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Copyright (c) 2020 Angélica Patricia Chamorro Arrieta
This work is licensed under a Creative Commons Attribution 4.0 International License.
Functioning profile of patients with cerebrovascular disease sequels cared at a third level hospital in Popayan 2016-2018
Corresponding Author(s) : Angélica Patricia Chamorro Arrieta
Ciencia e Innovación en Salud,
2020
Abstract
Background: The functioning profile allows the characterization of the different health domains in three pillars of the biopsychosocial model of health established in the International Classification of Functioning and Disability (ICF): body structures and functioning, activities and participation, contextual factors. Materials: Retrospective, descriptive, cross-sectional study, reviewing the medical records of the years 2016-2018 of patients diagnosed with Cerebrovascular Disease. Descriptive statistics of the functioning variables established by the International Classification of Functioning and Disability (ICFD) were used. Results: 363 medical records met the inclusion criteria, the average age was 74,5 years, 59,8 % from the rural area of the municipalities of central Cauca, 47,9 % had deficiency in lobe structures temporal, parietal and frontal, deficiencies in functions related to swallowing, mostly with a severe problem, 54,3 %, language 17,6 %, and muscular strength with a problem between moderate and severe in 81,2 %, presented limitations of all activities 30,3 % with facilitators such as close relatives 97,7 %. Conclusions: The study population presents functional dependency that requires rehabilitation processes for its operation and implementation of public policies that minimize the overload of the informal caregiver.
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- World Health Organization. International classification of functioning, disability, and health -children and youth version [Internet].2011. 1–371 p. https://apps.who.int/iris/bitstream/10665/81610/1/9789243547329_spa.pdf
- Ministerio de Salud y Protección Social C-. Guía de práctica clínica para el diagnóstico y manejodel episodio agudo del Ataque Cerebrovascular [Internet]. Vol. 62, Guia N° 54 de 2015.http://gpc.minsalud.gov.co/gpc_sites/Repositorio/Conv_637/GPC_acv/GPC_ACV_Profesionales.pdf
- Saposnik G, Del Brutto OH. Stroke in South America: A systematic review of incidence,prevalence, and stroke subtypes. Stroke [Internet]. 2003;34(9):2103 7.https://www.ahajournals.org/doi/pdf/10.1161/01.STR.0000088063.74250.DB
- Shahla ND, Ardashir A, Yaghoub P. The Effect of Proprioceptive Neuromuscular Facilitation(PNF) on Activities of Daily Living of Client with Cerebrovascular Accident. World Fam MedJournal/Middle East J Fam Med [Internet]. 2017;15(7):154–8.http://www.mejfm.com/September2017/PNF on ADL.pdf
- Cheng YD, Al-Khoury L, Zivin JA. Neuroprotection for Ischemic Stroke: Two Decades of Successand Failure. NeuroRx [Internet]. 2004;1(1):36–45.https://link.springer.com/content/pdf/10.1602/neurorx.1.1.36.pdf
- Kalra L. The influence of stroke unit rehabilitation on functional recovery from stroke. Stroke[Internet]. 1994;25(4):821–5. DOI: 10.1161/01.STR.25.4.821
- Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet [Internet].2011;377(9778):1693–702. Disponible en: DOI: 10.1016/S0140-6736(11)60325-5
- Stinear CM, Byblow WD, Ackerley SJ, Barber PA, Smith MC. Predicting Recovery Potential forIndividual Stroke Patients Increases Rehabilitation Efficiency. Stroke [Internet]. 2017;48(4):1011–9.DOI: 10.1161/STROKEAHA.116.015790
- Geyh S, Cieza A, Schouten J, Dickson H, Frommelt P, Omar Z, et al. ICF Core Sets for stroke. JRehabil Med Suppl [Internet]. 2004;(44):135–41.https://geriatrictoolkit.missouri.edu/reimbursement/documentation/icf/ICF-Core-Set-Stroke.pdf
- Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, et al. Global burden ofstroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the GlobalBurden of Disease Study 2013. Lancet Neurol [Internet]. 2016;15(9):913–24. DOI:10.1016/S1474-4422(16)30073-4
- Ovbiagele B, Nguyen-Huynh MN. Stroke Epidemiology: Advancing Our Understanding ofDisease Mechanism and Therapy. Neurotherapeutics [Internet]. 2011;8(3):319 29.https://link.springer.com/content/pdf/10.1007/s13311-011-0053-1.pdf
- Machado Cartagena A. Colombia rural: Razones para la esperanza [Internet]. Informe Nacionalde Desarrollo Humano2011. 2011. 440 p. http://www.co.undp.org/content/dam/colombia/docs/DesarrolloHumano/undp-co-ic_indh2011-parte1-2011.pdf
- Huenchuan Sandra. Los derechos de las personas mayores. Materiales de estudio y divulgación.Hacia un cambio de paradigma sobre el envejecimiento y la vejez. 2011;20.https://repositorio.cepal.org/handle/11362/21497
- González-celis Ana C PA. Calidad de vida y estrategias de afrontamiento ante problemas yenfermedades en ancianos. 2006. http://www.scielo.org.co/pdf/rups/v5n3/v5n3a06.pdf
- González Quiñones JC. Resumen: “Sabe Colombia 2015: Estudio Nacional de Salud, Bienestary Envejecimiento”. Cart Comunitaria [Internet]. 2017;25(144):24.https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/Resumen-Ejecutivo-Encuesta-SABE.pdf
- Dulcey Ruiz E, Arrubla D, Sanabria P. Envejecimiento y vejez en Colombia [Internet]. Vol. 6,Profamilia Colombia.2013. https://www.researchgate.net/publication/272087925_Envejecimiento_y_vejez_en_Colombia_Estudio_a_profundidad
- Fekadu G, Chelkeba L, Kebede A. Retraction Note: Risk factors, clinical presentations andpredictors of stroke among adult patients admitted to stroke unit of Jimma university medicalcenter, south west Ethiopia: Prospective observational study (BMC Neurology (2019) 19 (183)DOI:10.118. BMC Neurol [Internet]. 2019;19(1):1–12. https://link.springer.com/article/10.1186/s12883-019-1412-5
- Ader J, Wu J, Fonarow GC, Smith EE, Shah S, Xian Y, et al. Hospital distance, socioeconomicstatus, and timely treatment of ischemic stroke. Neurology [Internet]. 2019;93(8):e747–57.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711658/pdf/NEUROLOGY2018923300.pdf
- Moreno E, Rodríguez J, Bayona-Ortiz H. Trombólisis endovenosa como tratamiento del ACVisquémico agudo en Colombia: una revisión sistemática de la literatura. Acta Neurológica Colomb[Internet]. 2019;35(3):156–66. http://www.scielo.org.co/scielo.php?pid=S0120-87482019000300156&script=sci_abstract&tlng=en
- Tizón García JL. A propósito del modelo biopsicosocial, 28 años después: Epistemología,política, emociones y contratransferencia. Aten Primaria [Internet]. 2007;39(2):93-7.https://www.researchgate.net/profile/Jorge_Tizon2/publication/240075659_A_proposito_del_modelo_biopsicosocial_28_anos_despues_epistemologia_politica_emociones_y_contratransferencia_The_biopsychosocial_model_28_years
- Torres-Arreola LDP, Valenzuela-Flores AA, Villa-Barragán JP. [Characterization of strokepatients attended at IMSS hospitals in Mexico City]. Rev Med Inst Mex Seguro Soc [Internet].56(1):18–25. https://www.medigraphic.com/pdfs/imss/im-2018/im181d.pdf
- Pintado B. Factores asociados a enfermedad cerebrovascular en pacientes que acuden alhospital de especialidades Dr. Abel Gilbert Pontón, Guayaquil." [Internet]. Archivos Venezolanosde Farmacología y Terapéutica37.3 (2018): 270-274. 2018. 270–273 p. http://www.revistaavft.com/images/revistas/2018/avft_3_2018/15_factores_asociado_enfermedad.p
- Pradilla A. G, Vesga A. BE, León-Sarmiento FE. Estudio neuroepidemiológico nacional(EPINEURO) colombiano. Rev Panam Salud Pública [Internet]. 2003;14(2):104–11.https://iris.paho.org/handle/10665.2/8346?locale-attribute=es
- Di Carlo A, Lamassa M, Baldereschi M, Pracucci G, Basile AM, Wolfe CDA, et al. Sex differencesin the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe: Datafrom a multicenter multinational hospital-based registry. Stroke [Internet]. 2003;34(5):1114–9.https://pubmed.ncbi.nlm.nih.gov/12690218/
- Morales-Plaza CD, Aguirre-Castañeda C, Machado-Alba JE. Predictors of stroke mortality in theHospital Universitario San Jorge of Pereira (Colombia). Salud Uninorte [Internet]. 2016;32(1):56–64.http://rcientificas.uninorte.edu.co/index.php/salud/article/viewArticle/5050
- Castañeda-Guarderas A, Beltrán-Ale G, Casma-Bustamante R, Ruiz-Grosso P, Málaga G.Registry of patients with stroke stated in a public hospital of Peru, 2000-2009. Rev Peru Med ExpSalud Publica [Internet]. 2011;28(4):623–7. http://www.scielo.org.pe/scielo.php?pid=S1726-46342011000400008&script=sci_abstract
- Seitz RJ, Höflich P, Binkofski F, Tellmann L, Herzog H, Freund HJ. Role of the premotor cortexin recovery from middle cerebral artery infarction. Arch Neurol [Internet]. 1998;55(8):1081–8.https://jamanetwork.com/journals/jamaneurology/fullarticle/774148
- González RP, Luis G, Miranda H, Caridad Y De. Caracterización clínica-epidemiológica de laenfermedad cerebrovascular en el adulto mayor. Rev Ciencias Médicas Pinar del Río [Internet].2015;19(6):0–0. http://scielo.sld.cu/scielo.php?pid=S1561-31942015000600005&script=sci_arttext&tlng=en
- A. Arauz AR-F. Enfermedad vascular cerebral. Rev Mex Neurocienc [Internet]. 2006;7(6):617–21.http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0026-17422012000300003&lng=es.
- Marengoni A, Angleman S, Meinow B, Santoni G, Mangialasche F, Rizzuto D, et al. Coexistingchronic conditions in the older population: Variation by health indicators. Eur J Intern Med[Internet]. 2016;31:29–34. https://www.ejinme.com/article/S0953-6205(16)00061-3/pdf
- Abanto C, Ton TGN, Tirschwell DL, Montano S, Quispe Y, Gonzales I, et al. Predictors offunctional outcome among stroke patients in Lima, Peru. J Stroke Cerebrovasc Dis [Internet].2013;22(7):1156–62. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659203/
- Barlas RS, Clark AB, Bettencourt-Silva JH, Sawanyawisuth K, Kongbunkiat K, Kasemsap N, et al.Pneumonia and Risk of Serious Adverse Outcomes in Hospitalized Strokes in Thailand. J StrokeCerebrovasc Dis [Internet]. 2019;28(6):1448–54.https://aura.abdn.ac.uk/bitstream/handle/2164/13972/Barlas_et_al._Manuscript_Combined.pdf?sequence=1
- Ge Y, Wang Q, Wang L, Wu H, Peng C, Wang J, et al. Predicting post-stroke pneumonia usingdeep neural network approaches. Int J Med Inform [Internet]. 2019;132(September):103986.https://doi.org/10.1016/j.ijmedinf.2019.103986
- Wang ZY, Chen JM, Ni GX. Effect of an indwelling nasogastric tube on swallowing function inelderly post-stroke dysphagia patients with long-term nasal feeding. BMC Neurol [Internet].2019;19(1):1–8. https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1314-6
- Rozo A, Mendoza AM. Impacto funcional del evento cerebro vascular en los pacientes delHospital Militar Central entre octubre de 2010 y mayo de 2011. Rev Colomb Med Física y Rehabil[Internet]. 2012;22(1):49–57. http://revistacmfr.org/index.php/rcmfr/article/download/53/50
- Carvalho-Pinto BPB, Faria CDCM. Health, function and disability in stroke patients in thecommunity. Brazilian J Phys Ther [Internet]. 2016;20(4):355–66.https://www.scielo.br/pdf/rbfis/2016nahead/1413-3555-rbfis-bjpt-rbf20140171.pdf
- Ferri CP, Schoenborn C, Kalra L, Acosta D, Guerra M, Huang Y, et al. Prevalence of stroke andrelated burden among older people living in Latin America, India and China. J Neurol NeurosurgPsychiatry [Internet]. 2011;82(10):1074–82.https://jnnp.bmj.com/content/jnnp/82/10/1074.full.pdf
- Gómez-Galindo AM, Peñas-Felizzola OL, Parra-Esquivel EI. Caracterización y condiciones delos cuidadores de personas con discapacidad severa en Bogotá. Rev Salud Publica [Internet].2016;18(3):367–78. https://www.scielosp.org/pdf/rsap/2016.v18n3/367-378/es
- Ley de estabilidad laboral reforzada para personas que tengan a su cargo el cuidado y / omanutención de personas en condición de discapacidad Proyecto de Ley No . 062 DE 2014 Pormedio de la cual se implementan medidas de estabilidad reforzada para perso. 2014;(062)
References
World Health Organization. International classification of functioning, disability, and health -children and youth version [Internet].2011. 1–371 p. https://apps.who.int/iris/bitstream/10665/81610/1/9789243547329_spa.pdf
Ministerio de Salud y Protección Social C-. Guía de práctica clínica para el diagnóstico y manejodel episodio agudo del Ataque Cerebrovascular [Internet]. Vol. 62, Guia N° 54 de 2015.http://gpc.minsalud.gov.co/gpc_sites/Repositorio/Conv_637/GPC_acv/GPC_ACV_Profesionales.pdf
Saposnik G, Del Brutto OH. Stroke in South America: A systematic review of incidence,prevalence, and stroke subtypes. Stroke [Internet]. 2003;34(9):2103 7.https://www.ahajournals.org/doi/pdf/10.1161/01.STR.0000088063.74250.DB
Shahla ND, Ardashir A, Yaghoub P. The Effect of Proprioceptive Neuromuscular Facilitation(PNF) on Activities of Daily Living of Client with Cerebrovascular Accident. World Fam MedJournal/Middle East J Fam Med [Internet]. 2017;15(7):154–8.http://www.mejfm.com/September2017/PNF on ADL.pdf
Cheng YD, Al-Khoury L, Zivin JA. Neuroprotection for Ischemic Stroke: Two Decades of Successand Failure. NeuroRx [Internet]. 2004;1(1):36–45.https://link.springer.com/content/pdf/10.1602/neurorx.1.1.36.pdf
Kalra L. The influence of stroke unit rehabilitation on functional recovery from stroke. Stroke[Internet]. 1994;25(4):821–5. DOI: 10.1161/01.STR.25.4.821
Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet [Internet].2011;377(9778):1693–702. Disponible en: DOI: 10.1016/S0140-6736(11)60325-5
Stinear CM, Byblow WD, Ackerley SJ, Barber PA, Smith MC. Predicting Recovery Potential forIndividual Stroke Patients Increases Rehabilitation Efficiency. Stroke [Internet]. 2017;48(4):1011–9.DOI: 10.1161/STROKEAHA.116.015790
Geyh S, Cieza A, Schouten J, Dickson H, Frommelt P, Omar Z, et al. ICF Core Sets for stroke. JRehabil Med Suppl [Internet]. 2004;(44):135–41.https://geriatrictoolkit.missouri.edu/reimbursement/documentation/icf/ICF-Core-Set-Stroke.pdf
Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, et al. Global burden ofstroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the GlobalBurden of Disease Study 2013. Lancet Neurol [Internet]. 2016;15(9):913–24. DOI:10.1016/S1474-4422(16)30073-4
Ovbiagele B, Nguyen-Huynh MN. Stroke Epidemiology: Advancing Our Understanding ofDisease Mechanism and Therapy. Neurotherapeutics [Internet]. 2011;8(3):319 29.https://link.springer.com/content/pdf/10.1007/s13311-011-0053-1.pdf
Machado Cartagena A. Colombia rural: Razones para la esperanza [Internet]. Informe Nacionalde Desarrollo Humano2011. 2011. 440 p. http://www.co.undp.org/content/dam/colombia/docs/DesarrolloHumano/undp-co-ic_indh2011-parte1-2011.pdf
Huenchuan Sandra. Los derechos de las personas mayores. Materiales de estudio y divulgación.Hacia un cambio de paradigma sobre el envejecimiento y la vejez. 2011;20.https://repositorio.cepal.org/handle/11362/21497
González-celis Ana C PA. Calidad de vida y estrategias de afrontamiento ante problemas yenfermedades en ancianos. 2006. http://www.scielo.org.co/pdf/rups/v5n3/v5n3a06.pdf
González Quiñones JC. Resumen: “Sabe Colombia 2015: Estudio Nacional de Salud, Bienestary Envejecimiento”. Cart Comunitaria [Internet]. 2017;25(144):24.https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/Resumen-Ejecutivo-Encuesta-SABE.pdf
Dulcey Ruiz E, Arrubla D, Sanabria P. Envejecimiento y vejez en Colombia [Internet]. Vol. 6,Profamilia Colombia.2013. https://www.researchgate.net/publication/272087925_Envejecimiento_y_vejez_en_Colombia_Estudio_a_profundidad
Fekadu G, Chelkeba L, Kebede A. Retraction Note: Risk factors, clinical presentations andpredictors of stroke among adult patients admitted to stroke unit of Jimma university medicalcenter, south west Ethiopia: Prospective observational study (BMC Neurology (2019) 19 (183)DOI:10.118. BMC Neurol [Internet]. 2019;19(1):1–12. https://link.springer.com/article/10.1186/s12883-019-1412-5
Ader J, Wu J, Fonarow GC, Smith EE, Shah S, Xian Y, et al. Hospital distance, socioeconomicstatus, and timely treatment of ischemic stroke. Neurology [Internet]. 2019;93(8):e747–57.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711658/pdf/NEUROLOGY2018923300.pdf
Moreno E, Rodríguez J, Bayona-Ortiz H. Trombólisis endovenosa como tratamiento del ACVisquémico agudo en Colombia: una revisión sistemática de la literatura. Acta Neurológica Colomb[Internet]. 2019;35(3):156–66. http://www.scielo.org.co/scielo.php?pid=S0120-87482019000300156&script=sci_abstract&tlng=en
Tizón García JL. A propósito del modelo biopsicosocial, 28 años después: Epistemología,política, emociones y contratransferencia. Aten Primaria [Internet]. 2007;39(2):93-7.https://www.researchgate.net/profile/Jorge_Tizon2/publication/240075659_A_proposito_del_modelo_biopsicosocial_28_anos_despues_epistemologia_politica_emociones_y_contratransferencia_The_biopsychosocial_model_28_years
Torres-Arreola LDP, Valenzuela-Flores AA, Villa-Barragán JP. [Characterization of strokepatients attended at IMSS hospitals in Mexico City]. Rev Med Inst Mex Seguro Soc [Internet].56(1):18–25. https://www.medigraphic.com/pdfs/imss/im-2018/im181d.pdf
Pintado B. Factores asociados a enfermedad cerebrovascular en pacientes que acuden alhospital de especialidades Dr. Abel Gilbert Pontón, Guayaquil." [Internet]. Archivos Venezolanosde Farmacología y Terapéutica37.3 (2018): 270-274. 2018. 270–273 p. http://www.revistaavft.com/images/revistas/2018/avft_3_2018/15_factores_asociado_enfermedad.p
Pradilla A. G, Vesga A. BE, León-Sarmiento FE. Estudio neuroepidemiológico nacional(EPINEURO) colombiano. Rev Panam Salud Pública [Internet]. 2003;14(2):104–11.https://iris.paho.org/handle/10665.2/8346?locale-attribute=es
Di Carlo A, Lamassa M, Baldereschi M, Pracucci G, Basile AM, Wolfe CDA, et al. Sex differencesin the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe: Datafrom a multicenter multinational hospital-based registry. Stroke [Internet]. 2003;34(5):1114–9.https://pubmed.ncbi.nlm.nih.gov/12690218/
Morales-Plaza CD, Aguirre-Castañeda C, Machado-Alba JE. Predictors of stroke mortality in theHospital Universitario San Jorge of Pereira (Colombia). Salud Uninorte [Internet]. 2016;32(1):56–64.http://rcientificas.uninorte.edu.co/index.php/salud/article/viewArticle/5050
Castañeda-Guarderas A, Beltrán-Ale G, Casma-Bustamante R, Ruiz-Grosso P, Málaga G.Registry of patients with stroke stated in a public hospital of Peru, 2000-2009. Rev Peru Med ExpSalud Publica [Internet]. 2011;28(4):623–7. http://www.scielo.org.pe/scielo.php?pid=S1726-46342011000400008&script=sci_abstract
Seitz RJ, Höflich P, Binkofski F, Tellmann L, Herzog H, Freund HJ. Role of the premotor cortexin recovery from middle cerebral artery infarction. Arch Neurol [Internet]. 1998;55(8):1081–8.https://jamanetwork.com/journals/jamaneurology/fullarticle/774148
González RP, Luis G, Miranda H, Caridad Y De. Caracterización clínica-epidemiológica de laenfermedad cerebrovascular en el adulto mayor. Rev Ciencias Médicas Pinar del Río [Internet].2015;19(6):0–0. http://scielo.sld.cu/scielo.php?pid=S1561-31942015000600005&script=sci_arttext&tlng=en
A. Arauz AR-F. Enfermedad vascular cerebral. Rev Mex Neurocienc [Internet]. 2006;7(6):617–21.http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0026-17422012000300003&lng=es.
Marengoni A, Angleman S, Meinow B, Santoni G, Mangialasche F, Rizzuto D, et al. Coexistingchronic conditions in the older population: Variation by health indicators. Eur J Intern Med[Internet]. 2016;31:29–34. https://www.ejinme.com/article/S0953-6205(16)00061-3/pdf
Abanto C, Ton TGN, Tirschwell DL, Montano S, Quispe Y, Gonzales I, et al. Predictors offunctional outcome among stroke patients in Lima, Peru. J Stroke Cerebrovasc Dis [Internet].2013;22(7):1156–62. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659203/
Barlas RS, Clark AB, Bettencourt-Silva JH, Sawanyawisuth K, Kongbunkiat K, Kasemsap N, et al.Pneumonia and Risk of Serious Adverse Outcomes in Hospitalized Strokes in Thailand. J StrokeCerebrovasc Dis [Internet]. 2019;28(6):1448–54.https://aura.abdn.ac.uk/bitstream/handle/2164/13972/Barlas_et_al._Manuscript_Combined.pdf?sequence=1
Ge Y, Wang Q, Wang L, Wu H, Peng C, Wang J, et al. Predicting post-stroke pneumonia usingdeep neural network approaches. Int J Med Inform [Internet]. 2019;132(September):103986.https://doi.org/10.1016/j.ijmedinf.2019.103986
Wang ZY, Chen JM, Ni GX. Effect of an indwelling nasogastric tube on swallowing function inelderly post-stroke dysphagia patients with long-term nasal feeding. BMC Neurol [Internet].2019;19(1):1–8. https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1314-6
Rozo A, Mendoza AM. Impacto funcional del evento cerebro vascular en los pacientes delHospital Militar Central entre octubre de 2010 y mayo de 2011. Rev Colomb Med Física y Rehabil[Internet]. 2012;22(1):49–57. http://revistacmfr.org/index.php/rcmfr/article/download/53/50
Carvalho-Pinto BPB, Faria CDCM. Health, function and disability in stroke patients in thecommunity. Brazilian J Phys Ther [Internet]. 2016;20(4):355–66.https://www.scielo.br/pdf/rbfis/2016nahead/1413-3555-rbfis-bjpt-rbf20140171.pdf
Ferri CP, Schoenborn C, Kalra L, Acosta D, Guerra M, Huang Y, et al. Prevalence of stroke andrelated burden among older people living in Latin America, India and China. J Neurol NeurosurgPsychiatry [Internet]. 2011;82(10):1074–82.https://jnnp.bmj.com/content/jnnp/82/10/1074.full.pdf
Gómez-Galindo AM, Peñas-Felizzola OL, Parra-Esquivel EI. Caracterización y condiciones delos cuidadores de personas con discapacidad severa en Bogotá. Rev Salud Publica [Internet].2016;18(3):367–78. https://www.scielosp.org/pdf/rsap/2016.v18n3/367-378/es
Ley de estabilidad laboral reforzada para personas que tengan a su cargo el cuidado y / omanutención de personas en condición de discapacidad Proyecto de Ley No . 062 DE 2014 Pormedio de la cual se implementan medidas de estabilidad reforzada para perso. 2014;(062)