Atividade e participação de indivíduos pós-AVE na fase crônica que apresentam déficits de equilíbrio: uma revisão narrativa da literatura

Abstract

Stroke is an acute neurological disorder of vascular origin that is triggered by the rapid onset of symptoms. In addition to the fact that it has a high mortality rate, this health condition accommodates its survivors with various disabilities. The aim of the present study was to perform a narrative review of the literature on the activity and participation of post-stroke individuals in the chronic phase who presented balance deficits. Medline, SciELO, Lilacs and PeDro databases were searched using the following keys: stroke, cerebrovascular disorders, hemiparetic, postural balance, activity, motor activity, social participation, functioning, disability. Studies with a poststroke sample, aged ≥ 18 years, in the chronic phase of the disease (≥ 6 months), which presented balance deficit; studies that evaluate an activity with mobility and / or participation of these individuals; English and Portuguese studies published until September 2018. The electronic search found 259 studies and after a selection, seven were included because they met the eligibility requirements of this review. BBS was the most commonly used for balance assessment. Various instruments, aimed at gait evaluation and posture changes, were used to characterize the ICF activity domain, focusing on mobility. Two interventions have been shown to be effective in improving postural stroke balance, treadmill training watching real-world video and mini-trampoline training, the first also being effective in improving gait. The group physical therapy program, on the other hand, did not improve participants' functional mobility, but was able to maintain it. There was a reduction in participation in leisure activities in individuals after stroke, due to gait and balance disorders and muscle weakness. Participation in community ambulation was also significantly lower in this population. In addition, self-efficacy of balance was significantly and independently associated with post-stroke activity and participation.