This study aimed to evaluate the influence of Integrated Continuous Care on the functional independence of the elderly. This cohort study included participants aged 60 years or older who had experienced a disabling event or disease, and were admitted to rehabilitation in a Brazilian Integrated Continuous Care Unit. The functional gain was evaluated by the Barthel index. Fifty-nine elderly individuals admitted due to a disabling event or disease at the ICCU were assisted from March 2014 to February 2015. Since twenty-two of these were excluded, only 37 participants were evaluated. The mean age of the elderly that were included was 70.41 years (± 1.40) and most of them presented an ischemic stroke diagnosis (64.9%). The total functional gain was 24.05 (± 3.84) points, with an average stay of 32.32 (± 2.18) days. When compared with the degree of dependence on the admission and at discharge, total or severe dependence was identified in 62.2% on admission and mild dependence or total independence was identified in 54.1% at discharge, with a significant decrease in the percentage of the elderly with total dependence between admission and discharge (McNemar test, p = 0.001). At hospital discharge, 70.3% of the elderly had better individual performance in their Activities of Daily Living than at hospital admission and none of them got worse. The multi-professional team-based approach in the Integrated Continuous Care assistance model favors the elderly with gain in functionality and independence. The social network involvement of the elderly lead to their empowerment and co-responsibility along with their family/caregiver in pursuit of the therapeutic goals established together.
A dengue pode desencadear manifestações neurológicas como a Síndrome de Encefalomielite Aguda Disseminada (ADEM), de caráter inflamatório, desmielinizante, que pode ter dentre as consequências déficits motores e sensitivos, neurite ótica e disfunções vesicais, como a retenção urinária, tornando o indivíduo dependente da realização do cateterismo vesical intermitente (CVI). Desta forma, o objetivo deste estudo é descrever o tratamento fisioterapêutico de uma paciente com retenção urinária, decorrente de Síndrome de ADEM pós-dengue. Paciente do sexo feminino, 52 anos, internada em hospital de média complexidade com diagnóstico de ADEM. Na avaliação inicial apresentava grau de força muscular 3 de membros inferiores e 4 de membros superiores, 2 de musculatura do assoalho pélvico (MAP) e retenção urinária, necessitando realizar CVI. Foram realizados 32 atendimentos com duração de uma hora, incluindo o treinamento do assoalho pélvico em diferentes posturas e eletroestimulação de superfície da MAP com equipamento da marca Ibramed. Paciente recebeu alta hospitalar com evidente melhora da força muscular global e sem necessidade de CVI, apresentando micção voluntária e sem resíduo pós-miccional, favorecendo a prevenção de agravos do trato urinário inferior e superior.Palavras-chave: músculos do assoalho pélvico, bexiga neurogênica, encefalomielite aguda disseminada, dengue.
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