ABSTRACT
ABSTRACT Objective Radiographically evaluate the quality of reduction over six weeks of follow-up in patients with surgically treated deviated acetabular fractures who underwent rehabilitation with immediate loading as tolerated and compare this with the results of the unloaded protocol. Methods We retrospectively evaluated the records of 137 patients with deviated acetabular fractures treated with open reduction and internal fixation. Sixty-six (48.2%) patients underwent postoperative rehabilitation with immediate loading as tolerated, while 71 (51.8%) patients completed rehabilitation using a no-load protocol. The quality of the reduction was assessed radiographically by measuring the fracturing step and gap on radiographs taken immediately after surgery and three and six weeks after surgery. Results Comparing the joint step, group 1 had an average of 0.44 ± 1.4 mm, 0.47 ± 1.5 mm, and 0.51 ± 1.6 mm immediately, three and six weeks after surgery, respectively. Group 2 had a mean step of 0.24 ± 0.8 mm, 0.27 ± 0.9 mm, and 0.37 ± 1.2 mm immediately, three, and six weeks after surgery. No statistically significant differences were observed between the groups. With a joint gap, group 1 had a mean of 1.89 ± 1.7 mm, 2.12 ± 1.8 mm, and 2.36 ± 2.1 mm; and group 2 had a mean of 2.16 ± 2.4 mm, 2.47 ± 2.6 mm, and 2.67 ± 2.8 mm in the immediate postoperative period, three, and six weeks, respectively. There was also no statistical difference between groups in these measurements. Conclusion Immediate loading after surgical treatment of deviated acetabular fracture had no negative impact on radiographic reduction parameters and had similar results to the protocol without weight bearing. Level of evidence III; Therapeutic Retrospective Cohort Study.
RESUMO Objetivo Avaliar radiograficamente a qualidade da redução ao longo de 6 semanas de acompanhamento em pacientes com fratura desviada do acetábulo tratados cirurgicamente e submetidos à reabilitação com carga imediata conforme tolerado e comparar com os resultados do protocolo sem carga. Métodos Avaliamos retrospectivamente os prontuários de 137 pacientes com fraturas desviadas do acetábulo que foram tratadas com redução aberta e fixação interna. Sessenta e seis (48,2%) pacientes foram submetidos à reabilitação pós-operatória com carga imediata conforme tolerado, enquanto 71 (51,8%) pacientes completaram a reabilitação utilizando um protocolo sem carga. A qualidade da redução foi avaliada radiograficamente pela medição do degrau da fratura e do gap nas radiografias feitas imediatamente após a cirurgia e três e seis semanas após a cirurgia. Resultados Comparando o degrau articular, o grupo 1 teve uma média de 0,44 ± 1,4 mm, 0,47 ± 1,5 mm e 0,51 ± 1,6 mm imediatamente, três e seis semanas após a cirurgia, respectivamente. O grupo 2 teve um degrau médio de 0,24 ± 0,8 mm, 0,27 ± 0,9 mm e 0,37 ± 1,2 mm imediatamente, três e seis semanas após a cirurgia. Não foram observadas diferenças estatísticas significantes entre os grupos. Com gap articular, o grupo 1 teve uma média de 1,89 ± 1,7 mm, 2,12 ± 1,8 mm e 2,36 ± 2,1 mm; e o grupo 2 de 2,16 ± 2,4 mm, 2,47 ± 2,6 mm e 2,67 ± 2,8 mm nos pós-operatório imediato, três e seis semanas, respectivamente. Também não houve diferença estatística entre os grupos nessas medidas. Conclusão A carga imediata após o tratamento cirúrgico da fratura do acetábulo desviada não teve impacto negativo nos parâmetros de redução radiográfica e teve resultados semelhantes em comparação com o protocolo sem descarga de peso. Nível De Evidência III; Estudo Terapêutico de Coorte Retrospectivo.
ABSTRACT
El enfoque de Rehabilitación Basada en la Comunidad (RBC) representa una estrategia cuyo propósito es lograr la plena integración e inclusión de las personas en situación de discapacidad (PsSD) a nivel social. Considerando que la comunicación y el lenguaje humano representan herramientas de expresión del pensamiento, la Asociación Americana de Habla, Lenguaje y Audición (ASHA) insta a promover el desarrollo de una comunicación efectiva como un derecho humano accesible para todas las personas, en consideración de su dignidad inherente. OBJETIVO: conocer el quehacer de fonoaudiólogos(as) que se desempeñan en el contexto de RBC, en la Quinta Región de Valparaíso. MÉTODO: investigación de tipo cualitativa, con enfoque fenomenológico. Se realizó una entrevista semiestructurada y posteriormente se procedió a realizar un análisis de contenido. RESULTADOS: Los fonoaudiólogos(as) ejecutan acciones atingentes a los cinco pilares de la RBC y se observa la práctica de actos vinculados a la gestión del intersector. CONCLUSIONES: Los profesionales adoptan la estrategia RBC incorporada en la visión de la institución en la que se encuentran insertos, adoptando un perfil orientado a la transdisciplina.
The Community Based Rehabilitation (CBR) approach represents a strategy whose purpose is to achieve full social integration and inclu sion of people with disabilities. Considering that communication and human language represent tools of expression of thought, the American Speech, Language and Hearing Association (ASHA) advo cates the development of effective communication promotion, as a human right accessible to all people, considering its inherent dignity. OBJECTIVE: to analyze speech and language pathologist's CBR prac tices in the fifth region of Valparaíso. METHOD: qualitative research, with a phenomenological approach. A semi-structured interview was conducted followed by a content analysis. RESULTS: speech and Language pathologists carry out actions related to the five CBR key components and also the practice of actions in accord to intersector. CONCLUSIONS: The professionals adopt the CBR approach incorporat ing the institutional vision of service in which they are inserted and adopting a profile oriented to transdisciplinary.
Subject(s)
Humans , Professional Practice , Speech, Language and Hearing Sciences , Rehabilitation , Chile , Organizations , Public Health , Interviews as Topic , Qualitative ResearchABSTRACT
En Chile, los fonoaudiólogos han estado incorporados laboralmente en instituciones de salud, desde la apertura de la carrera a nivel nacional; sin embargo, el rol que el profesional cumple en dicho sector no está declarado, lo que ha dificultado su vinculación laboral en el sector público, particularmente en atención primaria. OBJETIVOS: Conocer la percepción de los fonoaudiólogos sobre las habilidades y tareas profesionales demandadas en el sector salud dentro del contexto nacional, y a partir de esta, generar una pro puesta del rol profesional en dicho ámbito laboral. MÉTODO: Diseño no experimental, tipo analítico, descriptivo y transversal. Se aplicó el protocolo "Autorreflexión del desempeño profesional en Salud" a 19 fonoaudiólogos, que cumplían con los criterios de inclusión. Resultados: Las responsabilidades profesionales más demandadas son: evaluación, intervención, derivación y colaboración; habilidades interpersonales, supervisión, gestión, e identificación, cobran menor importancia; acciones de prevención evidencian poca realización. CONCLUSIONES: conocer el rol del fonoaudiólogo que trabaja en salud en Chile permite configurar su actuar, generando una gama de funciones, habilidades, responsabilidades y técnicas a dominar, que retroalimentan la formación profesional y orientan en la creación de políticas públicas, facilitando la transición del fonoaudiólogo a otros ámbitos dentro del propio sector salud, como la atención primaria.
In Chile, Speech Language Pathologists (SLPs) have been incorpo rated in health care institutions, from the opening of the under-graduated program throughout the nation; however, the role that this professional should perform in that sector is not stated, which has hindered their employment relationship in the public sector and particularly in primary health. OBJECTIVES: To know the perception of SLPs about the abilities and tasks demanded in the health sector within the Chilean national context, and from this, to generate a proposal of the professional role in this field of work. Method: Non-experimental design, analytical, descriptive and transverse type. The protocol "Self Reflection of Health Professional Performance" was applied to 19 SLPs, who fulfilled the inclusion criteria. RESULTS: The most demanded professional responsibilities are: evaluation, inter vention, referral and collaboration; Interpersonal skills, supervision, management, and identification, Becomes more important; Prevention actions show little accomplishment. CONCLUSIONS: To know the role of the SLPs who works in health in Chile, allows to configure their performance, generating a range of functions, skills, responsibilities and techniques to master, which feedback the profes sional training and guide in the creation of public policies, facilitat ing The transition of the SLPs to other areas within the health sector itself, such as primary care.