"¿Qué hará el cuidador?" en casa para ejercicio de acv utilizando silla de ruedas: investigación cualitativa en la perspectiva de profesionales multidisciplinarios de la salud ("What will the caregiver do?" at home for stroke exercise using a wheelchair: qualitative research in multidisciplinary health professionals perspective)
DOI:
https://doi.org/10.47197/retos.v59.105219Palabras clave:
Cuidadores, Sillas de ruedas, Personas con discapacidad, Accidente cerebrovascularResumen
Antecedentes: Según datos recientes, el accidente cerebrovascular ocupa el segundo lugar entre los factores que más contribuyen a la mortalidad y la discapacidad a escala mundial. No ha habido una síntesis exhaustiva de estudios cualitativos relacionados con la orientación de los cuidadores de pacientes con accidente cerebrovascular en el hogar que utilizan sillas de ruedas. El objetivo de este estudio es examinar los principios fundamentales empleados por los cuidadores en la prestación de atención a pacientes en silla de ruedas en el hogar. Método: Realizamos grupos focales y entrevistas en profundidad con informantes clave y profesionales de la salud multidisciplinarios (n=17). La guía de entrevista describe a los pacientes de atención en centros, un enfoque multidisciplinario y explora el ejercicio de un paciente en silla de ruedas. Los datos se codificaron y revisaron utilizando un marco de análisis con el software NVivo. Este estudio se informó de acuerdo con las pautas COREQ (criterios consolidados para informar investigaciones cualitativas) Resultado: Ocho temas principales surgieron del análisis de datos: Atención en el centro del paciente, Enfoque multidisciplinario, Herramientas para crear creatividad, Experiencia familiar, Selección de una silla de ruedas eficaz, La habitación importa, El significado de la terapia, Movimientos eficaces, Conteo preciso durante la práctica. Conclusión: Los cuidadores poseen la capacidad de abordar el problema de la accesibilidad limitada a los servicios de rehabilitación de pacientes mediante la utilización de aplicaciones de autoayuda para sillas de ruedas. Los principales desafíos que enfrentan los cuidadores abarcan varios aspectos, incluida la implementación de la atención centrada en el paciente, la adopción de un enfoque multidisciplinario, la selección adecuada de sillas de ruedas que sean efectivas y la comprensión de la importancia de la terapia.
Palabras clave: Cuidadores, Sillas de ruedas, Personas con discapacidad, Accidente cerebrovascular
Abstract. Background: According to recent data, stroke ranks as the second most prominent contributor to both mortality and disability on a global scale. there has been no comprehensive synthesis of qualitative studies pertaining to caregiver guidance for home-based stroke patients utilizing wheelchairs. Objective of this study is to examine the fundamental principles employed by caregivers in the provision of care for wheelchair-bound patients within a home setting. Method: We conducted focus groups and in-depth interviews with key informant multidisciplinary health professionals (n=17). The interview guide describes center care patients, a multidisciplinary approach, and explores the exercise of a patient using a wheelchair. Data was coded and reviewed using an analysis framework with NVivo software. This study was reported according to COREQ guidelines (consolidated criteria for reporting qualitative research) Result: Eight main themes emerged from the data analysis: Patient Center care, Multidisciplinary approach, Creativity making tools Family experience, Selection of an effective wheelchair, Room matters, The meaning of therapy, Effective moves, Precise count during practice.Conclusion: Carers possess the capacity to address the issue of limited accessibility to patient rehabilitation services through the utilization of wheelchair self-help applications. The primary challenges faced by carers encompass various aspects, including the implementation of Patient Centered Care, adoption of a Multidisciplinary Approach, appropriate selection of wheelchairs that are effective, understanding the significance of therapy.
Keywords: Caregivers, Wheelchairs, Disabled Persons, Stroke
Citas
Alabdulaali, L., Hickman, L., Punt, T. D., & Jenkinson, N. (2022). Effectiveness of transcranial direct current stimulation on hand dexterity in stroke patients: A protocol for a systematic review and meta-analysis. BMJ Open, 12(2). https://doi.org/10.1136/bmjopen-2021-056064
Bai, Z., Fong, K. N. K., Zhang, J. J., Chan, J., & Ting, K. H. (2020). Immediate and long-term effects of BCI-based rehabilitation of the upper extremity after stroke: A systematic review and meta-analysis. Journal of NeuroEngineering and Rehabilitation, 17(1), 1–20. https://doi.org/10.1186/s12984-020-00686-2
Beucler, N., Cungi, P. J., Baucher, G., Coze, S., Dagain, A., & Roche, P. H. (2022). The Kernohan-Woltman Notch Phenomenon: A Systematic Review of Clinical and Radiologic Presentation, Surgical Management, and Functional Prognosis. Journal of Korean Neurosurgical Society, 65(5), 652–664. https://doi.org/10.3340/jkns.2022.0002
Burau, V., Carstensen, K., Lou, S., & Kuhlmann, E. (2017). Professional groups driving change toward patient-centred care: Interprofessional working in stroke rehabilitation in Denmark. BMC Health Services Research, 17(1), 1–8. https://doi.org/10.1186/s12913-017-2603-7
Butchart, S., Candow, D. G., Forbes, S. C., Mang, C. S., Gordon, J. J., Ko, J., Deprez, D., Chilibeck, P. D., & Ditor, D. S. (2022). Effects of Creatine Supplementation and Progressive Resistance Training in Stroke Survivors. International Journal of Exercise Science, 15(2), 1117–1132. http://www.ncbi.nlm.nih.gov/pubmed/35992184%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC9362889
Chiu, Y. H., Chang, K. V., Wu, W. T., Hsu, P. C., & Özçakar, L. (2021). Comparative effectiveness of injection therapies for hemiplegic shoulder pain in stroke: A systematic review and network meta-analysis. Pharmaceuticals, 14(8). https://doi.org/10.3390/ph14080788
Choi, Y., Her, J. G., Ko, J., Ko, D. H., Woo, J., O’Sullivan, D., & Kim, H. (2013). The effects of chair height and foot position on chronic stroke patients’ sit-to-walk movement. Journal of Physical Therapy Science, 25(4), 431–435. https://doi.org/10.1589/jpts.25.431
D’Souza, S., Godecke, E., Ciccone, N., Hersh, D., Janssen, H., & Armstrong, E. (2021). Hospital staff, volunteers’ and patients’ perceptions of barriers and facilitators to communication following stroke in an acute and a rehabilitation private hospital ward: A qualitative description study. BMJ Open, 11(5), 1–10. https://doi.org/10.1136/bmjopen-2020-043897
Duncan, P. W., Sullivan, K. J., Behrman, A. L., Azen, S. P., Wu, S. S., Nadeau, S. E., Dobkin, B. H., Rose, D. K., & Tilson, J. K. (2007). Protocol for the locomotor experience applied post-stroke (LEAPS) trial: A randomized controlled trial. BMC Neurology, 7(c), 1–23. https://doi.org/10.1186/1471-2377-7-39
Egan-Shuttler, J. D., Edmonds, R., Eddy, C., O’neill, V., & Ives, S. J. (2019). Beyond Peak, a Simple Approach to Assess Rowing Power and the Impact of Training: A Technical Report. International Journal of Exercise Science, 12(6), 233–244.
Epalte, K., Grjadovojs, A., & Berziņa, G. (2023). Use of the Digital Assistant Vigo in the Home Environment for Stroke Recovery: Focus Group Discussion With Specialists Working in Neurorehabilitation. JMIR Rehabilitation and Assistive Technologies, 10, 1–14. https://doi.org/10.2196/44285
Franco, J., Quintino, L. F., & Faria, C. D. C. M. (2021). Five-repetition sit-to-Stand test among patients post-stroke and healthy-matched controls: the use of different chair types and number of trials. Physiotherapy Theory and Practice, 37(12), 1419–1428. https://doi.org/10.1080/09593985.2019.1709234
Jeon, H. J., An, S., Yoo, J., Park, N. H., & Lee, K. H. (2016). The effect of monkey chair and band exercise system on shoulder range of motion and pain in post-stroke patients with hemiplegia. Journal of Physical Therapy Science, 28(8), 2232–2237. https://doi.org/10.1589/jpts.28.2232
Johansen, K. L., Stistrup, R. D., Schjøtt, C. S., Madsen, J., & Vinther, A. (2016). Absolute and relative reliability of the timed “Up & Go” test and “30second chair-stand” test in hospitalised patients with stroke. PLoS ONE, 11(10). https://doi.org/10.1371/journal.pone.0165663
Katowa-Mukwato, P., Banda, M. C., Kanyanta, M. M., Musenge, E. M., Phiri, P. D. C., Mwiinga-Kalusopa, V., Chapima, F., Simpamba, M., Kapenda, C., & Shula, H. (2021). Study Protocol on Stroke Management: Role of Nurses and Physiotherapists at the Adult University Teaching Hospital, Lusaka Zambia. Journal of Biosciences and Medicines, 09(09), 25–37. https://doi.org/10.4236/jbm.2021.99003
Kim, G. J., Gahlot, A., Magsombol, C., Waskjewicz, M., Capasso, N., Van Lew, S., Goverover, Y., & Dickson, V. V. (2023). Protocol for a remote home-based upper extremity self-training program for community-dwelling individuals after stroke. Contemporary Clinical Trials Communications, 33(March), 101112. https://doi.org/10.1016/j.conctc.2023.101112
Kwakkel, G., Kollen, B. J., & Wagenaar, R. C. (2002). Long term effects of intensity of upper and lower limb training after stroke: A randomised trial. Journal of Neurology Neurosurgery and Psychiatry, 72(4), 473–479. https://doi.org/10.1136/jnnp.72.4.473
Lam, S. K. Y., Chau, J. P. C., Lo, S. H. S., Siow, E. K. C., Lee, V. W. Y., Shum, E. W. C., & Lau, A. Y. L. (2022). User engagement in the development of a home-based virtual multidisciplinary stroke care clinic for stroke survivors and caregivers: a qualitative descriptive study. Disability and Rehabilitation, 44(20), 5983–5989. https://doi.org/10.1080/09638288.2021.1955305
Lavis, H., van Vliet, P., & Tavener, M. (2023). Stroke survivor, caregiver and therapist experiences of home-based stroke rehabilitation: a thematic synthesis of qualitative studies. Physical Therapy Reviews, 28(2), 157–173. https://doi.org/10.1080/10833196.2023.2180710
Maier, M., Ballester, B. R., & Verschure, P. F. M. J. (2019). Principles of Neurorehabilitation After Stroke Based on Motor Learning and Brain Plasticity Mechanisms. Frontiers in Systems Neuroscience, 13(December), 1–18. https://doi.org/10.3389/fnsys.2019.00074
Masuda, Y., Nisida, Y., & Kurosawa, K. (2004). Relationship of a 30-second chair-stand test to gait performance in stroke patients. Rigakuryoho Kagaku, 19(2), 69–73. https://doi.org/10.1589/rika.19.69
Park, S. E., & Moon, S. H. (2016). Effects of trunk stability exercise using proprioceptive neuromuscular facilitation with changes in chair height on the gait of patients who had a stroke. Journal of Physical Therapy Science, 28(7), 2014–2018. https://doi.org/10.1589/jpts.28.2014
Park, S. J., & Oh, S. (2020). Effect of diagonal pattern training on trunk function, balance, and gait in stroke patients. Applied Sciences (Switzerland), 10(13). https://doi.org/10.3390/app10134635
Platz, T., & Owolabi, M. (2021). Clinical pathways in stroke rehabilitation: Background, scope, and methods. In Clinical Pathways in Stroke Rehabilitation: Evidence-based Clinical Practice Recommendations. https://doi.org/10.1007/978-3-030-58505-1_2
Reddy, R. S., Gular, K., Dixit, S., Kandakurti, P. K., Tedla, J. S., Gautam, A. P., & Sangadala, D. R. (2022). Impact of Constraint-Induced Movement Therapy (CIMT) on Functional Ambulation in Stroke Patients—A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 19(19). https://doi.org/10.3390/ijerph191912809
Rodrigues, P. S. M., Shimano, M. M., de Oliveira, E., Kawamura, F. M., Silveira, A. F., José Luvizutto, G., & de Souza, L. A. P. S. (2023). Adaptation and clinical application of assistive device chair for bedside sitting in acute stroke phase: two case reports. Disability and Rehabilitation: Assistive Technology, 0(0), 1–7. https://doi.org/10.1080/17483107.2023.2166600
Saadatnia, M., Shahnazi, H., Khorvash, F., & Esteki-Ghashghaei, F. (2020). The Impact of Home-Based Exercise Rehabilitation on Functional Capacity in Patients With Acute Ischemic Stroke: A Randomized Controlled Trial. Home Health Care Management and Practice, 32(3), 141–147. https://doi.org/10.1177/1084822319895982
Sawtelle, M., Roddey, T., Ellison, J., & Tseng, S. C. (2022). Gluteus Maximus Muscle Activation Characteristics During a Chair-Rise in Adults With Chronic Stroke. Journal of Neurologic Physical Therapy, 46(4), 270–280. https://doi.org/10.1097/NPT.0000000000000404
Schnitzler, A., Dince, C., Freitag, A., Iheanacho, I., Fahrbach, K., Lavoie, L., Loze, J. Y., Forestier, A., & Gasq, D. (2022). AbobotulinumtoxinA Doses in Upper and Lower Limb Spasticity: A Systematic Literature Review. Toxins, 14(11), 1–48. https://doi.org/10.3390/toxins14110734
Stoykov, M. E., Heidle, C., Kang, S., Lodesky, L., Maccary, L. E., & Madhavan, S. (2022). Sensory-Based Priming for Upper Extremity Hemiparesis After Stroke: A Scoping Review. OTJR Occupation, Participation and Health, 42(1), 65–78. https://doi.org/10.1177/15394492211032606
Sunnerhagen, K. S., Brown, B., & Kasper, C. E. (2003). Sitting up and transferring to a chair: Two functional tests for patients with stroke. Journal of Rehabilitation Medicine, 35(4), 180–183. https://doi.org/10.1080/16501970306130
Thilarajah, S., Mentiplay, B. F., Bower, K. J., Tan, D., Pua, Y. H., Williams, G., Koh, G., & Clark, R. A. (2018). Factors Associated With Post-Stroke Physical Activity: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation, 99(9), 1876–1889. https://doi.org/10.1016/j.apmr.2017.09.117
van der Worp, H. B., Hofmeijer, J., Jüttler, E., Lal, A., Michel, P., Santalucia, P., Schönenberger, S., Steiner, T., & Thomalla, G. (2021). European Stroke Organisation (ESO) guidelines on the management of space-occupying brain infarction. European Stroke Journal, 6(2), XC–CX. https://doi.org/10.1177/23969873211014112
Van Duijnhoven, H. J. R., Heeren, A., Peters, M. A. M., Veerbeek, J. M., Kwakkel, G., Geurts, A. C. H., & Weerdesteyn, V. (2016). Effects of Exercise Therapy on Balance Capacity in Chronic Stroke: Systematic Review and Meta-Analysis. Stroke, 47(10), 2603–2610. https://doi.org/10.1161/STROKEAHA.116.013839
van Erp, J. H. J., Ostendorf, M., & Lansdaal, J. R. (2019). Shoulder surgery in beach chair position causing perioperative stroke: Four cases and a review of the literature. Journal of Orthopaedics, 16(6), 493–495. https://doi.org/10.1016/j.jor.2019.05.009
Wang, W., Lin, B., Mei, Y., Zhang, Z., & Zhou, B. (2021). Self-care interventions in stroke survivor-caregiver dyads: A protocol for systematic review and meta-analysis. BMJ Open, 11(12), 1–7. https://doi.org/10.1136/bmjopen-2021-051860
Wang, Y., Li, X., Sun, C., & Xu, R. (2022). Effectiveness of kinesiology taping on the functions of upper limbs in patients with stroke: a meta-analysis of randomized trial. Neurological Sciences, 43(7), 4145–4156. https://doi.org/10.1007/s10072-022-06010-1
Wattchow, K. A., McDonnell, M. N., & Hillier, S. L. (2018). Rehabilitation Interventions for Upper Limb Function in the First Four Weeks Following Stroke: A Systematic Review and Meta-Analysis of the Evidence. In Archives of Physical Medicine and Rehabilitation (Vol. 99, Issue 2). The American Congress of Rehabilitation Medicine. https://doi.org/10.1016/j.apmr.2017.06.014
Winstein, C. J., Stein, J., Arena, R., Bates, B., Cherney, L. R., Cramer, S. C., Deruyter, F., Eng, J. J., Fisher, B., Harvey, R. L., Lang, C. E., MacKay-Lyons, M., Ottenbacher, K. J., Pugh, S., Reeves, M. J., Richards, L. G., Stiers, W., & Zorowitz, R. D. (2016). Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. In Stroke (Vol. 47, Issue 6). https://doi.org/10.1161/STR.0000000000000098
Yoshimura, Y., Wakabayashi, H., Nagano, F., Bise, T., Shimazu, S., & Shiraishi, A. (2020). Chair-stand exercise improves post-stroke dysphagia. Geriatrics and Gerontology International, 20(10), 885–891. https://doi.org/10.1111/ggi.13998
Yoshimura, Y., Wakabayashi, H., Nagano, F., Bise, T., Shimazu, S., Shiraishi, A., Kido, Y., & Matsumoto, A. (2022). Chair-Stand Exercise Improves Sarcopenia in Rehabilitation Patients after Stroke. Nutrients, 14(3), 1–14. https://doi.org/10.3390/nu14030461
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