{"id":86962,"date":"2021-09-02T12:23:45","date_gmt":"2021-09-02T10:23:45","guid":{"rendered":"https:\/\/ibecbarcelona.eu\/?p=86962"},"modified":"2021-09-02T12:42:52","modified_gmt":"2021-09-02T10:42:52","slug":"la-rehabilitacio-dalta-intensitat-impulsa-la-recuperacio-despres-dun-ictus","status":"publish","type":"post","link":"https:\/\/ibecbarcelona.eu\/ca\/la-rehabilitacio-dalta-intensitat-impulsa-la-recuperacio-despres-dun-ictus\/","title":{"rendered":"La rehabilitaci\u00f3 d’alta intensitat impulsa la recuperaci\u00f3 despr\u00e9s d’un ictus"},"content":{"rendered":"

Aquests resultats suggereixen que els protocols est\u00e0ndards de tractament aplicats a pacients d\u2019icutus a molts sistemes de salut haurien de ser re-analitzats.<\/p>\n

\"\"
Imatge: Pacient d<\/span>\u2019<\/span>ictus durant una sessi\u00f3 de rehabilitaci\u00f3 amb el Sistema de Jocs de Rehabilitaci\u00f3 de l’IBEC (sigles en angl\u00e8s: RGS) a l’Hospital SJDD (Parc Sanitari, San Boi). Cortesia del projecte europeu \u201cRGS @ home\u201d<\/span> https:\/\/rgs-at-home.eu\/<\/a><\/figcaption><\/figure>L’<\/span>ictus, o accident cerebrovascular, \u00e9s una de les principals causes de mort i discapacitat en adults a tot el m\u00f3n. La ter\u00e0pia de rehabilitaci\u00f3 \u00e9s actualment\u00a0<\/span>una de les millors opcions que tenen els pacients per a ajudar a recuperar la funci\u00f3 motora perduda. Si b\u00e9 diversos estudis en les \u00faltimes d\u00e8cades han assenyalat els beneficis de comen\u00e7ar la ter\u00e0pia dins dels 6 mesos posteriors a un accident cerebrovascular, existeix un debat entre la comunitat m\u00e8dica sobre\u00a0<\/span>la intensitat\u00a0<\/span>en\u00a0<\/span>que hauria de tenir\u00a0<\/span>lloc\u00a0<\/span>exactament<\/span>.<\/span>\u00a0A m\u00e9s, les pautes sanit\u00e0ries actuals en moltes parts del m\u00f3n encara dicten que la rehabilitaci\u00f3\u00a0<\/span>no\u00a0<\/span>ha de comen\u00e7ar<\/span>\u00a0massa aviat<\/span>\u00a0despr\u00e9s d’un accident cerebrovascular<\/span>\u00a0(primeres 1-2 setmanes)<\/span>, que la durada de cada sessi\u00f3 individual ha de ser curta i que els pacients han de ser donats d’alta de seguida.<\/span><\/span>\u00a0<\/span><\/p>\n

No obstant aix\u00f2, els resultats d’un nou estudi publicat en la revista\u00a0<\/span><\/span>Journal<\/span>\u00a0of\u00a0<\/span>Neurology<\/span>,\u00a0<\/span>Neurosurgery<\/span>\u00a0<\/span>and<\/span>\u00a0<\/span>Psychiatry<\/span><\/span><\/a>\u00a0demostren els aclaparadors beneficis de la rehabilitaci\u00f3 d’alta intensitat – en oposici\u00f3 a la de baixa intensitat- reafirmant encara m\u00e9s els avantatges coneguts d’un inici primerenc de la rehabilitaci\u00f3 despr\u00e9s d’un ictus. L’estudi ha estat liderat pel Professor de Recerca ICREA Paul\u00a0<\/span>Verschure<\/span>\u00a0i Bel\u00e9n Rubio Ballester, respectivament l\u00edder de grup i investigadora\u00a0<\/span>postdoctoral<\/span>\u00a0del\u00a0<\/span><\/span>Grup de Sistemes Sint\u00e8tics, Perceptius, Emotius i Cognitius (SPECS)<\/span><\/span><\/a>\u00a0de l’IBEC, en col\u00b7laboraci\u00f3 amb Nick S.\u00a0<\/span>Ward<\/span>\u00a0de la UCL.<\/span><\/span>\u00a0<\/span><\/p>\n

Una\u00a0<\/span>t<\/span>er\u00e0pia intensiva\u00a0<\/span>comporta\u00a0<\/span>una millor recuperaci\u00f3<\/span>\u00a0<\/span>d<\/span>els pacients<\/span><\/span><\/strong>\u00a0<\/span><\/h2>\n

Els investigadors van comparar els resultats de dos estudis independents de rehabilitaci\u00f3 en els quals van participar un total de 455 pacients d’accident cerebrovascular que havien perdut part de la funci\u00f3 motora dels bra\u00e7os. En el primer estudi,\u00a0anomenat\u00a0Queen\u00a0Square\u00a0Upper\u00a0Limb\u00a0Neurorehabilitation\u00a0i dut a terme per la\u00a0\u00a0UCL, es va realitzar un programa de rehabilitaci\u00f3 de 3 setmanes, amb 6 hores de ter\u00e0pia per dia (o aproximadament 90 hores en total). En el segon estudi, amb el Sistema de Jocs de Rehabilitaci\u00f3 de l’IBEC, els pacients van seguir un programa de 3 a 12 setmanes en el qual van rebre nom\u00e9s de 20 a 30 minuts de ter\u00e0pia per dia (de 7,5 a 30 hores en total). En aquest l’\u00faltim grup, els pacients van rebre ter\u00e0pia convencional o rehabilitaci\u00f3 basada en realitat virtual.<\/span>\u00a0<\/span><\/p>\n

Mesurant la taxa de millora setmanal de cada pacient en relaci\u00f3\u00a0amb el seu respectiu potencial de recuperaci\u00f3,\u00a0els investigadors\u00a0van trobar que la recuperaci\u00f3 d’aquells que van rebre 6 hores de ter\u00e0pia per dia va ser significativament major que aquells que van rebre nom\u00e9s de 20 a 30 minuts. Els seus resultats tamb\u00e9 van recolzar\u00a0els\u00a0resultats\u00a0mostrant\u00a0que els avantatges de la rehabilitaci\u00f3 disminueixen com m\u00e9s tard comen\u00e7a la ter\u00e0pia despr\u00e9s d’un accident cerebrovascular. Malgrat\u00a0aix\u00f2, van observar que els beneficis de rebre ter\u00e0pia d’alta intensitat van ser suficients per a superar els efectes perjudicials d’un inici tard\u00e0.<\/span>\u00a0<\/span><\/p>\n

\u201cAquests resultats ens mostren que els est\u00e0ndards de tractament\u00a0que ofereixen molts sistemes de salut\u00a0s\u2019han de tornar a analitzar\u201d, explica Bel\u00e9n Rubio Ballester, primera autora de l’estudi. \u201cSi b\u00e9 els beneficis de la ter\u00e0pia d’alta intensitat s\u00f3n clars, queda una pregunta clau: com la podem implementar en els nostres sistemes de salut? Una possible resposta \u00e9s a trav\u00e9s de sistemes de rehabilitaci\u00f3 basats en realitat virtual que permetin als pacients fer ter\u00e0pia a casa, com els que estem desenvolupant en el grup SPECS\u201d.<\/span>\u00a0<\/span><\/p>\n

Finalment, els investigadors prediuen que els pacients que van rebre ter\u00e0pia d’alta intensitat haurien mostrat encara\u00a0m\u00e9s\u00a0millores si la durada del seu programa s’hagu\u00e9s prolongat durant m\u00e9s de 3 setmanes. \u201cMolts protocols segueixen una finestra de recuperaci\u00f3 de 3 a 6 mesos, per\u00f2 creiem que en realitat podria ser molt m\u00e9s llarga, potser fins i tot anys\u201d, conclou Rubio Ballester. Futurs estudis hauran de confirmar aquest fenomen.<\/span>\u00a0<\/span><\/p>\n

Els nostres resultats van demostrar els clars beneficis dels programes de rehabilitaci\u00f3 d’alta intensitat i amb un inici primerenc per a pacients d’accident cerebrovascular i ens suggereixen que s’ha de tornar a analitzar l’est\u00e0ndard de tractament ofert per molts sistemes de salut.<\/span><\/span><\/em><\/strong><\/p>\n

Bel\u00e9n Rubio Ballester, primera autora de l\u2019estudi<\/span>.<\/span><\/span><\/em><\/strong><\/p>\n<\/blockquote>\n

\n
\n

Article de refer\u00e8ncia:\u00a0\u00a0<\/strong><\/p>\n

Bel<\/span>\u00e9<\/span>n Rubio Ballester<\/span>, Nick S. Ward, Fran Brander, Martina Maier, Kate Kelly<\/span>\u00a0and Paul F.M.J. Verschure.<\/span>\u00a0<\/span>Relationship between intensity and recovery in post-stroke rehabilitation: a retrospective analysis<\/span><\/a>\u00a0J Neurology, Neurosurgery, and Psychiatry, 2021.<\/span>\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Una an\u00e0lisi retrospectiva realitzada per investigadors de l’Institut de Bioenginyeria de Catalunya (IBEC) i l’University College London (UCL) conclou que una ter\u00e0pia d’alta intensitat realitzada dins dels 6 mesos posteriors a l\u2019ictus ofereix els millors resultats de rehabilitaci\u00f3. <\/h3>\n","protected":false},"author":4,"featured_media":86958,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[96],"tags":[1145,1532],"post_formats":[],"class_list":["post-86962","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-noticies-de-recerca","tag-paul-verschure-ca","tag-sistema-de-jocs-de-rehabilitacio"],"yoast_head":"\nLa rehabilitaci\u00f3 d'alta intensitat impulsa la recuperaci\u00f3 despr\u00e9s d'un ictus - Institute for Bioengineering of Catalonia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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