Functional mobility assessment is reliable and correlated with satisfaction, independence and skills.

Mobility is essential for activities of daily living and therapists should give priority to evaluate its effects in their client's performance. We aimed to ascertain the intra- and inter-rater reliability of Functional Mobility Assessment (FMA) and to identify correlations among satisfaction, independence, and skills in 44 users of manual wheelchairs and three users of powered wheelchairs. We analyzed the test-retest and inter-rater reliability of the FMA in a sample of 47 wheelchair users using the Cronbach's Alpha. For correlations with FMA were used the Quebec User Evaluation of Satisfaction with Assistive Technology, Functional Independence Measure, and Wheelchair Skills Test Questionnaire (manual and powered forms). The test-retest reliability showed good internal consistency (α > 0.9). Associations between functional independence, wheelchair skills, and functional mobility were significant (p < .05). The Brazilian version of the FMA is reliable for use among wheelchair users, and its correlation with other measurements suggests cohesion among assessments related to mobility devices.

Correlações entre a Participação Ocupacional, Independência e Cognição em Adultos com Deficiência Física / Correlation among Occupational Participation, Independence and Cognition in Adults with Physical Disabilities

RESUMO: A participação ocupacional é uma questão crucial para a atenção à pessoa com deficiência e caracteriza-se pelo grau de participação de uma pessoa em várias ocupações, tais como as de autocuidado, trabalho, escola, lazer, dentre outras. O objetivo deste estudo foi, assim, verificar se a participação ocupacional avaliada pelo Model of Human Occupation Screening Tool (MOHOST Brasil) apresenta correlações com as medidas de independência funcional e de cognição em adultos com deficiências. Foram avaliadas 41 pessoas com deficiência física usando o MOHOST Brasil, a Medida de Independência Funcional (MIF) e o Mini Exame do Estado Mental (MEEM). A subescala motora da MIF apresentou correlação moderada com o fator de habilidades motoras MOHOST (r 0,586 p = 0,001). O item "Linguagem e práxis" do MEEM apresentou correlação moderada com o fator "habilidades de processo" do MOHOST (r 0,573 p = 0,001). As correlações entre o MOHOST e a MIF e entre o MOHOST e o MEEM mostram que há relação entre as dimensões de participação, desempenho e habilidades, confirmando que o MOHOST é útil para avaliar a participação ocupacional de pessoas com deficiências físicas. Conclui-se também que o MOHOST pode fornecer dados que possam contribuir para o planejamento de intervenções que estimulem a participação ocupacional em diferentes papéis no âmbito da Terapia Ocupacional e na sua inferface com a Educação Especial.

ABSTRACT: Occupational participation is a crucial issue for people with disabilities care and it is characterized by the degree of a person's participation in various occupations, such as self-care, work, school, leisure, among others. Thus, this study's objective was to examine if the occupational participation measured by Model of Human Occupation Screening Tool (MOHOST Brazil) has correlations with measures of functional independence and cognition in adults with disabilities. Forty-one (n=41) people with physical disabilities were assessed using the MOHOST Brazil, Functional Independence Measure (FIM) and the Mini-Mental State Examination (MMSE). The FIM's motor subscale presented moderate correlation with the MOHOST motor skills factor (r 0.586 p=0.001). The MMSE's item "Language and praxis" presented moderate correlation with the MOHOST's factor "process skills" (r 0.573 p= 0.001). The correlations between the MOHOST and FIM and between the MOHOST Brazil and MMSE show there is an inter-relation between the dimensions of participation, performance and skills, confirming that the MOHOST is useful for assessing occupational participation of people with disabilities. It is also concluded that MOHOST can provide information that can contribute on planning interventions to support occupational participation in different roles for Occupational Therapy and its possibilities of work in the field of Special Education.

Cross-cultural adaptation, face validity and reliability of the Model of Human Occupation Screening Tool to Brazilian Portuguese / Adaptação transcultural, validade de face e confiabilidade do Instrumento de Identificação da Participação Ocupacional do Modelo de Ocupação Humana para o português do Brasil

Abstract Introduction The Model of Human Occupation Screening Tool (MOHOST) was developed in the UK and measures the occupational participation. Until its translation, there were no standardised instruments in Brazil of a similar nature. Objectives To describe the translation and cross-cultural adaptation process of the MOHOST for Brazil, its face validity and test-retest reliability among occupational therapists. Method A translation agreement was established allowing the assessment to be translated and honed after a back translation. An expert committee was formed of ten occupational therapists to test face validity of the instrument with 50 occupational therapists. Statistical analysis was employed to investigate whether the occupational therapists' understanding of the MOHOST was linked to their length of clinical experience. The test-retest reliability was examined among a sample of eight adults with physical disabilities. Results The cross-cultural adaptation of the Brazilian MOHOST has been completed. A significant correlation (p=0.04) was found between years of professional experience and greater understanding of the MOHOST items. The MOHOST presented very high reliability in the test-retest (r>0.900). Conclusion A Brazilian translation of the MOHOST has face validation and test-retest reliability. Future studies addressing this instrument's psychometric properties of validity and inter-rater reliability are recommended.

Resumo Introdução O Instrumento de Identificação da Participação Ocupacional do Modelo de Ocupação Humana (MOHOST Brasil) foi desenvolvido no Reino Unido e mensura a participação ocupacional. Até a sua presente tradução, para o Brasil, não haviam instrumentos padronizados e que mensurassem o mesmo constructo. Objetivos Descrever o processo de tradução e adaptação cultural do MOHOST para o Brasil, examinar a sua validade de face e confiabilidade no teste-reteste por terapeutas ocupacionais. Método Inicialmente foi estabelecido um contato para a autorização da tradução e, posteriormente, seguidas as etapas de tradução, retrotradução, comitê de especialistas, validade de face e teste-reteste. O comitê de especialistas foi composto por dez terapeutas ocupacionais. A validade de face contou com a participação de 50 terapeutas ocupacionais. A análise estatística foi empregada para investigar se o entendimento do MOHOST pelos terapeutas ocupacionais estava vinculado à sua duração da experiência clínica. A confiabilidade teste-reteste foi examinada em uma amostra de oito adultos com deficiência física, em um intervalo de uma semana. Resultados A adaptação transcultural do MOHOST (Brasil) foi concluída. Foi encontrada uma correlação significativa (p=0,04) entre anos de experiência profissional e maior entendimento dos itens do MOHOST. O MOHOST apresentou confiabilidade muito alta no teste-reteste (r>0,900). Conclusão A versão brasileira apresenta validação de face e confiabilidade no teste-reteste. Estudos futuros abordando as propriedades psicométricas de validade convergente e confiabilidade entre avaliadores são recomendados.

The use of mobility assistive devices and the functional independence in stroke patients / O uso de dispositivos auxiliares para a mobilidade e a independência funcional em sujeitos com Acidente Vascular Cerebral

Abstract Introduction: Post-stroke limitations may cause problems and lead to dependency in daily activities, which requires the use of mobility assistive devices. Objective: Identify the level of functional independence and the use of mobility assistive devices among men as well as to check the relationship between these variables. Method: It is a descriptive, correlational research using convenience sampling carried at medical centers specialized in physical rehabilitation in a medium size town of São Paulo state. Then, a Data Form of the patient with stroke and the Functional Independence Measure were used. The data were sent to a simple descriptive analysis and biserial test. Results: It showed predominance of stroke subjects dependent for the activities of daily life (63%), and those using mobility assistive devices (66.6%). The devices were wheelchairs (10), shower chairs (9), and canes (7). Moderate positive correlations between the use of mobility device and the motor functional independence (p<0.05 and r=0.617), and the total functional independence (p<0.05 and r=0.590) was also identified. Conclusion: Data demonstrate the possible impact in preventing mobility during daily activities, in particular motor activities among stroke subjects. That increases the need of occupational therapy interventions aiming at the mobility improvement among these subjects.

Resumo Introdução: As limitações pós-AVC podem levar a dependência nas atividades de vida diária e mobilidade, requerendo o uso de dispositivos auxiliares para a mobilidade. Objetivo: Identificar os níveis de independência funcional e o uso de dispositivos auxiliares para a mobilidade entre sujeitos com AVC bem como verificar a presença de correlações entre essas variáveis. Método: Tratou-se de um estudo descritivo correlacional com amostra de conveniência, realizado em centros especializados em reabilitação física de uma cidade de médio porte do interior do Estado de São Paulo. Para tanto, foram aplicados o Formulário de Dados do Sujeito com AVC e a Medida de Independência Funcional. Os dados foram submetidos à análise descritiva simples e teste biserial. Resultados: 66,6% dos participantes faziam uso de dispositivos auxiliares para mobilidade, com maior frequência das cadeiras de rodas (10), cadeiras de banho (9) e bengalas (7). Observaram-se diferentes níveis de independência funcional para as atividades de vida diária entre a amostra, com preeminência de sujeitos dependentes (63%). Também foram identificadas correlações positivas moderadas entre o uso dos dispositivos auxiliares para a mobilidade e a independência funcional motora (p<0,05 e r=0,617) e independência total (p<0,05 e r=0,590). Conclusão: Os dados demonstram possíveis impactos da restrição na mobilidade no desempenho das atividades de vida diária com maior exigência de aspectos motores entre sujeitos com AVC, o que reforça a necessidade de intervenções em terapia ocupacional para a melhora da mobilidade entre esses sujeitos.

Burden and Quality of Life of Family Caregivers of Stroke Patients.

The purpose of this study was to identify the level of burden and quality of life of family caregivers of stroke patients and to investigate the correlation between burden, quality of life (including physical, social, psychological, and environmental domains), age of caregivers, and the care period. A descriptive correlational cross-sectional study was performed, with a convenience sample of family caregivers (n = 30) of stroke patients in São Paulo, Brazil. Data were collected using a questionnaire on participants' characteristics, the Zarit Burden Interview Scale (ZBIS), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) instrument. A descriptive analysis was performed, and correlations between variables were analyzed using Pearson's product-moment correlation coefficient. The average burden score on the ZBIS was 29.6, representing a moderate burden, and the average overall quality of life score on the WHOQOL-BREF was 62.06%, which indicates moderate quality of life. A significant weak negative correlation was observed between burden and environmental domains (r = -0.470; p =.009), quality of life (r = -0.414; p =.023), and physical domains (r = -0.394; p =.031). No significant correlations were found between burden and quality of life, and variables in the psychological and social domains, age of caregivers, or care period. Caregivers for stroke patients presented with moderate levels of burden and reduction in quality of life. Levels of burden correlated negatively with environmental domains, quality of life levels, and physical domains; however, these correlations were weak, indicating the possible interference of other factors.

Independence and cognition post-stroke and its relationship to burden and quality of life of family caregivers.

BACKGROUND: Stroke is a chronic disease responsible for changes in the functional capacity of the patients. Patient care is usually provided by family caregivers, but with great burden and negative impact on their quality of life. OBJECTIVES: (1) To investigate whether a correlation existed between the levels of independence and cognition in stroke patients and the burden and quality of life of their caregivers; (2) to assess whether periods of injury, rehabilitation and care, and age of the stroke patients interfered with these correlations. METHODS: This was a cross-sectional and correlational study that included 60 participants, of which 30 were post-stroke patients and 30 were their caregivers. The data collection instruments were the Mini Mental State Examination and the Functional Independence Measure for the post-stroke participants, and the Zarit Burden Interview Scale and the World Health Organization Quality of Life-BREF, for the caregivers. The Pearson's product-moment correlation was used for the data analysis. RESULTS: Independence and cognition showed no correlation with the burden and quality of life of the caregivers. We identified a strong positive correlation between independence and cognition (r = 0.882), and a moderate negative correlation between independence and rehabilitation period (r = -0.398) and between burden and quality of life of the caregivers (r = -0.414). CONCLUSIONS: Our data suggest the need for health interventions aimed not only at stroke patients, but also at their family caregivers, given the association between the burden and the low levels of quality of life of the caregivers.

A experiência da Terapia Ocupacional com contação de histórias em uma instituição educacional / The experience of Occupational Therapy with storytelling in an educational institution

As histórias são recursos importantes no processo educacional e no cotidiano das crianças, já que elas contribuem para a prática docente na educação infantil e para o desenvolvimento da criança em vários aspectos, principalmente na aprendizagem. O objetivo deste relato é apresentar a experiência de um grupo de contação de histórias realizado em uma instituição filantrópica no município de Uberaba-MG, no decorrer de Estágio Supervisionado I do Curso de Terapia Ocupacional da Universidade Federal do Triângulo Mineiro (UFTM). O referido grupo desenvolve estratégias para aprimorar aspectos psicomotores, cognitivos e habilidades expressivas dos educandos ali inseridos. Foram realizados 12 encontros grupais, semanais, denominados "Vivendo a história", com educandos entre 6 e 12 anos que permaneciam na instituição em contraturno escolar. No decorrer dos grupos foram desenvolvidas ações voltadas à criação, expressão gráfica, oral e escrita, e confecção de recursos vinculados às histórias infantis tradicionais e às relatadas pelos educandos. As ações se basearam nos pressupostos teóricos da Psicomotricidade Funcional e Relacional. Como resultado dos grupos foi possível observar melhoras em habilidades cognitivas, de regulação emocional, de atenção/concentração, resolução de problemas e aspectos psicomotores em geral, como grafomotores, coordenação global, esquema corporal, entre outros. A partir dos registros semanais, pôde-se perceber a influência das histórias, tanto tradicionais como pessoais, no processo de aprendizagem, aprimorando-se as habilidades cognitivas, o processo de leitura e escrita, e, principalmente, a expressão e comunicação infantil.

Stories are important tools in the educational process and daily lives of children, because they contribute to the teaching practice in early education and to child development in many aspects, especially in learning. The purpose of this report is to present the experience of a storytelling group in an educational institution in the municipality of Uberaba, Minas Gerais state, during an internship supervised by the Occupational Therapy Course - Federal University of Triângulo Mineiro. The group developed strategies to improve psychomotor and cognitive aspects and expressive abilities of the students. Twelve one-hour weekly meetings were held during the morning, and the public were students aged 6 to 12 years old that stayed in school the whole day. In the workshop, entitled "Living the Story", the group developed actions aimed at the creation and telling of stories, the confection of resources that were linked to the stories, and the concepts of experiences related to psychomotor aspects. As a result, it was possible to observe improvements in cognitive skills, emotional regulation, attention and concentration, problem solving, and general psychomotor aspects. Therefore, it is possible to point out that creating and listening to stories stimulate the imagination, educate, instruct, develop cognitive skills, facilitate the process of reading and writing, and enhance children's communication skills.