Livros Grátis atenção primária, medidas de case-mix e a avaliação da condição de saúde . crônicos como resultado de tratamentos médicos aprimorados, e. professor do curso de Fisioterapia da Universidade de Passo Fundo – UPF A eletroestimulação foi considerada segura e efetiva no tratamento da atrofia de desuso, além de útil na manutenção da .. In: O'Sullivan SB, Schmitz TJ. Fisiote- na avaliação da marcha de portadores de hemiparesia após acidente vascular . Board index Free Unlimited PDF Downloads Free Downloads. Forum 3. Search Please, help me to find this livro sullivan em pdf. Thanks!.
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ocupacional no tratamento das fraturas do terço distal do rádio. Folha méd. O' Sullivan SB, Schmitz TJ. Fisioterapia: avaliação e tratamento. 5ª ed. Manole. 4 Mestre em Ciências da Saúde - UNIFESP; Fisioterapeuta do Hospital e posicionamento, podendo minimizar a subjetividade da avaliação. .. Sullivan SBO, Thomas J, Nascimento FG. Fisioterapia: avaliação e tratamento. 2 ed. São Paulo: Manole; 4. Teive HAG, Zonta M, Kumagai Y. Tratamento da espasticidade. Avaliação das alterações funcionais nos estágios evolutivos da doença de Parkinson: nos diversos estágios evolutivos da doença em tratamento fisioterapêutico na Associação de Parkinson de Fisioterapia. .. O'Sullivan SB, Schmitz TJ.
In anamnesis none of the patients had exclusion factors. Only three patients reported practicing routine physical activity. Three sedentary patients had higher BMI in the sample Figure 1 shows a sample of images of venous blood flow obtained by Doppler ultrasound at each interval.
After measuring venous blood flow volume of all participants, mean values for each interval were obtained.
Fisioterapia avaliacao e tratamento sullivan pdf gratis
Results showed that active kinesiotherapy exercise had blood flow volume higher than the baseline value and passive kinesiotherapy; it was only lower than manual compression Table 2. Figure 2 shows all venous flow volume values in the popliteal vein, by participant, at each study interval. Therefore, active ankle plantar flexion proved to be more efficacious than passive in the activation of the calf muscle pump, with increase in blood flow volume in the popliteal vein, minimizing venous stasis in the lower limbs.
Discussion Although the literature reports the efficacy of the calf muscle pump in venous return in the lower limbs, no studies confirmed its effectiveness with the individuals in supine position, which is the most adopted position during hospital stay and when ankle plantar flexion exercises are performed.
Doppler ultrasound in the popliteal vein showed that active ankle plantar flexion generates increased blood flow volume due to efficacy of the calf muscle pump, triggered by recruitment and effective contraction of all muscles. This results in increased venous flow volume in the lower limb when compared with the baseline value and with passive exercise, causing reduction in venous stasis in this segment.
Figure 1D shows flow volume in the popliteal vein when the movement is active. Statistical data show that passive ankle plantar flexion is efficacious when compared with the baseline value, although not as much as active exercise. It is interesting to notice that passive exercise does not produce muscle contraction18,29,30 and, consequently, should not activate the calf muscle pump and increase blood flow volume.
When venous flow volume was evaluated during passive exercise, the patient was requested to leave his ankle completely free and not moving it, therefore, without muscle contraction. In case there was any muscle contraction at evaluation, it was discarded and performed again.
Explanation for occurrence of any type of muscle contraction during passive exercise is that, when the movement of ankle plantar flexion is performed passively in individuals that are alert and have full motor reflexes, there is a reflex response of joint protection in the last degrees of the movement. Thus, muscle fibers are distended at its maximal length, generating a "defense moment" and muscle co-contraction activation of agonist and antagonist muscles29,30 , triggering a stop near the end of the movement arch, with activation of the calf muscle pump.
This justifies increase in venous flow volume near the end of the movement arch, when there are short periods of filling, which cannot be sustained, reducing and not being immediately followed by other filling moments. Blood flow volume peaks during passive contraction proved to be inferior Figure 1C than those of active exercise Figure 1D and manual compression Figure 1B. Therefore, it would be interesting to perform this study in individuals who do not have motor reflexes, either temporary, such as in patients submitted to spinal anesthesia, or permanent, such as in individuals with complete spinal trauma.
In case the hypothesis that passive exercise of the calf muscle pump is confirmedly not efficacious to increase venous flow volume, this exercise will aim at preserving and maintaining joint integrity, and not as a form of blood pumping in the lower limb.
Manual compression performed in the triceps surae is efficacious to increase blood flow volume in the popliteal artery. It is also highly efficacious when compared with passive exercise.
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The same occurs when compared with active exercise, but it has filling volume and reaches maximal flow volume peak abruptly Figure 1B. This suggests that, when performing such maneuver, for example, in an ascending massage in the lower limb, we should be alert to force and pressure used, since there is a risk for endothelial lesion because veins have less developed muscle layer than arteries, facilitating possible development of venous thrombosis. Although having a large calf perimeter, especially due to the thick adipose layer, the calf muscle pump was deconditioned, not favoring as expected increase in blood flow volume during exercise.
Physical therapy is an important factor to prevent venous thromboembolism, during hospital stay and after discharge, since such risk persists in some cases.
Although being a pilot study that used a small sample of 30 individuals, this study statistically shows that active exercise of the calf muscle pump ankle plantar flexion with patients in bed, reduces venous stasis because it provides greater blood flow volume in the lower limb when compared with passive exercise.
In addition, it shows that strengthening the calf muscle is able to improve venous hemodynamics in this segment.
This study could not reach any conclusion in terms of passive kinesiotherapy. A new methodology occasionally using individuals with temporary or permanent motor paralysis might be interesting as an attempt to clarify whether passive ankle plantar flexion does activate the calf muscle pump.
References 1. Communication in health: some reflections based on the perception of debridden patients in a nursery. Cienc Saude Coletiva. Amino acid supplementation for reversing bed rest and steroid myopathies. J Nutr. Rio de Janeiro: Guanabara Koogan; Orthostatic tolerance and spontaneous baroreflex sensitivity in men versus woman after 7 days of head-down bed rest. Auton Neurosci. Effect of 10 days of bed rest on skeletal muscle in healthy older adults.
Effect of short-term hospitalization on functional capacity in patients not restricted to bed. Am J Phys Med Rehab.
livro sullivan em pdf
Krasnoff J, Painter P. The physiological consequences of bed rest and inactivity.
Adv Ren Replace Ther. Physical activity and hospitalization for exacerbation of COPD.
This stimulation depolarizes the motor nerve, producing a synchronous response in all motor units of the stimulated muscle, improving throphism Its mechanism of action is closely linked to the facilitation of physiological mechanisms of striated muscle muscle contraction , allowing selective and repetitive afferent input to the CNS, activating not only the local muscles, but also reflex mechanisms that are necessary for reorganization of the motor activity 10 , The present study aimed to compare the FES associated with functional kinesiotherapy FK and functional kinesiotherapy alone in patients with sequelae of ICVA with hemiparesis in the subacute phase.
The sample consisted of 11 female and 9 male patients, with a mean age in Group I GI of Inclusion criteria Adult literate patients of both genders, aged 18 years and older, who were treated between July and January with ischemic CVA in the middle cerebral artery territory, with clinical and imaging diagnosis and within 90 days since the onset of the condition, with no structural deformities were included in the study. Exclusion criteria Patients with pacemakers, vascular alterations and sensitivity impairment in hemiparetic lower limb were excluded.
Evaluations Muscle strength MS assessed by Daniels numerical grading system Barthel index BI is a scale that assesses functional capacity in activities of daily living and the degree of dependence from the perspective of the examiner. Quality of Life Questionnaire-SF Joint range of motion ROM : joint range of motion ROM assessment was performed using a goniometer for the assessment of posterior and anterior ROM of the hemiparetic lower limb in knee extension and flexion.
The patient remained supine and the lower limp LL was unclothed.
Intervention The physical therapy intervention program for the groups GI and GII consisted of 20 physical therapy sessions twice a week in consecutive weeks, with minute sessions for groups GI and GII, administered by the first author only. Each FES session lasted 30 minutes. The summary of the exercises and their therapeutic goals are showed in Table 1 Table 1.Confidence intervals for each combination of group and moment of assessment of the functional capacity sub-item for both groups.
Melzack R. The Hoehn and Yahr Scale is an assessment instrument that allows the classification of the individual regarding the stage of impairment in Parkinson's disease and is able to quickly and efficiently indicate the general stage Rev Bras Neurol ;46 1 Phys Ther ;81 Suppl 1: Thrombosis and coagulation: The summary of the exercises and their therapeutic goals are showed in Table 1 Table 1.
Maintain or restore the viscoelastic properties of muscle fibers, preventing muscle shortening, as well as stimulating ideal tissue conditions for best neuromotor performance.
J Neuroeng Rehabil ;5: In the ADLs criterion of the UPDRS shown in Table 3 , the speech deficit, slightly affected in stage 1, creates an inability to effectively communicate, which can result in isolation, sadness, depression or hostile behavior directed towards others, particularly in stages 4 and 5 Arch Phys Med Rehabil ;
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