Characteristics of individuals with hemiparesis according to perception about the difficulty climb stairs
Características de indivíduos com hemiparesia segundo a percepção sobre a dificuldade na subida de escadas
Cano, Fernando Wendelstein; Parizotto, Daniela; Michaelsen, Stella Maris
http://dx.doi.org/10.17784/mtprehabjournal.2015.13.269
Man. Ther., Posturology Rehabil. J., vol.13, nx, p.0, 2015
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Abstract
Introduction: climbing up and down stairs is entered directly into the Community ambulation and activities of daily living. In individuals with hemiparesis after stroke, this activity may be compromised due to deficits in components of body function and structures, activity and participation. Objective: To identify the characteristics of individuals with hemiparesis, according to the self-perception of difficulty climbing stairs and relate to components of body function and structures (BFS), activity and participation with the cadence of up / down stairs. Method: Twenty-five subjects (57.8±12.4 years) with chronic hemiparesis (57.8±42.7 months) were divided into two groups as perceived with and without difficulty climbing stairs by this particular question in the Stroke Specific Quality of Life Scale (SSQOL). In the BSF domain was rated lower limb motor impairment (Fugl-Meyer Scale), the activity domain, gait/mobility (gait speed, the Timed Up and Go-TUG) and balance (one-leg support and BERG) and participation domain the quality of life with SSQOL. Results: The group with self-perception without difficulty showed less motor impairment and higher levels of activity and participation. Strong correlations of the stair climbing cadence with the Fugl-Meyer Scale and TUG and between stair descent cadence with gait speed and TUG. Conclusion: Variables of body function andstructures , activity and participation are lower in the group with self-perceived difficulty in stair climbing and are correlated with the cadence of stair ascent and descent.
Keywords
self-perception, stairs ascend, hemiparesis.
Resumo
Introdução: A atividade de subida e descida de escada está inserida diretamente na deambulação comunitária e em atividades de vida diária. Em indivíduos com hemiparesia após Acidente Vascular Encefálico (AVE), essa atividade pode estar comprometida devido a déficits nas variáveis de estrutura e função corporal, atividade e participação. Objetivo: identificar as características de indivíduos com hemiparesia, segundo a auto-percepção da dificuldade para subida de escadas e relacionar com variáveis de estrutura e função corporal (EFC), atividade e participação com a cadência de subida/descida de escadas. Método: Participaram 25 indivíduos (57,8±12,4anos) com hemiparesia crônica (57,8±42,7meses) divididos em dois grupos, segundo a percepção com e sem dificuldade para subir escadas, avaliada através desta questão específica, da Escala de Qualidade de Vida Especifica Para Acidente Vascular Encefálico (EVQE-AVE). No domínio de EFC foi avaliado comprometimento motor de membros inferiores (Escala de Fugl-Meyer), no domínio atividade, marcha/mobilidade (velocidade de marcha, Timed Up and Go-TUG) e equilíbrio (apoio unipodal, BERG) e no domínio participação a qualidade de vida pela EVQE-AVE. Resultados: O grupo com auto-percepção sem dificuldade apresentou menor comprometimento motor e maiores níveis de atividade e participação. Foram encontradas fortes correlações da cadência de subida de escadas com a Escala de Fugl-Meyer e TUG e da cadência de descida de escadas com velocidade de marcha e TUG. Conclusão: Variáveis de estrutura e função corporal, atividade e participação são inferiores no grupo com auto-percepção de dificuldade para subida de escadas e são correlacionadas com a cadencia de subida e descida de escada.
Palavras-chave
auto-percepção, escada, hemiparesia.
References
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24. Lima RCM, Teixeira-Salmela LF, Magalhães LC, Gomes-Neto M. Propriedades psicométricas da versão brasileira da escala de qualidade de vida específica para acidente vascular encefálico: aplicação do modelo Rasch. Revista Brasileira de Fisioterapia. 2008;12(2):149-156.
25. Dancey C, Reidy J. Estatística Sem Matemática para Psicologia: Usando SPSS para Windows. Porto Alegre, Artmed; 2006.
26. Owens PL, Bradley EH, Horwitz SM, Viscoli CM, Kernan WN, Brass LM, et al. Clinical Assessment of Function among Women with a Recent Cerebrovascular Event: A Self-Reported versus Performance-Based Measure. Annals Internal Medicine. 2002;136(11):802-11.
27. Polese JC, Nascimento LR, Faria CDCM, Laurentino GEC, Rodrigues-de-Paula F, Ada L, et al. Percepção de hemiplégicos crônicos sobre o uso de dispositivos auxiliares na marcha. Revista Panamericana Salud Pública. 2011;30(3):204-208.
28. Stewart JC, Cramer SC. Patient-Reported Measures Provide Unique Insights Into Motor Function After Stroke. Stroke. 2013;44(4):1111-6.
29. Da-Silva MV, Gobbi LT. Percepção de dificuldade e comportamento locomotor de idosos ao descer degraus de ônibus. Motricidade. 2005;1(2):96-105.
30. Flansbjer UB, Holmbäck AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. Journal of Rehabilitation Medicine. 2005;37(2):75-82.
2. Patel MD, Tilling K, Lawrence E, Rudd AG, Wolfe CD, McKevitt C. Relationships between long-term stroke disability, handicap and health- related quality of life. Age and Ageing. 2006;35(3):273-279.
3. Geurts ACH, de Haart M, van Nes IJ, Duysens J. A review of standing balance recovery from stroke. Gait & Posture. 2005;22(3):267-281.
4. Neto MG, Sales V, Portella DDA, Lacerda VB, Conceição CS, Dias RS. Qualidade de vida e desempenho funcional em pessoas com hemiparesia. Ter Man. 2013;11(52):223-227.
5. Kitzmüller G, Häggström T, Asplund K. Living an unfamiliar body: the significance of the long-term influence of bodily changes on the perception of self after stroke. Medicine Health Care and Philosophy. 2013;16(1):19-29.
6. Gadidi V, Katz-Leurer M, Carmeli E, Bornstein NM. Long-term outcome poststroke: predictors of activity limitation and participation restriction. Archives of Physical Medicine and Rehabilitation. 2011;92:1802–1808.
7. Carod-Artal FJ, González-Gutiérrez JL, Herrero JA, Horan T, De Seijas EV. Functional recovery and instrumental activities of daily living: follow-up 1-year after treatment in a stroke unit. Brain Injury. 2002;16(3):207-16.
8. Mudge S, Stott S. Timed walking tests correlate with daily step activity in persons with stroke. Archives of Physical Medicine and Rehabilitation. 2009;90:293-301.
9. Amaral-Natalio M, Nunes GS, Herber V, Michaelsen SM. Relação entre cadência da subida e descida de escada, recuperação motora e equilíbrio em indivíduos com hemiparesia. Acta Fisiátrica. 2011;18(3):146-150.
10. De Bujanda E, Nadeau S, Bourbonnais D, Dickstein R. Associations between lower limb impairments, locomotor capacities and kinematic variables in the frontal plane during walking in adults with chronic stroke. Journal of Rehabilitation Medicine. 2003;35(6):259-64.
11. Said CM, Goldie PA, Culham E, Sparrow WA, Patla AE, Morris ME. Control of lead and trail limbs during obstacle crossing following stroke. Physical Therapy. 2005;85(5):413-27.
12. Ng SS, Ng HH, Chan KM, Lai JC, To AK, Yeung CW. Reliability of the 12-step ascend and descend test and its correlation with motor function in people with chronic stroke. Journal of Rehabilitation Medicine. 2013;45(2):123-9.
13. Oh-Park M, Wang C, Verghese J. Stair negotiation time in community- dwelling older adults: normative values and association with functional decline. Archives of Physical Medicine and Rehabilitation. 2011;92(12):2006-11.
14. Alzahrani M, Dean C, Ada L. Relationship between walking performance and types of community based activities in people with stroke: an observational study. Revista Brasileira de Fisioterapia. 2011;15(1):45-51.
15. World Health Organization (WHO). A Practical Manual for using the International Classification of Functioning, Disability and Health (ICF). 2013: Genebra.
16. Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH. Sugestões para o uso do Mini-Exame do Estado Mental no Brasil. Arquivos de Neuropsiquiatria. 2003;61(3B):777-81.
17. Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S. The post stroke hemiplegic patient. I. A method for evaluation of physical performance. Scandinavian Journal of Rehabilitation Medicine. 1975;7(1):13-31.
18. Michaelsen SM, Rocha AS, Knabben RJ, Rodrigues LP, Fernandes CGC. Tradução, adaptação e confiabilidade Inter examinadores do manual de administração da escala Fugl-Meyer. Revista Brasileira de Fisioterapia. 2011;15(1):80-8.
19. Faria CD, Teixeira-Salmela LF, Silva EB, Nadeau S. Expanded timed up and go test with subjects with stroke: Reliabity and comparison with matched healthy controls. Archives of Physical Medicine and Rehabilitation. 2011;93(6):1034-8.
20. Myamoto ST, Lombardi Junior I, Berg KO, Ramos LR, Natour J. Brazilian version of the Berg balance scale. Brazilian Journal of Medical and Biological Research. 2004;37(9):1411-21.
21. Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. Normative Values for the Unipedal Stance Test with Eyes Open and Closed. Journal Geriatric Physical Therapy. 2007;30(1):8-15.
22. Faria CDCM, Silva SM, Corrêa JCF, Laurentino GEC, Teixeira-Salmela LF. Identificação das categorias de participação da CIF em instrumentos de qualidade de vida utilizados em indivíduos acometidos pelo acidente vascular encefálico. Revista Panamericana de Salud Pública. 2012;31(4):338–44.
23. Nascimento LR, Caetano LCG, Freitas DCMA, Morais TM, Polese JC, Teixeira-Salmela LF. Diferentes instruções durante teste de velocidade de marcha determinam aumento significativo na velocidade máxima de indivíduos com hemiparesia crônica. Revista Brasileira de Fisioterapia.2012;16(2):122-127.
24. Lima RCM, Teixeira-Salmela LF, Magalhães LC, Gomes-Neto M. Propriedades psicométricas da versão brasileira da escala de qualidade de vida específica para acidente vascular encefálico: aplicação do modelo Rasch. Revista Brasileira de Fisioterapia. 2008;12(2):149-156.
25. Dancey C, Reidy J. Estatística Sem Matemática para Psicologia: Usando SPSS para Windows. Porto Alegre, Artmed; 2006.
26. Owens PL, Bradley EH, Horwitz SM, Viscoli CM, Kernan WN, Brass LM, et al. Clinical Assessment of Function among Women with a Recent Cerebrovascular Event: A Self-Reported versus Performance-Based Measure. Annals Internal Medicine. 2002;136(11):802-11.
27. Polese JC, Nascimento LR, Faria CDCM, Laurentino GEC, Rodrigues-de-Paula F, Ada L, et al. Percepção de hemiplégicos crônicos sobre o uso de dispositivos auxiliares na marcha. Revista Panamericana Salud Pública. 2011;30(3):204-208.
28. Stewart JC, Cramer SC. Patient-Reported Measures Provide Unique Insights Into Motor Function After Stroke. Stroke. 2013;44(4):1111-6.
29. Da-Silva MV, Gobbi LT. Percepção de dificuldade e comportamento locomotor de idosos ao descer degraus de ônibus. Motricidade. 2005;1(2):96-105.
30. Flansbjer UB, Holmbäck AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. Journal of Rehabilitation Medicine. 2005;37(2):75-82.
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