Dupla deficiência motora em um centro de reabilitação: hemiparesia após acidente vascular cerebral e amputação de membro inferior - Quem são eles?
DOI:
https://doi.org/10.11606/issn.2317-0190.v27i1a169617Palavras-chave:
Acidente Vascular Cerebral, Paresia, Amputação, Reabilitação, EpidemiologiaResumo
Objetivo: Estimar a prevalência da dupla deficiência motora e identificar as características social, demográficas, clinicas e relacionadas á reabilitação desses indivíduos. Métodos: Estudo descritivo retrospectivo realizado em um centro de reabilitação com indivíduos com dupla deficiência motora decorrente de amputação de membro inferior associada à hemiparesia após acidente vascular cerebral (AVC). Características sociodemografica, clinica e relacionada a reabilitação foram coletadas através de consulta a prontuários. Resultados: A prevalência da dupla deficiência motora foi de 5,4%. Dos 76 indivíduos avaliados, 69,7% eram do sexo masculino, com média de idade de 65,6 (±9,3). A hipertensão arterial sistema estava presente em 96,1% dos indivíduos e 25% eram tabagistas. Mais que 73% dos pacientes tiveram o AVC prévio à amputação. O tempo entre as lesões foi, em mediana, de 23 meses, as sequelas foram ipsilaterais em 51,3% dos pacientes. Desses, 54 pacientes (71%) foram encaminhados para as terapias físicas. O tempo entre a dupla deficiência e o início da terapia foi de 28 meses, com tempo de reabilitação total de 14,3 meses. Ao fim do processo de reabilitação 36% alcançaram suas metas, mas 30% teve alta devido a falta de adesão ao tratamento. Conclusão: A prevalência da dupla deficiência motora devido a hemiparesia após AVC e amputação de membro inferior foi 5,4%, e a população estudada apresentou características singulares relacionada ao processo de reabilitação, como um longo tempo entre a ocorrência da dupla deficiência e o inicio da reabilitação, e um longe tempo na reabilitação.
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Brunelli S, Fusco A, Iosa M, Delusso AS, Paolucci S, Traballesi M. Mid- to long-term factors influencing functional status of people affected by lower-limb amputation associated with hemiparesis due to stroke. Disabil Rehabil. 2013;35(12):982-9. Doi: https://doi.org/10.3109/09638288.2012.717583
Prvu-Bettger JA, Bates BE, Bidelspach DE, Stinemam MG. Short- and long-term prognosis among veterans with neurological disorders and subsequent lower-extremity amputation. Neuroepidemiology. 2009;32(1):4-10. Doi: https://doi.org/10.1159/000170085
Brunelli S, Averna T, Porcacchia P, Di Meo F, Trabalessi M. Functional status and factors influencing the rehabilitation outcome of people affected by above-knee amputation and hemiparesis. Arch Phys Med Rehabil. 2006;87(7):995-1000. Doi: https://doi.org/10.1016/j.apmr.2006.04.004
Chiu CC, Chen CE, Wang TG, Lin CM, Lien IN. Influencing factors and ambulation outcome in patients with dual disabilities of hemiplegia and amputation. Arch Phys Med Rehabil. 2000;81(1):14-7. Doi: https://doi.org/10.1016/S0003-9993(00)90214-4
Neumann VC, Cotter DH, Geddes JM, Waxan R. The influence of prior stroke on the prosthetic rehabilitation of lower limb amputees. Prosthet Orthot Int. 1998;22(2):102-6. Doi: https://doi.org/10.3109/03093649809164470
Hoover RM. Problems and complications of amputees. Clin Orthop Relat Res.1964;37:47-52. Doi: https://doi.org/10.1097/00003086-196411000-00007
OConnel PG, Gnatz S. Hemiplegia and amputation: rehabilitation in the dual disability. Arch Phys Med Rehabil. 1989;70(6):451-4. Doi: https://doi.org/10.1016/0003-9993(89)90005-1
World Health Organization. ICF - International Classification of Functioning, Disability and Health. Geneva: World Health Organization; 2001.
Hebert JS, Payne MWC, Wolfe DL, Deathe AB, Devlin M. Comorbidities in amputation: a systematic review of hemiplegia and lower limb amputation. Disabil Rehabil. 2012;34(23):1943-1949. Doi: https://doi.org/10.3109/09638288.2012.665131
Fortington LV, Geertzen JH, Van Netten JJ, Postema K, Rommers GM, Dijkstra PU. Short and long term mortality rates after a lower limb amputation. Eur J Vasc Endovasc Surg.2013;46(1):124-131. Doi: https://doi.org/10.1016/j.ejvs.2013.03.024
Lleras-Muney A. The relationship between education and adult mortality in the United States. Rev Econ Stud. 2005;72(1):189-221. Doi: https://doi.org/10.1111/0034-6527.00329
Ishii M, Yamanaka T. Leg orthosis treatment for a patient with left parietal foot amputation and right hemiplegia. Top Stroke Rehabil. 2004;11(3):16-18. Doi: https://doi.org/10.1310/TQMA-PAWW-TD49-CHWB
World Health Organization. World health statistics 2016: monitoring health for the sustainable development goals. Geneva: WHO; 2016.
Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev. 2011;10(4):430-9. Doi: https://doi.org/10.1016/j.arr.2011.03.003
Handa G, Singh U. Multiple vasculogenic disabilities : a challenge in rehabilitation. Neurol. India. 2001;49(1):84-6.
Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38-360. Doi: https://doi.org/10.1161/CIR.0000000000000350
Kong KH, Chua SG, Earnest A. Deep vein thrombosis in stroke patients admitted to a rehabilitation unit in Singapore. Int J Stroke. 2009;4(3):175-9. Doi: https://doi.org/10.1111/j.1747-4949.2009.00278.x
Altner PC, Rockley P, Kirby K. Hemiplegia and lower extremity amputation: double disability. Arch Phys Med Rehabil. 1987;68(6):378-9.
Garrison JH, Shankara B, Mueller MJ. Stroke hemiplegia and subsequent lower extremity amputation: which side is at risk? Arch Phys Med Rehabil. 1986;67(3):187-9. Doi: https://doi.org/10.1016/0003-9993(86)90082-1
Kayssi A, de Mestral C, Forbes TL, Roche-Nagle G. A Canadian population-based description of the indications for lower-extremity amputations and outcomes. Can J Surg. 2016;59(2):99-106. Doi: https://doi.org/10.1503/cjs.013115
Varghese G, Hinterbuchner C, Mondall P, Sakuma J. Rehabilitation outcome of patients with dual disability of hemiplegia and amputation. Arch Phys Med Rehabil. 1978;59(3):121-3.
Schaffalitzky E, Gallagher P, Maclachlan M, Weggener ST. Developing consensus on important factors associated with lower limb prosthetic prescription and use. Disabil. Rehabil. 2012;34(24):2085-94. Doi: https://doi.org/10.3109/09638288.2012.671885
Veerbeek J, van Wengen E, van Peppen RPS, Hendriks EJM, Rietberg MB, van der Wees PJ, et al. KNGF Clinical Practice Guideline for Physical Therapy in patients with stroke. Amersfoort: Royal Dutch Society for Physical Therapy - KNGF; 2014.
Remes L, Isoaho R, Vahlberg T, Hiekkanen H, Korhonen K, Vitanen M, et al. Major lower extremity amputation in elderly patients with peripheral arterial disease: incidence and survival rates. Aging Clin Exp Res. 2008;20(5):385-93. Doi: https://doi.org/10.1007/BF03325142
Eskelinen E, Lepantalo M, Hietala EM, Sell H, Maenpaa I, Pitkanen J, et al. Lower limb amputations in Southern Finland in 2000 and trends up to 2001. Eur J Vasc Endovasc Surg. 2004;27(2):193-200. Doi: https://doi.org/10.1016/j.ejvs.2003.10.011
Hunter D, Cole SE, Murray JM, Murray TD. Energy expenditure of below-knee amputees during harness-supported treadmill ambulation. J Orthop Sports Phys Ther. 1995;21(5):268-76. Doi: https://doi.org/10.2519/jospt.1995.21.5.268
Sansam K, O'Connor RJ, Neumann V, Bhakta B. Clinicians' perspectives on decision making in lower limb amputee rehabilitation. J Rehabil Med. 2014;46(5):447-53. Doi: https://doi.org/10.2340/16501977-1791
Gailey RS, Wenger MA, Raya M, Kirk N, Erbs K, Spyropoulos P, et al. Energy expenditure of trans-tibial amputees during ambulation at self-selected pace. Prosthet Orthot Int. 1994;18(2):84-91. Doi: https://doi.org/10.3109/03093649409164389
World Report on Disability. Lancet. 2011;377(9782):1977.Doi: https://doi.org/10.1016/S0140-6736(11)60844-1
O'Neill BF, Evans JJ. Memory and executive function predict mobility rehabilitation outcome after lower-limb amputation. Disabil Rehabil. 2009;31(13):1083-91. Doi: https://doi.org/10.1080/09638280802509579
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