Browsing articles tagged with "BESts Archives - Updates en Rehabilitación"
dic
8
2011

Terapia acuática en niños con parálisis cerebral

logo Cincinnati HospitalOs dejo un nuevo “BESts” sobre la terapia acuática en niños con paralisis cerebral infantil, os dejo el pdf completo  y un pequeño resumen en inglés, son términos sencillos, pero si no, siempre podéis usar el traductor del blog.

Clinical\ Question 
P (population/problem) Among children ages 0-12 years diagnosed with hemiplegic cerebral palsy
I (intervention) does aquatic therapy
C (comparison)
O (outcome) improve function and/or decrease impairment?

Target Population: Children diagnosed with hemiplegic cerebral palsy, age 0-12 years.

 Exclusion criteria: Children with a diagnosis of hemiplegia that does not also have a diagnosis of cerebral palsy. Children with significant cognitive delay who are unable to follow multi-step directions or to comply with recommendations. Children not ambulatory by age 3.

 Recommendation 

  1. It is recommended that aquatic therapy intervention be considered for children with hemiplegic cerebral palsy who demonstrate neurological and/or musculoskeletal impairments (Getz 2006 [1a], Hutzler 1998 [2b], Yaggie 2002 [5], Thorpe 2000 [5], Ruoti 1997 [5], Local Consensus [5]). 
  2. It is recommended that aquatic therapy interventions be used with children with cerebral palsy who demonstrate endurance or energy deficits and who have goals related to improving those deficits (Hutzler 1998 [2b], Local Consensus [5]). 
  3. There is insufficient evidence and a lack of consensus to make recommendations on the duration, frequency, intensity or strategy (theoretical model) used for aquatic therapy intervention. 
  4. It is recommended that clinicians receive specialized training in aquatic therapy interventions prior to providing this to patients (Sova 2000 [5], Local Consensus [5]).

 Podemos leer el artículo completo: Terapia acuática en niños con parálisis cerebral

sep
28
2011

BESTs: Maniobras reclutamiento alveolar Vs fisioterapia respiratoria convencional

No sé si conocéis los denominados “BESts” (Best Evidence Statements) promovidos por el el Cincinnati Children’s Hospital Medical Center. Son algo parecido a los CATs centrados en temas pediátricos.
Proporcionan recomendaciones, basadas en la evidencia, sobre un tema concreto o sobre una sola pregunta clínica.  Se elaboran a partir de fuentes de evidencia sintetizada en lugar de recursos primarios y me parecen una forma muy simple y cómoda de trasnmitir la información.
Por suerte, a veces se incluyen temas relacionados con la Rehabilitación, Fisioterapia, etc. os dejo el pdf completo comparando las maniobras de reclutamiento  Vs fisioterapia respiratoria convencional en niños con ventilación mecánica y un pequeño resumen (en inglés).

Clinical\ Question 
 P (population/problem) Among infants and children (newborn to 18 years) who are mechanically ventilated and have atelectasis
I (intervention) does the use of recruitment maneuvers
C (comparison) versus chest physiotherapy
O (outcome) lead to earlier resolution of atelectasis?

Target Population: Infants and children ages newborn to 18 years who are mechanically ventilated with documented atelectasis.

 Exclusion criteria: includes patients with increased intracranial pressure, pnuemothorax and hemodynamic instability.

 Definitions 

  •  Chest physiotherapy: a treatment modality that incorporates chest wall manipulation with chest clapping, percussion and vibration to mobilize retained secretions. 
  •  Recruitment maneuvers: an intervention to increase the number of alveoli participating in gas exchange by increasing the transpulmonary pressure via ventilator or flow inflation bag. 

 Recommendation 
 There is insufficient evidence and lack of consensus to make a recommendation for using recruitment maneuvers versus chest physiotherapy for treatment of atelectasis with the mechanically ventilated pediatric patient

 Podemos leer el artículo completo: Maniobras reclutamiento alveolar Vs fisioterapia respiratoria convencional

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