Intervenções de Terapia Ocupacional com pessoas com esclerose múltipla: revisão integrativa da literatura

Campos, Luana Aparecida Barbosa; Toldrá, Rosé Colom

doi:10.4322/2526-8910.ctoAR1840

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Sumário

Artigo de Revisão • Cad. Bras. Ter. Ocup. 27 (4) • Oct-Dec 2019 • https://doi.org/10.4322/2526-8910.ctoAR1840 copiar

Intervenções de Terapia Ocupacional com pessoas com esclerose múltipla: revisão integrativa da literatura

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo:

Introdução

A esclerose múltipla é uma doença autoimune, desmielinizante mais comum do sistema nervoso central, que afeta principalmente adultos e causa impactos significativos no desempenho ocupacional e na participação social.

Objetivo

Analisar e sistematizar o conhecimento produzido pela terapia ocupacional relacionado às intervenções com pessoas com esclerose múltipla, no período entre 2012 e 2017.

Método

Revisão integrativa da literatura tendo como fonte de busca as bases de dados Scientific Eletronic Library Online, Biblioteca Virtual em Saúde, National Library of Medicine, National Institutes of Health of United States e os periódicos nacionais: Cadernos Brasileiros de Terapia Ocupacional, Revista de Terapia Ocupacional da Universidade de São Paulo e Revista Internacional Brasileira de Terapia Ocupacional.

Resultados

Foram identificadas publicações em quinze periódicos diferentes, sendo apenas dois artigos nacionais e vinte estrangeiros. Os artigos foram classificados nas seguintes temáticas: Intervenção Individualizada/Autogestão, Intervenção Domiciliar, Uso da Tecnologia para Intervenção, Intervenção Grupal e Intervenção Centrada no Cliente. Os estudos apontam diversidade de intervenções na forma individual, grupal, curso, com uso de videoconferência e videogame, no contexto domiciliar e de trabalho.

Conclusão

As intervenções desenvolvidas pelos profissionais apontam diminuição dos sintomas, melhora da funcionalidade, maior conhecimento das potencialidades, autocontrole, autocuidado e promoção da qualidade de vida. O estudo contribui para maior divulgação e, consequentemente, maior reconhecimento da efetividade das práticas da terapia ocupacional, indicando a necessidade de pesquisas no âmbito nacional, visto a escassez de artigos publicados no Brasil sobre a temática.

Palavras-chave:
Terapia Ocupacional; Esclerose Múltipla; Reabilitação; Prática Profissional; Literatura de Revisão

Periódico	Base de indexação	Artigos
Am. J. Occup. Ther.	MEDLINE	4
Mult Scler. Journal	MEDLINE	2
Disabil. Rehabil.	MEDLINE	2
Int. J. MS. Care.	MEDLINE	2
Cad. Bras. Ter. Ocup.	BVS	2
Disabil Health J.	MEDLINE	1
Int. J. Rehabil Res.	MEDLINE	1
Clin. Rehabil.	MEDLINE	1
J. Rehabil. Med.	MEDLINE	1
Neuropsychol Rehabil.	MEDLINE	1
Phys. Med. Rehabil. Clin. N. Am.	MEDLINE	1
Mental Health Spec. Interest Sect Q.	MEDLINE	1
Neuro Rehabilitation	MEDLINE	1
Canadian J. Occup. Therapy	MEDLINE	1
Occup. Ther. Int.	MEDLINE	1

Categoria/Tema	Autor	Síntese do conhecimento
Intervenção individualizada/ Autogestão	Van Heest, Mongush e Mathiowetz (2017)VAN HEEST, K. N. L.; MONGUSH, A. R.; MATHIOWETZ, V. G. Effects of a one-to-one fatigue management course for people with chronic conditions and fatigue. The American Journal of Occupational Therapy, Boston, v. 71, n. 4, p. 7104100020p1-7104100020p9, 2017., Goverover et al. (2017)GOVEROVER, Y. et al. A randomized controlled trial to treat impaired learning and memory in multiple sclerosis: the self-GEN trial. Multiple Sclerosis, Houndmills, v. 24, n. 8, p. 1096-1104, 2017., Kos et al. (2016)KOS, D. et al. The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: a randomized-controlled trial. International Journal of Rehabilitation Research, London, v. 39, n. 3, p. 255-262, 2016., Goverover, Chiaravalloti e DeLuca (2014)GOVEROVER, Y.; CHIARAVALLOTI, N. D.; DELUCA, J. Task meaningfulness and degree of cognitive impairment: do they affect self-generated learning in persons with multiple sclerosis? Neuropsychological Rehabilitation, Hove, v. 24, n. 2, p. 155-171, 2014., Buzaid et al. (2013)BUZAID, A. et al. Activities of daily living: evaluation and treatment in persons with multiple sclerosis. Physical Medicine and Rehabilitation Clinics of North America, Philadelphia, v. 24, n. 4, p. 629-638, 2013..	Curso e programas individuais que possibilitaram aprendizagem autogerados, projetar intervenções, gerenciar sintomas tanto leves quanto graves para maior independência e segurança.
Intervenção Domiciliar	Kamm et al. (2015)KAMM, C. P. et al. Home-based training to improve manual dexterity in patients with multiple sclerosis: A randomized controlled trial. Multiple Sclerosis, Houndmills, v. 21, n. 12, p. 1546-1556, 2015., Sosnoff et al. (2015)SOSNOFF, J. J. et al. Fall risk and incidence reduction in high risk individuals with multiple sclerosis: a pilot randomized control trial. Clinical Rehabilitation, London, v. 29, n. 10, p. 952-960, 2015., Kalron et al. (2013)KALRON, A. et al. Effects of a new sensory re-education training tool on hand sensibility and manual dexterity in people with multiple sclerosis. Neuro Rehabilitation, Amsterdam, v. 32, n. 4, p. 943-948, 2013..	Programas domiciliares de fácil aplicação, executados independente dos serviços, com benefícios funcionais e para prevenção de quedas.
Uso da tecnologia para intervenção	Asano et al. (2015)ASANO, M. et al. Goals set after completing a teleconference-delivered program for managing multiple sclerosis fatigue. The American Journal of Occupational Therapy, Boston, v. 69, n. 3, p. 6903290010p1-6903290010p8, 2015., Dunleavy, Preissner e Finlayson (2013)DUNLEAVY, L.; PREISSNER, K. L.; FINLAYSON, M. L. Facilitating a teleconference-delivered fatigue management program: perspectives of occupational therapists. Canadian Journal of Occupational Therapy, Ottawa, v. 80, n. 5, p. 304-313, 2013., Finlayson, Preissner e Cho (2012FINLAYSON, M.; PREISSNER, K.; CHO, C. Outcome moderators of a fatigue management program for people with multiple sclerosis. The American Journal of Occupational Therapy, Boston, v. 66, n. 2, p. 187-197, 2012., 2013)FINLAYSON, M.; PREISSNER, K.; CHO, C. Impact of comorbidity on fatigue management intervention outcomes among people with multiple sclerosis: an exploratory investigation. International Journal of MS Care, Clifton, v. 15, n. 1, p. 21-26, 2013., Plow e Finlayson (2014)PLOW, M.; FINLAYSON, M. A qualitative study exploring the usability of Nintendo Wii Fit among persons with multiple sclerosis. Occupational Therapy International, London, v. 21, n. 1, p. 21-32, 2014..	Uso de teleconferência em grupo com efeitos para o autogerenciamento dos sintomas e estilo de vida. Aplicação de videogame para aprendizado de exercícios, com melhora nas habilidades e participação no lazer, embora necessite de adaptação.
Intervenção Grupal	Pimentel e Toldrá (2017aPIMENTEL, P. P.; TOLDRÁ, R. C. Método Self-Healing como estratégia de promoção à saúde e reabilitação de pessoas com esclerose múltipla no contexto da terapia ocupacional. Cadernos Brasileiro de Terapia Ocupacional, São Carlos, v. 25, n. 3, p. 565-573, 2017a., 2017bPIMENTEL, P. P.; TOLDRÁ, R. C. Desenvolvimento de manual para orientações básicas do dia a dia para pessoas com esclerose múltipla. Cadernos de Terapia Ocupacional da UFSCar, São Carlos, v. 25, n. 1, p. 67-74, 2017b.), Brown et al. (2016)BROWN, C. L. et al. Learning to live with multiple sclerosis cognitive impairment and how it influences readiness for group cognitive intervention. Disability and Health Journal, New York, v. 9, n. 4, p. 638-645, 2016..	Grupos favoreceram trocas de experiências, expressão e ajuda. Colaboraram para a experimentação de técnicas corporais, aprimoramento e uso de manual de orientações e aprendizagem para viver com alterações cognitivas.
Intervenção Centrada no Cliente	Preissner, Arbesman e Lieberman (2016)PREISSNER, K.; ARBESMAN, M.; LIEBERMAN, D. Occupational therapy interventions for adults with multiple sclerosis. The American Journal of Occupational Therapy, Boston, v. 70, n. 3, p. 7003395010p1-7003395010p 4, 2016., Eyssen et al. (2013EYSSEN, I. C. et al. A cluster randomised controlled trial on the efficacy of client-centred occupational therapy in multiple sclerosis: good process, poor outcome. Disability and Rehabilitation, London, v. 35, n. 19, p. 1636-1646, 2013., 2014EYSSEN, I. C. et al. Client-centred therapy in multiple sclerosis: more intensive diagnostic evaluation and less intensive treatment. Journal of Rehabilitation Medicine, Stockholm, v. 46, n. 6, p. 527-531, 2014.), Mesa et al. (2012)MESA, A. et al. The mental health needs of individuals living with multiple sclerosis: implications for occupational therapy practice and research. Mental Health Special Interest Section Quarterly, Rockville, v. 35, n. 2, p. 1-4, 2012., Falk-Kessler, Kalina e Miller (2012)FALK-KESSLER, J.; KALINA, J. T.; MILLER, P. Influence of occupational therapy on resilience in individuals with multiple sclerosis. International Journal of MS Care, Clifton, v. 14, n. 3, p. 160-168, 2012..	Eficiência da intervenção em fase de sintomas agudos; importância da avaliação do sofrimento psíquico e aumento da resiliência quando tratado por terapeuta ocupacional. Necessário maior equilíbrio do tempo usado para avaliação e intervenção.
Reabilitação Vocacional	Jellie et al. (2014)JELLIE, B. et al. Staying at work and living with MS: a qualitative study of the impact of a vocational rehabilitation intervention. Disability and Rehabilitation, London, v. 36, n. 19, p. 1594-1599, 2014..	Trabalhadores que vivenciaram instabilidade no trabalho sentiram-se habilitados para gerenciar melhor as relações e os desafios do trabalho em si. Empregadores reportaram maior compreensão das dificuldades dos funcionários.

Universidade Federal de São Carlos, Departamento de Terapia Ocupacional Rodovia Washington Luis, Km 235, Caixa Postal 676, CEP: , 13565-905, São Carlos, SP - Brasil, Tel.: 55-16-3361-8749 - São Carlos - SP - Brazil
E-mail: cadto@ufscar.br

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[1] Autor para correspondência: Luana Aparecida Barbosa Campos, Universidade de São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP 05360-000, São Paulo, SP, Brasil, e-mail: camposluana1997@gmail.com

Nº	Título	Autor(es)/Ano	Periódico
1	Effects of a One-to-One Fatigue Management Course for People With Chronic Conditions and Fatigue.	Van Heest, Mongush e Mathiowetz (2017)VAN HEEST, K. N. L.; MONGUSH, A. R.; MATHIOWETZ, V. G. Effects of a one-to-one fatigue management course for people with chronic conditions and fatigue. The American Journal of Occupational Therapy, Boston, v. 71, n. 4, p. 7104100020p1-7104100020p9, 2017.	Am. J. Occup. Ther.
2	A randomized controlled trial to treat impaired learning and memory in multiple sclerosis: The self-GEN trial.	Goverover et al. (2017)GOVEROVER, Y. et al. A randomized controlled trial to treat impaired learning and memory in multiple sclerosis: the self-GEN trial. Multiple Sclerosis, Houndmills, v. 24, n. 8, p. 1096-1104, 2017.	Mult. Scler.
3	Método self-healing como estratégia de promoção à saúde e reabilitação de pessoas com esclerose múltipla no contexto da terapia ocupacional	Pimentel e Toldrá (2017a)PIMENTEL, P. P.; TOLDRÁ, R. C. Método Self-Healing como estratégia de promoção à saúde e reabilitação de pessoas com esclerose múltipla no contexto da terapia ocupacional. Cadernos Brasileiro de Terapia Ocupacional, São Carlos, v. 25, n. 3, p. 565-573, 2017a.	Cad. Bras. Ter. Ocup.
4	Desenvolvimento de manual para orientações básicas do dia a dia para pessoas com esclerose múltipla	Pimentel e Toldrá (2017b)PIMENTEL, P. P.; TOLDRÁ, R. C. Desenvolvimento de manual para orientações básicas do dia a dia para pessoas com esclerose múltipla. Cadernos de Terapia Ocupacional da UFSCar, São Carlos, v. 25, n. 1, p. 67-74, 2017b.	Cad. Bras. Ter. Ocup.
5	Learning to live with multiple sclerosis cognitive impairment and how it influences readiness for group cognitive intervention.	Brown et al. (2016)BROWN, C. L. et al. Learning to live with multiple sclerosis cognitive impairment and how it influences readiness for group cognitive intervention. Disability and Health Journal, New York, v. 9, n. 4, p. 638-645, 2016.	Disabil Health J.
6	The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: a randomized-controlled trial.	Kos et al. (2016)KOS, D. et al. The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: a randomized-controlled trial. International Journal of Rehabilitation Research, London, v. 39, n. 3, p. 255-262, 2016.	Int. J. Rehabil Res.
7	Occupational Therapy Interventions for Adults With Multiple Sclerosis.	Preissner, Arbesman e Lieberman (2016)PREISSNER, K.; ARBESMAN, M.; LIEBERMAN, D. Occupational therapy interventions for adults with multiple sclerosis. The American Journal of Occupational Therapy, Boston, v. 70, n. 3, p. 7003395010p1-7003395010p 4, 2016.	Am. J. Occup. Ther.
8	Goals set after completing a teleconference-delivered program for managing multiple sclerosis fatigue.	Asano et al. (2015)ASANO, M. et al. Goals set after completing a teleconference-delivered program for managing multiple sclerosis fatigue. The American Journal of Occupational Therapy, Boston, v. 69, n. 3, p. 6903290010p1-6903290010p8, 2015.	Am. J. Occup. Ther.
9	Home-based training to improve manual dexterity in patients with multiple sclerosis: A randomized controlled trial.	Kamm et al. (2015)KAMM, C. P. et al. Home-based training to improve manual dexterity in patients with multiple sclerosis: A randomized controlled trial. Multiple Sclerosis, Houndmills, v. 21, n. 12, p. 1546-1556, 2015.	Mult. Scler.
10	Fall risk and incidence reduction in high risk individuals with multiple sclerosis: a pilot randomized control trial.	Sosnoff et al. (2015)SOSNOFF, J. J. et al. Fall risk and incidence reduction in high risk individuals with multiple sclerosis: a pilot randomized control trial. Clinical Rehabilitation, London, v. 29, n. 10, p. 952-960, 2015.	Clin. Rehabil.
11	Client-centred therapy in multiple sclerosis: more intensive diagnostic evaluation and less intensive treatment.	Eyssen et al. (2014)EYSSEN, I. C. et al. Client-centred therapy in multiple sclerosis: more intensive diagnostic evaluation and less intensive treatment. Journal of Rehabilitation Medicine, Stockholm, v. 46, n. 6, p. 527-531, 2014.	J. Rehabil. Med.
12	Staying at work and living with MS: a qualitative study of the impact of a vocational rehabilitation intervention.	Jellie et al. (2014)JELLIE, B. et al. Staying at work and living with MS: a qualitative study of the impact of a vocational rehabilitation intervention. Disability and Rehabilitation, London, v. 36, n. 19, p. 1594-1599, 2014.	Disabil. Rehabil.
13	Task meaningfulness and degree of cognitive impairment: do they affect self-generated learning in persons with multiple sclerosis?	Goverover, Chiaravalloti e DeLuca (2014)GOVEROVER, Y.; CHIARAVALLOTI, N. D.; DELUCA, J. Task meaningfulness and degree of cognitive impairment: do they affect self-generated learning in persons with multiple sclerosis? Neuropsychological Rehabilitation, Hove, v. 24, n. 2, p. 155-171, 2014.	Neuropsychol Rehabil.
14	A qualitative study exploring the usability of Nintendo Wii Fit among persons with multiple sclerosis.	Plow e Finlayson (2014)PLOW, M.; FINLAYSON, M. A qualitative study exploring the usability of Nintendo Wii Fit among persons with multiple sclerosis. Occupational Therapy International, London, v. 21, n. 1, p. 21-32, 2014.	Occup. Ther Int.
15	Facilitating a teleconference-delivered fatigue management program: perspectives of occupational therapists.	Dunleavy, Preissner e Finlayson (2013)DUNLEAVY, L.; PREISSNER, K. L.; FINLAYSON, M. L. Facilitating a teleconference-delivered fatigue management program: perspectives of occupational therapists. Canadian Journal of Occupational Therapy, Ottawa, v. 80, n. 5, p. 304-313, 2013.	Can J OccupTher
16	Activities of daily living: evaluation and treatment in persons with multiple sclerosis.	Buzaid et al. (2013)BUZAID, A. et al. Activities of daily living: evaluation and treatment in persons with multiple sclerosis. Physical Medicine and Rehabilitation Clinics of North America, Philadelphia, v. 24, n. 4, p. 629-638, 2013.	Phys. Med. Rehabil. Clin. N. Am.
17	Impact of comorbidity on fatigue management intervention outcomes among people with multiple sclerosis: an exploratory investigation.	Finlayson, Preissner e Cho (2013)FINLAYSON, M.; PREISSNER, K.; CHO, C. Impact of comorbidity on fatigue management intervention outcomes among people with multiple sclerosis: an exploratory investigation. International Journal of MS Care, Clifton, v. 15, n. 1, p. 21-26, 2013.	Int. J. of MS Care
18	Effects of a new sensory re-education training tool on hand sensibility and manual dexterity in people with multiple sclerosis.	Kalron et al. (2013)KALRON, A. et al. Effects of a new sensory re-education training tool on hand sensibility and manual dexterity in people with multiple sclerosis. Neuro Rehabilitation, Amsterdam, v. 32, n. 4, p. 943-948, 2013.	NeuroRehabilitation.
19	A cluster randomised controlled trial on the efficacy of client-centred occupational therapy in multiple sclerosis: good process, poor outcome.	Eyssen et al. (2013)EYSSEN, I. C. et al. A cluster randomised controlled trial on the efficacy of client-centred occupational therapy in multiple sclerosis: good process, poor outcome. Disability and Rehabilitation, London, v. 35, n. 19, p. 1636-1646, 2013.	Disabil. Rehabil.
20	Influence of occupational therapy on resilience in individuals with multiple sclerosis.	Falk-Kessler, Kalina e Miller (2012)FALK-KESSLER, J.; KALINA, J. T.; MILLER, P. Influence of occupational therapy on resilience in individuals with multiple sclerosis. International Journal of MS Care, Clifton, v. 14, n. 3, p. 160-168, 2012.	Int. J. MS. Care.
21	Outcome moderators of a fatigue management program for people with multiple sclerosis.	Finlayson, Preissner e Cho (2012)FINLAYSON, M.; PREISSNER, K.; CHO, C. Outcome moderators of a fatigue management program for people with multiple sclerosis. The American Journal of Occupational Therapy, Boston, v. 66, n. 2, p. 187-197, 2012.	Am. J. Occup. Ther.
22	The Mental Health Needs of Individuals Living With Multiple Sclerosis: Implications for Occupational Therapy Practice and Research.	Mesa et al. (2012)MESA, A. et al. The mental health needs of individuals living with multiple sclerosis: implications for occupational therapy practice and research. Mental Health Special Interest Section Quarterly, Rockville, v. 35, n. 2, p. 1-4, 2012.	Mental Health Spec. Interest Sect Q.