Palavras-chave
Cuidados Paliativos
Modalidades de Fisioterapia
Qualidade de Vida
Reabilitação
Resumo
Introdução: A esclerose múltipla (EM) é uma doença neurológica crônica e progressivamente incapacitante, para a qual se recomenda a integração precoce dos cuidados paliativos e da fisioterapia, embora seus efeitos permaneçam pouco sistematizados. Objetivo: Analisar os efeitos dos cuidados paliativos e da fisioterapia, com ênfase em sua inserção precoce, sobre a capacidade funcional e a qualidade de vida de pacientes com EM. Materiais e Métodos: Revisão integrativa segundo Whittemore e Knafl, guiada pela estratégia PICO, com buscas no PubMed/MEDLINE, PEDro e BVS entre agosto e novembro de 2026, incluindo estudos de 2011 a 2026 em português, inglês e espanhol. Resultados: Dos 113 registros triados, 28 estudos foram incluídos: 14 ensaios clínicos randomizados, três estudos não randomizados ou descritivos e 11 revisões. O encaminhamento imediato aos cuidados paliativos produziu benefícios inconsistentes, ora na sobrecarga do cuidador, ora na qualidade de vida e em sintomas, e o maior ensaio não demonstrou efeito significativo. Na EM grave e progressiva, programas de fisioterapia associaram-se a ganhos de mobilidade, função motora e qualidade de vida, em geral modestos e de curta duração. A fisioterapia iniciada logo após o diagnóstico mostrou ganhos funcionais e pequena melhora da qualidade de vida física. Conclusão: A fisioterapia apresenta benefícios modestos e transitórios, mas recorrentes, mesmo na EM avançada, o que sustenta sua inserção precoce e contínua no cuidado paliativo; os efeitos do encaminhamento precoce aos cuidados paliativos permanecem incertos.
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