Instrumentos utilizados para avaliação funcional em pacientes idosos amputados de membros inferiores: uma revisão narrativa

Abstract

With the aging population there is a considerable increase of patients submitted to amputations, characterizing a public health problem. Lower limb amputations are considered a disability factor, with a significant impact on functionality, especially in the elderly. The evaluation of functional capacity is essential for the physiotherapist and the rehabilitation team to be able to determine the patient's progression and development. The objective of this review was to identify in the literature instruments used for functional evaluation in elderly amputees of lower limbs and to carry out a critical analysis. After searching the databases (PUBMED, MEDLINE, LILACS, PEDRO, BIREME, GOOGLE ACADEMICO, SCIELO) and analysis of the literature, we selected 06 studies pertinent to the objective of the review. Samples ranged from 16 to 938 patients, all over the age of 60 years. In all studies, there were patients with amputation of different levels, unilateral or bilateral. Seven (7) gait tests were identified: 2-minute Walk Test (TC2 '), 6-minute Walk Test (TC6'), Berg Balance Scale, Timed Up and Go (TUG), Fullerton Functional Test, Index of Barthel, SIGAM mobility (Special Interest Group in Amputee Medicine mobility). Of these five are commonly used tests for the elderly evaluation. However, only SIGAM mobility and the Timed Up and Go (TUG) were validated for individuals with lower limb amputations. Although evidence in the literature highlights the importance of the use of instruments with wellestablished psychometric properties for functional evaluation, there is a lack of studies on instruments aimed at amputees, especially the elderly. Since the functional evaluation, based on the use of valid and reliable instruments, contributes to a prescription and correct indication of the prosthesis, studies are needed that investigate which ones are more appropriate to the specificities of the population of elderly amputees. Such information can guarantee an approach to the real demand of the elderly amputated patient, enabling rehabilitation targeting, aiming for independence and adequate prescription for success in the adaptation of the prosthesis.