2 Material and methods
2.3 Short tandem repeats
Considerando os resultados do presente estudo, sugerimos as seguintes sugestões para critérios de pesquisas futuras:
- Inclusão de indivíduos com múltiplos AVCs;
- Idade mínima de 18 anos, mas sem limite máximo;
- Inclusão de sujeitos com lesões em território vertebrobasilar sem ataxia ou distúrbios de movimento;
- Inclusão de pacientes com AVCH.
Há ainda a necessidade de estruturação dos serviços de coletas de dados pessoais de pacientes de modo a facilitar o contato e agendamento de avaliações. Para tanto, propostas educacionais voltadas para conscientização dos profissionais e pacientes que são atendidos pelo serviço de emergência seriam ferramentas importantes para a uniformização dos dados.
Com o entendimento dos critérios apropriados para as características da população estudada, é possível sugerir novas alternativas de seleção de participantes para ensaios clínicos. Faz-se necessário adaptar os critérios de elegibilidade para o contexto sócio-econômico-cultural e de assistência à saúde na região estudada. Mesmo alterações sutis nos critérios de seleção poderão ter impacto no recrutamento para protocolos de pesquisa (Hotter et al, 2013), na capacidade de generalização dos resultados de estudos de comprovação de conceitos, assim como no planejamento de ensaios clínicos maiores.
Em um protocolo de reabilitação do membro superior associada à EMTr de baixa frequência do hemisfério não afetado em pacientes em uma fase precoce pós-AVC, realizado no Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, as principais barreiras para a inclusão de participantes foram:
- Em relação à ausência de preenchimento de critérios de inclusão: localização da lesão, ausência de comprometimento motor e idade maior que 80 anos.
- Em relação ao preenchimento de critérios de exclusão: antecedente de AVC prévio, instabilidade clínica e contraindicações para EMTr.
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