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Advisor(s)
Abstract(s)
Introdução – Linfedema é uma condição crónica e progressiva que pode resultar em incapacidade considerável e perda de qualidade de vida, estimando-se que possa atingir 140 a 250 milhões de pessoas a nível mundial. Apesar da eficácia demonstrada pelo tratamento instituído em Portugal é frequente observar que os resultados obtidos são transitórios e pouco duradouros. Objetivo – Avaliar a efetividade do Protocolo de Intervenção em Grupo para Indivíduos com Linfedema na Fase de Manutenção na melhoria clínica, funcional e qualidade de vida, contribuindo para a introdução de uma nova tecnologia de saúde em Portugal, que aumente os níveis de adesão ao autotratamento e autogestão nos portadores de linfedema. Método – Realizou-se um estudo quantitativo quase-experimental sem grupo de controlo, com avaliação pré e pós-intervenção, que decorreu durante 24 sessões baseada na educação, automedição, autobandagem e compressão associada ao exercício físico. Para medição de resultados foram utilizados instrumentos de avaliação clínica (perimetria; peso), funcional (prova de marcha de seis minutos; escala de avaliação de equilíbrio estático FICSIT-4; teste de agachamento 30 segundos; teste flexão antebraço 30 segundos; questionário internacional de atividade física – IPAQ) e qualidade de vida (questionário de avaliação de ganhos em saúde SF-6D). Resultados – No primeiro ano de intervenção realizaram este protocolo 22 indivíduos, dos quais: 17 com linfedema de membro(s) inferior(es), quatro com linfedema de membro superior e uma desistência. A intervenção foi eficaz na redução da perimetria nos membros inferiores em todos os pontos avaliados (p’s<0,05), na redução de peso (p<0,0001), no aumento da distância percorrida na prova de marcha de seis minutos (p<0,0001), no aumento da pontuação da FICSIT (p<0,0001), no aumento da força/resistência muscular em ambos os membros (p’s<0,0001), no aumento dos níveis de atividade física totais (p=0,002) e na perceção subjetiva de qualidade de vida (p=0,001). Conclusão – Não sendo possível extrapolar os dados para a generalidade da população, os resultados descritos levam a pensar que este tipo de intervenção, baseada num modelo de cuidados crónicos centrado na educação e autogestão, poderá ser benéfico para o indivíduo portador de linfedema em Portugal.
ABSTRACT - Introduction – Lymphedema, estimated to affect 140 to 250 million people worldwide, is a chronic and progressive condition that can result in considerable disability and decreased quality of life. Despite the efficacy shown by instituted treatment in Portugal, it is common to note that the results obtained are transient and short-lived. Objective – To evaluate the effectiveness of the Group Intervention Protocol for Individuals with Lymphedema in the Maintenance Phase in improving clinical, functional, and quality of life measurements, contributing to the introduction of new health technology in Portugal, to increase adherence to self-treatment and self-management in individuals with lymphedema. Methods – A quasi-experimental quantitative study was carried out without a control group, with a pre-and post-intervention evaluation that took place during 24 sessions based on education, self-measurement, self-bandaging, and compression associated with physical exercise. Clinical evaluation (perimetry and weight measurement), functional evaluation (6-minute walking test; FICSIT-4 static balance assessment scale; 30-second squat test; 30-second forearm flexion test; international physical activity questionnaire – IPAQ) and quality of life evaluation (SF-6D health gains assessment questionnaire) instruments were assessed. Results – In the first year of intervention, 22 individuals underwent this protocol, of which: 17 with lymphedema of the lower limb(s), four with lymphedema of the upper limb, and one drop-out. The intervention was effective in reducing the perimeter in the lower limbs in all the evaluated points (p’s<0.05), in reducing weight (p<0.0001), in increasing the distance covered in the 6-minute walking test (p<0.0001), in increasing the FICSIT score (p<0.0001), in increasing muscle strength/endurance in both members (p’s<0.0001), in increasing total physical activity levels (p=0.002) and in the subjective perception on the quality of life (p=0.001). Conclusion – Since it’s not possible to extrapolate the data to the general population, the results described suggest that this type of intervention, based on a chronic care model centered on patient education and self-management, may be beneficial for individuals with lymphedema in Portugal.
ABSTRACT - Introduction – Lymphedema, estimated to affect 140 to 250 million people worldwide, is a chronic and progressive condition that can result in considerable disability and decreased quality of life. Despite the efficacy shown by instituted treatment in Portugal, it is common to note that the results obtained are transient and short-lived. Objective – To evaluate the effectiveness of the Group Intervention Protocol for Individuals with Lymphedema in the Maintenance Phase in improving clinical, functional, and quality of life measurements, contributing to the introduction of new health technology in Portugal, to increase adherence to self-treatment and self-management in individuals with lymphedema. Methods – A quasi-experimental quantitative study was carried out without a control group, with a pre-and post-intervention evaluation that took place during 24 sessions based on education, self-measurement, self-bandaging, and compression associated with physical exercise. Clinical evaluation (perimetry and weight measurement), functional evaluation (6-minute walking test; FICSIT-4 static balance assessment scale; 30-second squat test; 30-second forearm flexion test; international physical activity questionnaire – IPAQ) and quality of life evaluation (SF-6D health gains assessment questionnaire) instruments were assessed. Results – In the first year of intervention, 22 individuals underwent this protocol, of which: 17 with lymphedema of the lower limb(s), four with lymphedema of the upper limb, and one drop-out. The intervention was effective in reducing the perimeter in the lower limbs in all the evaluated points (p’s<0.05), in reducing weight (p<0.0001), in increasing the distance covered in the 6-minute walking test (p<0.0001), in increasing the FICSIT score (p<0.0001), in increasing muscle strength/endurance in both members (p’s<0.0001), in increasing total physical activity levels (p=0.002) and in the subjective perception on the quality of life (p=0.001). Conclusion – Since it’s not possible to extrapolate the data to the general population, the results described suggest that this type of intervention, based on a chronic care model centered on patient education and self-management, may be beneficial for individuals with lymphedema in Portugal.
Description
Keywords
Medicina de reabilitação Linfedema Autogestão Compressão Exercício físico Rehabilitation Lymphedema Self-management Compression Physical exercise
Citation
Peira FA, Morais DR, Ramalhinho M, Afonso G, Amaro AR, Araújo G, et al. Efetividade de um protocolo de intervenção em grupo para indivíduos com linfedema em fase de manutenção na melhoria clínica, funcional e qualidade de vida. Saúde & Tecnologia. 2020;(24):39-47.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa