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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(10): 1067-1074
DOI: 10.1055/s-0042-1758558
Brazilian Academy of Neurology

Access to rehabilitation after stroke in Brazil (AReA study): multicenter study protocol

Acesso à reabilitação após o AVC no Brasil (estudo AReA): protocolo de estudo multicêntrico
Roberta de Oliveira Cacho 
1   Universidade Federal do Rio Grande do Norte, Faculdade de Ciências da Saúde do Trairi, Santa Cruz RN, Brazil.
,
Carla Heloisa Cabral Moro 
2   Hospital Municipal de São José, Joinville SC, Brazil.
,
Rodrigo Bazan 
3   Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, São Paulo SP, Brazil.
,
Suzete Nascimento Farias da Guarda 
4   Universidade Federal da Bahia, Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Salvador BA, Brazil.
,
Elen Beatriz Pinto 
5   Escola Bahiana de Medicina e Saúde Pública, Fundação para o Desenvolvimento das Ciências, Salvador BA, Brazil.
,
Suellen Mary Marinho dos Santos Andrade 
6   Universidade Federal da Paraíba, Departamento de Fisioterapia, João Pessoa PB, Brazil.
,
Lenise Valler 
7   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas SP, Brazil.
,
Kelson James Almeida 
8   Universidade Federal do Piauí, Centro Universitário UniFacid, Departamento de Medicina Especializada em Neurologia, Teresina PI, Brazil.
,
Tatiana Souza Ribeiro 
9   Universidade Federal do Rio Grande do Norte, Departamento de Fisioterapia, Natal RN, Brazil.
,
Renata Viana Brígido de Moura Jucá 
10   Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Fortaleza CE, Brazil.
,
Cesar Minelli 
11   Hospital Carlos Fernando Malzoni, Instituto “Você sem AVC”, Matão SP, Brazil.
12   Universidade de São Paulo, Departamento de Neurociências e Ciências Comportamentais, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto SP, Brazil.
,
Maria Elisa Pimentel Piemonte 
13   Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo SP, Brazil.
,
Eric Homero Albuquerque Paschoal 
14   Hospital Ophir Loyola, Belém PA, Brazil.
,
Marco Túlio Araújo Pedatella 
15   Hospital Estadual de Urgência de Goiânia Dr Valdemiro Cruz, Goiânia GO, Brazil.
,
Octávio Marques Pontes-Neto 
16   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto SP, Brazil.
,
Ana Paula Fontana 
17   Universidade Federal do Rio de Janeiro, Faculdade de Fisioterapia, Laboratório Pesquisa em Recuperação Funcional Após AVC, Rio de Janeiro RJ, Brazil.
,
Aline de Souza Pagnussat 
18   Universidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Fisioterapia, Porto Alegre RS, Brazil.
,
Adriana Bastos Conforto 
19   Universidade de São Paulo, Hospital de Clínicas, Divisão de Neurologia Clínica, São Paulo SP, Brazil.
20   Hospital Israelita Albert Einstein, São Paulo SP, Brazil.
,
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Abstract

Background Most of the Brazilian population relies on public healthcare and stroke is a major cause of disability in this country of continental dimensions. There is limited information about access to rehabilitation after stroke in Brazil.

Objective To provide comprehensive information about Access to Rehabilitation After discharge from public hospitals in Brazil (AReA study), up to 6 months after stroke.

Methods The present study intends to collect information from 17 public health centers in 16 Brazilian cities in the 5 macroregions of the country. Each center will include 36 participants (n = 612). The inclusion criteria are: age ≥ 18 years old; ischemic or hemorrhagic stroke, from 6 months to 1 year prior to the interview; admission to a public hospital in the acute phase after stroke; any neurological impairment poststroke; patient or caregiver able to provide informed consent and answer the survey. Patients can only be recruited in public neurology or internal medicine outpatient clinics. Outcomes will be assessed by a standard questionnaire about rehabilitation referrals, the rehabilitation program (current status, duration in months, number of sessions per week) and instructions received. In addition, patients will be asked about preferences for locations of rehabilitation (hospitals, clinics, or at home).

Trial Status The study is ongoing. Recruitment started on January 31st, 2020 and is planned to continue until June 2022.

Conclusion The AReA study will fill a gap in knowledge about access to stroke rehabilitation in the public health system in different Brazilian regions.

Resumo

Antecedentes Grande parte da população brasileira depende de saúde pública e o acidente vascular cerebral (AVC) é uma das principais causas de incapacidade neste país de dimensões continentais. As informações sobre o acesso à reabilitação após AVC em instalações públicas no Brasil são limitadas.

Objetivo Fornecer informações abrangentes sobre o Acesso à Reabilitação pós-AVC (estudo AReA) nos primeiros 6 meses após a alta hospitalar da rede pública.

Métodos Serão coletadas informações de 17 centros de saúde públicos em 16 cidades brasileiras das cinco macrorregiões do país. Cada centro incluirá 36 participantes (n = 612). Os critérios de inclusão são: idade ≥ 18 anos; AVC isquêmico ou hemorrágico, com tempo de lesão entre 6 meses e 1 ano; admissão em hospital público na fase aguda; qualquer comprometimento neurológico pós-AVC; paciente ou cuidador capaz de fornecer consentimento informado e responder à pesquisa. Os pacientes só podem ser recrutados em ambulatórios públicos de neurologia ou medicina interna. Os resultados serão avaliados por um questionário padrão sobre encaminhamentos de reabilitação, o programa de reabilitação (estado atual, duração em meses, número de sessões por semana) e instruções recebidas. Além disso, os pacientes serão questionados sobre as preferências de locais de reabilitação (hospitais, clínicas ou casa).

Status do estudo O estudo está em andamento. O recrutamento começou em 31 de janeiro de 2020 e está previsto para continuar até junho de 2022.

Conclusão O estudo AReA preencherá uma lacuna no conhecimento sobre o acesso à reabilitação para AVC no sistema público de saúde em diferentes regiões brasileiras.

Keywords

Stroke - Patient Discharge - Referral and Consultation - Rehabilitation

Palavras-chave

Acidente Vascular Cerebral - Alta do Paciente - Encaminhamento e Consulta - Reabilitação

Authors' Contributions

ROC, ABC: conceptualization, writing, review, editing, and validation of the original draft; CHCM, RB, SNFG, EBP, SMMSA, LV, KJA, TSR, RVBMJ, CM, MEPP, EHAP, MTAP, OMPN, APF, ASP: review, editing, and validation of the original draft.




Publikationsverlauf

Eingereicht: 29. September 2021

Angenommen: 05. Februar 2022

Artikel online veröffentlicht:
19. Dezember 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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