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Revista Portuguesa de Pneumologia
Article . 2006
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Lesões vértebro-medulares â A perspectiva da reabilitação

Authors: Filipa Faria;

Lesões vértebro-medulares â A perspectiva da reabilitação

Abstract

Resumo: Este trabalho pretende proporcionar uma visão geral sobre a problemática da lesão medular, focando essencialmente os aspectos relacionados com a reabilitação.A lesão medular atinge indivíduos jovens numa fase activa da vida, podendo condicionar graves incapacidades. Na maioria dos casos a etiologia é traumática, constituindo os acidentes de viação a sua principal causa. Até meados do século passado a sobrevivência era muito reduzida e a morte ocorria sobretudo por problemas nefro-urológicos. Com a evolução do conhecimento médico e com os meios disponibilizados pela tecnologia tem sido possível um aumento significativo da esperança de vida. Também as causas de morte sofreram alterações ao longo do tempo, sendo actualmente as complicações respiratórias, sobretudo a pneumonia, a primeira causa.No quadro clínico da lesão medular podemos considerar uma fase inicial de choque medular, em que existe uma paralisia flácida e retenção urinária e fecal; progressivamente iniciase a fase de automatismo medular com retorno de algumas actividades reflexas da medula Através do exame neurológico é possível muito precocemente estabelecer o prognóstico motor e funcional e planificar o programa de reabilitação. Podemos considerar três fases no programa de reabilitação: a primeira, corresponde ao período de acamamento para estabilização cirúrgica e médica da lesão esquelética, sendo fundamental prevenir ou tratar as complicações relacionadas com a imobilidade e iniciar a reeducação dos esfíncteres; na segunda, pretende-se atingir a funcionalidade ao nível de cadeira de rodas; a terceira fase consiste no treino em ortostatismo. O programa de reabilitação engloba ainda actividades desportivas e recreativas, bem como o acompanhamento psicológico e social para uma abordagem global da lesão medular. Abstract: The present study provides an overview of the spinal cord injury focusing mainly on aspects related to rehabilitation.Spinal cord injury affects young people in an active phase of life, determining severe handicaps. Most of the lesions are traumatic, caused by car accidents.Until fifty years ago, the survival of individuals with spinal cord injury was very reduced and the leading cause of death was renal failure. Due to developments in medical knowledge and technical advances, the survival rates have significantly improved. The causes of death have also changed being respiratory complications, particularly pneumonia, the leading causes.Immediately after a spinal cord lesion there is a phase of spinal shock which is characterized by flaccid paralysis and bladder and bowel retention. Progressively there is a return of the spinal cord automatism with the beginning of some reflex activities. Based on neurological evaluation it is pos-sible to predict motor and functional recovery and establish the rehabilitation program.We can consider three phases on the rehabilitation program: the first while the patient is still in bed, directed to prevent or treat complications due to immobility and begin sphincters reeducation; the second phase is intended to achieve wheelchair autonomy; the last phase is training in ortostatism. The rehabilitation program also comprises sports and recreational activities, psychological and social support in order to achieve an integral of the individual with a spinal cord injury. Palavras-chave: Lesão medular, etiologia, epide-miologia, quadro clínico, reabilitação, Key words: Spinal cord, etiology, epidemiology, clinics, rehabilitation

Keywords

Diseases of the respiratory system, RC705-779

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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0
Average
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