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Abstract(s)
Introdução – A perturbação do equilíbrio após acidente vascular cerebral (AVC) é importante pela sua frequência e repercussões. Instrumentos de avaliação do equilíbrio validados e de fácil aplicação são necessários para identificar risco de queda e para adequar estratégias de intervenção. Objetivos – Verificar a concordância entre as avaliações do equilíbrio estático, dinâmico e mobilidade funcional após AVC e verificar se a concordância varia com o grau de dependência. Metodologia – Estudo transversal de amostra sequencial de adultos com marcha autónoma, até dois anos após AVC, referenciados para fisioterapia em ambulatório. O equilíbrio estático foi avaliado pelo teste de Romberg, o equilíbrio dinâmico pela Escala de Equilíbrio de Berg (EEB), a mobilidade funcional pelo Timed Up and Go test (TUG) e o grau de dependência pela Motor Assessment Scale (MAS). A concordância foi avaliada pelo coeficiente de correlação interclasse e pelo teste k de Cohen. Resultados – Foram incluídos 52 indivíduos, 26 com dependência leve, 20 moderada e seis grave. Tinham Romberg positivo 48/52; 39/52 tinham EEB<45 e o TUG>14 foi observado em 42/52. A concordância global entre as três variáveis avaliadas obteve ICC=0,63. Verificou-se uma concordância global k=0,61 entre EEB e TUG, nos indivíduos com dependência leve k=0,52 e naqueles com dependência moderada k=0,64. A concordância entre Romberg e EEB obteve globalmente k=0,27 e entre Romberg e TUG k=0,04. Conclusões – A concordância entre as avaliações do equilíbrio estático, dinâmico e mobilidade funcional após AVC é total nos casos de dependência grave e elevada nos casos de dependência moderada. Estes resultados reforçam a necessidade da utilização destes três instrumentos, particularmente nos casos de dependência leve.
ABSTRACT: Introduction – Balance disorders assessment after stroke is essential because of their frequency and consequences. The use of validated instruments, easy to apply is important for fall risk identification and allows selecting individualized intervention strategies. Goals – Check the agreement between assessments of static and dynamic balance and functional mobility after stroke and verify if the agreement changes according to the degree of dependence. Methodology – Transversal study in a sequential sample of adults with independent walking until 2 years after stroke, referred for physiotherapy as an outpatient. The static balance was assessed by Romberg test, the dynamic balance by the Berg Balance Scale (BBS), functional mobility by Timed Up and Go test (TUG) and the degree of dependence by the Motor Assessment Scale (MAS). The agreement was evaluated by inter-class correlation coefficient and the Cohen k test. Results – 52 were enrolled, 26 with mild dependence, 20 moderate and 6 severe. Romberg was positive 48/52; 39/52 had BBS<45 and TUG>14 was observed in 42/52. The global agreement between the three evaluations obtained ICC=0.63. The agreement between BBS and TUG globally obtained k=0.61, and in subjects with mild dependence k=0.52, and with moderate dependence k=0.64. The agreement between Romberg and BBS globally obtained k=0.27 and between Romberg and TUG k=0.04. Conclusions – The agreement between the evaluations of static balance, dynamic balance and functional mobility after stroke is virtually complete in severe dependence cases and high in subjects with moderate dependency. These results reinforce the need to use these three assessment tools, particularly in cases of mild dependence.
ABSTRACT: Introduction – Balance disorders assessment after stroke is essential because of their frequency and consequences. The use of validated instruments, easy to apply is important for fall risk identification and allows selecting individualized intervention strategies. Goals – Check the agreement between assessments of static and dynamic balance and functional mobility after stroke and verify if the agreement changes according to the degree of dependence. Methodology – Transversal study in a sequential sample of adults with independent walking until 2 years after stroke, referred for physiotherapy as an outpatient. The static balance was assessed by Romberg test, the dynamic balance by the Berg Balance Scale (BBS), functional mobility by Timed Up and Go test (TUG) and the degree of dependence by the Motor Assessment Scale (MAS). The agreement was evaluated by inter-class correlation coefficient and the Cohen k test. Results – 52 were enrolled, 26 with mild dependence, 20 moderate and 6 severe. Romberg was positive 48/52; 39/52 had BBS<45 and TUG>14 was observed in 42/52. The global agreement between the three evaluations obtained ICC=0.63. The agreement between BBS and TUG globally obtained k=0.61, and in subjects with mild dependence k=0.52, and with moderate dependence k=0.64. The agreement between Romberg and BBS globally obtained k=0.27 and between Romberg and TUG k=0.04. Conclusions – The agreement between the evaluations of static balance, dynamic balance and functional mobility after stroke is virtually complete in severe dependence cases and high in subjects with moderate dependency. These results reinforce the need to use these three assessment tools, particularly in cases of mild dependence.
Description
Keywords
Acidente vascular cerebral Equilíbrio Mobilidade Dependência Stroke Balance Mobility Dependency
Citation
Correia A, Pimenta C, Alves M, Virella D. Concordância entre instrumentos de avaliação do equilíbrio após acidente vascular cerebral. Saúde & Tecnologia. 2017;(17):33-8.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa