RESUMO
To date, medical education lacks Europe-wide standards on neurorehabilitation. To address this, the European Federation of NeuroRehabilitation Societies (EFNR) here proposes a postgraduate neurorehabilitation training scheme. In particular, the European medical core curriculum in neurorehabilitation should include a two-year residency in a neurorehabilitation setting where trainees can gain practical experience. Furthermore, it should comprise six modules of classroom training organized as weekend seminars or summer/winter schools. In conclusion, after defining the European medical core curriculum in neurorehabilitation, the next activities of the EFNR will be to try and reach the largest possible consensus on its content among all national societies across Europe in order to further validate it and try to extend it to the other, non-medical, professionals on the neurorehabilitation team in line with their core curricula defined by each professional association.
Assuntos
Currículo , Educação Médica , Reabilitação Neurológica , Educação Médica/métodos , Educação Médica/normas , Europa (Continente) , Humanos , Doenças do Sistema Nervoso/reabilitação , Reabilitação Neurológica/educação , Reabilitação Neurológica/métodos , Reabilitação Neurológica/normas , Sociedades Médicas/normasAssuntos
Espasticidade Muscular/reabilitação , Reabilitação Neurológica/métodos , Vias Aferentes/fisiopatologia , Terapia Combinada , Humanos , Doença dos Neurônios Motores/diagnóstico , Doença dos Neurônios Motores/fisiopatologia , Doença dos Neurônios Motores/reabilitação , Espasticidade Muscular/diagnóstico , Espasticidade Muscular/fisiopatologia , Músculo Esquelético/inervação , Exame Neurológico , Equipe de Assistência ao Paciente , Medula Espinal/fisiopatologia , Resultado do TratamentoRESUMO
OBJECTIVE: In patients with cerebral palsy (CP), psychological problems influence their participation in society. Little is known about the persistence of behavioral and social problems into adulthood. MATERIALS AND METHODS: In a two-center cross-sectional study, caregivers of 121 adults and 88 children were ask to assess behavior of the patients through the parent/caregiver forms of the Child Behavior Checklist (CBCL), the Strengths and Difficulties Questionnaire (SDQ), and the Vineland Adaptive Behavior Scale II (VABS). Questionnaires were returned from 43 adults and 39 children. RESULTS: In both groups we found the same frequency of abnormalities in attention problems (32.4 vs. 36.1%, p = 0.826) and social interaction problems (32.3 vs. 33.3%; p = 0.926) in the CBCL, and peer problems (38.9 vs. 75.7%; p = 0.115) in the SDQ. Children show a lower percentage of abnormal prosocial behavior (41.7 vs. 16.2%, p = 0.016) and lower abnormal rates of communication (88.2 vs. 61.5; p = 0.01) and daily living skills (90.0 vs. 71.8; p = 0.041), whereas the level of abnormalities in both groups in these dimensions of VABS notably high. CONCLUSION: The persistence of psychological and social problems from childhood into adulthood underlines the importance of focusing on early intervention.
Assuntos
Paralisia Cerebral/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Adolescente , Adulto , Cuidadores/psicologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Pais , Inquéritos e QuestionáriosAssuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Doenças do Sistema Nervoso/reabilitação , Atividades Cotidianas , Toxinas Botulínicas Tipo A/economia , Aprovação de Drogas , Humanos , Locomoção/efeitos dos fármacos , Guias de Prática Clínica como Assunto , Qualidade de Vida , Mecanismo de ReembolsoAssuntos
Cuidados Críticos/ética , Tomada de Decisões/ética , Consentimento Livre e Esclarecido/ética , Cuidados Críticos/legislação & jurisprudência , Dissidências e Disputas , Objetivos , Humanos , Futilidade Médica/ética , Competência Mental/legislação & jurisprudência , Qualidade de Vida , SuíçaRESUMO
A group of clinicians from across Europe experienced in the use of botulinum toxin type A for the treatment of spasticity following acquired brain injury gathered to develop a consensus statement on best practice in managing adults with spasticity. This consensus table summarizes the current published data, which was collated following extensive literature searches, their assessment for level of evidence and discussion among the whole group. Published information is supplemented by expert opinion based on clinical experience from 16 European countries, involving 28 clinicians, who treat an average of approximately 200 patients annually, representing many thousand spasticity treatments with botulinum toxin per year.
