As causas da deficiência física em municípios do nordeste brasileiro e estimativa de custos de serviços especializadosThe causes of physical disability in municipalities of the northeast of Brazil and an estimate of costs of specialized services

BackgroundSpastic paraplegia, optic atrophy and neuropathy (Spoan syndrome) is an autosomal recessive disease with approximately 70 cases recorded in Brazil and Egypt.MethodsThis is a prospective longitudinal study performed with 47 patients affected with Spoan syndrome of seven communities of Rio Grande do Norte (Brazil) to investigate changes in motor function based on comparative data obtained from a 10-year follow-up.ResultsThe mean age of the participants was 47.21 ± 12.42 years old, and the mean age at loss of ambulation and hand function were 10.78 ± 5.55 and 33.58 ± 17.47 years old, respectively. Spearman’s correlation analysis between the score on the Modified Barthel Index and the investigated variables evidenced statistical significance for age (p < 0.001) and right- and left-hand grip strength (p = 0.042 and p = 0.021, respectively). Statistical significance was not evidenced for the remainder of the variables, including age at onset of symptoms (p = 0.634), age at loss of ambulation (p = 0.664) and age at loss of hand function (p = 0.118).ConclusionsOur analysis allows asserting that the participants exhibited slight dependence until age 35. The greatest losses occurred from ages 35 to 41, and starting at 50, practically all patients become completely dependent. These findings are relevant for determining the prognosis as well as suitable treatment, rehabilitation and assistive technology for these individuals.

The Orthesis and Prosthesis Grant Program from Rio Grande do Norte State was restructured by a team of occupational and physical therapists specialized in Assistive Technology. The sector has a showroom for the equipment, prepares prescriptions, and makes deliveries after individual assessment made by the team. The work is developed in conjunction with orthopedic workshop technicians to adjust and adapt the wheelchairs when necessary.Social workers guide and follow the bureaucratic processes of documentation and purchasing, which allows the handing in of wheelchairs throughout the year. This program is considered distinctive compared to programs from other states. In this work, a study was conducted to characterize the demand for locomotion assistance devices, such as wheelchairs, and describe the delivery and acquisition process of the Orthesis and Prosthesis Grant Program from Rio Grande do Norte State. The study was carried out after analyzing and correlating information on the wheelchair delivery process in the past three years. A discussion on the organizational structure, operation, and acquisition facilities of this program is presented in order to promote the social inclusion of people with special needs.Resumo: O Programa de Concessão de Órteses e Próteses do Estado Rio Grande do Norte foi reestruturado por uma equipe de terapeutas ocupacionais e fisioterapeutas especializados em tecnologia assistiva, que contam com um showroom de equipamentos para dar suporte na realização de prescrições e avaliações de forma individualizada, permitindo a entrega de equipamentos específicos. O programa também possui outros profissionais, como técnicos de oficinas ortopédicas, que fazem o trabalho de ajuste e adaptações das cadeiras de rodas, quando necessário, e assistentes sociais, que seguem todos os processos burocráticos de documentação e de compra das cadeiras de rodas, levando a um fluxo contínuo de entrega de equipamentos ao longo do ano. Esse tipo de organização estrutural pode ser considerado diferenciado do de outros estados. Neste trabalho, um estudo foi promovido para caracterizar a demanda de dispositivos de assistência para locomoção como, por exemplo, cadeiras de rodas, e descrever o processo de licitação e entrega do Programa de Concessão de Órteses e Próteses do Estado do Rio Grande do Norte. O estudo foi conduzido após informações dos últimos três anos do processo de entrega de cadeira de rodas desse programa terem sido analisadas e correlacionadas. Com o fim de promover a inclusão social das pessoas com deficiência, são discutidas a estrutura organizacional, o funcionamento e as facilidades apresentadas. Palavras-chave:

This article presents a systematic review, for which research was carried out in the following electronic databases: Web of Science, Scopus, PubMed, and ERIC, in which several articles were found (n = 560). The results were analyzed based on the information obtained in the titles and abstracts, and the remaining studies were read in full for the analysis. The aim of this article was to identify the different questionnaires used for selecting items of assistive technology, describe and evaluate the translation and transcultural adaptation procedures, characterize the thematic domains of each resource, evaluate the cultural adaptation process adopted, and describe the psychometric properties. Data extraction and evaluation of the methodological quality of the eligible studies were performed in accordance with the COSMIN verification list with a checklist of 4 points. The publication of systematic review studies and others that synthesize research results is fundamental to provide support for change in the behavior of professionals in the field of health, and not only to access the available literature but also to incorporate this information into daily clinical practice. The results of this review could provide subsidies that would enable the planning, execution, identification, and choice of specific instruments for a determined study within the context of assistive technology, with a view to helping researchers and health professionals in clinical and investigatory practices.

The aim of this study was to investigate the prevalence of inherited neuromuscular disorders (NMDs) in eight communities in Northeast (NE) Brazil in which there was an elevated rate of inbreeding. A cross-sectional epidemiological study, using the key informant (KI) approach, was performed to estimate the prevalence of NMD among the 48,499 individuals living in these eight communities, located in the backlands of the Paraíba State. Twenty-seven individuals fulfilled the diagnostic criteria for inherited NMD, which means that 1 out of 1,796 inhabitants of this highly consanguineous population was affected by NMD. This is twofold higher than that observed in previous studies in general population and was probably due to a combination of genetic drift and inbreeding. Public policies should be implemented to offer genetics services in high-risk communities.