Fatores associados ao acesso aos serviços de reabilitação um mês após o AVC no Brasil: Influência de fatores sociodemográficos, clínico-funcionais e do período pandêmico

Autores

  • Zaqueline Fernandes Guerra Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil.
  • Jordana de Paula Magalhães Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil.
  • Nathália Aparecida Gravito Rodrigues Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil.
  • Iza de Faria- Fortini Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil.
  • Christina Danielli Coelho de Morais Faria Universidade Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil.

DOI:

https://doi.org/10.1590/

Palavras-chave:

Acidente Vascular Cerebral, COVID-19

Resumo

Apesar de devastadora, a pandemia trouxe
oportunidades para investigar o funcionamento dos
serviços de reabilitação em diferentes contextos de
saúde. O objetivo deste artigo é identificar os fatores
relacionados ao acesso de indivíduos com AVC aos
serviços de reabilitação um mês após a alta hospitalar.
Trata-se de estudo longitudinal prospectivo, em
que indivíduos com AVC foram recrutados em uma
metrópole brasileira no período de setembro de 2019 a
fevereiro de 2021. Os fatores relacionados ao acesso aos
serviços de reabilitação foram investigados por meio
de análise de regressão linear, considerando 11 variáveis
sociodemográficas e clínico-funcionais e o período de
acesso aos serviços de reabilitação (antes ou durante a
pandemia de covid-19) (α=5%). No total foram incluídos 150 participantes, dos quais 50,7% tiveram acesso a serviços
de reabilitação no período pré-pandemia e 49,3% no período
pandêmico. O nível de independência funcional foi o único
fator significativo, explicando 27% (F=56,2; p<0,001) do acesso.
O menor nível de independência funcional foi o único fator
associado ao acesso aos serviços de reabilitação um mês após a
alta hospitalar em indivíduos com AVC, independentemente do
período pandêmico.

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Referências

1. Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, et al.

Guidelines for adult stroke rehabilitation and recovery: a

guideline for healthcare professionals from the American

Heart Association/American Stroke Association. Stroke.

2016;47(6):e98-e169. doi: 10.1161/STR.0000000000000098

2. Bernhardt J, Hayward KS, Kwakkel G, Ward NS, Wolf SL, et

al. Agreed definitions and a shared vision for new standards

in stroke recovery research: the stroke recovery and

rehabilitation roundtable taskforce. Neurorehabil Neural Repair.

2017;31(9):793-9. doi: 10.1177/1545968317732668

3. Weinstein SM. How COVID-19 informed the future impact of

the specialty of physical medicine and rehabilitation across

the health care continuum. PM & R. J Injury Func Rehabil.

2021;13(6):551-3. doi: 10.1002/pmrj.12620

4. Olmedo-Vega V, Aguilar-Idáñez MJ, Arenillas-Lara JF.

Comprehensive post-stroke rehabilitation: its long-term effects

and the socio-environmental factors conditioning access to it.

Rev Neurol. 2021;73(1):1-9. doi: 10.33588/rn.7301.2021037

5. Ostwald SK, Godwin KM, Cheong H, Cron SG. Predictors of

resuming therapy within four weeks after discharge from

inpatient rehabilitation. Topics Stroke Rehabil. 2009;16(1):80-91.

doi: 10.1310/tsr1601-80

6. Vázquez-Guimaraens M, Caamaño-Ponte JL, Seoane-Pillado

T, Cudeiro J. Factors related to greater functional recovery

after suffering a stroke. Brain Scienc. 2021;11(6). doi: 10.3390/

brainsci11060802

7. Dawkins B, Renwick C, Ensor T, Shinkins B, Jayne D, Meads

D. What factors affect patients’ ability to access healthcare?

An overview of systematic reviews. Trop Med Int Health.

2021;26(10):1177-88. doi: 10.1111/tmi.13651

8. Demenech LM, Dumith SC, Vieira MECD, Neiva-Silva L.

Income inequality and risk of infection and death by

COVID-19 in Brazil. Rev Bras Epidemiol. 2020;23:e200095.

doi: 10.1590/1980-549720200095

9. Hamiduzzaman M, De-Bellis A, Abigail W, Fletcher A. Critical

social framework on the determinants of primary healthcare

access and utilisation. Family Med Community Health.

2021;9(Suppl 1):e001031. doi: 10.1136/fmch-2021-001031

10. Magalhães JP, Faria-Fortini I, Menezes KK, Lara IA,

Batista LR, et al. Determinants of access to rehabilitation

professionals by individuals with stroke in the first six months

after hospital discharge in Brazil: a study based on the

Andersen model. Topics Stroke Rehabil. 2024;31(6):615-24.

doi: 10.1080/10749357.2024.2304969

11. Silva SM, Dutra TMFV, Braga MAF, Silva EAM, Faria-Fortini I,

et al. Predictors of access to healthcare services within 1 month

after stroke in a developing country: a longitudinal prospective

study. Physiother Res Int. 2023:e2000. doi: 10.1002/pri.2000

12. Dalise S, Tramonti F, Armienti E, Niccolini V, Caiglia-Tenaglia M,

et al. Psycho-social impact of social distancing and isolation

due to the COVID-19 containment measures on patients with

physical disabilities. Eur J Phys Rehabil Med. 2021;57(1):158-65.

doi: 10.23736/S1973-9087.20.06535-1

13. Castro MC, Kim S, Barberia L, Ribeiro AF, Gurzenda S, et al.

Spatiotemporal pattern of COVID-19 spread in Brazil. Science.

2021;372(6544):821-6. doi: 10.1126/science.abh1558

14. Benevides ML, Elias S, Costa PB, Martins ALP, Martins GL, et

al. Acute ischemic stroke and COVID-19 pandemic in Brazil: a

comparative study of frequency and risk factors before and

during SARS-CoV-2 era. Neurol Sci. 2022;43(8):4611-7. doi:

10.1007/s10072-022-05873-8

15. Cuschieri S. The STROBE guidelines. Saudi J Anaesth.

2019;13(Suppl.1):S31-4. doi: 10.4103/sja.SJA_543_18

16. Herbert R, Jamtvedt G, Hagen KB, Mead J. Practical evidencebased

physiotherapy. 2nd ed. Oxford: Elsevier Health Sciences,

2011. 186 p.

17. Cincura C, Pontes-Neto OM, Neville IS, Mendes HF, Menezes DF,

et al. Validation of the National Institutes of Health Stroke Scale,

modified Rankin Scale and Barthel Index in Brazil: the role of

cultural adaptation and structured interviewing. Cerebrovasc

Dis. 2009;27(2):119-22. doi: 10.1159/000177918

18. Collin C, Wade DT, Davies S, Horne V. The Barthel ADL

Index: a reliability study. Int Disabil Stud. 1988;10(2):61-3. doi:

10.3109/09638288809164103

19. Kwon S, Hartzema AG, Duncan PW, Min-Lai S. Disability

measures in stroke: relationship among the Barthel Index,

the Functional Independence Measure, and the Modified

Rankin Scale. Stroke. 2004;35(4):918-23. doi: 10.1161/01.

STR.0000119385.56094.32

20. Lees R, Fearon P, Harrison JK, Broomfield NM, Quinn TJ.

Cognitive and mood assessment in stroke research: focused

review of contemporary studies. Stroke. 2012;43(6):1678-80.

doi: 10.1161/STROKEAHA.112.653303

21. Audigé L. Veterinary Epidemiologic Research: I. Dohoo, W.

Martin, H. Stryhn, Atlantic Veterinary College, Charlottetown,

PE, Canada, 2003. Prev Vet Med. 2005;68(2-4):289-92.

doi: 10.1016/j.prevetmed.2004.11.001

22. Baccaro A, Wang YP, Candido M, Conforto AB, Brunoni AR,

et al. Post-stroke depression and cognitive impairment: Study

design and preliminary findings in a Brazilian prospective

stroke cohort (EMMA study). J Affect Disord. 2019;245:72-81.

doi: 10.1016/j.jad.2018.10.003

23. Kamakura W, Mazzon JA. Critérios de estratificação e

comparação de classificadores socioeconômicos no

Brasil. Rev Admin Empres. 2016;56:55-70. doi: 10.1590/

s0034-759020160106

24. Taylor-Rowan M, Wilson A, Dawson J, Quinn TJ. Functional

assessment for acute stroke trials: properties, analysis,

and application. Front Neurol. 2018;9:191. doi: 10.3389/

fneur.2018.00191

25. Jan S, Essue BM, Glozier N, Lindley R, Li Q, Hackett ML. Are

rehabilitation services following stroke accessed equitably

in Australia?: findings from the psychosocial outcomes in

stroke (POISE) cohort study. BMC Public Health. 2013;13:884.

doi: 10.1186/1471-2458-13-884

26. Labberton AS, Barra M, Rønning OM, Thommessen B, Churilov

L, et al. Patient and service factors associated with referral and

admission to inpatient rehabilitation after the acute phase

of stroke in Australia and Norway. BMC Health Serv Res.

2019;19(1):871. doi: 10.1186/s12913-019-4713-x

27. Haan R, Limburg M, van der Meulen J, van den Bos GA.

Use of health care services after stroke. Qual Health Care.

1993;2(4):222-7. doi: 10.1136/qshc.2.4.222

28. Paim J, Travassos C, Almeida C, Bahia L, Macinko J.

The Brazilian health system: history, advances, and

challenges. Lancet. 2011;377(9779):1778-97. doi: 10.1016/

S0140-6736(11)60054-8

29. Odone A, Lugo A, Amerio A, Borroni E, Bosetti C, et al.

COVID-19 lockdown impact on lifestyle habits of Italian

adults. Acta Biomed. 2020;91(9-S):87-9. doi: 10.23750/abm.

v91i9-S.10122

30. Rimmer A. Covid-19: GPs can stop health checks for over 75s and

routine medicine reviews. BMJ. 2020;368:m1157. doi: 10.1136/

bmj.m1157

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Publicado

2026-07-20

Edição

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Como Citar

Fatores associados ao acesso aos serviços de reabilitação um mês após o AVC no Brasil: Influência de fatores sociodemográficos, clínico-funcionais e do período pandêmico. (2026). Fisioterapia E Pesquisa, 33(n cont), e23015126. https://doi.org/10.1590/