A compreensão do corpo na formação profissional do fisioterapeuta

Physical therapy has suffered of a mechanistic influence, with the superspecialization and fragmentation of learning, which interfers directly in the professional s understanding of the body, besides affecting his therapeutic performance. Worried about this reality, this research analyzed perceptions of Physical therapy students from Universidade Federal do Rio Grande do Norte and Universidade Potiguar about the human body. This is a descriptive study where 167 students were evaluated through objective and subjective responses to questionnaires designited QUEB Questionnare of understanding body evaluation. Searching the complement of the datas the QUEB open-ended was created, which gives freedom to students to answer freely. This questionnnaire was applicated on a subgroup composed by 21 students of the Health Sociology subject of the Physical therapy course. The validation process of these questionnaires included strategies of a panel of experts and face validity. The theorical reference analyzed based on the studies which favor the rejoining of knowledge represented by transdisciplinary support. The analysis of the results were performed quantitativavely and qualitatively through categorization of the responses selectioning key-words and the most expressive discourses , besides using descritive statistics interpretation. According to the responses, the body thought only thought biologically, ignoring the understanding of man as a cultural and social construction, confirming the presence of the reductionist model, with overvalorization of early specialization, technical training and purely biological and mechanical considerations of the body and its mobility. Probably, the dialogic knowledge of the body human inside Physical Therapist s learning can promote a growth of health s concept and a true activeness of Physical therapy on it, being the body a link with social environment. So, through understanding of the body as a complex form, the physical therapy will be able to attend your patients considerating their biological characteristics, but so the religious, political, social and ethics. Finally, this reflection suggests a search for a less technical vision, which allows the professional to discern more than segments of the body and which will contribute to a wider understanding of the patient and his social context, leading to greater humanization of the body , improvement in services and consequently, in the quality of life of these patients

Efeitos biológicos in vitro de agentes físicos utilizados em fisioterapia

The uses of radiobiocomplexes labeled with technetium-99m contributed to health science advances. Stannous chloride (SnCl2) has been used as a reducing agent for the labeling process. Cytotoxic and genotoxic effect of the SnCl2 have been described in several studies and with this experimental models alterations in molecular and cellular level can be evaluated. In the last years the physicals therapists acquired new devices which emits electromagnetic radiation such us Extremely Low Frequency Pulsated Electromagnetic Fields (E.L.F. P.E.M.F.), radiofrequency, Intense Pulsed Light (I.P.L.) and others which emits sonic waves such us Biorresonance. Scientific evidence of the effects and dosage is important to protect public health and to reach exposition levels that result in significant biological effects. The aim of this project is to verify the effects of these physical agents in plasmid DNA and E. coli AB1157 cultures in presence or absence of SnCl2 and the effects in blood constituents labeled with technetium-99m. Wistar rats blood was exposed to the cited sources and the labelling of blood constituents with 99mTc was carried through. Cultures of E. coli AB1157 and plasmidial samples DNA had been also exposed the physical agents. The results suggest that these agents are capable of altering neither the survival of E. coli cells or plasmid DNA electrophoresis mobility. The multidiscipline character was clearly in this study due the interaction between Nuclear Medicine department of the UERJ and the Laboratory of Physical Agents of the Maimonides University in Argentina until the union between the teacher (biomedical and physiotherapist) and student (physiotherapist), besides collaborators of the area of Physics and Biology, promoting new ideas and perspectives and also adding the knowledge of different areas and origins

Hemiparesia congênita e adquirida na criança: interrelação entre presença de crises epilépticas, os achados eletrencefalográficos e de neuroimagem por ressonância nuclear magnética

The purpose of this paper was to study patients with congenital and acquired hemiparesis, their clinical aspects, the presence or not of epileptic seizures, and electroencephalographic (EEG) and Magnetic Resonance Imaging (MRI) findings. We analyzed the interrelation between etiology, the presence and seriousness of epileptic seizures (ES) and the possible causes of refractoriness. This is a prospective study using the clinical diagnosis of a child neurologist, who attested to the presence of unilateral motor lesions. We compared the electroencephalographic findings in patients with or without epileptic seizures, and investigated if among the former, these seizures were controlled or not, their likely etiology and risks of refractoriness. EEG background activity on the lesion and contralateral side was analyzed, in addition to the presence of concomitant epileptiform activity. Encephalon MRIs of all the patients were studied to correlate etiology and the control or not of epileptic seizures. The disorganization of bilateral EEG activity correlated with the difficult-to-control epileptic seizures. Suitably organized background activity contralateral to the lesion is a good prognosis in relation to epileptic seizures. Focal epileptogenic activity does not necessarily predispose to epileptic manifestation. The MRI is more important in determining etiology than in prognosing epileptic seizures. This study used a multidisciplinary approach involving child neurologists, a physical therapist and a neuroradiologist. This meets the criteria of multidisciplinarity of the Postgraduate Program in Health Sciences

Dimensões da satisfação do paciente geriátrico com a assistência fisioterapêutica

Introdução: Os idosos constituem os maiores consumidores dos serviços de saúde, especialmente os de reabilitação, tornando imprescindível a avaliação da qualidade da assistência fisioterapêutica prestada. A satisfação do paciente tem sido considerada uma das melhores e mais eficazes formas de avaliar o cuidado e direcionar o provedor do serviço para suprir as necessidades e expectativas do paciente-cliente. O objetivo deste estudo foi investigar os principais aspectos (preditores) que contribuem para a satisfação do paciente geriátrico com o tratamento fisioterapêutico ambulatorial. Métodos: Trata-se de um estudo com enfoque epidemiológico, transversal e descritivo de cunho exploratório. Foi utilizado o instrumento de avaliação da satisfação do paciente com a fisioterapia, desenvolvido e validado para a população brasileira por Mendonça em 2007, com uma escala de satisfação do paciente composta por 23 itens. Os dados foram coletados na sala de espera de 29 clínicas de Fisioterapia da rede privada da capital do RN/Brasil e a amostra selecionada de forma não-probabilística constou de 221 pacientes com idade superior a 60 anos, que realizaram entre 5 e 60 sessões de fisioterapia onde os dados foram coletados, deveriam ser usuários de plano de saúde e ter condições cognitivas preservadas. Resultados: A análise fatorial indicou a existência de quatro fatores com autovalor maior que 1: interação pacienteterapeuta (7 itens) α = 0,901; acesso e atendimento de recepcionista e pessoal de apoio (8 itens) α = 0,888; ambiente físico e satisfação global (5 itens) α = 0,835; e conveniência (3 itens) α = 0,711. Os itens com maiores escores de satisfação completa foram os contemplados nos aspectos de interação paciente-terapeuta, especialmente o respeito e a gentileza do fisioterapeuta. As associações realizadas através do teste do Qui-quadrado e regressão logística binária entre a satisfação do paciente e as variáveis sócio-demográficas, percepção do estado de saúde e capacidade funcional demonstraram que a satisfação do paciente idoso associa significativamente com o sexo e estado civil. Os achados revelam que as mulheres mostram-se mais satisfeitas com a fisioterapia. Conclusão: Os aspectos interpessoais demonstraram ser preditores relevantes para assistência fisioterapêutica satisfatória, especialmente na população idosa que requer atenção além do suporte puramente técnico

O exame neurológico do recém-nascido pré-termo não complicado: avaliação pela escala de saint-anne dargassies, e screening pelas escalas de amiel-barrier-shnider modificada e prechtl ao termo

This study compared the evolution of posture, tone and neonatal reflexes in preterm infants without clinical or neurological complications before and after the age of term using the scale of Saint-Anne Dargassies. To reach the age of the term, was applied Scales Amiel-Barrier-Shnider changed and the Prechtl, traditionally used in the evaluation of term newborns, looking for possible changes to the term, while also evaluating the sensitivity of these scales. We studied 20 non-complicated preterm infants, both sexes aged 32-36 weeks, born in Januário Cicco Maternity School, from August 2006 to August 2007. Was applied to the scale of Saint-Anne Dargassies every two weeks until reach the term, and the range of Amiel-Barrier-Shnider changed and the Prechtl, after reaching 39 and 41 weeks. The evaluation result of articular angles was subjected to the test of Friedman ANOVA, significant differences between the three measurements of the scale of Saint-Anne Dargassies only for angles heel-to-ear to term. Neonatal reflexes changed in the period of prematurity were the cardinal points reflexes, Moro reflexes, cross extensions reflex and the automatic walking reflexes. The posture was the parameter which remained unchanged in the three scales. Considering a significance level of 5% by applying Cochran Q Test, it was found that the scale of Saint-Anne Dargassies is more sensitive to detect suspects. With this methodology and the results it was possible to prepare a manuscript: The neurological examination of non-complicated preterm newborns using the Sanit-Anne Dargssies Scale from birth to term: normal or altered? In which we describe that despite the good clinical condition, the RNP show changes in tone and neonatal reflexes. These data are important because though non-complicated RNP need further attention its maturation process, enabling us to detect and intervene early. With these results we can build a scale simplified neurological assessment made with items found most altered during the application of three scales. The development of this project has a multidisciplinary approach, because it involved Paediatric Neurologist, Physiotherapist and Neonatologist, as recommended by PPGCSA

Custos e benefícios de um programa de exercício aeróbios na doença pulmonar obstrutica crônica: ensaio cliníco aleatório controlado

Pulmonary Rehabilitation, especially due to aerobic exercise, positive impact in reducing morbidity/mortality of patients with COPD, however the economic impact with costs of implementing simple programs of aerobic exercise are scarce. This is a blind randomized clinical trials, which aimed to evaluate the costs and benefits of a simple program of aerobic exercise in individuals with COPD, considering the financial costs of the Public Health System and its secondary endpoints. We evaluated lung function, the distance walked during six minutes of walking, the respiratory and peripheral muscle strength, quality of life related to health (QLRH), body composition and level of activity of daily living (ADL) before and after eight weeks of an aerobic exercise program consisting of educational guidance for both groups, control and intervention and supervised walks to the intervention group. The health costs generated in both groups were calculated following table Brazilian Public Health System. The sample consisted of forty patients, two being excluded in the initial phase of desaturation during the walk test six minutes. Were randomized into control and intervention group thirty-eight patients, three were excluded from the control group and one was excluded from the intervention group. At the end, thirty-four COPD comprised the sample, 16 in the control group and 18 in the intervention group (FEV1: 50.9 ± 14% pred and FEV1: 56 ± 0.5% pred, respectively). After for intervention, the intervention group showed improvement in meters walked, the sensation of dyspnea and fatigue at work, BODE index (p <0.01) in QLRH, ADL level (p <0.001) as well as increased strength lower limbs (p <0.05). The final cost of the program for the intervention group was R $ 148.75, including: assessments, hiking supervised by a physiotherapist and reassessments. No patient had exacerbation of IG, while 2 patients in the CG exacerbated, generating an average individual cost of R $ 689.15. The aerobic exercises in the form of walking showed significant clinical benefits and economic feasibility of its implementation, due to low cost and easy accessibility for patients, allowing them to add their daily practice of aerobic exercises

Proposta de Intervenção para Auxiliar a Reabilitação Motora e Cognitiva de Pacientes com Acidente Vascular Cerebral

Stroke is the leading cause of combined motor and cognitive disability worldwide. The rehabilitation of stroke patients is mostly directed towards motor recovery through the training of the affected member under supervision of a Physical Therapist. In the present study we introduce a new approach for both cognitive and motor therapy, which relies on motor imagery of the upper limbs and working memory training. This therapy should be utilized as an adjuvant to physical therapy. Ten individuals (5 men and 5 women) were selected for the pilot study, all of them in the acute phase of the first ischemic stroke episode. The control group had 5 individuals who were submitted to physical therapy only, whilst the other 5 patients in the experimental group also performed the cognitive and motor training with a video game specially built for this study. Two patients left the experimental group before the end. Total training lasted for 9 weeks, 2 times a week, for half an hour. Patients reported they enjoyed playing the game, even though it required a lot of mental effort, according to them. Plus, they considered it had a beneficial influence in their activities of daily living. No side effects were reported. Preliminary results suggest there is a difference between groups in cognitive and upper limb motor evaluation following the intervention. It is important to notice that our conclusions are limited due the small sample number. Overall, this work is supported by other studies in literature focused in rehabilitation with motor imagery and working memory and indicate a continuity of the research, increasing total training hours

A interação ensino-serviço no processo de formação dos graduandos em fisioterapia da UFPB: a percepção dos docentes

The health paradigm, consolidated in the last century, directed the training of health professionals, educated under the aegis of the Flexnerian training, fragmentary and hospital-centered model. However, it proved to be insufficient to meet the demands of the Unified Health System and the population. In this sense, the National Curriculum Guidelines for Undergraduate health courses emerge as a normative framework in proposing a new professional profile, as well as the recommendation of strategies for the restructuring of curricula and teaching practices, and one of them is the teaching-service integration. Therefore, the aim of this study was to investigate the process of training of Physiotherapy course students of the Federal University of Paraíba with the guiding principle of teaching-service integration, considering DCN. In this sense, the chosen method was a case study with qualitative approach. The sample was intentional, including all faculty members of the permanent staff of the Department of Physiotherapy at UFPB, linked to curriculum components whose practice scenarios occur in the SUS network and time longer than one year in that component. The data collection technique was the semi-structured interview. Data analysis was performed using the content analysis technique. The following categories were considered: professional training for SUS, integration of students to the SUS network services, the relationship between theory and practice in the training of physiotherapists, teaching and health professional partnership in the teaching-learning process and programs of training reorientation and their integration with the course. The results allowed identifying positive points in the teaching-service integration: recognition of the importance of integration activities between university and health services based on the insertion of students in the network, the combined actuation with health service professionals and the opportunity to work in a multidisciplinary team; the existence of structured and organized School Network; participation of students and teachers in government programs that offer the experience of insertion in the labor market. The following weaknesses stood out: difficulties in agreement, planning and evaluation of activities by the service; gap between theoretical and practical activities; lack of definition of roles of teacher and health service professionals in the training process and the fragile relationship of reorientation of vocational training programs with the curricular activities of the course. The teaching-service integration as a guiding principle in the analysis of the formation of physiotherapists reveals limits and possibilities for training that meets the health needs of the population. Thus, the choices of educational institutions regarding the care model have an influence on health practices, as well as the commitment by management and services and the permeability to social control instances decisively contribute to the improvement in the training of future professionals. Thus, the commitment of all involved for the effective change in the training process of health paradigm is indispensable.

A interação ensino-serviço no processo de formação dos graduandos em fisioterapia da UFPB: a percepção dos docentes

The health paradigm, consolidated in the last century, directed the training of health professionals, educated under the aegis of the Flexnerian training, fragmentary and hospital-centered model. However, it proved to be insufficient to meet the demands of the Unified Health System and the population. In this sense, the National Curriculum Guidelines for Undergraduate health courses emerge as a normative framework in proposing a new professional profile, as well as the recommendation of strategies for the restructuring of curricula and teaching practices, and one of them is the teaching-service integration. Therefore, the aim of this study was to investigate the process of training of Physiotherapy course students of the Federal University of Paraíba with the guiding principle of teaching-service integration, considering DCN. In this sense, the chosen method was a case study with qualitative approach. The sample was intentional, including all faculty members of the permanent staff of the Department of Physiotherapy at UFPB, linked to curriculum components whose practice scenarios occur in the SUS network and time longer than one year in that component. The data collection technique was the semi-structured interview. Data analysis was performed using the content analysis technique. The following categories were considered: professional training for SUS, integration of students to the SUS network services, the relationship between theory and practice in the training of physiotherapists, teaching and health professional partnership in the teaching-learning process and programs of training reorientation and their integration with the course. The results allowed identifying positive points in the teaching-service integration: recognition of the importance of integration activities between university and health services based on the insertion of students in the network, the combined actuation with health service professionals and the opportunity to work in a multidisciplinary team; the existence of structured and organized School Network; participation of students and teachers in government programs that offer the experience of insertion in the labor market. The following weaknesses stood out: difficulties in agreement, planning and evaluation of activities by the service; gap between theoretical and practical activities; lack of definition of roles of teacher and health service professionals in the training process and the fragile relationship of reorientation of vocational training programs with the curricular activities of the course. The teaching-service integration as a guiding principle in the analysis of the formation of physiotherapists reveals limits and possibilities for training that meets the health needs of the population. Thus, the choices of educational institutions regarding the care model have an influence on health practices, as well as the commitment by management and services and the permeability to social control instances decisively contribute to the improvement in the training of future professionals. Thus, the commitment of all involved for the effective change in the training process of health paradigm is indispensable.