Eficacia do metodo Meir Schneider de autocuidado em pessoas com distrofias musculares progressivas : ensaio clinico fase II

AUTOR(ES)
DATA DE PUBLICAÇÃO

1999

RESUMO

People affected by Progressive Muscular Dystrophy (PMD) live on the edge of the medical knowledge and are constantly waiting for new research results on prevention, rehabilitation and even the possible cure of those who carry the trait. The efficacy of the Meir Schneider Self-healing Method is discussed in this context, based on a phase II clinical trial with twelve patients with various types of PMD. They underwent outpatient treatment on intensive sessions three times weekly and non-intensive sessions about once a week. Selected cases were seven patients with Duchenne Muscular Dystrophy - DMD (3 under intensive treatment); 3 with Steinert Miotonic Dystrophy - SMD (1 intensive) and 2 with other types (1 intensive). The intervention was carried out at a Health Center of a Federal Government University located in the southwestern Brazil at Sâo Carlos City, São Paulo State, from June 1995 through August 1996. For the purpose of building an evaluation protocol system, to measure the response to the treatments, two instruments were chosen from the literature: the Functional Evaluation of Brooke et alii (1981) that was taken every 3 months, and the Life Satisfaction Index - Form A recorded at every 4 months (McDowell &Newmann, 1987). The most sensible results of the self-healing method thai were drawn from the data were muscle strength and life satisfaction. As a consequence, they were used to built a set of Functional Indicators that dealt with comparisons of muscular strength of opposite complementary movements in three selected body regions: The shoulders (horizontal abduction and adduction); the elbows (extension and flexion) and the knees (extension and flexion) showed greatest sensibility. These functional indicators associated with life satisfaction bring up the evidences of the "dose-dependent" personal gains proportionated by the self-healing method either intensive or non-intensive. In the intensive treatment group 3 children under age 6 with DMD showed the equalization of values in their functional indicators that permitted them better coordination and more stable movements of shoulders, elbows and knees. Their global strength improved despite drifts occurred during the treatment.In the non intensive treatment group 4 children aged 7 to 10 presented losses in the same functional indicators and in their global strength that resulted of their body growth both in weight and height. All families of children with DMD both in the intensive and non intensive groups maintained a high level on their life satisfaction, even during critical phases of the children s diseases especially during the differential diagnosis period for the intensive group and the loss of walking capabilities for the school aged children in the non- intensive group. The Meir Schneider self-healing method has shown efficacy to gaining family support to carry on the exercises program at home and for personal involvement linked to preserved intellectual ability when 3 cases were especially described under clinical terms being: 1 boy aged 5 with DMD; a woman aged 54 with SMD; and 1 boy aged 4 with Congenital MD. The study states that the self-healing method in the intensive treatment shows efficacy for people with family support and with mental or intellectual impairment. This efficacy was also found when dealing with emotional needs in the critical phases of the disease both in the intensive and non-intensive treatments. It is also partially efficacious for people that are resistant to changes in personal habits. Another set of observations in the trial pointed out that when the disease is accelerating its physical losses the method must be intensified, but the therapist have to give way to the coping needs of the child or adult, in order not to transform the very treatment into a burden. In much of these occasions most of the therapist attention is to be focussed on the family offering support for relief of mental and physical tension and general advising about the disease. This study has contributed to distinguish the "dose-equivalent" treatment to be given to PMD patients according to their chronicity status, family and personal losses of self expectancy and psychic grief to avoid treatment overdose, personal conflicts and overload that could prevent from getting advantages on the more sensible indicators. A final suggestion is made, that the Meir Schneider self-healing method be associated with current treatments as occupational therapy and physiotherapy, because it widens the available tools; gives new insight to the intervention strategies besides also puts in evidence the relationships between therapy and an educational approach towards patients and their families

ASSUNTO(S)

fisioterapia terapia ocupacional medicina alternativa holismo

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