Physiotherapy intervention in anal incontinence in elderly

The objective of this study was to group and update knowledge related to physical therapy intervention in anal incontinence in the elderly. The literature research was done in electronic databases: Medline, Lilacs, Cochrane, PubMed and Scielo, from January 2006 to July 2011. The keywords used in various combinations were anal incontinence, fecal incontinence, elderly, physical therapy, physiotherapy, exercises, electrotherapy and rehabilitation. The physiotherapy intervention includes assessment of anal incontinence constituted by signs and symptoms, physical examination and laboratory tests, including anorectal manometry, retosigmoidoscopia, defecography, anorectal electromyography, endoanal ultrasonography and terminal motor latency of the pudendal nerve; exercises to strengthen pelvic floor muscles, biofeedback, rectal balloon training and electrostimulation are the mainstay of treatment. This update showed the scarcity of studies addressing this theme; only five studies published in recent years were found, which mostly emphasize the procedures already established in the literature to treat these patients. However, a considerably new mode of treatment, sacral neurostimulation, has been investigated with apparently positive results, raising the need for further studies with specific methodological designs on this problem.</p

Atuação fisioterapêutica na lesão medular em unidade de terapia intensiva: Atualização de literatura

Objective. Collate and update knowledge in relation to physical therapy in spinal cord injury (SCI) in the intensive care unit (ICU). Method. We performed a literature update in the databases Lilacs, PubMed and Scielo, crossing the descriptors spinal cord injury, cinesiotherapy, physiotherapy, mobilization, rehabilitation, intensive care unit, respiratory therapy and electrotherapy in the period of 2005 to 2010. Results. We found 21 studies, however, only five articles met the inclusion criteria. Kinesiotherapy is essential since the phase of spinal shock, since it favors the maintenance of joint range of motion and flexibility, and to prevent circulatory complications caused/ resulted from prolonged immobilization in bed. Respiratory therapy promotes bronchial hygiene, correction of abnormal respiratory patterns and respiratory diseases. The electrotherapy is a feature still little used by physiotherapists in the intensive care units. Conclusions. The physical therapy in SCI in ICU is focused on motor rehabilitation through kinesiotherapy and intervention through the respiratory bronchial hygiene and training of respiratory muscles. New treatment modalities such as electrotherapy, there have been in intensive environment, there is a need for more studies to confirm benefits and risks of this feature in the spinal cord

Physiotherapeutic conduct in amyotrophic lateral sclerosis

Amyotrophic Lateral Sclerosis (ALS) is a fatal progressive neurodegenerative disease with multifactorial etiology for which, so far, there is no effective medicinal treatment. However, by means of kinesiotherapy intervention and patient guidance and care, physiotherapy can delay physical functional losses, muscle fatigue and immobility of the joint-muscle system, thereby improving the quality of life. This survey had the aim of reviewing the physiotherapeutic conduct currently used in ALS cases. Monthly monitoring is recommended, with changes in goals and conduct at each stage of the disease, activities to be pursued around the home, and emphasis on stretching, muscle strengthening, posture adequacy and respiratory kinesiotherapy