Maso Iara, Luvizutto Gustavo José, Miranda Jéssica Mariana de Aquino, Nascimento Carla Ferreira do, Bonome Luana Aparecida Miranda, Pinto Elen Beatriz, Klitzke Fabiane Maria, Souza Ricardo Machado, Moro Carla Heloisa Cabral, Bazan Rodrigo, Jesus Pedro Antonio Pereira de, Rocha Eduardo de Melo Carvalho, Minelli Cesar, Martins Sheila Ouriques, Baggio Jussara Almeida de Oliveira
Hospital Geral Roberto Santos, Unidade de AVC, Salvador BA, Brazil.
Escola Bahiana de Medicina e Saúde Pública, Grupo de Pesquisa Comportamento Motor e Reabilitação Neurofuncional, Salvador BA, Brazil.
Arq Neuropsiquiatr. 2025 Apr;83(4):1-18. doi: 10.1055/s-0045-1806924. Epub 2025 Apr 22.
The present protocol provides general recommendations based on the best evidence currently available for physiotherapists to use as a guide for the care of stroke patients during hospitalization. The Brazilian Early Stroke Rehabilitation Task Force, comprising physical therapy experts and researchers from different Brazilian states, was organized to develop this care protocol based on a bibliographical survey, including meta-analyses, systematic reviews, clinical trials, and other more recent and relevant scientific publications. Professionals working in stroke units were also included in the task force to ensure the practicality of the protocol in different contexts. This protocol provides guidance on assessment strategies, safety criteria for the mobilization of patients with stroke, recommendations for mobilization and proper positioning, as well as evidence-based practices for treatment during hospitalization, including preventive measures for shoulder pain and shoulder-hand syndrome. The protocol also provides information on the organization of the physiotherapy service at stroke units, guidelines for hospital discharge, and quality indicators for physiotherapy services. We have included detailed activities that can be performed during mobilization in the supplementary material, such as postural control training, sensory and perceptual stimulation, task-oriented training, and activities involving an enriched environment. The protocol was written in a user-friendly format to facilitate its application in different social and cultural contexts, utilizing resources readily available in most clinical settings.
本方案基于目前可得的最佳证据，为物理治疗师提供一般性建议，作为住院期间中风患者护理的指导。巴西早期中风康复特别工作组由来自巴西不同州的物理治疗专家和研究人员组成，旨在通过文献调查制定本护理方案，文献调查包括荟萃分析、系统评价、临床试验以及其他更新的相关科学出版物。中风单元的专业人员也被纳入特别工作组，以确保该方案在不同情况下的实用性。本方案提供了评估策略、中风患者活动的安全标准、活动和正确体位的建议，以及住院期间基于证据的治疗方法，包括肩痛和肩手综合征的预防措施。该方案还提供了中风单元物理治疗服务的组织信息、出院指南以及物理治疗服务的质量指标。我们在补充材料中纳入了活动期间可以进行的详细活动，如姿势控制训练、感觉和知觉刺激、任务导向训练以及涉及丰富环境的活动。该方案以用户友好的格式编写，以便于在不同的社会和文化背景下应用，利用大多数临床环境中 readily available 的资源。 （注：“readily available”直译为“随时可用的”，结合语境这里可理解为“容易获得的”，但按要求不添加额外解释，保留英文原文）
