Actividad acuática adaptada en el tratamiento rehabilitador interdisciplinario de la esclerosis múltiple

S. Sánchez Pous, G. Loyola Sanmillán, M. Janer Cabo, D. Fábregas Xaudaró, C. Santoyo Medina
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引用次数: 6

Abstract

Objective

To assess the impact of physical, psychological and autonomy conditions of persons with multiple sclerosis (PwMS) through an Adapted Aquatics Actitvity Program (AAAP).

Methods

Twenty-five outpatients (twenty-four with MS and one with an amyothrophic lateral sclerosis) from the MS Day Hospital were included in the AAAP. The program consisted of 12 one-hour weekly consecutive sessions.

Clinical data were: 54.2 % of patients had a relapsing-remitting MS, 33.3 % had a secondary progressive MS and 12.5 % had a primary progressive MS. 68 % were female and 32 % were male; mean age: 45; mean Kurtzke Expanded Disability Status Scale (EDSS): 4.5 The range of scores for 12.5 % of the patients was 1.0 to 3.5 and 4.0 to 6.5 for the rest.

Measurements assessed at the beginning and at the end of the period of treatment were EDSS, the modified Ashworth Scale, the Oxford test, the Tinetti Test on walking, the modified Rivermead Mobility Index, the Motor Assessment Scale and a self satisfaction questionnaire.

Results

A statistically significant improvement was observed in the gait pattern (Wilcoxon; z = −2.754, p = 0.006) and in the strength of the lower limbs (Kolmogorov-Smirnov; z = 1.874, p = 0.002).

The Tinetti score with the subjective fatigue degree score correlated significantly (U de Mann-Whitney; p = 0.005).

Conclusions

The results suggested that our program is beneficial using both objective and subjective scores. In spite of the results, most participants did not continue with the AAAP as a health activity because of arquitectural barriers. More resources should be provided to eliminate such barriers in order to promote autonomy in handicapped PwMS.

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适应水上活动在多发性硬化症跨学科康复治疗
目的通过适应性游泳活动项目(AAAP)评估多发性硬化症(PwMS)患者的身体、心理和自主性状况的影响。方法将25例MS日间医院门诊患者(24例MS, 1例肌萎缩性侧索硬化症)纳入AAAP。该计划包括12个每周一小时的连续课程。临床数据为:54.2%的患者为复发缓解型多发性硬化,33.3%为继发性进展性多发性硬化,12.5%为原发性进展性多发性硬化,68%为女性,32%为男性;平均年龄45岁;平均库尔茨克扩展残疾状态量表(EDSS): 4.5分,12.5%的患者得分范围为1.0 ~ 3.5分,其余患者得分范围为4.0 ~ 6.5分。在治疗开始和结束时评估的测量方法是EDSS、修改的Ashworth量表、Oxford测试、Tinetti步行测试、修改的Rivermead活动能力指数、运动评估量表和自我满意度问卷。结果步态模式的改善有统计学意义(Wilcoxon;z =−2.754,p = 0.006)和下肢力量(Kolmogorov-Smirnov;Z = 1.874, p = 0.002)。Tinetti评分与主观疲劳程度评分显著相关(U de Mann-Whitney;p = 0.005)。结论无论从客观评分还是主观评分来看,我们的方案都是有益的。尽管有这样的结果,大多数参与者由于结构上的障碍而没有继续参加AAAP的健康活动。应该提供更多的资源来消除这些障碍,以促进残疾妇女的自治。
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