Relatório de estágio : Centro de Apoio ao Desenvolvimento Infantil, CADin

O trabalho apresentado enquadra-se na realização do estágio curricular no âmbito do 2º ciclo de reabilitação psicomotora. O estágio curricular decorreu no Centro de Apoio ao Desenvolvimento Infantil durante o ano letivo 2012/2013. Nesta instituição a estagiária desenvolveu o seu trabalho dentro de problemáticas como a perturbação de hiperatividade e défice de atenção e os problemas de comportamento. O trabalho envolve a caraterização da instituição, a consideração da intervenção psicomotora no âmbito do desenvolvimento e aprendizagem e o aprofundamento teórico das problemáticas observadas. No sentido deste trabalho refletir as conquistas e dificuldades de todo um processo, são apresentadas as atividades realizadas no âmbito do estágio e uma reflexão crítica sobre o contributo de todo o processo para a aprendizagem e futuro profissional da estagiária.

Psicomotricidade na anorexia nervosa : Unidade de Internamento/Ligação de Pedopsiquiatria no Hospital Dona Estefânia

O presente relatório descreve as atividades de estágio desenvolvidas no âmbito do Ramo de Aprofundamento de Competências Profissionais (RACP) do Mestrado de Reabilitação Psicomotora, que decorreu na Unidade de Internamento/ligação de Pedopsiquiatria integrada no Hospital Dona Estefânia do Centro Hospitalar Lisboa Central. O objetivo do estágio centrou-se na implementação da intervenção psicomotora em saúde mental na pedopsiquiatria deste serviço, no qual se acompanharam oito casos com Perturbação do Comportamento Alimentar (PCA), nomeadamente com Anorexia Nervosa (AN). O relatório integra um enquadramento teórico que inclui a revisão bibliográfica da saúde mental em Portugal e a terapia psicomotora em saúde mental, especificamente na prática com PCA e AN. Este relatório agrega também o enquadramento da prática profissional que aborda a organização das atividades desenvolvidas, a caracterização da população atendida e de dois estudos de caso. No período de estágio foi permitido à aluna incluir-se numa equipa multidisciplinar, onde foi possível desenvolver as suas competências pessoais e profissionais. Conclui-se que os objetivos de estágio foram alcançados, na medida em que se verificou que a intervenção psicomotora nesta unidade foi fundamental para a evolução dos casos seguidos em internamento/ligação e, posteriormente, existiu a oportunidade de alargar a terapia a outras perturbações além da PCA.

A dimensão preventiva da intervenção precoce : intervenção psicomotora na creche

O presente relatório tem como principal objetivo apresentar a caracterização do estágio realizado na Equipa Móvel de Desenvolvimento Infantil e Intervenção Precoce (EMDIIP) no âmbito da promoção do desenvolvimento infantil de crianças em contexto de creche, ao longo do segundo ano do mestrado em Reabilitação Psicomotora. Toda a intervenção psicomotora foi planeada consoante os resultados das avaliações formais, das observações informais de cada criança e das preocupações e dificuldades enunciadas pela Educadora de Infância da creche tendo sempre em conta as práticas recomendadas da Intervenção Precoce. Para além das sessões de psicomotricidade realizadas em grupo e individualmente, foi desenvolvido um trabalho de formação parental, com o intuito de promover as interações familiares e divulgar informação sobre o desenvolvimento normal das crianças, e um ajustamento do contexto da sala Arco-Íris. A psicomotricidade revelou ser uma ferramenta essencial na promoção do desenvolvimento infantil não só na sua vertente (re)educativa e terapêutica mas também na sua vertente preventiva.

Relatório de estágio : Centro de Apoio ao Desenvolvimento Infantil, CADIn

O presente relatório descreve a prática profissional desenvolvida no Centro de Apoio ao Desenvolvimento Infantil (CADIn), no âmbito do Ramo de Aprofundamento de Competências Profissionais (RACP), enquadrado no 2º Ano do 2º Ciclo de Reabilitação Psicomotora, correspondente ao ano letivo 2014/2015. O trabalho desenvolvido no CADIn foi realizado, principalmente, junto de crianças e jovens com Dificuldades de Aprendizagem Específicas (DAE). As DAE, de origem neurobiológica e intrínsecas ao indivíduo, caracterizam-se por um conjunto de traços heterogéneos que se manifestam na aquisição e uso das competências auditivas, da fala, da leitura, da escrita, do raciocínio e/ou matemáticas. Podem coexistir com outras perturbações, como é o caso da Perturbação de Hiperatividade e Défice de Atenção (PHDA). A heterogeneidade dos perfis de aprendizagem de crianças com DAE torna o processo de intervenção um desafio permanente. Neste sentido, a intervenção psicomotora surge como uma resposta que permite o desenvolvimento holístico do indivíduo, viabilizando a apropriação dos processos simbólicos. O relatório está organizado em Enquadramento da Prática Profissional, que inclui o Enquadramento Teórico e o Enquadramento Institucional, e Realização da Prática Profissional, onde são abordados dois estudos de caso, de uma forma mais detalhada.

Empregabilidade nos récem licenciados da Faculdade de Motricidade Humana

A presente investigação enquadra-se nos estudos sobre o percurso académico e inserção profissional dos recém-licenciados dos anos letivos de 2010/11 e 2011/12 da Faculdade de Motricidade Humana, em colaboração com o Observatório da Empregabilidade da FMH. Tem como principal objetivo a caraterização do emprego dos recém-licenciados pela Faculdade. A metodologia aproveitou e aperfeiçoou uma plataforma eletrónica proprietária (AgonScopio v.1.7.51), para o desenvolvimento de questionários online, no meio Web. O universo do estudo foi representado pelos recém-licenciados dos dois anos letivos em estudo, das seguintes licenciaturas: Ciências do Desporto, Dança, Ergonomia, Gestão do Desporto e Reabilitação Psicomotora. A amostra foi representada pelos resultados obtidos das 105 respostas conseguidas, de um universo de 334 licenciados, permitindo caraterizar o comportamento dos recém-licenciados, de acordo com nove dimensões estudadas, nomeadamente: dados gerais, enquadramento sociocultural com o objeto da FMH, primeiro emprego, formação, experiência profissional, trabalho e remuneração, expetativas, mobilidade e formação pós licenciatura. Aferimos que os recém-licenciados da FMH possuem um bom índice de empregabilidade e o emprego é maioritariamente na sua área de formação. A maioria dos licenciados obtém emprego até 12 meses após a conclusão das respetivas licenciaturas (71%).

Terapia psicomotora no Serviço de Psiquiatria do Hospital Prof. Doutor Fernando Fonseca

O presente relatório descreve as atividades de estágio desenvolvidas no âmbito do Ramo de Aprofundamento de Competências Profissionais (RACP) do mestrado em Reabilitação Psicomotora da Faculdade de Motricidade Humana. O estágio profissionalizante realizou-se no serviço de psiquiatria do Hospital Prof. Doutor Fernando Fonseca, e contou com sessões de observação participada e intervenção psicomotora na equipa de pedopsiquiatria e de psiquiatria de adultos. O relatório inclui um enquadramento teórico com uma revisão legal da saúde mental e o enquadramento profissional do psicomotricista, da prática psicomotora em saúde mental e uma revisão de literatura das psicopatologias mais prevalentes, destacando os principais objetivos da psicomotricidade em cada uma delas. Inclui também o enquadramento da prática profissional, no qual se descreve a organização das atividades de estágio, a caracterização dos utentes acompanhados e do processo terapêutico com dois estudos-caso. Este estágio permitiu a participação da aluna numa equipa multidisciplinar, e contribuiu positivamente para a sua formação profissional e pessoal, no âmbito dos objetivos definidos pelo RACP no contexto da prática em saúde mental. Considerando as evoluções observadas nos diferentes utentes acompanhados conclui-se que a intervenção psicomotora realizada foi pertinente quer no contexto pedopsiquiátrico, quer no contexto psiquiátrico.

A prediction model for establishing the disability degree in adults with spinal cord injury: results based on WHO-DAS II perspective

Objective: To establish a prediction model of the degree of disability in adults with Spinal CordInjury (SCI ) based on the use of the WHO-DAS II . Methods: The disability degree was correlatedwith three variable groups: clinical, sociodemographic and those related with rehabilitation services.A model of multiple linear regression was built to predict disability. 45 people with sci exhibitingdiverse etiology, neurological level and completeness participated. Patients were older than 18 andthey had more than a six-month post-injury. The WHO-DAS II and the ASIA impairment scale(AIS ) were used. Results: Variables that evidenced a significant relationship with disability were thefollowing: occupational situation, type of affiliation to the public health care system, injury evolutiontime, neurological level, partial preservation zone, ais motor and sensory scores and number ofclinical complications during the last year. Complications significantly associated to disability werejoint pain, urinary infections, intestinal problems and autonomic disreflexia. None of the variablesrelated to rehabilitation services showed significant association with disability. The disability degreeexhibited significant differences in favor of the groups that received the following services: assistivedevices supply and vocational, job or educational counseling. Conclusions: The best predictiondisability model in adults with sci with more than six months post-injury was built with variablesof injury evolution time, AIS sensory score and injury-related unemployment.

Mechanical behavior of dental implants in different positions in the rehabilitation of the anterior maxilla

Statement of problem. In dental rehabilitations that involve implants, the number of implants is sometimes smaller than the number of lost teeth. This fact can affect the biomechanical behavior and success of the implants.Purpose. The purpose of this study was to investigate the mechanical behavior of different implant positions in the rehabilitation of the anterior maxilla.Material and methods. Three-dimensional models of the maxilla were created based on computed tomography images for 3 different anterior prosthetic rehabilitations. In group IL, the implants were placed in the lateral incisor positions with pontics in the central incisor positions; in group IC, the implants were in the central incisor positions with cantilevers in the lateral incisor positions; and, in group ILIC, one implant was in a lateral incisor position and one was in a central incisor position, with a pontic and a cantilever in the remaining positions. A 150 N load was distributed and applied at the center of the palatal surface of each tooth at a 45-degree angle to the long axis of the tooth. The resulting stress-strain distribution was analyzed for each group.Results. The lowest displacement of the prosthetic structure was observed in group IC, although the same group exhibited the largest displacement of the bone tissue. In the bone tissue, the von Mises stress was mainly observed in the cortical bone in all groups. The maximum value of the von Mises stress shown in the cortical tissue was 35 MPa in the implant that neighbors the cantilever in group ILIC. The maximum von Mises stress in the trabecular bone was 3.5 MPa.Conclusion. The prosthetic configuration of group IC limited the displacement of the prosthetic structure but led to greater displacement of the bone structure. The use of a cantilever increased the stress concentration in the implant and in the bone structure adjacent to the cantilever under the conditions studied here.

[Implementation of a routine gradual psycho-diagnostic programme in somatic rehabilitation centres - results of a pilot study]

STUDY AIM: A pilot study was conducted to implement and evaluate a routine gradual psycho-diagnostic programme to improve diagnostics and treatment of mental disorders in somatic rehabilitation centres. First of all, implementation strategies were acquired in trainings together with psychologists and physicians. The psycho-diagnostic programme consists of a screening instrument (PHQ-9) designed to permit time-effective detection of comorbid mental disorders. Besides evaluation of the training, the aim of the study was to analyze the extent to which it is possible to implement the routine gradual psycho-diagnostic programme in practice. Additionally, it was intended to identify beneficial and obstructive conditions for implementation. METHODOLOGY: The pilot study was conducted in two orthopaedic and one cardiological rehabilitation centre. The training was evaluated directly after its completion using a questionnaire. Three months after its implementation, the introduction of the psycho-diagnostic programme was evaluated using interviews with n=11 physicians and psychologists. RESULTS: The training was rated positively by the participants . Implementation of the entire gradual psycho-diagnostic programme was possible in one centre and to some degree in the other two. Beneficial for implementation were a frank organisational climate, sufficient time resources, and physicians' biopsychosocial understanding of disease. A dismissive attitude towards psycho-diagnostics, little communication between staff members, little perceived advantage for one's own work and fear to stigmatise patients by psychiatric diagnoses were obstructive. CONCLUSION: Essential for a successful implementation are sufficient time and personal resources, a motivation for change in staff and centre management, and a positive attitude regarding psycho-diagnostics in clinic staff. Furthermore, flexibility in implementation strategies and the opportunity to participate in the implementation process are important.

Whole of life cycle cost analysis in bridge rehabilitation

The report presents a methodology for whole of life cycle cost analysis of alternative treatment options for bridge structures, which require rehabilitation. The methodology has been developed after a review of current methods and establishing that a life cycle analysis based on a probabilistic risk approach has many advantages including the essential ability to consider variability of input parameters. The input parameters for the analysis are identified as initial cost, maintenance, monitoring and repair cost, user cost and failure cost. The methodology utilizes the advanced simulation technique of Monte Carlo simulation to combine a number of probability distributions to establish the distribution of whole of life cycle cost. In performing the simulation, the need for a powerful software package, which would work with spreadsheet program, has been identified. After exploring several products on the market, @RISK software has been selected for the simulation. In conclusion, the report presents a typical decision making scenario considering two alternative treatment options.

Practice-led research and the innovation agenda : beyond the postgraduate research degree in the arts, design and media

The rise of the ‘practice-led’ research approach has given us a new way of understanding what creative practice in art, design and media can do in the academy and the world— it can materialise new ideas and forms into being as a form of experimental research. Yet, to date, attention around the world, and especially in Australia, has been chiefly directed at the postgraduate research degrees, most notably the PhD or doctoral equivalents. Recent mapping projects and surveys of practice-led research in Australia reveal much about the institutional conditions of higher degree researchers, supervisors, examiners and research training (Baker et al 2009; Evans et al 2003; Dally et al 2004; Paltridge et al 2009; Phillips et al 2009). Given this focus, we might well ask: is the practice-led approach destined to be a part of the higher degree ghetto only, or does it have an afterlife? What is the place of ‘practice-led’ beyond the postgraduate degree? After all postgraduate researchers do not remain postgraduates forever, and perhaps the practice-led approach to research may have benefits in wider university, professional and communal contexts.

Importance of soil ecology in vegetation rehabilitation on a North Stradbroke Island sand mine

Sibelco Australia Limited (SAL), a mineral sand mining operation on North Stradbroke Island, undertakes progressive rehabilitation of mined areas. Initial investigations have found that some areas at SAL’s Yarraman Mine have failed to redevelop towards approved criteria. This study, undertaken in 2010, examined ground cover rehabilitation of different aged plots at the Yarraman Mine to determine if there was a relationship between key soil and vegetation attributes. Vegetation and soil data were collected from five plots rehabilitated in 2003, 2006, 2008, 2009 and 2010, and one unmined plot. Cluster (PATN) analysis revealed that vegetation species composition, species richness and ground cover differed between plots. Principal component analysis (PCA) extracted ten soil attributes that were then correlated with vegetation data. The attributes extracted by PCA, in order of most common variance, were: water content, pH, terrolas depth, elevation, slope angle, leaf litter depth, total organic carbon, and counts of macrofauna, fungi and bacteria. All extracted attributes differed between plots, and all except bacteria correlated with at least one vegetation attribute. Water content and pH correlated most strongly with vegetation cover suggesting an increase in soil moisture and a reduction in pH are required in order to improve vegetation rehabilitation at Yarraman Mine. Further study is recommended to confirm these results using controlled experiments and to test potential solutions, such as organic amendments.

Development and feasibility of a smartphone, ECG and GPS based system for remotely monitoring exercise in cardiac rehabilitation

Background Despite its efficacy and cost-effectiveness, exercise-based cardiac rehabilitation is undertaken by less than one-third of clinically eligible cardiac patients in every country for which data is available. Reasons for non-participation include the unavailability of hospital-based rehabilitation programs, or excessive travel time and distance. For this reason, there have been calls for the development of more flexible alternatives. Methodology and Principal Findings We developed a system to enable walking-based cardiac rehabilitation in which the patient's single-lead ECG, heart rate, GPS-based speed and location are transmitted by a programmed smartphone to a secure server for real-time monitoring by a qualified exercise scientist. The feasibility of this approach was evaluated in 134 remotely-monitored exercise assessment and exercise sessions in cardiac patients unable to undertake hospital-based rehabilitation. Completion rates, rates of technical problems, detection of ECG changes, pre- and post-intervention six minute walk test (6 MWT), cardiac depression and Quality of Life (QOL) were key measures. The system was rated as easy and quick to use. It allowed participants to complete six weeks of exercise-based rehabilitation near their homes, worksites, or when travelling. The majority of sessions were completed without any technical problems, although periodic signal loss in areas of poor coverage was an occasional limitation. Several exercise and post-exercise ECG changes were detected. Participants showed improvements comparable to those reported for hospital-based programs, walking significantly further on the post-intervention 6 MWT, 637 m (95% CI: 565–726), than on the pre-test, 524 m (95% CI: 420–655), and reporting significantly reduced levels of cardiac depression and significantly improved physical health-related QOL. Conclusions and Significance The system provided a feasible and very flexible alternative form of supervised cardiac rehabilitation for those unable to access hospital-based programs, with the potential to address a well-recognised deficiency in health care provision in many countries. Future research should assess its longer-term efficacy, cost-effectiveness and safety in larger samples representing the spectrum of cardiac morbidity and severity.

Timed Up and Go Tests in cardiac rehabilitation : reliability and comparison with the 6-minute walk test

PURPOSE: To test the reliability of Timed Up and Go Tests (TUGTs) in cardiac rehabilitation (CR) and compare TUGTs to the 6-Minute Walk Test (6MWT) for outcome measurement. METHODS: Sixty-one of 154 consecutive community-based CR patients were prospectively recruited. Subjects undertook repeated TUGTs and 6MWTs at the start of CR (start-CR), postdischarge from CR (post-CR), and 6 months postdischarge from CR (6 months post-CR). The main outcome measurements were TUGT time (TUGTT) and 6MWT distance (6MWD). RESULTS: Mean (SD) TUGTT1 and TUGTT2 at the 3 assessments were 6.29 (1.30) and 5.94 (1.20); 5.81 (1.22) and 5.53 (1.09); and 5.39 (1.60) and 5.01 (1.28) seconds, respectively. A reduction in TUGTT occurred between each outcome point (P ≤ .002). Repeated TUGTTs were strongly correlated at each assessment, intraclass correlation (95% CI) = 0.85 (0.76–0.91), 0.84 (0.73–0.91), and 0.90 (0.83–0.94), despite a reduction between TUGTT1 and TUGTT2 of 5%, 5%, and 7%, respectively (P ≤ .006). Relative decreases in TUGTT1 (TUGTT2) occurred from start-CR to post-CR and from start-CR to 6 months post-CR of −7.5% (−6.9%) and −14.2% (−15.5%), respectively, while relative increases in 6MWD1 (6MWD2) occurred, 5.1% (7.2%) and 8.4% (10.2%), respectively (P < .001 in all cases). Pearson correlation coefficients for 6MWD1 to TUGTT1 and TUGTT2 across all times were −0.60 and −0.68 (P < .001) and the intraclass correlations (95% CI) for the speeds derived from averaged 6MWDs and TUGTTs were 0.65 (0.54, 0.73) (P < .001). CONCLUSIONS: Similar relative changes occurred for the TUGT and the 6MWT in CR. A significant correlation between the TUGTT and 6MWD was demonstrated, and we suggest that the TUGT may provide a related or a supplementary measurement of functional capacity in CR.

High risk feet in subacute rehabilitation facilities : how many are there?

Background Australian subacute rehabilitation facilities face significant challenges from the ageing population with increased burden of chronic disease. High risk foot complications are a negative consequence of many chronic diseases. With the rapid expansion of subacute services, it seems imperative to investigate the prevalence of foot complications in this population. The primary aim of this study was to quantify the high risk foot complication prevalence in a subacute rehabilitation population. Methods Eligible participants were all adults admitted overnight, over two 4 week periods, into a large Australian subacute rehabilitation facility. Consenting participants underwent a short non-invasive foot examination by a podiatrist. The standard Queensland Health High Risk Foot Form collected data on age, sex, co-morbidities and foot complications. Descriptive statistics, logistic regression and odds ratios were used to determine the prevalence of foot complications and associations with explanatory variables. Results Overall, 85 of 97 eligible participants consented; mean age 80(9) and 71% were female. At least one foot complication was present in 56.5% participants; including 21.2% defined as high risk and 11.8% current foot ulcer. A previous diagnosis of neuropathy increased the risk of presenting with a high risk foot by 13-fold (OR 13.504, p = 0.001). Conclusion This study highlights the significance of foot complications in the subacute population. It appears that one in every two patients present with a foot complication and one in eight with a foot ulcer. It is suggested all patients admitted to subacute rehabilitation services should be screened for foot complications.