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- Physiotherapy intervention in Angola: what physicians think?Publication . Leal, Edilson; Pedro, LuisaBackground: Physical therapy is an essential part of health systems. Physiotherapists can practice independent of other health professionals and also in the context of programs and interdisciplinary projects of habilitation/rehabilitation with the aim of giving function and quality of life in individuals with loss movement. There are guidelines for physiotherapists based on international standards issued by the World Confederation of Physical Therapy. (WCPT), what must be followed by physiotherapists globally. There are several health problems in Angola such as Malaria, stroke and traffic accidents that require physical therapy intervention in their rehabilitation process. Since doctors are professionals first contact in Angola responsible for referral of patients for physical therapy, it is pertinent to understand their awareness of the importance of the intervention of physiotherapists. Purpose: This study sought to investigate the perception of medical professionals in orthopedics, neurology and general practitioner of some hospital institutions in Luanda, Porto Amboim, Sumbe in Angola on the intervention of physiotherapists. Methods: The method used was quantitative descriptive and exploratory. The evaluation was conducted through a questionnaire response you close to 19 items, and the first part of the characterization of the sample (5 Items) and the second part consisting for items the advice of the doctors on the intervention of the physiotherapist in Angola (14 Items). The sample consisted of 38 doctors from orthopedists, neurologists and general practitioner in Luanda, Porto Amboim and Sumbe in Angola. For the analysis of the data was used IBM software Statistical Package for Social Sciences (SPSS statistics 20.0for Windows®). Results: The 38 individuals in the study 22 were male and 16 were female, Luanda is the city with the highest frequency of individuals who participated in the study, most are a general practitioner and worked in private clinics. Most believe that physiotherapists have a specific body of knowledge and can support their interventions. Most participants said that doctors have little knowledge of the professional physiotherapist role and not always refer their patients to physical therapy. The results of the study showed that neurologists and orthopedists have a perception of the greater importance of physiotherapy intervention. Conclusion(s): The doctors think it is important the intervention of the physiotherapist, and the three specialties orthopedics was considered as the one that needs more of the physiotherapist performance. Implications: This work can serve as an indicator of the view that doctors in Angola have of physiotherapists, can also serve to raise awareness of policies related to the integration of the physiotherapist in the multidisciplinary team in Angola.
- Instruments to assess gait in individuals with multiple sclerosis: a systematic reviewPublication . Jesus, Maria Margarida de; Pedro, LuisaBackground: Gait impairment is considered a significant cause of disability and is a clinical feature of Multiple Sclerosis. For this reason, their regular assessment is essential for better management and treatment and to evaluate the effectiveness of rehabilitation. Objective: This study aims to know what instruments are available in the literature to assess gait in patients diagnosed with MS. Data Sources and Searches: A complete literature search was conducted in MEDLINE, Web of Science, Embase, and Scopus, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The study protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO). Study Selection: The authors selected studies written in English and representing validation of gait assessment tools exclusively for adults with a diagnosis of MS. Data Extraction and Quality Assessment: Two authors independently extracted the data for reliability, measurement error, validity, and assessed methodological quality using the COnsensus-based standards to select health Measurement Instruments (COSMIN). Data Synthesis and Analysis: All authors performed data synthesis to determine the level of evidence per measurement property per tool.
- Smart walker solutions for physical rehabilitationPublication . Postolache, Octavian; Pereira, José Miguel Dias; Viegas, Vítor; Pedro, Luisa; Girão, Pedro Silva; Oliveira, Raul; Postolache, GabrielaIn the last decade, the clinical reasoning in physical therapy has been to develop systems for physiotherapists to make clinical decisions rapidly, effectively and efficiently, in response to the increasingly complex needs of health and rehabilitation units. Some studies show the importance of walking aids during rehabilitation from some diseases, and after surgery for arthroplasty in the elderly population, and in elderly patients with balance disorders, muscle weakness or in people with diabetes mellitus. Walkers are important devices that aid the rehabilitation process. The use of a walker is recommended for gait changes and imbalance due to various factors, such as surgery of the lower limbs or neurodegenerative changes, especially in the early recovery period.
- How can a self-regulation program be implicated in the management of disease severity and well-being in MS patients?Publication . Pedro, Luisa; Pais-Ribeiro, José Luís; Pinheiro, João PáscoaMultiple sclerosis is a chronic disease of the central nervous system that mainly affects young adults, promoting a great impact on functionality. Multiple sclerosis leads to strong functional restrictions, particularly in the context of daily living activities, as well as in patient participation. The aim of this study is to understand the implications of a self-regulation program in the perception of disease severity and well-being and in multiple sclerosis patients.
- Características psicométricas dos instrumentos usados para avaliar a qualidade de vida na esclerose múltipla: uma revisão bibliográficaPublication . Pedro, Luisa; Pais-Ribeiro, José LuísA esclerose múltipla (EM) é a doença crónica neurológica que mais afeta adultos jovens; em 80% dos casos, a doença progride para situações de níveis variados de incapacidade, o que torna necessário avaliar a qualidade de vida (QV) desses indivíduos. O objetivo desta revisão foi localizar estudos que avaliam a QV em indivíduos com EM, identificando os instrumentos utilizados e suas características psicométricas. Foram consultadas as bases Psycinfo, Psycarticles, Psycbooks, Psychology & Behavioral Science Collection, EJS E-Journal, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Medline, e Academic Search Complete, utilizando os descritores 'multiple sclerosis' e 'quality of life', para localizar artigos publicados no período 1997-2007. Foram selecionados 1.376 artigos e, após a leitura dos resumos, excluídos os referentes a instrumentos que não tinham boas características psicométricas e/ou eram pouco referenciados. Foram encontrados 461 artigos, dos quais 267 usaram instrumentos genéricos e 194 específicos para a EM. Dos 7 instrumentos (2 genéricos, 5 específicos) com boas características psicométricas utilizados pelos estudos consultados, o mais usado é o SF-36 (em 237 estudos). Todos os instrumentos têm validade verificada e apresentam grau elevado de confiabilidade, podendo ser utilizados para avaliação da qualidade de vida de pacientes com EM tanto em pesquisa quanto na clínica. ABSTRACT - Multiple sclerosis (MS) is the chronic neurological disease that most affects young adults; 80% of patients experience a transition towards persistent disability, hence the need to assess their quality of life (QoL). The aim of the study was to review studies that assess QoL in patients with multiple sclerosis, inquiring on the instruments used and their psychometric features. Articles published from 1997 through 2007 were searched for by means of key words 'multiple sclerosis' and 'quality of life' in databases Psycinfo, Psycarticles, Psycbooks, Psychology & Behavioral Science Collection, EJS E-Journal, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Medline, and Academic Search Complete. From the 1,376 studies found, after abstract reading those that reported on instruments with poor psychometric properties and/or were little referred were excluded. A total of 461 articles were selected, of which 267 reported using generic instruments and 194, MS-specific ones. Among the 7 instruments reported by the studies as having good psychometric characteristics (2 generic, five MS-specific), the most used is the SF-36 (by 237 studies). All instruments have shown adequate psychometric properties and a high degree of reliability, hence may be used to assess QoL in subjects with multiple sclerosis both in clinic and research.
- A influência da microgravidade na musculatura esquelética: alterações musculares e intervenção terapêuticaPublication . Quirino, Diogo; Pedro, LuisaIntrodução – O incremento do tempo de exposição à microgravidade origina um descondicionamento músculo-esquelético que precisa de ser prevenido através do treino. Objetivos – Identificar os padrões destas alterações e descrever os programas de treino em microgravidade e estratégias pós-exposição. Método – A pesquisa da revisão da literatura foi conduzida através da MEDLINE/PubMed e PEDro com as seguintes palavras--chave: “spaceflight rehabilitation”, “spaceflight muscle”, “microgravity muscle” e “bed rest muscle”, seguida de uma seleção dos artigos. Resultados – Os estudos encontrados apresentam uma resposta músculo-tendinosa diferencial sendo que o treino protege total ou parcialmente estas estruturas. Conclusão – O treino de resistance de intensidade elevada e baixas repetições associado a exercícios específicos é o mais adequado para responder ao descondicionamento. - ABSTRACT - Introduction – The increased microgravity exposition time raised the need for training programs to avoid muscle and tendinous deconditioning. Objectives – To identify the deconditioning patterns and to identify and describe the training programs used for its prevention during and after microgravity exposure. Methods – This literature review is based on a search conducted via MEDLINE/PubMed and PEDro using the following search words: “spaceflight rehabilitation”, “spaceflight muscle”, “microgravity muscle” and “bed rest muscle”. The search was followed by an article selection. Results – The studies reveal a differential exposure phenomenon for which the training programs reviewed are partly effective. Conclusion – According to the literature the high intensity low volume resistance programs with specific exercises are more appropriate to address the deconditioning problem.
- Preferências no exercício físico em mulheres portuguesas sobreviventes de cancro da mamaPublication . Ferreira, Germano; Antunes, Cláudia; Pereira, Andreia; Amaral, Renata; Pedro, Luisa; Carolino, ElisabeteIntrodução – Os benefícios do exercício físico em sobreviventes de cancro da mama têm sido reportados; contudo, a sua prática permanece baixa, tornando importante o conhecimento dos fatores que promovam a motivação e adesão ao exercício nesta população. Objetivos – Identificar as preferências quanto à programação e aconselhamento do exercício físico de uma amostra da população de mulheres portuguesas sobreviventes de cancro da mama e averiguar a influência das variáveis demográficas e médicas nestas preferências. Método – Foi aplicado um questionário a uma amostra não probabilística sequencial de 26 mulheres sobreviventes de cancro da mama. Resultados – A amostra era maioritariamente constituída por mulheres entre os 45 e os 62 anos, casadas ou em união de facto, com ensino básico, empregadas e com Índice de Massa Corporal (IMC) > 24,4. Maioritariamente tinham realizado cirurgia radical há um mês ou mais, apresentavam estadio I do tumor, efetuavam quimioterapia como tratamento adjuvante e algumas realizavam classes de fisioterapia. A maioria das participantes demonstrava interesse em receber aconselhamento, sentia-se apta a participar num programa de exercício, preferia receber aconselhamento face-a-face no hospital e acompanhada por outros doentes oncológicos. O exercício deveria ser supervisionado e com intensidade moderada, sendo as caminhadas o tipo de exercício preferido. Não foi estatisticamente possível realizar a associação entre as variáveis demográficas e médicas e as preferências. Conclusão – Alguns resultados obtidos estão em concordância com estudos prévios; contudo, outros divergem destes. Os resultados obtidos podem fornecer informações importantes para a construção futura de programas de exercício para esta população. ABSTRACT - Introduction – The benefits of physical exercise in cancer survivors have been reported, although it’s practice remains low, becoming important the acknowledgement of the factors that promote the motivation and adhesion of physical exercise in this population. Objectives – To identify the preferences about programming and counseling of physical exercise inside a population-based sample of Portuguese women who have survived breast cancer. We also intend to investigate the influence of demographic and medical variables in those preferences. Method – A questionnaire was applied to a non-probabilistic sequential sample of 26 women that have survived breast cancer. Results – Our sample was mainly composed by women aged between 45 and 62, married or in a cohabitation state, with basic instruction, employed and with a Body Mass Index (BMI)> 24.4. Most of them have had radical mastectomy for at least one month, had the Stage I of the tumor, and had done chemotherapy as an adjuvant treatment and some of them were practicing post-surgery physical therapy. The majority of participants showed interest in receiving counseling, felt able to participate in an exercise program, preferred receiving face-to-face counseling, at the hospital and with other cancer patients. The exercise should be supervised and with a moderate intensity. Walking was their preferred choice of exercise. It was not statistically possible to establish the relationship between demographic and medical variables and those preferences. Conclusion – Some results are in agreement with previous studies; however, others diverge from these. The results obtained can provide important information for future construction of exercise programs for this population.
- The influence of a physical activity program in quality of life and well-being in the elderly peoplePublication . Pedro, Luisa; Pais-Ribeiro, José Luís; Pinheiro, João PáscoaIntroduction: Regular exercise and physical activity are important for physical, mental health and quality of life in the elderly. Being physically active is very important to independence, self-determination, and quality of life of the elderly. Objective: In this study, we will see the effect of an intervention program to promote physical activity, based on self-regulation in the quality of life and well-being in elderly people. Methods: This is a prospective study. The study includes 17 people, aged between 66 and 83 years old, 75% female, 65% married, were all retired and all had functional independence. The data collection was performed on seniors universities. We use the SF-36 and the subscale psychological well-being (PWB) belonging to the Mental Health Inventory. The program consists of an intervention to promote physical activity in a group of eight people, in once a week sessions of 90 minutes. The program was held for seven weeks. Results: In order to evaluate the results we used non-parametric tests in the correlations between the PWB and the SF-36 domains before the application of the physical activity program and after the implementation of the program showed statistically significant differences between all SF-36 and PWB dimensions Except in the Cognitive Function. Conclusions: There are statistically significant differences between the two moments of assessment, suggesting that physical intervention programs for the promotion of physical activity can play an important role in the quality of life and well being of the elderly population.
- Validação para Português da Functional Gait Assessment em doentes com ParkinsonPublication . Carvalhosa, Leslie; Bacelar, Patrícia; Rodrigues, Margarida; Silva, Cláudia; Pais-Ribeiro, José Luís; Pedro, LuisaA doença de Parkinson (DP) é uma patologia neurodegenerativa que leva a alterações do padrão da marcha (como velocidade lentificada, hipocinesia, festinação e freezing), diminuindo a qualidade de vida com aumento do risco de queda e da mortalidade. Como tal, seria pertinente avaliar a progressão dos parâmetros da marcha nestes indivíduos. A Functional Gait Assessment (FGA) tem mostrado ser um instrumento válido e fidedigno na avaliação da marcha e do equilíbrio na DP. O objetivo do estudo é contribuir para a validação da FGA para português e para a DP. Este estudo pretende fornecer uma ferramenta para a avaliação clínica dos utentes em causa e promover o treino da marcha. Após a tradução e retroversão por dois tradutores bilingues, obteve-se a versão portuguesa do FGA. A amostra incluiu 32 participantes com DP idiopática, de três instituições. Procedeu-se à realização da análise psicométrica da FGA, que incluía a verificação da consistência interna e inter-avaliador. O valor do alfa de Cronbach obtido para a pontuação final da FGA para o avaliador A foi de 0,87 e para o avaliador B foi de 0,90. Obteve-se um coeficiente de correlação intraclasse (CCI) para a pontuação final da FGA de 0,96 com intervalo de confiança (IC) de 95% entre 0,93 e 0,98. A FGA demonstrou no presente estudo uma boa consistência interna e fidelidade inter-avaliador para medir a evolução do equilíbrio e das alterações do padrão de marcha na DP.
- Programa de intervenção segundo o modelo de auto-regulação na esclerose múltiplaPublication . Pedro, Luisa; Pais-Ribeiro, José Luís; Pinheiro, João PáscoaA esclerose múltipla é um doença crónica do sistema nervoso central, que afecta mais frequentemente adultos jovens, no auge da sua carreira profissional e desenvolvimento pessoal, sem cura e de causas desconhecidas. Os sintomas e sinais mais comuns são a fadiga, fraqueza muscular, alterações da sensibilidade, ataxia, alterações do equilíbrio, dificuldades na marcha, dificuldades de memória, alterações cognitivas e dificuldades na resolução de problemas. A esclerose múltipla é uma doença progressiva e imprevisível, resultando, nalguns casos, em incapacidades e limitações de actividade de vida diária, causando danos irreparáveis para os indivíduos. Esta doença pode surgir através de surtos ou de uma forma progressiva.
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