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Objectivo: Pretendeu-se avaliar as modificações no comportamento neuro-motor a nível da funcionalidade do membro superior predominantemente afectado e a sua influência no ciclo da marcha de dois indivíduos com Acidente Vascular Cerebral, face a um programa de intervenção em fisioterapia, segundo uma abordagem baseada no Conceito de Bobath. Foi também objectivo averiguar o impacto qualitativo nos componentes e estados de saúde.
Metodologia: A avaliação foi realizada em dois indivíduos com sequelas de Acidente Vascular Cerebral, antes e após o plano de intervenção segundo o Conceito de Bobath, através do registo observacional, da Classificação Internacional de Funcionalidade, Incapacidade e Saúde, da Performance-Oriented Mobility Assessment POMA I, da Time Up and Go Test, da Motor Assessement Scale e da Motor Evaluation Scale for Upper Extremity in Patients.
Resultados: Obteve-se um incremento da funcionalidade do membro superior predominantemente afectado, com uma atribuição na Classificação Internacional de Funcionalidade, Incapacidade e Saúde de qualificadores correspondentes a dificuldade ligeira a moderada ao nível da mobilidade e dos auto cuidado após o plano de intervenção, repercutindo-se assim numa diminuição da restrição na participação e limitação da actividade. Houve um aumento de score total em todos os instrumentos e escalas de medidas de avaliação utilizadas, tendo os indivíduos alcançado uma maior funcionalidade do membro superior e um padrão de marcha mais eficiente, com uma menor necessidade de recorrer a estratégias compensatórias de movimento.
Conclusão: O plano de intervenção, baseado numa abordagem segundo o Conceito de Bobath, essencialmente dirigido para a obtenção de ganhos funcionais ao nível do membro superior predominantemente afectado nos indivíduos em estudo, parece ter contribuído para induzir mudanças no comportamento neuro-motor, verificando-se uma influência no ciclo de marcha ao nível da qualidade e eficiência do movimento.
Purpose: Evaluate the changes in the neuro-motor behaviour regarding the functioning of the affected upper limb and its influence on the walk cycle of two subjects diagnosed with a stroke after a physical therapeutic intervention plan, according to Bobath’s Concept, as well as evaluate its qualitative impact on its components and health states. Methodology: The assessment was performed on two subjects suffering from stroke after-effects before and after the physical therapeutic intervention plan, according to Bobath's concept, by the observational registration, the International Classification of Functioning, Disability and Health, the Performance-Oriented Mobility Assessment POMA I, the Time Up and Go Test, the Motor Assessement Scale and the Motor Evaluation Scale for Upper Extremity in Patients. Results: An increase in the functioning of the mostly affected upper limb was verified, with a starting contribution of qualifiers corresponding to hard to moderate difficulties that, after the intervention plan, increased to soft to moderade at the level of mobility and self-care, at International Classification of Functioning, Disability and Health which reflected on a decreased limitation in the partitipation of the activity. A complete score increase was verified in all instruments and evaluation scales used. The subjects reached a greater mobility of the upper limb, were able to develop a more efficient walk cycle, reducing the need for compensatory movement strategies. Conclusion: The intervention plan according to Bobath’s Concept, mainly directed to improve the functioning of the affected upper limb of the subjects, engendered a change in the neuro-motor behaviour, where a positive influence in the increase of quality and efficiency of movement could be verified on the walk cycles of both test subjects.
Purpose: Evaluate the changes in the neuro-motor behaviour regarding the functioning of the affected upper limb and its influence on the walk cycle of two subjects diagnosed with a stroke after a physical therapeutic intervention plan, according to Bobath’s Concept, as well as evaluate its qualitative impact on its components and health states. Methodology: The assessment was performed on two subjects suffering from stroke after-effects before and after the physical therapeutic intervention plan, according to Bobath's concept, by the observational registration, the International Classification of Functioning, Disability and Health, the Performance-Oriented Mobility Assessment POMA I, the Time Up and Go Test, the Motor Assessement Scale and the Motor Evaluation Scale for Upper Extremity in Patients. Results: An increase in the functioning of the mostly affected upper limb was verified, with a starting contribution of qualifiers corresponding to hard to moderate difficulties that, after the intervention plan, increased to soft to moderade at the level of mobility and self-care, at International Classification of Functioning, Disability and Health which reflected on a decreased limitation in the partitipation of the activity. A complete score increase was verified in all instruments and evaluation scales used. The subjects reached a greater mobility of the upper limb, were able to develop a more efficient walk cycle, reducing the need for compensatory movement strategies. Conclusion: The intervention plan according to Bobath’s Concept, mainly directed to improve the functioning of the affected upper limb of the subjects, engendered a change in the neuro-motor behaviour, where a positive influence in the increase of quality and efficiency of movement could be verified on the walk cycles of both test subjects.
Descrição
Palavras-chave
AVE Intervenção Membro superior Ciclo de marcha Impacto funcional Stroke Interventation Bobath concept Upper limb Gait cicle Functional impact
Contexto Educativo
Citação
Editora
Instituto Politécnico do Porto. Escola Superior de Tecnologia da Saúde do Porto