Introduction: the Brazilian version of the Functional Independence Measure (FIM) was developed in the 2000. Studies of validity is still required in order corroborate its use in rehabilitation assessment of Brazilian individuals, since local peculiarities may determine differences in the data provided by such instrument. Objectives: the aim of this study is test construct validity of the FIM by checking its convergent validity in groups of patients with impairments expected to develop specific levels of disability. Methods: Medical charts of 150 SCI and 103 hemiplegic patients from 2 rehabilitation centers in São Paulo provided data about demographic characteristics, clinical and functional features. The level of disability was evaluated by the Functional Independence Measure. Traumatic SCI patients were classified according to the level of injury as cervical, thoracic and lumbar or below. Hemiplegic patients were classified according to the side of motor impairment as right, left or bilateral.
Data on patients' profiles were made available through services provided by the MU--including the average index of 1.85 devices delivered to each patient and demand projections--which can be used in the planning of public policies. The MU made rehabilitation services more accessible, trained professionals, raised awareness on the correct delivery and use of assistive devices, and identified and organized people's demand in each region. Implications for Rehabilitation Delivering prostheses, orthoses and other mobility aids fulfills the rights of persons with disabilities to personal mobility with the greatest possible independence, as foreseen by the Convention on the Rights of Persons with Disabilities, increasing their participation in society on an equal basis with others. The direct impact of actively reaching out into the community to provide quality rehabilitation services and assistive devices increases the level of access of persons with disabilities to health services and equalizes opportunities. Outreach initiatives to deliver rehabilitation services in the community must include a capacity-building component. Building the capacities of local practitioners and health personnel will further empower both these professionals and persons with disabilities, diminishing attitudinal barriers. Reaching out into the community allows gathering data on the prevalence of health conditions, local need and demand for assistive devices and rehabilitation services, and informs decision-making.
The acquired brain injury (ABI) may induce a wide variety of impairments and the result of rehabilitation on an outpatient basis is questioned when performed long after its onset. The objective of this study was to evaluate the functional gain of ABI patients submitted to rehabilitation on an outpatient basis. Hospital discharge forms of 118 patients treated at the Division of Rehabilitation Medicine between 1999 and 2001 were reviewed. Functioning is systematically registered by the Functional Independence Measure (FIMTM) at the first evaluation, medical appointments and upon discharge. Mean values of each FIMTM item at the first and last evaluations were compared. The median period from the onset of the impairment was 9 months. There was an increase in the proportion of independent individuals in all FIMTM items at the end of treatment, as well as a significant increase in their mean values. These results differ from those reported by centers in countries where rehabilitation is performed in the early phase after the onset of impairments. This may result from rehabilitation approaches that focus on the physical impairment, without taking the importance of functional independence into account. We conclude that in our country, patients with ABI may present functional gain even if rehabilitation is carried out at later periods.
The main purpose of this review was to analyze the incidence of periventricular, intraventricular hemorrhage (PIVH) and associated mechanisms such as periventricular leukomalacia (PVL) and post-hemorrhagic hydrocephalus in preterm newborns. The data were obtained at the Division of Rehabilitation Medicine (DMR- HCFMUSP), Umarizal Rehabilitation Center, from January 2004 to July 2005 and compared to the specialized literature. Each patient was thoroughly analyzed and the following variables were correlated: age at the triage, diagnosis, gestational age at birth, birth weight, etiology and gender. The results were significant for some variables: 46% (13) were aged 1 to 2 years at the triage; 14% (4) had a diagnosis of PIVH and 46% (13) of PVL; 32% (9) had gestational age of 24 to 26 weeks at birth; 36% (10) had birth weight of 2,000 to 3,000g; 30% (8) presented an etiology of sepsis and 75% (21) of the patients were males. Considering the data obtained, a multidisciplinary intervention is important to improve survival of these at-risk or impaired newborns through preventive actions, by providing adequate stimulation, averting further damage and allowing maximum development of the child’s potential.
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