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Authors
Advisor(s)
Abstract(s)
Introdução: Mais de metade das pessoas que sofreram acidentes vasculares cerebrais (AVC) usam Auxiliares de Marcha (AM) para possibilitar uma marcha independente. Contudo, não existe consenso quanto aos ganhos funcionais efetivos do uso de AM, visto estes conduzirem frequentemente a alterações posturais e compensações. Objetivo: Identificar os principais efeitos do uso de AM por pessoas com sequelas de AVC, em fase crónica, observados em estudos experimentais. Método: Foi efetuada uma revisão sistemática qualitativa (sem meta-análise), considerando a metodologia indicada nas diretrizes da Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). As bases de dados utilizadas foram: PubMed, ScienceDirect e PEDro. A pesquisa foi restrita a estudos experimentais controlados e aleatorizados, ou sem aleatorização ou grupo controlo. O procedimento de seleção dos estudos foi conduzido de acordo com os critérios de elegibilidade pré-definidos por três fisioterapeutas de forma independente, assim como a avaliação da qualidade metodológica dos estudos selecionados, tendo sido realizada com a escala PEDro. Recolheram-se dados sobre os participantes, tipo de AM, procedimentos do estudo e principais resultados sobre variáveis da marcha. Resultados: A pesquisa em bases de dados permitiu identificar 489 artigos no total, tendo sido incluídos sete destes estudos após a aplicação dos critérios de elegibilidade. De uma forma geral, a velocidade, comprimento dos passos, cadência, ativação muscular, precisão do posicionamento dos pés, índice de simetria, forças de reação ao solo, consumo de oxigénio e resistência à marcha parecem beneficiar do uso de AM, porém estão dependentes de certas características intrínsecas dos sujeitos, como o equilíbrio, a velocidade média, a força muscular, entre outras. Conclusões: De uma forma geral, o uso de AM é benéfico para a funcionalidade da marcha em indivíduos em fase crónica pós-AVC. A indicação de AM deve ser equacionada consoante as características individuais dos seus utilizadores para a recuperação/manutenção da marcha.
ABSTRACT - Background: Most people who have suffered stroke use walking aids (WA) to enable independent walking. However, there is no consensus on the effective functional gains of using WA, since, this leads to postural changes and compensations. Objective: To identify the main effects of using WA in people with stroke sequelae, specifically in the chronic phase, observed in experimental studies. Method: A qualitative systematic review (without meta-analysis) was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The databases searched were PubMed/MEDLINE, ScienceDirect, and PEDro. The search was restricted to controlled and randomized experimental studies or studies without randomization or control group. The study selection procedure and the assessment of the methodological quality of the selected studies (PEDro scale) were conducted according to the pre-defined eligibility criteria by three independent judges. Data on the participants, the type of WA, study procedures, and main results on gait variables were collected. Results: 489 articles were identified in the selected databases, from which seven fulfilled the eligibility criteria. In general, speed, step length, cadence, muscle activation, the accuracy of foot positioning, symmetry index, ground reaction forces, oxygen consumption, and gait resistance seem to benefit from the use of WA, however, the outcomes depend on certain characteristics of the subjects, such as balance, average speed, muscle strength, among others. Conclusion: In general, the use of WA is beneficial for a functional gait in individuals post-stroke chronic phase functionality. WA should be recommended according to the individual characteristics of its users for gait recovery/maintenance.
ABSTRACT - Background: Most people who have suffered stroke use walking aids (WA) to enable independent walking. However, there is no consensus on the effective functional gains of using WA, since, this leads to postural changes and compensations. Objective: To identify the main effects of using WA in people with stroke sequelae, specifically in the chronic phase, observed in experimental studies. Method: A qualitative systematic review (without meta-analysis) was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The databases searched were PubMed/MEDLINE, ScienceDirect, and PEDro. The search was restricted to controlled and randomized experimental studies or studies without randomization or control group. The study selection procedure and the assessment of the methodological quality of the selected studies (PEDro scale) were conducted according to the pre-defined eligibility criteria by three independent judges. Data on the participants, the type of WA, study procedures, and main results on gait variables were collected. Results: 489 articles were identified in the selected databases, from which seven fulfilled the eligibility criteria. In general, speed, step length, cadence, muscle activation, the accuracy of foot positioning, symmetry index, ground reaction forces, oxygen consumption, and gait resistance seem to benefit from the use of WA, however, the outcomes depend on certain characteristics of the subjects, such as balance, average speed, muscle strength, among others. Conclusion: In general, the use of WA is beneficial for a functional gait in individuals post-stroke chronic phase functionality. WA should be recommended according to the individual characteristics of its users for gait recovery/maintenance.
Description
Mestrado em Fisioterapia. - Área de especialização: Fisioterapia Neurológica
Keywords
Acidente vascular cerebral Fase crónica Auxiliares de marcha Marcha Stroke Chronic phase Walking aids Walking
Citation
Agostinho AI. Efeitos do uso de auxiliares de marcha em pessoas com sequelas de acidente vascular cerebral - Fase crónica: revisão sistemática [dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2020.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa