Responsividade de dois instrumentos de avaliação do equilíbrio em pacientes pós-AVE trombolisado na fase aguda

Autores

  • Lemuel Victor da Silva Bernardes Hospital Geral Roberto Santos - HGRS
  • Iara Maso Hospital Geral Roberto Santos - HGRS
  • Marilucia Reis dos Santos Hospital Geral Roberto Santos - HGRS https://orcid.org/0000-0002-3220-883X
  • Alana das Mercês Silva Hospital Geral Roberto Santos - HGRS
  • Francisco Robson Oliveira Hospital Geral Roberto Santos - HGRS
  • Jorge Luís Motta dos Anjos Hospital Geral Roberto Santos - HGRS

DOI:

https://doi.org/10.11606/issn.2317-0190.v28i2a183160

Palavras-chave:

Acidente Vascular Cerebral, Equilíbrio Postural, Reabilitação

Resumo

A Escala de Equilíbrio de Berg (EEB) e a Escala de Avaliação Postural para Pacientes com Sequelas de AVE (EAPA) são ferramentas de medida úteis e válidas na prática clínica. Objetivo: Comparar a responsividade da EEB e EAPA na avaliação do equilíbrio de indivíduos pós-AVE trombolisado na fase aguda. Métodos: Trata-se de um estudo longitudinal analítico, realizado em uma Unidade de AVC, no qual foram aplicados a EEB e a EAPA nas primeiras 24 horas e no sétimo dia de internamento ou no dia da alta. Para determinação da responsividade adotou-se o Índice de Tamanho de Efeito (TE) e a Média de Resposta Padronizada (MRP), sendo calculados efeito solo e teto de ambas as escalas. Resultados: 44 pacientes, predominantemente do sexo masculino, média de idade 60 (±13) anos e mediana NIHSS 3,5 [1-6]. Ambos os instrumentos de avaliação detectaram melhora do equilíbrio. As escalas apresentaram TE pequeno, sendo o TE da EEB igual a 0,2 e o da EAPA igual a 0,3. A MRP foi moderada para as duas escalas, sendo a MRP da EEB igual a 0,7 e da EAPA igual a 0,6. A EAPA apresentou efeito solo menor do que a EEB nas primeiras 24 horas, enquanto no sétimo dia, a EEB apresentou efeito teto menor. Conclusão: A EAPA pode ser uma melhor opção para avaliação do equilíbrio em pacientes pós-AVE nas primeiras 24 horas, à medida em que a EEB pode ser uma melhor escolha para avaliação a partir do sétimo dia nessa população específica.

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Referências

Brasil. Ministério da Saúde. Manual de rotinas para atenção ao AVC. Brasília (DF): Ministério da Saúde; 2013.

Hankey GJ. Stroke. Lancet. 2017;389(10069):641-54. Doi: https://doi.org/10.1016/S0140-6736(16)30962-X

Araújo JP, Darcis JVV, Tomas ACV, Mello WA. Tendência da Mortalidade por Acidente Vascular Cerebral no Município de Maringá, Paraná entre os anos de 2005 a 2015. Int J Cardiovasc Sci. 2017;31(1):56-62. Doi: https://doi.org/10.5935/2359-4802.20170097

Makhoul MP, Maso I, Monteiro M, Rosa I, Vasconcelos L, Mascarenhas L, et al. Clinical and functional characteristics of young adult patients admitted in a stroke unit. Braz J Med Human Health. 2016;4(3):89-98. Doi: http://dx.doi.org/10.17267/2317-3386bjmhh.v4i3.964

Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(7):2064-89. Doi: https://doi.org/10.1161/STR.0b013e318296aeca

Lee H, Nam YS, Lee KM. Development-assistance Strategies for Stroke in Low- and Middle-income Countries. J Korean Med Sci. 2015;30 Suppl 2(Suppl 2):S139-42. Doi: https://doi.org/10.3346/jkms.2015.30.S2.S139

Muhl L, Kulin J, Dagonnier M, Churilov L, Dewey H, Lindén T, et al. Mobilization after thrombolysis (rtPA) within 24 hours of acute stroke: what factors influence inclusion of patients in A Very Early Rehabilitation Trial (AVERT)? BMC Neurol. 2014;14:163. Doi: https://doi.org/10.1186/s12883-014-0163-6

Rha JH, Saver JL. The impact of recanalization on ischemic stroke outcome: a meta-analysis. Stroke. 2007;38(3):967-73. Doi: https://doi.org/10.1161/01.STR.0000258112.14918.24

de Graaf JA, van Mierlo ML, Post MWM, Achterberg WP, Kappelle LJ, Visser-Meily JMA. Long-term restrictions in participation in stroke survivors under and over 70 years of age. Disabil Rehabil. 2018;40(6):637-45. doi: https://doi.org/10.1080/09638288.2016.1271466

Chan CKC, Chan DWC, Wong SKM. Evaluation of the functional independence for stroke survivors in the community. Asian J Gerontol Geriatr. 2009; 4(1):24-9.

Wagner JM, Lang CE, Sahrmann SA, Edwards DF, Dromerick AW. Sensorimotor impairments and reaching performance in subjects with poststroke hemiparesis during the first few months of recovery. Phys Ther. 2007;87(6):751-65. Doi: https://doi.org/10.2522/ptj.20060135

Singam A, Ytterberg C, Tham K, von Koch L. Participation in complex and social everyday activities six years after stroke: predictors for return to pre-stroke level. PLoS One. 2015;10(12):e0144344. Doi: https://doi.org/10.1371/journal.pone.0144344

Joseph C, Rhoda A. Activity limitations and factors influencing functional outcome of patients with stroke following rehabilitation at a specialised facility in the Western Cape. Afr Health Sci. 2013;13(3):646-54. Doi: https://doi.org/10.4314/ahs.v13i3.18

Matos I, Fernandes A, Maso I, Oliveira Filho J, Jesus PA, Fraga-Maia H, et al. Investigating predictors of community integration in individuals after stroke in a residential setting: A longitutinal study. PLoS One. 2020;15(5):e0233015. Doi: https://doi.org/10.1371/journal.pone.0233015

Daly JJ, Ruff RL. Construction of efficacious gait and upper limb functional interventions based on brain plasticity evidence and model-based measures for stroke patients. ScientificWorldJournal. 2007;7:2031-45. Doi: https://doi.org/10.1100/tsw.2007.299

Oliveira AIC, Silveira KRM. Utilização da CIF em pacientes com sequelas de AVC. Rev Neurociencias. 2011;19(4):653-62. Doi: https://doi.org/10.34024/rnc.2011.v19.8336

Berg K, Wood-Dauphinee S, Williams JI, Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiother Canada. 1989;41(6):304-11. Doi: https://doi.org/10.3138/ptc.41.6.304

Huang YC, Wang WT, Liou TH, Liao CD, Lin LF, Huang SW. Postural Assessment Scale for Stroke Patients Scores as a predictor of stroke patient ambulation at discharge from the rehabilitation ward. J Rehabil Med. 2016;48(3):259-64. Doi: https://doi.org/10.2340/16501977-2046

Chinsongkram B, Chaikeeree N, Saengsirisuwan V, Horak FB, Boonsinsukh R. Responsiveness of the Balance Evaluation Systems Test (BESTest) in People With Subacute Stroke. Phys Ther. 2016;96(10):1638-47. Doi: https://doi.org/10.2522/ptj.20150621

Huang YJ, Lin GH, Lee SC, Hsieh CL. A Comparison of the Responsiveness of the Postural Assessment Scale for Stroke and the Berg Balance Scale in Patients With Severe Balance Deficits After Stroke. J Geriatr Phys Ther. 2020;43(4):194-8. Doi: https://doi.org/10.1519/JPT.0000000000000247

Miyamoto ST, Lombardi Junior I, Berg KO, Ramos LR, Natour J. Brazilian version of the Berg balance scale. Braz J Med Biol Res. 2004;37(9):1411-21. Doi: https://doi.org/10.1590/s0100-879x2004000900017

Vieira C, Fernandes S, Mimoso TP. Adaptação cultural e linguística e contributo para a validação da Escala de Avaliação postural para Pacientes com sequelas de AVE (PASS). EssFisi Online. 2008;4(1):50-65.

Benaim C, Pérennou DA, Villy J, Rousseaux M, Pelissier JY. Validation of a standardized assessment of postural control in stroke patients: the Postural Assessment Scale for Stroke Patients (PASS). Stroke. 1999;30(9):1862-8. Doi: https://doi.org/10.1161/01.str.30.9.1862

Cincura C, Pontes-Neto OM, Neville IS, Mendes HF, Menezes DF, Mariano DC, et al. Validation of the National Institutes of Health Stroke Scale, modified Rankin Scale and Barthel Index in Brazil: the role of cultural adaptation and structured interviewing. Cerebrovasc Dis. 2009;27(2):119-22. Doi: https://doi.org/10.1159/000177918

Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000;53(5):459-68. Doi: https://doi.org/10.1016/s0895-4356(99)00206-1

Cohen J. Statistical power analysis for the behavioral sciences: Jacob Cohen. J Am Stat Assoc. 1988;84(363):19-74.

McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32(1):40-66. Doi: https://doi.org/10.1097/00005650-199401000-00004

Portney L, Watkins M. Foundations of clinical research: applications to practice. 3rd ed. Norwalk: Appleton & Lange; 2007.

Mao HF, Hsueh IP, Tang PF, Sheu CF, Hsieh CL. Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke. 2002;33(4):1022-7. Doi: https://doi.org/10.1161/01.str.0000012516.63191.c5

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Publicado

2021-07-23

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1.
Responsividade de dois instrumentos de avaliação do equilíbrio em pacientes pós-AVE trombolisado na fase aguda. Acta Fisiátr. [Internet]. 23º de julho de 2021 [citado 28º de março de 2024];28(2):111-5. Disponível em: https://www.revistas.usp.br/actafisiatrica/article/view/183160