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Advisor(s)
Abstract(s)
Introdução: O acidente vascular encefálico (AVE) é uma importante e frequente
condição de saúde que se repercute na funcionalidade do indivíduo. No sentido de
reabilitar a função perdida, é comum o recurso a intervenções de fisioterapia baseado o
conceito de Bobath. Como tal, importa verificar, as modificações no âmbito do controlo
postural, através da migração do centro de pressão na base de suporte, face à aplicação
de uma intervenção segundo abordagem baseada no conceito de Bobath em dois
indivíduos com AVE.
Métodos e participantes: Foram recrutados dois indivíduos com diagnóstico de AVE
num hospital da zona do grande Porto. Dados referentes ao equilíbrio estático na
condição de medição “olhos abertos ou fechados” e “calçado ou descalço” foram
obtidos através de plataforma de forças, antes e após uma intervenção baseado no
conceito de Bobath durante 13 semanas (M0 e M1). Nestes dois momentos foram ainda
avaliados a mobilidade, função cognitiva, participação, equilíbrio através do teste
Timed Up & Go (TUG) e Timed Up & Go Modificado (TUGM), e das escalas Mini
Mental State Examination (MMSE), Postural Assessment for Stroke Scale (PASS),
Escala de Berg (EB) e Índice de Barthel Modificado (IBM).
Resultados: Os participantes obtiveram em ambos os momentos pontuação máxima no
MMSE. Ambos os indivíduos atingiram o valor máximo no IBM em M1 (Mo: A: 78; B:
65). Ambos os indivíduos aumentaram o score entre M0 e M1, relativamente ao PASS
(A: M0:21; M1:33; B: M0: 26; M1:34) e EB (A: M0:48; M1:54; B: M0: 30; M1:50). O
tempo de realização do TUG e do TUGM diminuíram entre momentos em ambos os
indivíduos (respectivamente: A: 15''13'' a 13''27''; B: 24''13'' a 13''88'' e A: 19''08''' a
13''27''; B: 29''60''' a 17''64'''). A área de deslocação do centro de pressão (CP) variou
entre momentos em todas as condições de avaliação, sendo menor na condição “olhos
abertos e descalço” em ambos os participantes (“olhos abertos e calçado”: A: M0=
1,364, M1=2,796; B: M0=1,892, M1=2,979; “olhos abertos e descalço”: A: M0= 0,758,
M1=0,727; B: M0=3,064, M1=1,952; “olhos fechados e calçado”: A: M0= 2,360,
M1=2,998; B: M0=2,232, M1= 4,392; “olhos fechados e descalço”: A: M0= 1,347,
M1=2,388; B: M0=1,652, M1= 1,016). O desvio padrão das deslocações anteroposteriores
variou entre momentos, sendo tendencialmente maior em M1 e na condição “descalço e olhos abertos”(“olhos abertos e calçado”: A: M0= 0,201, M1=0,500; B:
M0=0,252, M1=0,310; “olhos abertos e descalço”: A: M0= 0,118, M1=0,165; B:
M0=0,282, M1=0,276; “olhos fechados e calçado”: A: M0= 0,308, M1=0,398; B:
M0=0,274, M1= 0,471; “olhos fechados e descalço”: A: M0= 0,158 , M1=0,373; B:
M0=0,230, M1= 0,172), o desvio padrão das deslocações médio-lateral seguem a mesma
tendência (“olhos abertos e calçado”: A: M0= 0,370 , M1=0,473; B: M0=0,454,
M1=0,517; “olhos abertos e descalço”: A: M0= 0,354, M1=0,236 ; B: M0=0,584,
M1=0,381; “olhos fechados e calçado”: A: M0= 0,425, M1=0,463; B: M0=0,462, M1=
0,583; “olhos fechados e descalço”: A: M0= 0,475, M1=0,416; B: M0=0,389, M1=
0,342). A velocidade de oscilação na direcção antero – posterior variou entre momentos,
sendo tendencialmente menor em M1, em ambos os participantes e em todas as
condições de avaliação: “olhos abertos e calçado”: A: M0= 0,886 , M1=0,532; B:
M0=2,507, M1=01,072; “olhos abertos e descalço”: A: M0= 2,562, M1=3,815 ; B:
M0=4,367, M1=0,262; “olhos fechados e calçado”: A: M0= 2,689, M1=1,757; B:
M0=2,821, M1= 0,769; “olhos fechados e descalço”: A: M0= 2,984, M1=2,525; B:
M0=4,100, M1= 0,265), a velocidade de oscilação na direcção médio – lateral seguem a
mesma tendência para as condições de “olhos abertos e calçado”: A: M0= 6,524 ,
M1=6,218; B: M0=0,467, M1=0,404; “olhos fechados e calçado”: A: M0= 6,387,
M1=1,927; B: M0=0,351, M1= 0,505; mas a velocidade de oscilação aumenta para as
condições de “olhos abertos e descalço”: A: M0= 3,108, M1=7,806 ; B: M0=1,150,
M1=8,054; “olhos fechados e descalço”: A: M0= 3,444, M1=3,839; B: M0=1,434, M1=
7,891).
Conclusão: Entre os dois momentos os indivíduos melhoraram a sua mobilidade,
equilíbrio, participação e actividades, potencialmente devido à intervenção baseado no
conceito de Bobath.
Introduction: Stroke is an important and frequent health event, with an impact on patient’s functionality. Aiming the rehabilitation of lost function, interventions using the Bobath concept are common. As such, it’s important to know the modifications in postural control, assessed by the motion of center of pressure in a pressure platform, before and after an intervention based on Bobath Concept in two individuals with stroke. Methods and participants: two stroke patients were recruited in a hospital from the Oporto Region. Balance results were measured in a pressure platform in different conditions (eyes open and closed, barefooted and with shoes ) in two moments, after (M1) and before (M0) an intervention based on Bobath concept (13 weeks). In these two moments were also used the Timed Up & Go (TUG) and the Modified Timed Up & Go (TUGM), Mini Mental state Examination (MMSE), Postural Assessment for Stroke Score (Pass), Berg Scale (BS) and Barthel Index (BI). Results: Both individuals obtained maximal score on the MMSE in both moments of evaluation. Both individual scored the maximal score in BI in M1 ((Mo: A: 78; B: 65). Both individuals raised their score between M0 and M1 in the PASS (A: M0:21; M1:33; B: M0: 26; M1:34) and Berg (A: M0:48; M1:54; B: M0: 30; M1:50). ). TUG and TUGM decreased in both individuals in M1 (respectively: A: 15''13'' a 13''27''; B: 24''13'' a 13''88'' e A: 19''08''' a 13''27''; B: 29''60''' a 17''64'''). The center of pressure area of displacement changed between moments and between condition measures, being smaller in the eyes open barefoot condition (eyes open with shoes: A: M0= 1,364, M1=2,796; B: M0=1,892, M1=2,979; eyes open barefoot: A: M0= 0,758, M1=0,727; B: M0=3,064, M1=1,952; eyes closed with shoes: A: M0= 2,360, M1=2,998; B: M0=2,232, M1= 4,392; eyes closed barefoot: A: M0= 1,347, M1=2,388; B: M0=1,652, M1= 1,016). The standard deviation of the anterior posterior displacement changed between moments, being slightly higher in M1 and in the barefoot eyes open condition (eyes opens with shoes: A: M0= 0,201, M1=0,500; B: M0=0,252, M1=0,310; eyes open barefoot: A: M0= 0,118, M1=0,165; B: M0=0,282, M1=0,276; eyes closed with shoes: A: M0= 0,308, M1=0,398; B: M0=0,274, M1= 0,471; eyes closed barefoot: A: M0= 0,158 , M1=0,373; B: M0=0,230, M1= 0,172). The standard deviation of the lateral medial displacement changed between moments, being similar to those from the anterior posterior displacement (eyes open with shoes: A: M0= 0,370 , M1=0,473; B: M0=0,454, M1=0,517; eyes open barefoot: A: M0= 0,354, M1=0,236 ; B: M0=0,584, M1=0,381; eyes closed with shoes: A: M0= 0,425, M1=0,463; B: M0=0,462, M1= 0,583; eyes closed barefoot: A: M0= 0,475, M1=0,416; B: M0=0,389, M1= 0,342. ). The velocity of the anterior-posterior shift changed between moments, being slightly lower in M1 in both individuals and all measurement conditions (eyes open with shoes: A: M0= 0,886 , M1=0,532; B: M0=2,507, M1=01,072; eyes open and barefoot: A: M0= 2,562, M1=3,815 ; B: M0=4,367, M1=0,262; eyes closed with shoes: A: M0= 2,689, M1=1,757; B: M0=2,821, M1= 0,769; eyes closed barefoot: A: M0= 2,984, M1=2,525; B: M0=4,100, M1= 0,265). The velocity of the lateral-medial shift changed between moments being similar to those from the anterior posterior displacement in the measure condition eyes open with shoes, but, being higher in all other conditions (eyes open with shoes: A: M0= 6,524 , M1=6,218; B: M0=0,467, M1=0,404 eyes closed with shoes: A: M0= 6,387, M1=1,927; B: M0=0,351, M1= 0,505; eyes open barefoot: A: M0= 3,108, M1=7,806 ; B: M0=1,150, M1=8,054; eyes closed and barefoot: A: M0= 3,444, M1=3,839; B: M0=1,434, M1= 7,891). Conclusion: between moments, both individuals improved their mobility, balance, activities and participation, due eventually to the intervention based on Bobath concept
Introduction: Stroke is an important and frequent health event, with an impact on patient’s functionality. Aiming the rehabilitation of lost function, interventions using the Bobath concept are common. As such, it’s important to know the modifications in postural control, assessed by the motion of center of pressure in a pressure platform, before and after an intervention based on Bobath Concept in two individuals with stroke. Methods and participants: two stroke patients were recruited in a hospital from the Oporto Region. Balance results were measured in a pressure platform in different conditions (eyes open and closed, barefooted and with shoes ) in two moments, after (M1) and before (M0) an intervention based on Bobath concept (13 weeks). In these two moments were also used the Timed Up & Go (TUG) and the Modified Timed Up & Go (TUGM), Mini Mental state Examination (MMSE), Postural Assessment for Stroke Score (Pass), Berg Scale (BS) and Barthel Index (BI). Results: Both individuals obtained maximal score on the MMSE in both moments of evaluation. Both individual scored the maximal score in BI in M1 ((Mo: A: 78; B: 65). Both individuals raised their score between M0 and M1 in the PASS (A: M0:21; M1:33; B: M0: 26; M1:34) and Berg (A: M0:48; M1:54; B: M0: 30; M1:50). ). TUG and TUGM decreased in both individuals in M1 (respectively: A: 15''13'' a 13''27''; B: 24''13'' a 13''88'' e A: 19''08''' a 13''27''; B: 29''60''' a 17''64'''). The center of pressure area of displacement changed between moments and between condition measures, being smaller in the eyes open barefoot condition (eyes open with shoes: A: M0= 1,364, M1=2,796; B: M0=1,892, M1=2,979; eyes open barefoot: A: M0= 0,758, M1=0,727; B: M0=3,064, M1=1,952; eyes closed with shoes: A: M0= 2,360, M1=2,998; B: M0=2,232, M1= 4,392; eyes closed barefoot: A: M0= 1,347, M1=2,388; B: M0=1,652, M1= 1,016). The standard deviation of the anterior posterior displacement changed between moments, being slightly higher in M1 and in the barefoot eyes open condition (eyes opens with shoes: A: M0= 0,201, M1=0,500; B: M0=0,252, M1=0,310; eyes open barefoot: A: M0= 0,118, M1=0,165; B: M0=0,282, M1=0,276; eyes closed with shoes: A: M0= 0,308, M1=0,398; B: M0=0,274, M1= 0,471; eyes closed barefoot: A: M0= 0,158 , M1=0,373; B: M0=0,230, M1= 0,172). The standard deviation of the lateral medial displacement changed between moments, being similar to those from the anterior posterior displacement (eyes open with shoes: A: M0= 0,370 , M1=0,473; B: M0=0,454, M1=0,517; eyes open barefoot: A: M0= 0,354, M1=0,236 ; B: M0=0,584, M1=0,381; eyes closed with shoes: A: M0= 0,425, M1=0,463; B: M0=0,462, M1= 0,583; eyes closed barefoot: A: M0= 0,475, M1=0,416; B: M0=0,389, M1= 0,342. ). The velocity of the anterior-posterior shift changed between moments, being slightly lower in M1 in both individuals and all measurement conditions (eyes open with shoes: A: M0= 0,886 , M1=0,532; B: M0=2,507, M1=01,072; eyes open and barefoot: A: M0= 2,562, M1=3,815 ; B: M0=4,367, M1=0,262; eyes closed with shoes: A: M0= 2,689, M1=1,757; B: M0=2,821, M1= 0,769; eyes closed barefoot: A: M0= 2,984, M1=2,525; B: M0=4,100, M1= 0,265). The velocity of the lateral-medial shift changed between moments being similar to those from the anterior posterior displacement in the measure condition eyes open with shoes, but, being higher in all other conditions (eyes open with shoes: A: M0= 6,524 , M1=6,218; B: M0=0,467, M1=0,404 eyes closed with shoes: A: M0= 6,387, M1=1,927; B: M0=0,351, M1= 0,505; eyes open barefoot: A: M0= 3,108, M1=7,806 ; B: M0=1,150, M1=8,054; eyes closed and barefoot: A: M0= 3,444, M1=3,839; B: M0=1,434, M1= 7,891). Conclusion: between moments, both individuals improved their mobility, balance, activities and participation, due eventually to the intervention based on Bobath concept
Description
Keywords
Acidente vascular encefálico Conceito de Bobath Controlo postural Plataforma de forças Centro de pressão Stroke Bobath concept Pressure platform Center of pressure Postural control
Citation
Publisher
Instituto Politécnico do Porto. Escola Superior de Tecnologia da Saúde do Porto