Conclui-se que a TE promoveu melhora significativa da função motora e da independência funcional do MS parético pós-AVC independente do tempo decorrido após a lesão encefálica. de cualquier tiempo tras la lesión cerebral, con secuela en MS; textos publicados integralmente entre 2010 y 2015 en revistas científicas de las citadas bases de datos, en lengua inglesa y en portugués brasileño, que empleasen la TE en la rehabilitación de MS de pacientes con ACV y presentasen como resultados función motora e independencia funcional. Los textos recolectados fueron evaluados por la escala PEDro en función de la calidad metodológica. Trece estudios clínicos evaluaron los efectos de la TE en MS parético. Las pruebas más empleadas fueron la escala Fugl-Meyer y la Medida de Independencia Funcional. En estos estudios se comprobó la eficacia de la TE en la rehabilitación motora de MS y en la independencia funcional de los pacientes, especialmente en los aspectos transferencia y autocuidado.Se evaluaron los textos como de moderada a alta calidad metodológica. Se concluye que la TE mejora significativamente la función motora y la independencia funcional de MS parético pos-ACV independiente del tiempo transcurrido de la lesión cerebral.Palabras clave | Accidente Cerebrovascular; Extremidad Superior; Destreza Motora; Modalidades de Fisioterapia; Retroalimentación Sensorial.

Efeitos da terapia espelho na reabilitação do membro superior pós-acidente vascular cerebral RESUMOO objetivo do estudo foi avaliar os efeitos da Terapia Espelho na recuperação funcional do membro superior de pacientes com sequelas crônicas de Acidente Vascular Cerebral. Neste estudo de caso, com abordagem qualitativa, a amostra foi composta por três indivíduos com idades de 51, 68 e 72 anos, submetidos a doze sessões de tratamento por quatro semanas. Foram avaliados antes e após o período de tratamento, utilizando-se a Escala Modificada de Ashworth, a Escala de Fugl-Meyer e a Medida de Independência Funcional. Como resultados foram observadas a diminuição da espasticidade em dois pacientes, e melhora modesta da função do membro superior parético além de independência funcional de todos os pacientes. Conclui-se que o uso da Terapia Espelho produziu alterações benéficas, principalmente quanto ao grau de espasticidade e função motora do membro superior parético. Ainda é necessária a realização de estudos com amostras mais amplas, para resultados mais consistentes e amplos. Descritores Effects of mirror therapy in upper limb rehabilitation after stroke ABSTRACTThe objective of the study was to evaluate the effects of mirror therapy on functional recovery of the upper limb of patients with chronic sequels of stroke. In this case study with qualitative approach the sample was composed of three individuals with ages 51, 68 and 72 years. They were submitted to twelve treatment sessions during four weeks, assessed before and after the treatment period using the Modified Ashworth Scale, the Fugl-Meyer Scale, and the Functional Independence Measure. As a result, a reduction of spasticity in two patients, and modest improvement in upper limb function besides functional independence of all patients were observed. It can be conclude that the use of Mirror Therapy produced beneficial alterations mainly in the degree of spasticity and motor function of the upper limb. It is still necessary carrying out studies with larger samples for more consistent results.

Background/Aims Strokes lead to different levels of disability. During the chronic stage, hemiparesis, spasticity and motor deficits may cause loss of functional independence. Mirror therapy aims to reduce deficits and increase functional recovery of the impaired upper limb. This study aimed to evaluate the effects of mirror therapy on upper limb spasticity and motor function, as well as its impact on functional independence in chronic hemiparetic patients. Methods In this quasi-experimental study, eight chronic hemiparetic patients (age 55.5 ± 10.8 years) were assessed to determine their degree of spasticity (Modified Ashworth Scale), level of upper limb motor function (Fugl-Meyer Assessment) and functionality (Functional Independence Measure). All participants received 12 sessions of mirror therapy delivered three times per week, over a period of 4 weeks. Participants were re-evaluated post-intervention and these results were compared to their pre-intervention scores to determine the impact of mirror therapy. Results A decrease in spasticity was observed, with significant improvements in shoulder extensors (P=0.033) and a significant increase in motor function (P=0.002). The therapeutic protocol adopted did not have a significant effect on functional independence (P=0.105). Conclusions Mirror therapy led to improvements in upper limb spasticity and motor function in chronic hemiparetic stroke patients. No effects on functional independence were observed. Further research with a larger number of patients is needed to provide more robust evidence of the benefits of mirror therapy in chronic hemiparetic stroke patients.

Many health systems (HS) have adopted novel models of care which have included non-medical prescription (NMP) by physiotherapists. The aim of this study was to verify in the literature the existence of this practice and its possible benefits. A literature review was carried out through search on Science Direct, PubMed, SciELO, Lilacs and Google Scholar, and in the World Confederation for Physical Therapy and Chartered Society of Physiotherapy websites. In recent decades the United Kingdom adopted the NMP for health professionals, followed by Canada. In Australia and New Zealand physiotherapists have acted in the prescription and administration of medications under medical orders, which is the first step into independent prescription. Brazilian physiotherapists cannot prescribe any medication, despite of high demands from patients in the Brazilian HS, shortage of physicians in many regions and bureaucracy in accessing health services. The adoption of NMP by physiotherapists may play an important role in the HS, and it seems to be an inevitable achievement in the next years in Australia and New Zealand. The main benefits include decreasing bureaucracy for assistance, population demands for medication as well as major professional refinement.