Avaliação da função do ombro e da qualidade de vida de pacientes com lesão do manguito rotador: estudo de casos
Data
2010
Autores
Saito, André Kenzo 
Orientadores
Peccin, Maria Stella
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O ombro é a articulação mais móvel e de grande importância para o ser humano porque permite que coloque a mão em diversos locais no espaço para realizar suas atividades de vida diária. Por ser altamente móvel e instável depende de estabilizadores dinâmicos, o manguito rotador. Uma afecção nessa articulação compromete toda a cintura escapular, diminuindo a funcionalidade do ombro, afetando a qualidade de vida do individuo. As lesões do manguito rotador podem ter diferentes etiologias – degenerativa ou traumática –, tendo como opções o tratamento conservador ou cirúrgico. Objetivos: Avaliar a qualidade de vida e funcionalidade do ombro pré e pós-operatório utilizando os questionários SF-36, WORC (ambos para qualidade de vida) e o UCLA para funcionalidade. Métodos: Foram avaliados pacientes com ruptura de manguito rotador que procuraram o serviço de ortopedia da Santa Casa de Santos entre março e setembro de 2010, totalizando três pacientes entre 46 e 66 anos de idade. Todos permaneceram imobilizados por 45 dias em tipóia americana e foram avaliados e orientados – sendo fornecidos cadernos de exercícios para realizar em domicílio – periodicamente durante o tratamento e realizaram fisioterapia supervisionada em clínica de sua preferência. Resultados: Apenas um paciente apresentou resultados bons na ultima reavaliação. Dois pacientes evoluíram com ombro rígido durante todo o período de reabilitação, o que continuou interferindo nas atividades de vida diária desses pacientes e na qualidade de vida. Conclusão: A fisioterapia pós-operatória é fundamental para que a cirurgia realizada tenha seu valor, uma vez que, se o paciente não realiza fisioterapia, pode evoluir com rigidez articular e afetar a funcionalidade do membro operado e a qualidade de vida do indivíduo. Dois pacientes evoluíram com ombro rígido e não alcançaram a ADM completa em quatro meses de pós-operatório, sendo que o com a pior ADM estava afastado do serviço pelo INSS, o que deve ser levado em conta durante a reabilitação, já que ele pode buscar empregos informais para complementar sua renda e, consequentemente, retardar a reabilitação. Talvez se os pacientes tivessem realizado fisioterapia precocemente os resultados fossem melhores, porém o serviço não disponibilizava esse tipo de atendimento, o que pode ser considerado como uma falha no sistema de saúde.
Background: The shoulder joint is the most mobile and it is very important for humans because it lets put the hand in various locations in space to perform their activities of daily living. Being highly mobile and unstable it depends on dynamic stabilizers, the rotator cuff. A disease that compromises the shoulder joint also compromises the shoulder girdle, reducing the functionality of the shoulder, affecting quality of life of the individual. The rotator cuff injuries may have different etiologies - traumatic or degenerative – and there are two options of treatment: conservative or surgical treatment. Objectives: To assess the quality of life and functionality of the shoulder pre-and postoperatively using the SF-36, WORC (both for quality of life) and UCLA for functionality. Methods: Patients with rotator cuff tear that came to the orthopedics service of Santa Casa de Santos between March and September 2010. A total of three patients between 46 and 66 years of age were included. All patients were immobilized in sling for 45 days post-surgery and were evaluated and targeted - being provided workbooks to perform at home - periodically during treatment and underwent supervised physiotherapy clinic of your choice. Results: Only one patient had good results at the last revaluation. Two patients developed frozen shoulder during the rehabilitation period, which continued to interfere with daily activities and quality of life of the patients. Conclusion: The postoperative physiotherapy is essential part of treatment. If the patient does not perform physical therapy, joint stiffness may evolve and affect the functionality of the operated limb and quality of life of the individual. Two patients developed frozen shoulder and did not achieve full ROM in four months postoperatively, and the worst with ADM was removed from service by the INSS, which should be taken into consideration during rehabilitation, as it can get informal jobs to supplement their income and thus delay the rehabilitation. Perhaps if patients had performed physiotherapy early results would be better, but the service does not provide this type of care, which can be regarded as a failure in the health system.
Background: The shoulder joint is the most mobile and it is very important for humans because it lets put the hand in various locations in space to perform their activities of daily living. Being highly mobile and unstable it depends on dynamic stabilizers, the rotator cuff. A disease that compromises the shoulder joint also compromises the shoulder girdle, reducing the functionality of the shoulder, affecting quality of life of the individual. The rotator cuff injuries may have different etiologies - traumatic or degenerative – and there are two options of treatment: conservative or surgical treatment. Objectives: To assess the quality of life and functionality of the shoulder pre-and postoperatively using the SF-36, WORC (both for quality of life) and UCLA for functionality. Methods: Patients with rotator cuff tear that came to the orthopedics service of Santa Casa de Santos between March and September 2010. A total of three patients between 46 and 66 years of age were included. All patients were immobilized in sling for 45 days post-surgery and were evaluated and targeted - being provided workbooks to perform at home - periodically during treatment and underwent supervised physiotherapy clinic of your choice. Results: Only one patient had good results at the last revaluation. Two patients developed frozen shoulder during the rehabilitation period, which continued to interfere with daily activities and quality of life of the patients. Conclusion: The postoperative physiotherapy is essential part of treatment. If the patient does not perform physical therapy, joint stiffness may evolve and affect the functionality of the operated limb and quality of life of the individual. Two patients developed frozen shoulder and did not achieve full ROM in four months postoperatively, and the worst with ADM was removed from service by the INSS, which should be taken into consideration during rehabilitation, as it can get informal jobs to supplement their income and thus delay the rehabilitation. Perhaps if patients had performed physiotherapy early results would be better, but the service does not provide this type of care, which can be regarded as a failure in the health system.
Descrição
Citação
SAITO, André Kenzo. Avaliação da função do ombro e da qualidade de vida de pacientes com lesão do manguito rotador: estudo de casos. 2010. 97 f. Trabalho de conclusão de curso (Graduação em Fisioterapia) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2010.