RESUMO
This report describes a case of an amputee with a lumber spinal cord injury who successfully recovered ambulation with the use of prosthesis.A 30-year-old man with schizophrenia underwent amputation of the lower legs and concurrently developed lumbar spinal cord injury from of a suicide attempt. After the treatment of stump plasty and posterior fusion, the patient was transferred to our facility. Lower-extremity prostheses for both legs were fitted, and orthostatic training was commenced following admission. During the initial evaluation, the patient could not maintain a stable standing position because of weakness in the hip extensor muscle. An inflexion angle of the prosthesis was set to 0° to extend the knee joint and achieve standing stability. Appropriate adjustments of the prosthesis were made as required, specifically addressing the paraplegia caused by his lumbar spinal cord injury. Thus, the patient successfully regained ambulation with the treatment.Recovering walking independence after bilateral lower leg amputations or paraplegia caused by lumber spinal cord injury is not uncommon. However, this case is unique in that the muscle weakness caused by lumbar spinal cord injury presented unforeseen difficulties for the patient to achieve ambulation, which is not ordinarily observed in amputation rehabilitation cases. No similar cases have been reported in which patients concurrently suffered from both these conditions in Japan；therefore, this case is extremely rare.
RESUMO
This report describes a case of an amputee with a lumber spinal cord injury who successfully recovered ambulation with the use of prosthesis.A 30-year-old man with schizophrenia underwent amputation of the lower legs and concurrently developed lumbar spinal cord injury from of a suicide attempt. After the treatment of stump plasty and posterior fusion, the patient was transferred to our facility. Lower-extremity prostheses for both legs were fitted, and orthostatic training was commenced following admission. During the initial evaluation, the patient could not maintain a stable standing position because of weakness in the hip extensor muscle. An inflexion angle of the prosthesis was set to 0° to extend the knee joint and achieve standing stability. Appropriate adjustments of the prosthesis were made as required, specifically addressing the paraplegia caused by his lumbar spinal cord injury. Thus, the patient successfully regained ambulation with the treatment.Recovering walking independence after bilateral lower leg amputations or paraplegia caused by lumber spinal cord injury is not uncommon. However, this case is unique in that the muscle weakness caused by lumbar spinal cord injury presented unforeseen difficulties for the patient to achieve ambulation, which is not ordinarily observed in amputation rehabilitation cases. No similar cases have been reported in which patients concurrently suffered from both these conditions in Japan；therefore, this case is extremely rare.
RESUMO
We provided inpatient rehabilitation treatment and return-to-school guidance to a junior high school student with medulloblastoma and pervasive developmental disorder (autism spectrum disorder). Here we describe the rehabilitation treatment for patients with physical and developmental disabilities. A 13-year-old boy who was diagnosed with pervasive developmental disorder at 4 years of age was able to perform activities of daily living independently and attend junior high school. However, he was admitted to our hospital with new-onset ataxia. Magnetic resonance imaging revealed a cerebellar tumor. After total tumor excision was performed, pathological analysis revealed medulloblastoma, which was treated initially with radiation therapy and then chemotherapy for 1 year. Rehabilitation was initiated 2 days post-surgery. We evaluated his communication abilities. He showed stereotypical behavior owing to the autism spectrum disorder；therefore, we performed low-intensity repetitive exercises. The functional independence measure score at discharge was 67/126 (motor 44/91, cognitive 23/35). We taught his teachers how to properly assist him, and he successfully returned to school post-discharge. Although this was a case in which the child had multiple disabilities, ataxia caused by the medulloblastoma aggravated his developmental disability. Thus, understanding the characteristics of communication and its strengths was vital in determining a treatment plan that enabled his return to school.
RESUMO
We provided inpatient rehabilitation treatment and return-to-school guidance to a junior high school student with medulloblastoma and pervasive developmental disorder (autism spectrum disorder). Here we describe the rehabilitation treatment for patients with physical and developmental disabilities. A 13-year-old boy who was diagnosed with pervasive developmental disorder at 4 years of age was able to perform activities of daily living independently and attend junior high school. However, he was admitted to our hospital with new-onset ataxia. Magnetic resonance imaging revealed a cerebellar tumor. After total tumor excision was performed, pathological analysis revealed medulloblastoma, which was treated initially with radiation therapy and then chemotherapy for 1 year. Rehabilitation was initiated 2 days post-surgery. We evaluated his communication abilities. He showed stereotypical behavior owing to the autism spectrum disorder；therefore, we performed low-intensity repetitive exercises. The functional independence measure score at discharge was 67/126 (motor 44/91, cognitive 23/35). We taught his teachers how to properly assist him, and he successfully returned to school post-discharge. Although this was a case in which the child had multiple disabilities, ataxia caused by the medulloblastoma aggravated his developmental disability. Thus, understanding the characteristics of communication and its strengths was vital in determining a treatment plan that enabled his return to school.
RESUMO
RESUMO: Crianças com deficiência múltipla sensorial visual enfrentam desafios diários para comunicar seus interesses e necessidades e para compreender adequadamente conceitos. Um dos grandes obstáculos para iniciar uma intervenção eficaz com essas crianças consiste em identificar suas preferências e fornecer estratégias de ensino e oportunidades de aprendizagem específicas que valorizem os seus pontos fortes. Nesse sentido, o objetivo deste estudo foi apresentar cinco cartões de símbolos tangíveis como recurso para ensinar conceitos sobre a pandemia da COVID-19 para crianças que apresentam deficiência múltipla sensorial visual. Pensando nisso, este ensaio teórico coloca em evidência a importância dos símbolos tangíveis como valiosos recursos da comunicação alternativa tátil, capazes de favorecer a comunicação, a antecipação de atividades, a compreensão de conceitos, e como opções de escolhas a serem feitas por estas crianças. Destaca-se a importância das interações táteis exploratórias por meio da modalidade háptica e do distanciamento entre o eu, os outros, os objetos e as representações. Por tratar-se de um assunto pouco explorado no cenário nacional, considera-se relevante apresentá-lo para que outros professores e pesquisadores o conheçam e o utilizem com seus alunos.
ABSTRACT: Children with multi-sensory impairment face daily challenges to communicate their interests and needs and properly understand concepts. One of the major obstacles to start an effective intervention with these children is to identify their preferences and provide specific teaching strategies and learning opportunities that value their strengths. In this sense, the objective of this study was to present five cards of tangible symbols as a resource to teach concepts about the COVID-19 pandemic to children who have multi-sensory impairment. With this in mind, this theoretical essay highlights the importance of tangible symbols as valuable resources for alternative tactile communication, capable of favoring communication, anticipating activities, understanding concepts, and as options for choices to be made by these children. It highlights the importance of exploratory tactile interactions through haptic modality and distance between the self, others, objects and representations. As it is a subject little explored in the national scenario, it is considered relevant to present it so that other professors and researchers can get to know it and use it with their students.
RESUMO
Resumen El objetivo fue evaluar la calidad de vida de personas con discapacidad intelectual y múltiple de 4 a 21 años a través de la Escala KidsLife validada para Colombia. Se adelantó un estudio de corte cuantitativo-explicativo, en el que participaron 220 informantes clave. Las dimensiones donde se evidenciaron puntuaciones medias más altas en calidad de vida fueron bienestar físico y bienestar emocional; contrariamente, las puntuaciones más bajas se registraron en autodeterminación e inclusión social. Se encontraron diferencias significativas de acuerdo con nivel de discapacidad, nivel de necesidades de apoyo y nivel de dependencia reconocida. Las mayores diferencias significativas correspondieron a las variables: sexo, contar con la familia y tener acceso a la escolaridad; sin embargo, las variables explicativas de la calidad de vida fueron: nivel de necesidades de apoyo, contar con el apoyo de una familia, residir en el hogar familiar y escolarización ordinaria. Se concluyó que los menores puntajes en autodeterminación e inclusión social indican la necesidad de promover la participación en actividades comunitarias de interés que sean incluyentes. De igual forma, las relaciones encontradas entre los factores sociodemográficos y la calidad de vida evidencian la necesidad de implementar intervenciones orientadas a la creación de planes de apoyo individualizados, con el fin de promover su autodeterminación y estimular los logros personales y organizacionales.
Abstract The objective of this study was to evaluate the quality of life of the persons with intellectual and multiple disabilities between 4 to 21 years through the KidsLife Scale validated for Colombia. A quantitative-explanatory study was carried out involving 220 key informants. The dimensions with higher average scores in quality of life were physical well-being and emotional well-being; conversely, the lowest scores recorded were related to self-determination and social inclusion. Significant differences were found according to: level of disability, level of support needs and level of recognized dependence. The greatest significant differences corresponded to variables such as sex, having a family and the access to schooling. However, the explanatory variables of quality of life were: level of support needs, having family support, family home residing and ordinary schooling. It was concluded that the lower scores in self-determination and social inclusion indicate the need to promote participation in community activities of interest that are inclusive. Likewise, the relationships found between sociodemographic factors and quality of life show the need to implement interventions aimed at the creation of individualized support plans in order to promote self-determination and stimulate personal and organizational achievements.