Severidade clínica e funcionalidade de pacientes hemiplégicos pós-AVC agudo atendidos nos serviços públicos de fisioterapia de Natal (RN)Clinical severity and functionality of acute stroke patients attended at the physiotherapy public services of Natal, Rio Grande do Norte State, Brazil

RESUMOObjeti vou-se investi gar por meio de uma equipe multi disciplinar o estado neurológi-co e o desempenho cogniti vo de pacientes pós-AVC mediante um estudo transversal com 45 pacientes em processo de reabilitação após um AVC agudo. Uti lizaram-se como instrumentos de coleta de dados uma fi cha de avaliação, o Mini Mental--MEEM e o Nati onal Internati onal Health Stroke Scale-NIHSS. Amostra predominantemente feminina (55,6%), AVC Isquêmico (86,7%), Hemisfério cerebral direito (60%) e Escolarizados (68,8%). A média do MEEM para escolarizados e analfabetos foi de 19,3 ± 5,0 e 15,92 ± 3,7 respecti vamente. A média geral do estado neurológico encontrado foi 13,0±4,8. Houve diferença signi fi cati va entre as médias cogniti vas dos pacientes quanto à escolaridade (p valor = 0,017) e relação signifi cati va entre o estado neurológico e o desempenho cogniti vo (r = -0,44 p valor = 0,002). O estado neurológi-co e o nível cogniti vo de pacientes pós-AVC agudo parecem estar diretamente relacionados, o que evidencia a necessidade de maior atenção à questão cogniti va envolvida no início do processo de reabilitação. DESCRITORES Acidente cerebral vascular Cognição Avaliação ReabilitaçãoThe neurological state and cognition of patients after a stoke * ORIGINAL ARTICLE ABSTRACTThe objecti ve of this study was to have a multi disciplinary team investi gate the neurological state and cogniti ve performance of pati ents aft er a stroke, through a cross-secti onal study with 45 pati ents in rehabilitati on aft er having an acute stroke. The data collecti on instruments used were an assessment sheet, the Mini Mental-ME-EM, and the Nati onal Internati onal Health Stroke Scale-NIHSS. The sample consisted mostly of women (55.6%), Ischemic Stroke (86.7%), right hemisphere of the brain (60%) and Educated (68.8%). The mean MEEM for educated and illiterate pati ents was 19.3 ± 5.0 and 15.92 ± 3.7, respectively. The overall mean of the neurological state was 13.0±4.8. A signifi cant diff erence was found between the cogniti ve means of pati ents in terms of educati on (p value = 0.017), and there was a signifi cant relati onship between the neurological state and cogniti ve performance (r = -0.44 p value = 0.002). It appears to be a direct relati onship between the neurological state and cogniti on performance of pati ents after an acute stroke, which evinces the need for greater att enti on to the cogniti ve issue involved early in rehabilitati on. DESCRIPTORS Stroke Cogniti on Evaluati on Rehabilitati on RESUMENSe objeti vó investi gar mediante equipo multi disciplinario el estado neurológico y el desempeño cogniti vo de pacientes post-ACV. Estudio transversal con 45 pacientes post-ACV agudo en proceso de rehabilitación. Se uti lizaron para recolección de datos una fi cha de evaluación; el Mini Mental-MEEM y el Nati onal Internati onal Health Stroke Scale-NIHSS. Muestra predominantemente femenina (55,6%), ACV Isquémico (86,7%), Hemisferio cerebral derecho (60%) y Escolarizados (68,8%). La media de MEEM para escolarizados y analfabetos...

Building flood control rule curves (FCRC) for multipurpose multireservoir systems involves treating simultaneously the stochasticity of future inflows and the multivariate aspect of the problem. The study demonstrates how theoretical findings concerning flood control multireservoir systems regulation obtained by Marien (1984) (the so‐called controllability conditions) can be used to build generalized FCRC in multipurpose multireservoir systems. These FCRC are generalized FCRC in the sense that they consist of a time varying constraint set on the needed empty space provisions in the different reservoirs of the system. The applicability of the proposed technique is enhanced by the derivation of new controllability conditions for systems with more than one flood control section and mandatory releases. By means of several examples, it is shown how the proposed methodology is superior to the approach which consists of lumping all the reservoirs of the system into a single imaginary reservoir. A practical example with an eight‐reservoir hydropower system in Brazil demonstrates the applicability of the methodology.

A alteração da pressão arterial no idoso vem sendo estudada como sendo um fator de risco para o déficit na cognição e na capacidade funcional. OBJETIVOS: investigar a função cognitiva e a capacidade funcional e sua correlação em idosos hipertensos (GH) e normotensos (GN). MÉTODOS: estudo observacional, analítico e transversal, com 56 idosos divididos em dois grupos GH (n=42) e GN (n=14) avaliados através do Mini-Exame do Estado Mental (MEEM), Questionário Internacional de Atividade Física (IPAQ) e bateria de testes de aptidão física (Functional Fittness Test). ANÁLISE ESTATÍSTICA: os dados foram avaliados utilizando o teste t de Student, o teste do Qui-quadrado e o teste de correlação de Pearson através do SPSS 17.0, sendo atribuído o nível de significância de 5% para todos os testes. RESULTADOS: houve correlação negativa, porém fraca entre os grupos GH e GN quanto ao déficit cognitivo (r=-0,23; p=0,08), força de MMII (r=-0,24; p=0,08) e a endurance aeróbica - TME2' (r=-0,31 e p =0,02). Em relação aos testes de flexibilidade de MMSS e MMII, houve correlação negativa moderada entre o grupo GH e GN (r=-0,62; p<0,001 e r=-0,39; p=0,003) e correlação positiva moderada para agilidade e equilíbrio - TUG (r=0,38 e p=0,004). Foi encontrada diferença significativa para o nível de atividade física entre GH e GN com p<0,001. CONCLUSÕES: esses achados sugerem que a hipertensão arterial afeta diretamente o idoso na medida em que predispõe o declínio cognitivo e limita a capacidade do indivíduo de realizar suas atividades básicas de forma independente, diminuindo a mobilidade funcional principalmente se associada a outras comorbidades e a hábitos de vida não saudáveis.

Musculoskeletal pain and functionality are linked to the individual health and, thus, influence the mode of interaction between individuals and between them and the environment that surrounds them. However, there are not many studies that question such health issues concerning the population in general, especially when we look at these issues from the basic care point of view. The aim of this article is to present initial data on the subject of pain and functionality in individuals with musculoskeletal complaints enrolled in a primary care unit and prompt a discussion on how complete the services provided by these units are. This study was carried out in a primary care unit and various households, among subjects aging 20 years or older. A functionality assessment tool and a Visual Analogue Scale were applied, and social and demographic issues were also considered. By using these tools, it was made an attempt to evaluate the profile of individuals in association with their degree of musculoskeletal pain and the degree of functionality in the activities of their daily lives, ages and occupations. We found a predominance of women in both groups: 84.37% and 81.25%, respectively. Nearly half of all people with musculoskeletal pain were housewives, and the average age between groups was over 55.