o grupo de alunos-monitores manifestou desenvolvimento acadêmico e pessoal, construção de conhecimento científico e aprendizado significativo ao orientar, sob supervisão docente, grupos de estudantes em experimentos sobre o corpo humano em movimento.
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