Evaluation of a manual of home exercises for outpatients from a neuromuscular block program

Abstract

Stroke is a great challenge to rehabilitation causing, among secondary symptoms, spastic and hypertonic hemiplegia, reduction of strength, flexibility and joint deformity, leading to desability THUS. So, to reduce the complications related to this condition, physical therapeutic measures must be frequent and continuous. Our work is aimed at evaluating the feasibility of a home exercises program manual for Peripheral Neuromuscular Blockade Ambulatory at the Division of Rehabilitation Medicine (DMR) outpatients, considering the patients and caregivers' ability to understand the need of practicing the prescribed exercises after type A botulinum toxin (TBA) treatment. Thirty new outpatients with spastic hemiplegia caused by ischemic or hemorrhagic stroke and treated with lower limb TBA injection were enrolled on it. The program had 13 exercises and a physical therapist would select which of them should be done every day, according to the injected muscles. Exercises were performed with the patients in order to clarify any doubts. After 1 month, patients answered 10 questions about the home exercises manual feasibility as a therapeutic resource. Results showed the efficacy of the program, because manual was clear and most of patients had practiced the exercises actively, favoring the heath-related education between them and the caregivers. Otherwise, some subjects had difficulty to realize the exercises that demanded the diseased upper limb action. These subjects suggested the inclusion of complimentary exercises, favoring kinesiotherapy practice allied to execution autonomy. In conclusion, it is necessary to increase the manual efficiency, the inclusion of different execution methods to attend all the stroke patients with their respective motor pattern and disabilities.