ocupacional no tratamento das fraturas do terço distal do rádio. Folha méd. O' Sullivan SB, Schmitz TJ. Fisioterapia: avaliação e tratamento. 5ª ed. Manole. 4 Mestre em Ciências da Saúde - UNIFESP; Fisioterapeuta do Hospital e posicionamento, podendo minimizar a subjetividade da avaliação. .. Sullivan SBO, Thomas J, Nascimento FG. Fisioterapia: avaliação e tratamento. 2 ed. São Paulo: Manole; 4. Teive HAG, Zonta M, Kumagai Y. Tratamento da espasticidade. Avaliação das alterações funcionais nos estágios evolutivos da doença de Parkinson: nos diversos estágios evolutivos da doença em tratamento fisioterapêutico na Associação de Parkinson de Fisioterapia. .. O'Sullivan SB, Schmitz TJ.
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Livros Grátis atenção primária, medidas de case-mix e a avaliação da condição de saúde . crônicos como resultado de tratamentos médicos aprimorados, e. professor do curso de Fisioterapia da Universidade de Passo Fundo – UPF A eletroestimulação foi considerada segura e efetiva no tratamento da atrofia de desuso, além de útil na manutenção da .. In: O'Sullivan SB, Schmitz TJ. Fisiote- na avaliação da marcha de portadores de hemiparesia após acidente vascular . Board index Free Unlimited PDF Downloads Free Downloads. Forum 3. Search Please, help me to find this livro sullivan em pdf. Thanks!.
Gender, affected hemisphere and comorbidities. With these differences, it becomes difficult to evaluate which protocol would be recommended for lower-limb improvement in the hemiparetic patient. Guanabara Koogan; Subtyping in ischemic stroke genetic research. Evaluations Muscle strength MS assessed by Daniels numerical grading system This results in increased venous flow volume in the lower limb when compared with the baseline value and with passive exercise, causing reduction in venous stasis in this segment.
Doppler ultrasound in the popliteal vein showed that active ankle plantar flexion generates increased blood flow volume due to efficacy of the calf muscle pump, triggered by recruitment and effective contraction of all muscles.
This results in increased venous flow volume in the lower limb when compared with the baseline value and with passive exercise, causing reduction in venous stasis in this segment. Figure 1D shows flow volume in the popliteal vein when the movement is active.
Statistical data show that passive ankle plantar flexion is efficacious when compared with the baseline value, although not as much as active exercise. It is interesting to notice that passive exercise does not produce muscle contraction 18,29,30 and, consequently, should not activate the calf muscle pump and increase blood flow volume.
When venous flow volume was evaluated during passive exercise, the patient was requested to leave his ankle completely free and not moving it, therefore, without muscle contraction. In case there was any muscle contraction at evaluation, it was discarded and performed again. Explanation for occurrence of any type of muscle contraction during passive exercise is that, when the movement of ankle plantar flexion is performed passively in individuals that are alert and have full motor reflexes, there is a reflex response of joint protection in the last degrees of the movement.
Thus, muscle fibers are distended at its maximal length, generating a "defense moment" and muscle co-contraction activation of agonist and antagonist muscles 29,30 , triggering a stop near the end of the movement arch, with activation of the calf muscle pump.
This justifies increase in venous flow volume near the end of the movement arch, when there are short periods of filling, which cannot be sustained, reducing and not being immediately followed by other filling moments.
Blood flow volume peaks during passive contraction proved to be inferior Figure 1C than those of active exercise Figure 1D and manual compression Figure 1B. Therefore, it would be interesting to perform this study in individuals who do not have motor reflexes, either temporary, such as in patients submitted to spinal anesthesia, or permanent, such as in individuals with complete spinal trauma.
In case the hypothesis that passive exercise of the calf muscle pump is confirmedly not efficacious to increase venous flow volume, this exercise will aim at preserving and maintaining joint integrity, and not as a form of blood pumping in the lower limb.
Manual compression performed in the triceps surae is efficacious to increase blood flow volume in the popliteal artery. It is also highly efficacious when compared with passive exercise. The same occurs when compared with active exercise, but it has filling volume and reaches maximal flow volume peak abruptly Figure 1B.
This suggests that, when performing such maneuver, for example, in an ascending massage in the lower limb, we should be alert to force and pressure used, since there is a risk for endothelial lesion because veins have less developed muscle layer than arteries, facilitating possible development of venous thrombosis.
Individuals that, at the interview, reported performing physical exercises routinely had higher popliteal vein diameters and higher blood flow volume peaks, because conditioned muscles have higher tonus, effectiveness in contraction and torque strength, showing the beneficial effects of continued physical activity over skeletal muscle and the vascular system and lower predisposition to risk of venous thrombosis.
Although having a large calf perimeter, especially due to the thick adipose layer, the calf muscle pump was deconditioned, not favoring as expected increase in blood flow volume during exercise.
Physical therapy is an important factor to prevent venous thromboembolism, during hospital stay and after discharge, since such risk persists in some cases. Although being a pilot study that used a small sample of 30 individuals, this study statistically shows that active exercise of the calf muscle pump ankle plantar flexion with patients in bed, reduces venous stasis because it provides greater blood flow volume in the lower limb when compared with passive exercise.
In addition, it shows that strengthening the calf muscle is able to improve venous hemodynamics in this segment. This study could not reach any conclusion in terms of passive kinesiotherapy. A new methodology occasionally using individuals with temporary or permanent motor paralysis might be interesting as an attempt to clarify whether passive ankle plantar flexion does activate the calf muscle pump.
Communication in health: Cienc Saude Coletiva. Amino acid supplementation for reversing bed rest and steroid myopathies. J Nutr.
Rio de Janeiro: Guanabara Koogan; Orthostatic tolerance and spontaneous baroreflex sensitivity in men versus woman after 7 days of head-down bed rest. Auton Neurosci. Effect of 10 days of bed rest on skeletal muscle in healthy older adults. Effect of short-term hospitalization on functional capacity in patients not restricted to bed. Am J Phys Med Rehab.
Krasnoff J, Painter P. The physiological consequences of bed rest and inactivity. Adv Ren Replace Ther. Physical activity and hospitalization for exacerbation of COPD.
Profilaxia para tromboembolia venosa em uma unidade de tratamento intensivo. J Pneumol. Sarvier; Booth M. Effects of limb immobilization on skeletal muscle.
J Appl Physiol. Rev Cubana Enferm. Increased rates of muscle protein turnover and amino acid transport following resistance exercise in humans.
Am J Physiol. Roca; Free mobilization and low-to-high-intensity exercise in immobilization-induced muscle atrophy. The effect of different exercise intensities on the fibrinolytic system. Manole; J Vasc Bras.
Trombose venosa profunda em artroplastia total de quadril. Rev Bras Ortop. Trombose venosa profunda: Francis CW.
Clinical practice. Prophylaxis for thromboembolism in hospitalized medical patients. N Engl J Med. Marques LJ. Tromboembolismo pulmonar. Rev Assoc Med Bras. Thrombosis and coagulation: The summary of the exercises and their therapeutic goals are showed in Table 1 Table 1.
Functional kinesiotherapy. Physical exercises for lower limbs with therapeutic objective for orthostatic position.
If a difference was detected, Tukey's multiple comparisons test was used. The variables were displayed as figures. These were distributed in order to demonstrate the evolution of patients from GI and GII, in the pretreatment period, after 10 sessions and at the end of 20 physical therapy sessions, verifying whether there was a difference between the evaluation periods, between the groups and for the interaction.
General distribution of patients in Groups I and II according to age and time since injury, are shown in Table 2. Table 2. Age and time of lesion. General distribution of patients in Groups I and II, according to age and time of lesion. Table 3 shows gender, affected hemisphere and comorbidities.
There were no significant differences between the groups regarding the parameters of the table. Table 3. Gender, affected hemisphere and comorbidities. The SF scale is subdivided into eight domains, namely: The mean score in the study group ranged from We have the following hierarchy as a result: Fig 1.
Confidence intervals for each combination of group and moment of assessment of the functional capacity sub-item for both groups. Table 4. Means and standard deviations: Fig 1 shows the confidence intervals for each combination of group and time of assessment of the functional capacity sub-item for both groups. The mean in the study group ranged from We have the following hierarchy as result: Fig 2. Confidence intervals for each combination of group and moment of assessment of the social aspects sub-item for both groups.
Table 5. Fig 2 shows the confidence intervals for each combination of group and time of assessment of the sub-item social aspects for both groups. Regarding other domains of the SF, and other items assessed, there was no significant difference from a statistical viewpoint. The functional electrical stimulation was well tolerated by all study patients, respecting their tolerance threshold.
Although some hemiparetic patients with ischemic CVA may show spontaneous improvement, best results occur when patients are treated with physical therapy 21 , The element that made up the study intervention and promoted satisfactory results was the fact that the beginning of the program did not exceed 40 days since the CVA onset.
It has been suggested that treatment started as soon as possible is a factor to achieve more satisfactory results Some authors have inferred that the early start of therapy seems to be more important for patient evolution than the duration of the program Regarding muscle strength, the study showed a significant increase in strength after the treatment period, in flexion and knee extension for both groups, with no difference between them.
Traditionally, epidemiological studies with a population of CVA patients are focused on mortality and its occurrence, but not on quality of life of these patients 25 , considering that the dysfunctions and disadvantages in this regard are significant for CVA patients Although the quality of life for CVA patients is clearly influenced by multiple factors, functional independence is one of the most important factors Several studies differ regarding the training protocol with FES associated with several techniques according to the aforementioned studies.
With these differences, it becomes difficult to evaluate which protocol would be recommended for lower-limb improvement in the hemiparetic patient.
This study was important, as in addition to showing the effects of FES, functional kinesiotherapy and associated treatment, it also evaluated the quality of life and activities of daily living of the patient. These variables are significantly impaired in many aspects, especially when the patient is affected by an ischemic CVA in the acute and subacute phases.
In conclusion, functional electrical stimulation associated with functional kinesiotherapy was more effective than functional kinesiotherapy alone, regarding quality of life in the domains functional capacity and social aspects. Both muscle strength and passive and active range of motion as well as activities of daily living showed no difference between the groups.
Primeiro consenso brasileiro do tratamento da fase aguda do acidente vascular cerebral. Arq Neuropsiquiatr ; Gagliardi RJ. Manole, Stroke ; Short-term prognosis after emergency department diagnosis of TIA.
JAMA ; Meschia JF. Subtyping in ischemic stroke genetic research. J Stroke Cerebrovasc Dis ; Motor recovery after stroke: Arch Phys Med Rehabil ; Late motor recovery is influenced by muscle tone changes after stroke. Schaechter JD. Motor rehabilitation and brain plasticity after hemiparetic stroke. Prog Neurobiol ; Stabilization of human standing posture using functional neuromuscular stimulation. J Biomech ; Therapeutic effects of functional electrical stimulation on the upper limb of eight children with cerebral palsy.
Dev Med Child Neurol ; Chae J, Yu DA. A critical review of neuromuscular electrical stimulation for treatment of motor dysfunction in hemiplegia.
Assist Technol ; Electrical stimulation of wrist extensors in poststroke hemiplegia. Rev Bras Fisioter ;1: Rev Bras Fisioter ;2: Robinson AJ, Snyder-Macler. Porto Alegre: Artmed,