[The neurological state and cognition of patients after a stoke]. / Estado neurológico e cognição de pacientes pós-acidente vascular cerebral.

The objective of this study was to have a multidisciplinary team investigate the neurological state and cognitive performance of patients after a stroke, through a cross-sectional study with 45 patients in rehabilitation after having an acute stroke. The data collection instruments used were an assessment sheet, the Mini Mental-MEEM, and the National International Health Stroke Scale-NIHSS. The sample consisted mostly of women (55.6%), Ischemic Stroke (86.7%), right hemisphere of the brain (60%) and Educated (68.8%). The mean MEEM for educated and illiterate patients was 19.3 ± 5.0 and 15.92 ± 3.7, respectively. The overall mean of the neurological state was 13.0±4.8. A significant difference was found between the cognitive means of patients in terms of education (p value=0.017), and there was a significant relationship between the neurological state and cognitive performance (r=-0.44 p value=0.002). It appears to be a direct relationship between the neurological state and cognition performance of patients after an acute stroke, which evinces the need for greater attention to the cognitive issue involved early in rehabilitation.

[Clinical severity and functionality of acute stroke patients attended at the physiotherapy public services of Natal, Rio Grande do Norte State, Brazil]. / Severidade clínica e funcionalidade de pacientes hemiplégicos pós-AVC agudo atendidos nos serviços públicos de fisioterapia de Natal (RN).

This article investigates the severity and functional independence of hemiplegics patients' post-acute stroke by means of a multidisciplinary clinical staff. It is a descriptive study composed by 40 hemiplegics attended at the four largest physiotherapy public services in Natal, Rio Grande do Norte State. The methods used were an evaluation form, Functional Independence Measure and NIHSS. The results showed a sample predominantly female (55%), stroke ischemic (90%), right brain hemisphere (52.5%) and Hypertension Risk Factor (90%). The mean of clinical severity and functional independence was 13.32±4.7 and 54.6±17.15 respectively. There was no significant difference between the mean of functionality about stroke side (pvalue = 0.66). There is a significant relation between clinical severity and functional independence (r = -0.45 pvalue=0.003). It can be concluded that the level of clinical severity and functional dependence of stroke patients that make use of public physiotherapy services is significant and show the necessity, beyond the classic treatment, to be encouraged preventive educational actions to improve knowledge of this population.

[Pain and functionality in primary health care]. / Dor e funcionalidade na atenção básica à saúde.

Musculoskeletal pain and functionality are linked to the individual health and, thus, influence the mode of interaction between individuals and between them and the environment that surrounds them. However, there are not many studies that question such health issues concerning the population in general, especially when we look at these issues from the basic care point of view. The aim of this article is to present initial data on the subject of pain and functionality in individuals with musculoskeletal complaints enrolled in a primary care unit and prompt a discussion on how complete the services provided by these units are. This study was carried out in a primary care unit and various households, among subjects aging 20 years or older. A functionality assessment tool and a Visual Analogue Scale were applied, and social and demographic issues were also considered. By using these tools, it was made an attempt to evaluate the profile of individuals in association with their degree of musculoskeletal pain and the degree of functionality in the activities of their daily lives, ages and occupations. We found a predominance of women in both groups: 84.37% and 81.25%, respectively. Nearly half of all people with musculoskeletal pain were housewives, and the average age between groups was over 55.

Cognitive evolution by MMSE in poststroke patients.

The aim of this study was to investigate the cognitive and clinical evolution of post-acute stroke patients and the evolution of each Mini-Mental State Examination (MMSE) item. A longitudinal study was conducted with 42 poststroke individuals in rehabilitation. The MMSE and the National Institutes of Health Stroke Scale were used to assess cognition and stroke severity. Significant evolution in MMSE was found only for schooled individuals, total MMSE (P=0.008), spatial orientation (P=0.010) and language (P=0.010). Significant improvement was observed in clinical severity for both schooled and illiterate individuals (P<0.001). Relation between cognitive and clinical evolution showed significance only for the schooled individuals (r=-0.47; P=0.01). These findings showed a favorable improvement in the cognitive evolution of poststroke schooled individuals in the first 6 months, in addition to a relationship between clinical severity and cognition, and evidenced the necessity of cognitive rehabilitation.