Controle circadiano e homeostático do sono-virgília em pacientes com acidente vascular encefálico e correlações com a qualidade de vida e o nível de atividade física

The cerebral vascular accident is a neurological dysfunction of vascular origin that leds to development of motor sensibility, cognitive, perceptive and language deficits. Despite the fact that the main sleep disorders in stroke patients are well known, it is still necessary to analyze which mechanisms of regulation of sleep and wakefulness are affected. The objective of this study was to evaluate the changes in the circadian and homeostatic control of sleep-wakefulness in stroke patients and the correlations with quality of life and level of physical activity. The study analyzed 22 stroke patients (55± 12 years old) and 24 healthy subjects (57 ±11 years old). The instruments used in this study were questionnaires on sleep quality, daytime sleepiness, quality of life, physical activity level and the actigraphy. The data were analyzed using the Student `t test, Mann-Whitney test, ANOVA and Spearman's correlation tests. The results showed stability in the sleep-wake circadian expression with changes in the amplitude of the rhythm. However, significant changes were found related to the homeostatic component characterized by increased sleep duration, increased latency, fragmented sleep and lower sleep efficiency. Additional data showed decreased quality of sleep and increased daytime sleepiness, as well as decreased quality of life and level of physical activity. The results indicate that the interaction of circadian and homeostatic control of sleep-wake is compromised and the main reason might be because of the homeostatic component and the lower activity level resulting from the brain damage. Thus, further studies may be developed to evaluate whether behavioral interventions such as increased daytime activity and restriction of sleep during the day can influence the homeostatic process and its relation to circadian component, resulting in improved quality of nocturnal sleep in stroke patients

Grau de conhecimento de pacientes sobre o acidente vascular cerebral e a necessidade do uso de cartilha educativa para orientação fisioterapêutica

Stroke is a neurological dysfunction of vascular origin that causes physical impairments and disabilities. Brazil leads the statistics stroke mortality among Latin American countries, demonstrating still be a neglected disease in this country. The incidence is related to risk factors and still is great misinformation in our country about stroke, treatment and prophylaxis. The aim of this study was to assess the degree of knowledge about stroke and patients need to use educational booklet for physiotherapy. The sample consisted of 53 patients, 22 females and 31 males, mean age 56.2 ± 10.9 years. Patients were evaluated by completing questionnaires, observing the socio-demographic and clinical aspects, neurological assessment, functional assessment, knowledge of pathology and presenting educational booklet. The data were analyzed using the chi-square test. According to the results, it was observed that the patients had not enough knowledge about the terminology, complications and warning signs of stroke, were not aware and did not perform the proper positioning of the limb and transfers, however, were aware and performed the stretching maneuvers. This reveals the need to implement policies that lead to information about stroke population. Following discharge from outpatient physical therapy using educational booklets with guidelines on positioning, stretching exercises and transfer is important in functional rehabilitation and encouraging independence of the individual affected by stroke