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Previous issue date: 2016-01-28 / O Acidente Vascular Cerebral (AVC) causa comprometimentos motores principalmente no membro superior (MS). A Observa??o da A??o (OA) tem sido utilizada para a reabilita??o do MS desses pacientes. ? uma terapia multissensorial que consiste na observa??o de um sujeito saud?vel realizando uma tarefa motora, seguida de pr?tica f?sica. O objetivo do estudo foi verificar se a OA melhora a fun??o motora do MS e a depend?ncia para as atividades da vida di?ria (AVD?s) dos pacientes com AVC e se tem rela??o com algum efeito adverso. Uma estrat?gia de busca de palavras e termos foi utilizada para a identifica??o dos artigos, nas seguintes bases cient?ficas: Cochrane; MEDLINE; PsycINFO; CINAHL e LILACS. Al?m de busca manual nas refer?ncias dos artigos e busca de teses e disserta??es no Portal da Capes e LILACS. Foram selecionados estudos do tipo ensaio cl?nico randomizado (ECR) com pacientes de AVC, com comprometimento do MS e que utilizou a OA como interven??o. Os dados extra?dos dos estudos foram utilizados para an?lise do risco de vi?s, do efeito do tratamento e da qualidade do corpo da evid?ncia. Foram inclu?dos 6 estudos, totalizando 270 pacientes e foram realizadas as metan?lises. Em rela??o ? fun??o motora do bra?o, o efeito estimado em favor da terapia n?o foi significativo. Entretanto, quando considerada a fun??o da m?o a estimativa do efeito foi favor?vel ao grupo que realizou a AO, em curto (diferen?a de m?dia=6,93; 95% IC 1,48 a 12,39; p=0,01) e em longo prazo (diferen?a de m?dia=7,57; 95% IC 1,34 a 13,80; p=0,02). N?o foi poss?vel a an?lise para a depend?ncia funcional. Os estudos apresentaram um baixo ou incerto risco de vi?s, por?m a qualidade do corpo da evid?ncia foi considerada de baixa e muito baixa qualidade. A OA foi efetiva em melhorar a fun??o da m?o dos pacientes com AVC. Apesar da baixa qualidade dessa evid?ncia o uso da OA na pr?tica cl?nica n?o deve ser desencorajado. Novos estudos de ECR devem ser realizados com maior rigor metodol?gico e maiores amostras, contemplando desfechos importantes como depend?ncia funcional para as AVD?s. / Background: stroke causes long-term impairments, limitation of activities and
restriction in participation in daily life situations, especially for upper limb impairment
(UL). Action Observation (AO) has been used for the rehabilitation of UL in these
patients. It's a multisensory therapy which consists in observing a healthy subject
performing a motor task, followed by physical practice.
Objectives: assess whether the AO improves motor function of UL and dependence
for activities of daily living (ADLs) of stroke patients or cause any adverse effects.
Search methods: a search strategy was words and terms used for the identification
of articles, in the following scientific basis Cochrane Central Register of Controlled
Trials; MEDLINE; PsycINFO; CINAHL and LILACS. In addition to manual search of
the references of articles and search for theses and dissertations in Portal Capes and
LILACS. The identification of the studies was conducted from October to December
2015, being the last search on December 3.
Selection criteria: randomised controlled trials (RCT) involving adults with stroke
who had deficits in upper limb function and used AO as an intervention.
Data collection and analysis: the data extracted from the studies were used to
analyze the risk of bias, the effect of the treatment and the quality of the body of
evidence.
Main results: 6 studies were included, totaling 270 patients. The primary outcome
analyzed was the motor function of MS. Were combined in meta-analyzes studies
comparing AO versus placebo or an active control, considering the immediate and
long-term effect (n=241). Regarding the motor function of the arm (5 trials), the
estimated effect for the therapy was not significant. However, when considering the
hand function estimating the effect was favorable to the group that conducted the
AO, in short (mean difference = 6.93, 95% CI 1.48 to 12.39; P = 0.01) and long-term
(mean difference = 7.57; 95% CI 1.34 the 13.80; p = 0.02). Unable to perform the
analysis for functional dependency. The studies showed a low or uncertain risk of
bias, but the quality of evidence the body was considered low and very low quality.
Authors? conclusions: AO was effective in improving hand function of stroke
patients. Despite the low quality evidence that the use of OA in clinical practice
should not be discouraged. RCT new studies should be conducted with greater methodological rigor and larger samples, covering important outcomes such as
functional dependence for ADLs.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/21104 |
| Date | 28 January 2016 |
| Creators | Borges, Lorenna Raquel Dantas de Macedo |
| Contributors | 60336641400, http://lattes.cnpq.br/7200517552154428, Cavalcanti, Fabricia Azevedo da Costa, 00847101444, Souza, Dami?o Ernane de, 79881122449, http://lattes.cnpq.br/1932273466740095, Campos, Tania Fernandes |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM FISIOTERAPIA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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