Objective: Detect the main predictive non-motor factors related to independent community ambulation after stroke. Furthermore, we propose a scale to estimate the probability of a stroke patient achieving independent community ambulation after 6 months of rehabilitation. Design and Settings:Prospective cohort. Subjects treated in a rehabilitation center in a large metropolitan area. Independent community ambulation was evaluated after rehabilitation according to the Hoffer classification. Functional ambulation was assessed at four levels: nonambulatory, nonfunctional ambulation, household ambulation, and community ambulation.Participants: Patients (n=201) with a moderate disability after stroke. Results:The average time of hospitalization was 19.3 days. However, only 32.8% of the patients started the rehabilitation program during the first 6 months after stroke. We found that 121 patients achieved community ambulation (60.2%), 40 achieved household ambulation (19.9%), 12 achieved therapeutic ambulation (5.9%), and 28 were non-ambulatory after 6 months of treatment. Based on our final model, a scoring scale was created in order to evaluate the probability of stroke patients achieving independent community ambulation after 6 months of rehabilitation. Higher scores were associated with better chances of community ambulation within 6 months. Conclusions:The scale that evaluated these factors proved to have acceptable sensitivity and specificity to establish the prognosis of community ambulation after 6 months of rehabilitation.

ObjectiveThe purpose of this study was to evaluate cryotherapy effectiveness in the immediate postoperative period of ACL reconstruction to improve pain and range of motion (ROM) of the knee.MethodsThis is a pilot study of a prospective and randomized clinical trial. Patients (n=25) were divided into two groups: Intervention (A) group (n=10): patients were submitted to an inpatient physical therapy protocol and received ice compress for 20 minutes, twice a day; Control (B) group (n=9): patients had the same protocol, twice a day. The pain intensity was evaluated with the visual analogic scale (VAS) and range of motion was measured with a goniometer.ResultsThe Intervention (A) group had important absolute and percentual improvement when compared with the Control (B) group regarding measures of pain and knee flexion/extension ROM.ConclusionCryotherapy in the immediate postoperative period of ACL reconstruction was effective to improve pain and range of motion of the knee. Level of Evidence I, Randomized Clinical Trial.

BACKGROUND: Quality of life has been one of the main issues for patients with a chronic condition.OBJECTIVE: To translate, adapt and validate a Brazilian Portuguese version of the Prosthesis Evaluation Questionnaire (PEQ).METHODS: The questionnaire was translated into Portuguese, back translated into English, and cross-culturally adapted to the Brazilian Population. Sixty-five transtibial unilateral amputees were recruited. The sample comprised 45 men and 20 women with a mean age of 44 years, 47 with traumatic amputations, 14 with vascular dysfunction and 4 with other reasons for amputation, and all of them fitted with prostheses. Patients were interviewed twice, at baseline and again after 15 days. The Brazilian Portuguese version of the SF-36 (a generic Quality of Life outcome measure) and the FIM (a Functional Independence Measure) were also administered.RESULTS: The internal consistency of the nine PEQ scales was tested by computing Cronbach's Alpha coefficients (0.65 - 0.89: high values). Student's t test coefficients were used for interobserver evaluation (0.35 to 084: reliable values with one exception- the Residual Limb Health scale), and Intraclass Correlation Coefficients (ICC), which ranged from 0.65 to 0.92: reliable values. Student's t test coefficients and ICCs were also used for intraobserver evaluation (0.42 to 0.83, except the Residual Limb Health scale and 0.80 to 0.94, respectively: reliable values). Correlations between PEQ, SF-36 and FIM were tested using Pearson's correlation coefficients, which were not statistically significant (p > 0, 01).CONCLUSION: The Brazilian-Portuguese version of the PEQ has high internal consistency and is a reliable quality of life measure for use in amputee patients, but is not associated with the SF-36 or FIM.

Objective To evaluate the indication of prosthesis during rehabilitation and the maintenance of their use or abandonment rate after discharge, as well as mortality of lower limb amputees due to peripheral arterial disease.Methods A retrospective and cross-sectional study carried out with lower limb amputee patients, at transfemoral and transtibial levels, due to vascular conditions. The sample was composed of 310 patients (205 men, 105 women, mean age 61.8 years), transfemoral (142) and transtibial (150) levels, unilateral or bilateral (18). A total of 217 were fitted with prosthesis and 93 did not. Nonparametric statistical tests with equality of two proportions, 95% confidence interval and p value <0,05 were used.Results Out of 195 patients we contacted, 151 were fitted with prosthesis and 44 not. Of those that were fitted with prosthesis, 54 still use it, 80 abandoned and 17 died. In the group without prosthesis, 27 were on wheelchair and 17 died. Mortality is statistically higher among patients who were not fitted with prosthesis and 34 death occur, on average, 3.91 years after amputation. Survival time of patients who were not fitted with prosthesis was smaller than those were fitted.Conclusion The use of prosthesis in lower limb amputees, due to vascular conditions, during rehabilitation is high. However, maintenance of prosthesis is not frequent after discharge. Early and high mortality is observed mainly among diabetic patients.

Objetivo. avaliar os efeitos do treinamento funcional pós bloqueio químico na função motora, na amplitude de movimento passiva e na espasticidade de crianças com paralisia cerebral espástica. Método. foram selecionados 5 pacientes, porém somente 1 concluiu o estudo. O paciente LGP com diagnóstico de paralisia cerebral espástica diparética, do sexo masculino, e com 6 anos de idade, foi avaliado pré e pós bloqueio químico e pós intervenção fisioterapêutica. Os itens avaliados foram função motora grossa pelo Gross Motor Function Measure (GMFM), Amplitude de Movimento (ADM) passiva pela goniometria, e grau de espasticidade pela Escala Modificada de Ashworth. A intervenção fisioterapêutica consistiu em 12 sessões de treinamento funcional, com duração de 1 hora cada. Resultados.foi observado um aumento nos escores do GMFM e nos valores da ADM passiva em relação às 3 avaliações, sem grandes alterações no grau de espasticidade. Considerações finais. neste caso estudado houve melhora das habilidades funcionais com o treinamento funcional pós bloqueio químico. No entanto, sugerimos mais pesquisas com uma amostra maior para a comprovação dos resultados

Objetivo: O objetivo deste estudo foi avaliar se a fisioterapia em ambiente hospitalar melhora a funªo do membro superior (MS) acometido em pacientes aps acidente vascular encefÆlico, e os objetivos secundÆrios foram avaliar a fora muscular (FM) e a sensibilidade deste membro. MØtodo: Participaram do estudo 8 pacientes com diagnstico de AVE isquŒmico. Estes receberam fisioterapia padronizada para o MS durante o perodo de internaªo no Hospital Sªo Paulo, duas vezes por dia. Todos foram avaliados atravØs das escalas de Fugl-Meyer modificada e de FM do Medical Research Council em dois momentos: antes e aps o tratamento fisioterapŒutico, a fim de obter dados comparativos de forma quantitativa em relaªo funªo motora e sensibilidade, e fora muscular do MS respectivamente. Resultados: Seis pacientes apresentaram melhora da fora muscular e da funªo do MS, e cinco dos sete pacientes que apresentavam alteraªo da sensibilidade, apresentaram melhora aps o tratamento fisioterÆpico. Conclusªo: Desta forma a fisioterapia pode ser considerada de grande valia na reabilitaªo precoce de indivduos hemiparØticos hospitalizados, proporcionando a estes melhora da funªo motora, sensibilidade e fora muscular. No entanto os pacientes plØgicos foram os menos beneficiados com o tratamento.

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OBJETIVOS: Avaliar a função e a qualidade de vida dos pacientes pós-artroplastia de Girdlestone e comparar os resultados entre os grupos Girdlestone unilateral e o grupo com prótese total de quadril contralateral. MÉTODOS: estudo transversal no qual foram avaliados 9 pacientes com Girdlestone unilateral e 3 com Girdlestone em um quadril e prótese total no quadril contralateral. A avaliação constitui-se em aplicar o questionário genérico de qualidade de vida SF-36 e um questionário funcional específico para o quadril, Harris Hip Score (HHS). A comparação dos grupos foi realizada usando-se o teste t- Student e o teste de Fisher. RESULTADOS: Os pacientes do grupo Girdlestone unilateral apresentaram maior quantidade de domínios do SF-36 classificados como elevados, embora 77,8% destes tenham obtido resultados ruins no HHS. Todos os pacientes apresentaram o teste de Trendelenburg positivo e discrepância de membros, o que levou à marcha claudicante em 11 dos 12 pacientes avaliados. Destes, apenas 6 submeteram-se a fisioterapia pós-operatória. CONCLUSÃO: A qualidade de vida e a função pós-operatória de Girdlestone, na população brasileira, ainda necessita ser mais pesquisada, pois estes resultados são indicações do comportamento das variáveis de estudo e não podem ser consideradas encerradas.