Nível de evidência do conceito Halliwick em disfunções neurológicas - revisão sistemática

Abstract

Introduction: Neurological diseases can manifest in different ways, influenced by environmental and genetic factors. Being the main sequels of these diseases, such as increased tone, decreased trunk movements and range of motion - ROM, reduced dissociation of the shoulder girdle and changes in gait. Among the physiotherapeutic treatments in patients with neurological diseases, aquatic hysical therapy (AF) has been highlighted for contributing to therapeutic management and symptomatic relief. The main techniques used in FA are: Watsu; the Bad Ragaz and the Halliwick Method - MH. Among them, the MH method deserves to be highlighted, as it works involving patients in a biopsychosocial context and uses important tools such as the International Classification of Functioning, Disability and Health (ICF). Objectives: To verify the level of scientific evidence of MH in neurological disorders and classify the functional benefits of this method in the ICF. Method: The research is a systematic review developed in accordance with the guidelines for systematic reviews and meta-analysis (PRISMA) and GRADE. Searches were carried out in the Scielo, Pubmed, Lilacs, PEDro, Ovid and Medline databases, including articles on clinical trials of all types, systematic reviews and without limits on the year of publication, excluding those that are not systematic reviews, with the limitations of data, not being related to the theme; not having objective and functional measures or having only qualitative measures. Results: In the end, 18 articles were selected for this review. System Traffic Lights was used to summarize the methodological quality found with GRADE. The MH showed high evidence for the domains of body function in relation to ROM and activity in terms of carrying out Activities of Daily Living (ADLs), being represented by the color green. A moderate level of evidence (yellow color) was presented for MH alone for structure (symmetry in the stance phase), body function (pain) and activity (mobility, balance and gait), and MH together with conventional therapy on the ground in the domain of participation and environmental and personal factors. The MH was classified in red in the domain of body function and activity, the outcomes of muscle tone and disease severity, respectively. Conclusion: Through the results obtained from the analysis of the articles found regarding the level of evidence of the Halliwick method in neurological disorders, it is possible to conclude that it is efficient when associated with other therapeutic strategies, both when applied alone in neurological diseases. However, it is also concluded that the amount of information available in the literature is low, mainly based on the variety of existing neurological diseases and the deepening of some domains of the ICF, making it necessary that more clinical studies of the Halliwick method be carried out.