Efeito Do Padrão Circadiano Na Reabilitação De Pacientes Após Acidente Vascular Cerebral

• Ano de defesa: 2018
• Autor(a) principal: Pereira, Debora Dias [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Stroke; Reinstatement By Retention; Circadian Preference; Sleep; Acidente Vascular Cerebral; Reabilitação Por Contenção; Preferência Circadiana; Sono
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6435317; https://repositorio.unifesp.br/handle/11600/52896

Objectives: The objectives of this study were: compare pre and post-treatment, according to the Constraint-Induced Movement Therapy (CIT) assessment scales, in stroke patients regarding circadian preference, sleep quality, and risk of Obstructive Sleep Apnea Syndrome (OSAS). Methods: In a retrospective study of patients after stroke who underwent CIT only in the morning, between 2009 and 2016 in the AACD, three different approaches were divided: A- three groups, according to the circadian reference; B- in two groups depending on the risk of OSAS and C- three groups according to sleep quality. Subsequently, the difference in the functional capacity scores before and after treatment with CIT were recorded. Results: Fortythree patients, 56.93 ± 14.97 years old, 58.14% males, the Body Mass Index (BMI) was 30.33 ± 2.37 kg / m2, with rehabilitation performed 6.15 ± 4.26 years after stroke. The stroke was ischemic in 29 patients (67.44%) and hemorrhagic in 12 patients (32.56%). All CIT assessment scales improved after therapy in general. When we analyzed the circadian preferences, the evening patients (with discordant circadian preference) had less improvement after the rehabilitation than the other groups, as well as the bad sleepers had worse performance. Conclusions: Patients after stroke with discordant circadian preference had lower gain after CIT. Patients after stroke with poor sleep quality had lower improvement too. Our stroke population was relatively young, the type of stroke and it’s location were consistent with the literature and most part of them were obese. There was a long time between the event and the beginning of rehabilitation. There was no excessive daytime sleepiness in stroke patients after stroke even with poor sleep quality and higher risk of OSAS.