ABSTRACT
Objetivo: Identificar instrumentos utilizados para a avaliação funcional de pessoas com lesão medular não-traumática (LMNT) e comparar seu conteúdo de acordo com os conceitos da CIF. Método: A revisão sistemática foi realizada nas bases de dados Medline, Scielo, Pubmed e Bireme com os descritores "paraparesia espástica", "avaliação funcional", "exame neurológico", "escalas neurológicas", "avaliação neurológica" e "medidas de avaliação neurológica". Para encontrar artigos relatando as escalas de avaliação funcional aplicadas em indivíduos com LMNT. O conteúdo de tais instrumentos foi comparado após vinculá-los à CIF. Resultados: A revisão sistemática identificou 12 instrumentos de avaliação funcional de LMNT, foram identificadas 153descrições das categorias da CIF, concentradas principalmente em: funções neuromusculoesqueléticas, digestivas, atividades motoras e autocuidado. Entre os fatores ambientais: a tecnologia assistida para mobilidade, para uso pessoal na vida cotidiana, mereceu maior atenção. Conclusão: Este estudo forneceu um guia para identificar instrumentos para avaliar a funcionalidade de indivíduos com LMNT.
Purpose: Identify instruments used for the functional evaluation of people with Non-traumatic Spinal Cord Injury (NTSP), and compare their contents according to ICF concepts. Method: Literature review was conducted in the Medline, Scielo, Pubmed, and Bireme databases with the descriptors "spastic paraparesis," "functional evaluation," "neurological examination," "neurological scales," "neurological evaluation," and "neurological evaluation measurements," to find articles reporting the functional evaluation scales having been applied on individuals with NTSP. The content of such instruments was compared after linking them to ICF. Results: The systematic review identified 12 instruments for functional evaluation instruments of NTSP, in we described 153 ICF categories, concentrated mainly in: neuromusculoskeletal functions, digestive, motor activities, and self-care. Among the environmental factors: assistive technology for mobility, to personal use in daily life deserved greater attention. Conclusion: This study provided a guide to identify instruments to evaluate the functionality of individuals with NTSP.
Subject(s)
Quality of Life , Spinal Cord Injuries , International Classification of Functioning, Disability and Health , Surveys and Questionnaires , Paraparesis, SpasticABSTRACT
Objetivo: Descrever o processo de desenvolvimento e validação do instrumento baseado no Core Set resumido da Classificação Internacional da Funcionalidade, Incapacidade e Saúde para indivíduos com lesão medular aguda. Método: No estudo metodológico foi desenvolvido um instrumento para avaliação da funcionalidade de indivíduos com lesão medular aguda traumática. A validação de face e conteúdo do instrumento foi realizada por um comitê de especialistas, compreendendo as etapas preconizadas na literatura. Como parte desse processo, foi realizado o pré-teste, com 10 indivíduos com lesão medular aguda traumática, com até 6 meses de lesão. Resultados: Na maioria dos itens do instrumento, os participantes fizeram sugestões que visavam à modificação de termos técnicos, para serem substituídos ou reformulados para melhor compreensão pelo público alvo. Para a análise de dados o mínimo de concordância estabelecido foi de 80%. Conclusão: A contribuição do estudo refere-se à possibilidade de utilizar uma ferramenta inovadora pela equipe multidisciplinar na prática clínica.
The research aimed to describe the instrument development and validation process based on the brief Core Set of the International Classification of Functioning, Disability and Health for individuals with Acute Spinal Cord Injury. In the methodological study, an instrument was developed to evaluate the functionality of individuals with acute traumatic spinal cord injury. The face and content validation of the instrument was performed by an expert committee, understanding the steps recommended in the literature. As part of this process, a pretest was performed with 10 individuals with acute traumatic spinal cord injury with up to 6 months of injury. In the results, in most items of the instrument, participants made suggestions to modify technical terms, to be replaced or reformulated for better understanding by the target audience. For data analysis the minimum agreement established was 80%. In conclusion, the contribution of the study refers to the possibility of using an innovative tool by the multidisciplinary team in clinical practice.
Subject(s)
Humans , Spinal Cord Injuries/rehabilitation , International Classification of Functioning, Disability and Health , Validation StudyABSTRACT
PURPOSE: To verify the applicability, reproducibility and validity of the SCIM III patients with non-traumatic spinal cord injury. METHOD: The cross-sectional study included 30 patients (66% females; 41.5 ± 14.7 yo) with non-traumatic spinal cord injury of any etiology. Subjects were subjected by computerized gait analysis and answered the Brazilian versions of SCIM III (0-100 points) and FIM™ (18-126 points) by two raters (A and B) at the same day and 1 week later (A). RESULTS: The intraclass correlation coefficient for the use of SCIM III indicated appropriated intra- and inter-evaluator reproducibility (ICC = 0.9). Correlation between the SCIM III and the motor FIM™ was appropriate (r = 0.6; p = 0.0). SCIM III subscales and FIM™ domains correlated strongly for self-care (r = 0.8; p ≤ 0.001), moderately for transfers (r = 0.6; p = 0.0005) and locomotion (r = 0.6; p = 0.0006). SCIM III mobility subscale positively correlated with the cadence (r = 0.8; p ≤ 0.01), gait speed (r = 0.7; p ≤ 0.01) and step length (r = 0.6; p ≤ 0.01). CONCLUSIONS: SCIM III is a reproducible functional assessment instrument and capable of evaluating the level of independence of the individual with non-traumatic spinal cord injury. The SCIM III is more sensitive than the MIF™ for non-traumatic spastic paraplegic patients with higher levels of independence, particularly if they can walk independently. Linear gait parameters correlated with its mobility subscale. Implications for Rehabilitation Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions. There are not many studies focused on patients with non-traumatic spinal cord lesion. Disability varies in severity, but frequently contributes to limitations in the activities of daily living (ADL) and participation. We do not find in the literature studies that assess the functionality of these individuals as comprehensive as ours.
