Rehabilitación

Recovery of Postural Control and Gait After a Severe Stroke. A Descriptive Study

2026-01-01T00:00:00Z

Recovery of Postural Control and Gait After a Severe Stroke. A Descriptive Study Gath, Christian Federico; Gianella, Matías Gabriel; Gatti, Marcelo Andrés; Rivas, María Elisa Background and purpose: Research into recovery of postural control after a severe stroke needs to be improved. The objective is to describe postural control at admission and the recovery of postural control during rehabilitation according to gait assistance required at discharge of subacute rehabilitation in subjects with severe motor impairment after a stroke. Methods: A descriptive longitudinal retrospective study was conducted. Subacute post-stroke patients who could not walk without physical assistance at admission were included (n = 151). Recovery during rehabilitation is described in terms of Absolute Recovery (AR) and Relative Recovery (RR). AR and RR were calculated with Berg Balance (BBS) at admission and at discharge. Gait performance was assessed using the Functional Ambulation Category. A secondary analysis was conducted in the subgroup of subjects with an admission BBS less than 6 (n = 106). Results: Postural control at admission, AR and RR showed statistically significant differences between groups according to gait assistance requirement at discharge (p < 0.05). In subjects with BBS less than 6 at admission, differences were similar for RA and RR (p < 0.05). For BBS at admission, statistically significant differences were found between assisted gait group with supervised or independent group; however, statistical differences were not found (p > 0.05) between those patients that achieved a supervised gait and independent gait at discharge. Discussion: The results of this study could be a new step to evince why longitudinal analysis is needed during stroke rehabilitation in subjects with severe motor impairments after a stroke. The clinical relevance of BBS at admission in this population may be rethought.

Delivery timelines and determinants of assistive technology for mobility and participation in paediatric rehabilitation: a retrospective cohort study

2026-02-03T00:00:00Z

Delivery timelines and determinants of assistive technology for mobility and participation in paediatric rehabilitation: a retrospective cohort study; info:eu-repo/semantics/publishedVersion Areta, Alejandra; Molina, Mariana; Festino, Ricardo; Mora, Analía; Muzio, Diana María; Andreu, Mauro Federico Purpose To estimate the proportion and timing of assistive technology (AT) device delivery during paediatric inpatient rehabilitation and identify factors associated with delivery rates. Materials and methods We conducted a retrospective cohort study at a neurorehabilitation centre in Argentina, including patients <22 years with hospital stays >20 days, discharged between January and December 2024, and with at least one mobility- or participation-related AT prescription. The primary outcome was time from prescription to documented delivery during hospitalisation. Delivery probabilities were estimated with Kaplan–Meier curves and compared using the log-rank test. Factors associated with delivery were analysed with multivariate Cox regression, with clustered standard errors by patient. Results Thirty-three patients were included (mean age 10.6 years; 39.4% female). Sixty devices were prescribed; 41 (68.3%) were delivered during the inpatient stay. Median delivery time after prescription was 27 days (IQR 10–64). Cumulative delivery probabilities at 30, 60, and 90 days were 45%, 64.3%, and 72.8%, respectively. In the multivariate model, postural or self-propelled wheelchairs had a lower delivery rate than other devices (adjusted HR 0.32, 95% CI 0.12–0.86; p = 0.02). Devices processed through provincial public health insurance were delivered more slowly compared with social security, private coverage, or out-of-pocket payment (adjusted HR 0.41, 95% CI 0.22–0.76; p < 0.01). No significant associations were observed for prescription timing or clinical priority classification. Conclusion Nearly one-third of prescribed AT devices for mobility and participation were not delivered before discharge, and delivery times were often prolonged, particularly for wheelchairs and devices processed through provincial public insurance.

“Programa de Entrenamiento Laboral Administrativo”: intervención en un paciente con Lesión Cerebral Adquirida

2021-12-01T00:00:00Z

“Programa de Entrenamiento Laboral Administrativo”: intervención en un paciente con Lesión Cerebral Adquirida Aranguren, Isabel; Ron, Melania; Saenz Rozas, María Teresa; Russo, María Julieta El retorno al trabajo es un importante indicador de participación comunitaria. Luego de una lesión cerebral adquirida la reinserción laboral es un desafío debido a los déficits físicos, cognitivos y emocionales de esta población. Teniendo en cuenta esta problemática hemos desarrollado un programa de entrenamiento laboral administrativo (PELA) en el cual se simula un puesto de trabajo con tareas específicas. En el presente trabajo se reporta la experiencia con un paciente con secuela de accidente cerebro vascular. La incorporación del PELA dentro de una unidad de rehabilitación brinda la posibilidad de abordar en estadios tempranos del proceso de rehabilitación la problemática de la reinserción laboral.

Cambios en nivel de la lesión de pacientes pediátricos con trauma medular

2025-06-25T00:00:00Z

Cambios en nivel de la lesión de pacientes pediátricos con trauma medular Ares, Julieta Jael; Gatti, Marcelo Andrés; Benett, Nalia Milagros; Monzón, Estela Maris; Andreu, Mauro Federico La lesión medular traumática (LMT) es poco frecuente en población pediátrica, con un significativo impacto en la calidad de vida. Existe escasa literatura en esta población que documente la recuperación neurológica en los primeros meses post lesión. Objetivo: Describir los cambios en nivel neurológico de la lesión (NNL) y en grado de la escala de deficiencia ASIA (AIS) en pacientes pediátricos con LMT. Secundariamente, explorar la asociación entre variables clínicas y los cambios en el NNL y AIS. Pacientes y Método: Estudio observacional, analítico y retrospectivo. Se incluyeron pacientes de 6 a 18 años con diagnóstico de LMT, internados entre 2005 y 2022 en Fleni, sede Escobar. Las variables principales fueron el cambio en el NNL y/o en el AIS al alta. Las variables secundarias evaluadas fueron datos demográficos, etiología de la lesión, compromiso vertebral, lesiones asociadas, cirugía y tiempo de evolución. Resultados: participaron 33 participantes, con media de edad 13,1 (DE 3,1) años. El 57.6% era de sexo masculino y 21 individuos presentaban LMT completa al ingreso. Al alta, el 63,6% de los pacientes experimentaron cambios favorables en NNL y/o en AIS: 39,4% sólo en el NNL, 6,1% solo en AIS, y 18,2% en el NNL-AIS. Las LMT completas no mostraron cambios significativos en el AIS, sin embargo, el 57% presentó mejoras en al menos un NNL. Al analizar la relación entre las variables clínicas y los cambios en el AIS, sólo se encontraron diferencias significativas según la gravedad de la lesión (p = 0,02), con cambios en el 9,5% (2/21) de las lesiones completas y en el 50% (6/12) de las incompletas. Conclusión: En el grupo estudiado, se observó mayor cambio en el NNL en comparación con AIS. Aunque los casos con LMT completa tienen pocas probabilidades de experimentar cambio en el AIS, aun así pueden mejorar en al menos un NNL, lo cual podría impactar positivamente en la funcionalidad.