FCSE - Teses de Doutoramento / Doctoral Theses
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Browsing FCSE - Teses de Doutoramento / Doctoral Theses by Author "Almeida, Patrícia Maria Duarte de"
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- Physiotherapy and neuro rehabilitation on stroke evidence and needsPublication . Almeida, Patrícia Maria Duarte de; Caldas, Alexandre CastroScientific knowledge in the area of rehabilitation and physiotherapy for stroke is booming and leading to more sustainable models of practice. Several interventions show positive effects with strong scientific support. However, some issues remain to be clarified like what are the effects of PT on brain activity and what are the effects of hands on interventions. Also a general coherence of interventions and outcomes and outcomes measures need to improve. With the intent to clarify these questions and to give an overview of Physiotherapy evidence and needs on stroke rehabilitation, this thesis will present the state of the art on a literature review and the four studies developed on the context of this PhD: Physiotherapy Hands-on Interventions and Stroke - Systematic Review; Physiotherapy and Brain Activity on Stroke - Systematic Review; Brain activity during lower limb movement with physiotherapy manual facilitation – an fMRI study; ICF Linking Process for Categorization of Interventions and Outcomes Measures on Stroke Physiotherapy - Delphi panel. As innovative aspects of this thesis, we highlight: the organization within the ICF framework for the outcomes related with movement; the study of brain activity during a complex multijoint movement of lower limb; the study of immediate effects of manual facilitation of movement, as no similar studies was found on our literature search for this thesis. Regardless the limitations encountered, the non-conclusive findings and some non-identified evidence, it seems still valid to conclude that Physiotherapy is no longer a “black box”, instead is a evidence-based profession. Exists clear and evidence based information for clinical settings and scientific community, that hands off physiotherapy is relevant and has efficacy proved on the rehabilitation of stroke patients on the domains of Structure & Functions and Activities & Participation. This efficacy is extended to the brain activity, which validates the idea that PT can influence neuroplasticity process and consequently contribute for a better recovery in a neurobiological perspective with impact on human performance and autonomy.