A mensuração da preensão é um importante componente da reabilitação da mão. Os testes de força de preensão são comumente usados para avaliar pacientes com desordens da extremidade superior, antes e após procedimentos terapêuticos. São testes simples de administrar e quando adequadamente realizados, podem fornecer informações objetivas que contribuem para análise da função da mão. Protocolo de teste deve ser desenvolvido e cuidadosamente seguido. Um dos instrumentos reconhecidos na literatura é o dinamômetro Jamar, que tem mostrado bons índices de validade e confiabilidade. Tem sido aceito como um instrumento padrão para mensuração da força de preensão e é muito utilizado na clínica por terapeutas ocupacionais e fisioterapeutas. Este artigo faz uma revisão sobre alguns aspectos envolvidos na mensuração da força de preensão utilizando o dinamômetro Jamar, tais como, confiabilidade e precisão do instrumento, protocolo sugerido para seu uso, principais aspectos que podem influenciar os resultados, o uso de dados normativos e os fatores que influenciam a força de preensão, incluindo sexo, idade, peso e altura do indivíduo. Recomendações são feitas em relação a estes aspectos para capacitar os clínicos a conduzir adequadamente avaliações de força de preensão.PalavRas-chave avaliação, membro superior, força da mão, dinamômetro de força muscular abstRact The measurement of grip strength is an important element in hand rehabilitation. Tests of grip strength are often used to assess patients with upper extremity disorders, before and after therapeutic procedures. These tests are simple to administer and if properly conducted, they provide objective information that may contribute to the analysis of hand function. The test protocol must be carefully developed and adequately followed. A well-recommended instrument in the literature is the Jamar dynamometer, with high rates of reliability and validity. This instrument has been accepted as a gold standard for the measurement of grip strength and has been frequently used in clinical practice by occupational and physical therapists. The present study reviews some aspects involved in the measurement of grip strength using the Jamar dynamometer, including the instrument reliability and precision, a suggested protocol for its use, important variables that may influence the results, the use of normative data and the factors that influence grip strength such as the individual's sex, age, weight and height. Recommendations are made regarding these variables in order to help the clinicians' conduct appropriate assessments of grip strength.
Chronic pain contributes towards less diversified participation centred on household activities, fewer social relationships and smaller number of recreational activities. The aim of the study was to further investigate the effects of chronic pain on participation, focusing on how workers deal with the experienced restrictions. Ten workers with chronic pain participated in the survey, which was conducted with qualitative interviews. Analyses of thematic units revealed that chronic pain has consequences for participation, leading to work restrictions and loss of social roles. Social relationships tend to be limited to family, and workers become isolated from other social groups. The rebuilding of participants' lives was a counterpoint to the identified social rupture. The narratives revealed strategies for dealing with pain, attempts at reorganizing their daily activities and formulating new plans. Understanding what resources individuals use to cope with their difficulties allow occupational therapists to plan client-centred treatment goals. A limitation of the study was to involve employees of very similar socio-economic classes. Studies directed to understanding the relationship between social support and the reconstruction of participation must be conducted to further advance knowledge on possible mechanisms underlying social participation among workers with chronic pain.
Results of this study provide evidence for functional gains in clients treated in a rehabilitation service and supply information about the relation between specific components and functional performance.
The measurement of grip strength is an important element in hand rehabilitation. Tests of grip strength are often used to assess patients with upper extremity disorders, before and after therapeutic procedures. These tests are simple to administer and if properly conducted, they provide objective information that may contribute to the analysis of hand function. The test protocol must be carefully developed and adequately followed. A well-recommended instrument in the literature is the Jamar dynamometer, with high rates of reliability and validity. This instrument has been accepted as a gold standard for the measurement of grip strength and has been frequently used in clinical practice by occupational and physical therapists. The present study reviews some aspects involved in the measurement of grip strength using the Jamar dynamometer, including the instrument reliability and precision, a suggested protocol for its use, important variables that may influence the results, the use of normative data and the factors that influence grip strength such as the individual’s sex, age, weight and height. Recommendations are made regarding these variables in order to help the clinicians’ conduct appropriate assessments of grip strength.
The International Classification of Functionality, Disability, and Health (ICF) is based on the bio-psycho-social model and enables understanding of the processes of functionality and disability through the interaction of its components. The aim of this study was to analyze the interrelationships between the domains of the ICF, describing the process of functionality and disability from the perspective of the individual. A qualitative approach was used with interviews and a life grid, built out of ICF domains, applied to 11 patients, and followed by filling in a diary of weekly activities. Most respondents made use of products and technologies such as canes, prostheses, or orthoses, and they had no difficulty in acquiring them through the SUS system. Personal factors that stood out were the ways of coping with new health conditions and new meaning in their lives. During the interviews, the importance of social support, particularly that offered by family and friends, the barriers encountered in the use of public transport, in addition to access of health care and Social Security benefits were prominent. Developing day-to-day strategies was a topic that showed how respondents reorganized their lives to minimize the difficulties they experienced. The data analysis from the interviews confirmed the existence of interaction between the components of ICF. This model was shown to be an important tool for understanding the process of human functionality and disability from the standpoint of the patient’s subjectivity and individuality, as well as for developing interventions and guiding public policy and health research.
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