Autism Spectrum Disorders (ASD) are characterized by a triad of clinical features which include lack of social interaction and communication, behavioral stereotypes, and a range of cognitive deficits. The presence of motor deficits has often been observed in the children with autism who are described as being clumsy or awkward in their movements. There is, however, considerable ambiguity related to universality, severity and exact nature of these motor difficulties. The objective of this study was to assess the movement characteristics of children with ASD and to place their motor dysfunction in the context of their functional independence in the performance of daily living skills. Seventeen children diagnosed with Autism or PDD-NOS in the age range of 5-11 years were recruited and assessed using two standardized tests of motor function; the Bruininks-Oseretsky Test of Motor Proficiency - Second Edition (BOT-2; Bruininks 2005) and the Movement Assessment Battery for children (M ABC-2; Henderson, Sugden, & Barnett 2007) and a third assessment of functional independence in children WeeFIM (WeeFIM System, 1999). Most of the children showed movement characteristics that ranged from mild to severe impairment, though two children showed no motor difficulties. However, when compared, as a group, to age matched norms, it was noted that the motor skill performance of children with ASD was noticeably poorer. Marked impairments were observed in tasks that required manual dexterity, upper limb coordination, strength and agility. Children with ASD also showed greater functional disability compared to age-matched norms, however, their degree of motor dysfunction by itself did not correlate with their performance of daily living skills. This study provides invaluable insights into movement characteristics of children on the autism spectrum and highlights the need for including motor assessment as a routine investigation for children with autism. / text

Background: The rehabilitation of older persons is often complicated by increased frailty and medical complexity – these in turn present challenges for the development of health information systems. Objective investigation and comparison of the effectiveness of geriatric rehabilitation services requires information systems that are comprehensive, reliable, valid, and sensitive to clinically relevant changes in older persons. The Functional Independence Measure is widely used in rehabilitation settings – in Canada this is used as the central component of the National Rehabilitation Reporting System of the Canadian Institute of Health Information. An alternative system has been developed by the interRAI consortium. We conducted a literature review to compare the development and measurement properties of these two systems and performed a direct empirical comparison of the operating characteristics and validity of the FIM motor and the ADL items on the PAC in a sample of older adults receiving rehabilitation. Methods: For the first objective english language literature published between 1983 (initial development of the FIM) and 2008 was searched using Medline and CINAHL databases, and the reference lists of retrieved articles. Additionally, attention was paid to the ability of the two systems to address issues particularly relevant to older rehabilitation clients, such as medical complexity, comorbidity, and responsiveness to small but clinically meaningful improvements. For the second objective we used Rasch analysis and responsiveness statistics to investigate and compare the instruments dimensionality, item difficulty, item fit, differential item function, number of response options and ability to detect clinically relevant change. Results: The majority of FIM articles studied inpatient rehabilitation settings; while the majority of interRAI/MDS articles focused on nursing home settings. There is evidence supporting the reliability of both instruments. There were few articles that investigated the construct validity of the interRAI/MDS. The analysis showed that the FIM may be slightly more responsive than the PAC, especially in the MSK patients. However, both scales had similar limitations with regards the large ceiling effect and many unnecessary response options. Conclusions: Additional psychometric research is needed on both the FIM and MDS, especially with regard to their use in different settings and ability to discriminate between subjects with functional higher ability.

Background: The rehabilitation of older persons is often complicated by increased frailty and medical complexity – these in turn present challenges for the development of health information systems. Objective investigation and comparison of the effectiveness of geriatric rehabilitation services requires information systems that are comprehensive, reliable, valid, and sensitive to clinically relevant changes in older persons. The Functional Independence Measure is widely used in rehabilitation settings – in Canada this is used as the central component of the National Rehabilitation Reporting System of the Canadian Institute of Health Information. An alternative system has been developed by the interRAI consortium. We conducted a literature review to compare the development and measurement properties of these two systems and performed a direct empirical comparison of the operating characteristics and validity of the FIM motor and the ADL items on the PAC in a sample of older adults receiving rehabilitation. Methods: For the first objective english language literature published between 1983 (initial development of the FIM) and 2008 was searched using Medline and CINAHL databases, and the reference lists of retrieved articles. Additionally, attention was paid to the ability of the two systems to address issues particularly relevant to older rehabilitation clients, such as medical complexity, comorbidity, and responsiveness to small but clinically meaningful improvements. For the second objective we used Rasch analysis and responsiveness statistics to investigate and compare the instruments dimensionality, item difficulty, item fit, differential item function, number of response options and ability to detect clinically relevant change. Results: The majority of FIM articles studied inpatient rehabilitation settings; while the majority of interRAI/MDS articles focused on nursing home settings. There is evidence supporting the reliability of both instruments. There were few articles that investigated the construct validity of the interRAI/MDS. The analysis showed that the FIM may be slightly more responsive than the PAC, especially in the MSK patients. However, both scales had similar limitations with regards the large ceiling effect and many unnecessary response options. Conclusions: Additional psychometric research is needed on both the FIM and MDS, especially with regard to their use in different settings and ability to discriminate between subjects with functional higher ability.

Programs that address the needs of the elderly are especially important in Canada today as it experiences population aging. There are currently no pretest-posttest studies evaluating functional independence of patients attending the Geriatric Day Hospital at Bruyère Continuing Care in Ottawa, Ontario using the set of indicators and outcome measurement instruments in this study. Evaluation of older patients (age over 65) in this program using various outcome measures was carried out using a single group pretest-post test design. Results showed that there was statistically significant improvement between pretest and post-test scores measuring fear of falling, balance, and functional exercise capacity. However, no significant difference was found between pre- and post-scores for caregiver stress, for which various hypothesized reasons are proposed. There were similar findings for the subgroups analyzed (patients with a history of: stroke or TIA; previous falls; or osteoarthritis) with the exception of fear of falling, which did not show a significant decrease in the stroke subgroup. Some caregivers suggested that “burden” was not an appropriate word for describing their experience, as care-giving was often seen as a moral obligation or an act of love. Future evaluation research using a mixed methods approach and repeated measures design is recommended for a more comprehensive understanding of the effects of this Day Hospital. It may also be of value to compare the different geriatric day hospital programs at the local and regional levels.

As the older adults of Ontario go through the phases of aging, some might experience functional deficiency and loss of independence in Activities of Daily Living (ADL). With rehabilitation and facilitation of essential health services, older adults will have tremendous opportunities in the pursuit of self-sufficiency and functional independence. The current study focused on detailing a quick-paced rehabilitation program provided to older adults in northeastern Ontario. The program of interest was the Assess-Restore program provided by the St. Joseph’s Continuing Care Centre (SJCCC) in Sudbury, Ontario. The study involved a retrospective chart review of 144 patients treated in the past four years, which facilitated the examination of patient charts, as well as the extraction and analysis of their functional status and capabilities prior to admission (PTA) and at discharge. Data were extracted from the Resident Assessment Instrument-Minimum Data Set Version 2.0 (RAI-MDS), which is part of the “PointClickCare” system. Although the study did not find significant changes in the level of functionality and self-sufficiency, it succeeded in effectively promoting functional restoration allowing the majority of patients to return to a level of independence in the community and avert subsequent need for residential care rather than risk further functional deterioration.

O presente experimento teve como objetivo replicar o estudo de Finn, Miguel e Ahearn (2012), manipulando a presença do quadro autoclítico de mandos e tatos e avaliar o efeito do treino de mandos e tatos de peças de duas tarefas de construção na emergência de tatos e mandos (não treinados) destas peças. Quatro participantes eram ensinados a montar duas tarefas de construção e, em seguida, a emitirem respostas vocais (pseudopalavras) com funções de tatos e mandos. Um contrabalanceamento foi aplicado para que cada participante iniciasse a fase de treinos com o treino de um operante verbal diferente (tatos ou mandos) das peças de uma Tarefa de Construção diferente (Tarefa de Construção 1 ou Tarefa de Construção 2), os participantes, então, passavam pela fase de teste dos dois operantes verbais para todas as peças das duas tarefas de construção. Após essa fase, os participantes passavam por mais uma fase de treino, do outro operante verbal diferente da primeira fase, para a outra tarefa de construção e, então, mandos e tatos eram testados para todas as peças das duas tarefas de construção. Todos os participantes emitiram tatos após o treino de mandos e apenas um participante (P3) não emitiu mandos após o treino de tatos para as peças das tarefas de construção. A emergência dos operantes verbais não treinados aconteceu em menores taxas do que as observadas nos achados de Finn et al (2012), demonstrando influência da ausência dos quadros autoclíticos nos treinos e testes de mandos e tatos. O segundo treino teve influência nos resultados dos testes da primeira tarefa de construção para os participantes P2 e P5, o que indica que a história de reforçamento de diferentes operantes verbais em condições semelhantes às das fases de teste podem favorecer a emergência de operantes verbais / The present experiment aimed to replicate the study by Finn, Miguel and Ahearn (2012), manipulating the presence of the autoclitic frame of mands and tacts and evaluating the effect of the training of mands and tacts of pieces of two construction tasks in the emergence of untrained mands and tacts of these pieces. Four participants were taught to set up two construction tasks and then to emit vocal responses (pseudowords) with mands and tacts functions. A counterbalance was applied so that each participant started the training phase with the training of a different verbal operant (mand or tact) of the parts of a different Construction Task (Construction Task 1 or Construction Task 2), the participants, then, went through the testing phase of the two verbal operants for all the pieces of the two construction tasks. Afterwards, the participants went through another training phase, from the other verbal operant, to the other construction task, and then mands and tacts were tested for all the pieces of the two construction tasks. All participants emitted tacts after the mand training and only one participant (P3) did not emit mands after the training of tacts for the pieces of the construction tasks. The emergence of the untrained verbal operants occurred at lower rates than those observed in Finn et al (2012), demonstrating the influence of the absence of autoclitic frames on mands and tacts training and tests. The second training had influence on the results of the tests of the first construction task for the participants P2 and P5, which indicates that the history of reinforcement of different verbal operants in conditions similar to those of the test phases can favor the emergence of verbal operants

O envelhecimento é um fenômeno mundial, resultado da diminuição progressiva das taxas de fecundidade e mortalidade e do aumento da expectativa de vida. O grupo de idosos, no Brasil e em países em desenvolvimento, segundo a OMS, é constituído por pessoas a partir dos 60 anos. Dentre desse grupo, a população que mais rapidamente cresce são os denominados idosos em velhice avançada (80 anos e mais) cujas demandas específicas ainda são desconhecidas em nosso meio. O envelhecimento pode ser acompanhado por um declínio funcional progressivo que pode estar associado a quadros de dependência responsáveis por demandas assistenciais específicas. A dependência em si constitui o maior temor dos idosos. Assim, conhecer os fatores preditores do alcance das idades mais longevas com independência funcional torna-se primordial e constitui o objetivo desse estudo que é parte do Estudo SABE - Saúde Bem-estar e Envelhecimento na América Latina e Caribe. Esse estudo, realizado no ano 2000, foi coordenado pela Organização Pan-Americana de Saúde (OPAS) e desenvolvido simultaneamente em sete países da dessa região com o objetivo de traçar as condições de vida e saúde dos idosos aí residentes. No Brasil, foi desenvolvido na zona urbana do Município de São Paulo com uma amostra de 2.143 idosos representativa da população residente na região no período. Para o desenvolvimento desse estudo, foi utilizada a parcela dos idosos com 80 anos e mais que foi subdividida segundo seu estado funcional. Trata-se de uma pesquisa descritiva e exploratória. Do total dos idosos em velhice avançada, 9,9% eram funcionalmente independentes nas atividades de vida diária, básicas e instrumentais. Desses 66,4% eram mulheres, 33,6% eram homens, 75% eram nascidos no Brasil, 25,6% eram analfabetos e 63,1% estudaram entre 1e 6 anos, 10,1% ainda trabalhavam. Quanto ao estado marital, 71,1% eram viúvos e 26,5 % eram casados; 53,6% viviam sozinhos e a maioria (68,6%) tiveram pais que faleceram com 80 anos ou mais. Com relação a renda 38% se enquadravam no primeiro quintil, no entanto, 44,1% referiram que a renda era suficiente. Quanto aos hábitos de vida, 43,2% praticavam atividade física, 41,6% praticavam atividades de lazer, 70,4% nunca beberam e 68,9% nunca fumaram. Em relação às condições de vida e saúde na infância, 47,7% referiram que saúde e 35,2% boas condições econômicas. Quanto ao estado de saúde atual, 63,5% referiram ter saúde excelente, 43,5% referiram a presença de HAS, 34,7% de DPOC e de 7,3% DM e 95,1% apresentavam capacidade cognitiva preservada. Quanto a assistência à saúde, 81,2% referiam ter procurado por assistência médica nos doze meses anteriores à entrevista sendo que 83,8% referiram uma ou duas consultas. Quanto a história laboral 50,2% trabalharam como empregados e 37,3% como autônomos. Entre as mulheres 50% referiram ter trabalhado porque gostavam e 85% dos homens porque necessitavam. 97,5% deles sentiram-se capacitados para realizar os testes de flexibilidade e mobilidade. Essa variáveis foram submetidas à analise multivariada através da Regressão Logística, utilizando-se um nível de significância (µ = 0,05). As variáveis foram agrupadas em blocos temáticos de interesse, sendo submetidas à analise univariada, mostrando-se significantes diabetes referida, companhia e atividade física. Essas variáveis foram agrupadas e submetidas à análise múltipla de forma a constituir o modelo do estudo. Os testes estatísticos mostraram que a presença da diabetes diminui por um fator de 0.14 vezes o odds para não ter dificuldades nas ABVDs e/ou AIVDS. Viver acompanhado diminui esse risco por um fator de 0.15. Não praticar atividade física diminui os odds para não ter dificuldade de 0.13 vezes. Apesar dos idosos conseguirem chegar na velhice avançada sem incapacidades, o estudo mostrou que poucos são fatores que possam influenciar neste processo. Pode ser porque estes fatores já tenham feito diferença entre os idosos mais “jovens", mas com a idade avançada, os “muito velhos" tendem a igualar estas diferenças / Aging is a world phenomenon and it is a result of the progressive decrease of the fecundity and mortality rates and of the increase of life expectation. The elderly group, in Brazil, is composed by people since 60 years. Inside this group, the population which grows very fast is called very old people (80 years and more) whose specific demand are yet unknown. Aging is normally associated with progressive functional decrease which creates attendance demands and a lot of dependent scene, the great fear of this population. So, to know the factors associated with functional independence become primordial and compose the aim of this study. In this context, predict factors are considered important for the elaboration of preventive acts that alter disability events, responsible for dependence. Aiming to clarify the health load that may come up from a population that has grown old too fast, the Pan-American Health Organization developed a multi central study called SABE, involving seven countries of Latin America and the Caribbean. In Brazil, it was developed at an urban area of Sao Paulo city in 2000 with a total final sample of 2.143 elderly people representing the population who live in this region in this period. The elderly with 80 years and more, were used to develop this study. This is a descriptive and exploratory research. Of the total of the elderly in advanced old age, 9,9% were functionally independents in the activities of daily living. Of these 66.4% were women, 33.6% were men, 75% were born in Brazil, 25.6% never went to school, 10.1% have already worked. Concerning the marital condition 71.1% were widow and 26.5 % were marriage; 53.6% were living alone and the most of them (68.6%) have had parents who died with 80 years or more. Concerning the income 38% were in the first quintile, meanwhile, 44.1% had reported that the income was sufficient. Concerning the life habits, 43.2% had practiced physical activity, 41.6% had practice leisure activities, 70.4% had never drunken and 68,9% had never smoked. In relation to life conditions in childhood 47.7% had reported that they had good health and 35.2% good economical conditions. Concerning the health condition current, 63.5% had reported to have excellent health, 43.5% had reported the presence of hypertension, 34.7% chronicle pulmonary disease and 7.3% diabetes. 95.1% had shown preserved cognitive ability. These variables were submitted to the multivariety analysis through Logistical Regression, using a significance level (µ = 0,05). The variables were gather in thematic blocks of interested, being submitted to the univariety analysis, showing itself meaning diabetes reported, fellowship and physical activity. Regarding to the predict factors for aging without disability, data was submitted to multivaried analysis through Logistic Regression, using a significance level of 5% (a=0.05). These variables were grouped and submitted to multiple analyses in order to constitute the model of the study. The statistical analysis have shown that the presence of diabetes decreases by a factor of 0.14 times the odds for do not have the difficulties in the ADL. To live with company decreases this risk by a factor of 0.15. The odds decrease if there is not the practice of physical activity. The study shows that factors are few and these can influence in this process. This can happen because these factors have already been difference among the “younger" elderly, but among the very old people, the “older" tends to equalize these differences

Introdução: A Doença Renal Crônica (DRC) está associada à alta morbidade e mortalidade, com aumento progressivo nas populações mundiais. A DRC e o tratamento hemodialítico podem desencadear mudanças no estilo de vida dos pacientes como alterações em seu cotidiano, na capacidade para desempenhar atividades do seu dia a dia e no autocuidado. Objetivos: Caracterizar os pacientes atendidos nos serviços de hemodiálise de uma cidade do interior paulista quanto aos aspectos sociodemográficos, econômicos e clínicos; descrever a independência funcional utilizando o instrumento de Medida de Independência Funcional (MIF); descrever a capacidade de autocuidado utilizando a escala para avaliar as capacidades de autocuidado (ASA-A); verificar a associação da independência funcional e da capacidade do autocuidado com as variáveis sociodemográficas e clínicas e verificar correlação entre a independência funcional e a capacidade de autocuidado. Material e Método: Foi realizado um estudo transversal, populacional e descritivo com abordagem quantitativa nos três serviços de diálise do município de São José do Rio Preto-SP, nos quais foram entrevistados 214 pacientes com 18 anos ou mais de idade, residentes nesse município, em tratamento por hemodiálise e que aceitaram participar do estudo. Os instrumentos utilizados para a coleta de dados foram: Miniexame do Estado Mental (MEEM) para a avaliação do estado cognitivo; instrumento para caracterização dos dados sociodemográficos, econômicos e clínicos; a MIF e a ASA-A. Os dados foram analisados por meio do programa estatístico SAS®9.0, no qual foram gerados as análises descritivas, os testes de associação e a correlação entre as variáveis do estudo. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Medicina de São José do Rio Preto - FAMERP. Resultados: Dos 214 pacientes, 108 eram adultos e 106 idosos, dos quais 136 eram homens e 78 mulheres. O número médio de comorbidades para cada paciente foi de 2,3, e o número médio de complicações físicas foi de 4,7 por paciente. Foram evidenciados um nível de independência completa ou modificada nessa população (média MIF total 118,38; dp12,4) e um relativo conhecimento dos pacientes referente a sua capacidade de autocuidado (média 94,53; dp12,86). A MIF se correlacionou positivamente com a ASA-A e as duas negativamente com as variáveis idade, complicações relacionadas ao tratamento hemodialítico e comorbidades. Conclusão: Os pacientes em tratamento hemodialítico apresentaram resultados satisfatórios de independência funcional e a capacidade de autocuidado. À medida que aumentam os escores de independência funcional, aumentam também os de capacidade de autocuidado. As variáveis sexo, idade, comorbidades, complicações relacionadas ao tratamento hemodialítico constituíram fatores importantes que prejudicaram a independência funcional e a capacidade de autocuidado dessa população. Os resultados deste estudo permitiram compreender aspectos referentes a essas variáveis que poderão subsidiar intervenções para a melhoria da assistência de enfermagem prestada a essa população. / Introduction: Chronic Kidney Disease (CKD) is associated with high and progressively increasing morbidity and mortality levels around the world. CKD and hemodialysis treatment can trigger changes in patients\' lifestyles, such as changes in their daily lives, in their ability to perform daily activities and in self-care. Aims: To characterize the patients attended at hemodialysis services in an interior city in São Paulo State, Brazil regarding sociodemographic, economic and clinical aspects; to describe their functional independence using the Functional Independence Measure (FIM) scale; to describe their self-care ability using the Appraisal of Self-Care Agency Scale (ASA-A); to check the association between functional independence and self-care ability and sociodemographic and clinical variables and to check for the correlation between functional independence and self-care ability. Material and Method: A cross-sectional and descriptive population study with a quantitative approach was developed at the three dialysis services in the city of São José do Rio Preto- SP, where 214 patients were interviewed, aged 18 years or older, living in this city, under hemodialysis treatment and who accepted to participate in the study. The instruments used for data collection were: Mini-Mental State Examination (MMSE) for cognitive state assessment; instrument to characterize sociodemographic, economic and clinical data; FIM and ASA-A. Data were analyzed in SAS®9.0, used to generate descriptive analyses, association tests and correlations among the study variables. Approval for the project was obtained from the Research Ethics Committee at São José do Rio Preto Medical School - FAMERP. Results: Out of 214 patients, 108 were adults and 106 elderly, with 136 men and 78 women. The average number of comorbidities for each patient was 2.3, and the mean number of physical complications was 4.7 per patients. Complete or modified independence levels were evidenced in this population (mean total FIM 118.38; sd12.4) and patients\' relative knowledge about their self-care skills (mean 94.53; sd12.86). The FIM was positively correlated with the ASA-A and both instruments were negatively correlated with age, hemodialysis treatment-related complications and comorbidities. Conclusion: Patients under hemodialysis treatment presented satisfactory functional independence and self-care ability results. Gender, age, comorbidities, hemodialysis treatment-related complications represented important factors that impaired this population\'s functional independence and self-care ability. These study results permitted understanding aspects related to these variables that can support interventions to improve nursing care delivery to this population.

The numbers of people with spinal cord injuries (SCI) in Thailand are increasing. Thai rehabilitation care focuses treatment on acute care with little attention to the lives of clients after discharge from institutions. To date, there has been no research on rehabilitation outcomes and factors relevant to these issues for people with SCI at home and in the community in Thailand. The purpose of this study was to identify and compare the outcomes of functional status, depression, anxiety and stress, and health status of people with SCI, both at discharge and at three months post-discharge from hospital. One hundred twenty-one participants with SCI were recruited from ten major hospitals in Thailand. Data was collected at 48 hours pre-discharge and again at three months post-discharge using the Functional Independence Measure (FIM), the Depression, Anxiety, and Stress Scale (DASS), and the SF-36 Health Survey. The results demonstrated that mean scores of functional status at discharge were significantly higher than at three months post-discharge. Depression and anxiety scores at discharge were significantly lower than depression and anxiety scores at three months postdischarge. Stress score had not significantly changed from discharge to post-discharge. Health status scores at discharge were also higher than at three months post-discharge on eight subscales. Factors relevant to or predicting functional status were marital status, attendant care, number of architectural barriers, fulfilled occupational therapy (OT) needs, and number of different services required but not received. Factors predicting depression, anxiety and stress were marital and economic status, age at onset, education level, duration of disability, fulfilled OT needs, number of different services received, and numbers of different service required but not received. / Factors predicting health status were marital status, economic status, age at onset, education level, duration of disability, attendant care, number of architectural barriers, fulfilled OT needs, number of different services received, and number of different services required but not received. Some predictive factors are culture-specific, but on others, rehabilitation professionals could ease the transition from hospital to home for people with SCI.

Tyrimo objektas: smulkiosios motorikos ir funkcinio savarankiškumo kaita pirminės reabilitacijos eigoje. Tyrimo problema: kadangi kiekvieno sergančiojo insultu reabilitacija turi skirtingų krypčių poreikius, o literatūroje iki šiol nėra apibrėţtos stratifikacijos ir reabilitacijos programų individualizavimo krypčių, skirtų insulto paţeistos rankos judesių valdymui atgauti (Meldrum, 2004), siekiant efektyviai panaudoti reabilitacijos išteklius, svarbu numatyti galimas ligos baigtis (Milinavičienė ir kt., 2007). Todėl analizavome smulkiosios motorikos atsigavimą pirminės reabilitacijos etape pacientams, patyrusiems išeminį galvos smegenų insultą, siekiant įvardinti nors kelis atskaitos taškus formuojant kineziterapijos artimuosius bei tolimuosius tikslus – retrospektyviai perţiūrint įgyvendintus tikslus, keltus tipiškos funkcinės būklės tiriamųjų grupei – kuriuos matome rezultatų analizėje. Tyrimo tikslas: išanalizuoti ir įvertinti pacientų, patyrusių išeminį galvos smegenų insultą, smulkiosios motorikos atsigavimą bei funkcinio savarankiškumo kaitą, pirminės reabilitacijos eigoje. Tyrimo uţdaviniai: 1. Ištirti ir įvardinti dominuojantį smulkiosios motorikos atsigavimą pirminės reabilitacijos eigoje; 2. Ištirti ir įvertinti pacientų funkcinio savarankiškumo kaitą, pirminės reabilitacijos eigoje; Tyrimo hipotezė: pirminės reabilitacijos etape artimieji bei tolimieji kineziterapijos tikslai turėtų atitikti paciento regeneracinį potencialą, kuris taip pat galėtų būti įvertintas... [toliau žr. visą tekstą] / Study subject: the dynamis of interchange of fine motor and functional independence in the process of the initial rehabilitation. The problem of the study: the rehabilitation of each patient suffering from stroke has different requirements, however, to this date literature does not indicate defined individualisation types of stratification and rehabilitation programmes, assigned to recover the control of stroke affected hand/arm movement (Meldrum, 2004). In order to effectively use rehabilitation resources, it is important to foresee the possible consequences of the disease (Milinavičienė ir kt., 2007). Therefore we analysed the fine motor recovery at the initial rehabilitation stage in the patients who had suffered ischemic head brain stroke. Study aim: to analyse and evaluate patients‘, who had suffered ischemic head brain stroke, the small motor post stroke recovery as well as the change in functional independence in the initial rehabilitation stage. Study goals: 1. To examine and name the dominant fine motor recovery in the initial rehabilitation stage; 2. to examine and evaluate change in patients‘ functional independence in the initial rehabilitation stage; Hypothesis: at the initial rehabilitation stage the short-term and long-term physio-therapeutic goals have to match a patient‘s regenerative potential, which can also be evaluated with reference to the initial functional stage at a patient‘s arrival to hospital. Study methods: Barthel test measuring a patient‘s... [to full text]