Addressing functional activities and the influence of environmental factors in post-stroke hemiparetic patients before and after physical therapy

Abstract

Stroke is the leading cause of neurological disability and hemiparesis is its most common sequelae. The physical and functional limitations combined with the influence of environmental factors directly affect an individual's functionally. For an effective neurological rehabilitation, it is essential that physiotherapists know the patient's functional profile in order to plan the treatment to meet his/her real needs. Objective: To analyze the functional activities and influence of environmental factors in poststroke hemiparetic patients before and after physical therapy. Method: Twelve post-stroke hemiparetic patients were evaluated before and after 20 physical therapy sessions with the Barthel Index (BI) and an evaluation model based on an abbreviated core set of the International Classification of Functioning, Disability and Health (ICF) for stroke, based in the generic qualifiers system of the ICF. Results: There was significant improvement for the activities walk (d450) (p = 0.0033), dress (d540) (p = 0.018) and eat (d550) (p = 0.018) for the evaluation model based on the ICF. According to the BI, significant improvement was detected for the activities of feed (p = 0.0341), dress (p = 0.0277), toilet (p = 0.0117), and up/ down stairs (p = 0.0077). The environment factors immediate family and health professionals were the most positive influence on the health status of patients. Conclusion: Physical therapy was effective for improving the condition of patients since, according to the patients, some daily activities can be performed with more ease at the end of the physical therapy treatment. To meet their needs, it is important to develop an individual treatment plan, emphasizing the context in which he/she is inserted, in order to address the real limitations on activities and restrictions to participation.

Classificação Internacional de Funcionalidade, Incapacidade e Saúde e afasia: um estudo da participação social

“…Such conditions result from brain lesions and are sequelae (hemiplegia and hemiparesis), which impair (at different intensities) the person's daily life. Another study (21) showed hemiparesis as the most common stroke sequelae and, also, associates the physical and functional limitations to environmental factors (it highlights that they directly affect the functionality of the subjects), which imposes difficulties in participating in tasks and daily life activities. Check Table 3 for the limitations in activities and the restriction to participation.…”

Fisioterapia em grupo melhora o equilíbrio e a funcionalidade de indivíduos com hemiparesia

“…Os achados do presente estudo corroboram com os achados de outros autores que tem estudado as repercussões de atividades terapêuticas para a melhora na funcionalidade de sujeitos pós AVE 27,28,29 , relatando melhoras após diferentes protocolos de intervenção, como o uso da dança, treino em esteira e mesmo a terapia convencional.…”