Análise da concordância entre instrumentos de avaliação do equilíbrio corporal em idosos

CONTEXTUALIZAÇÃO: Diagnosticar os parâmetros clínicos associados com as quedas em idosos tornou-se um grande desafio para a comunidade científica. Apesar da existência de diversos instrumentos direcionados à avaliação do equilíbrio corporal em idosos, ainda é escasso o número de trabalhos que investigaram e discutiram a concordância entre os diversos métodos. OBJETIVO: Analisar a correlação entre alguns testes usados para avaliar o equilíbrio corporal no idoso. MÉTODOS: Tratou-se de um estudo transversal, observacional, realizado com 30 voluntárias idosas comunitárias, hígidas, com diferentes níveis de condicionamento físico. Foram utilizados o Teste de Alcance Funcional Anterior (TAF), a Escala de Equilíbrio de Berg (EEB), o teste Timed Up and Go (TUG) e o Teste de Equilíbrio de Tinetti (Performance Oriented Mobility Assessment - POMA). A correlação dos dados foi realizada por meio da aplicação do Coeficiente de Correlação de Spearman, com nível de significância de 5% (p<0,05). RESULTADOS: Observou-se correlação positiva e moderada entre o TAF e a EEB (r=0,4845; p=0,0067), entre o TAF e a POMA (r=0,4136; p= 0,0231), entre a EEB e a POMA (r=0,6088; p=0,0004). CONCLUSÃO: Os testes são complementares, dado que se mostraram com particularidades e limitações distintas. Torna-se razoável, portanto, a aplicação conjunta desses instrumentos para melhor avaliar o equilíbrio de idosas.

Equilíbrio postural e risco para queda em idosos da cidade de Garça, SP

OBJETIVOS: Avaliar o equilíbrio postural e o risco de quedas em idosos institucionalizados e não-institucionalizados. MÉTODOS: Foram incluídos no estudo 45 idosos institucionalizados e 43 idosos não-institucionalizados. O equilíbrio e o risco de quedas foram avaliados através da Escala de Equilíbrio de Berg. A comparação do equilíbrio entre os grupos foi feita por meio do teste de Mann-Whitney. Foi avaliado o risco para queda entre as populações. Adotou-se um valor de p ≤ 0,05 como significante. RESULTADOS: Houve diferença entre os escores da Escala de Berg nas populações estudadas (p < 0,0001). Os resultados mostraram que a população institucionalizada apresenta nove vezes mais risco de cair do que idosos da comunidade (p=0,0001). CONCLUSÕES: Os resultados indicam que o equilíbrio postural é menor na população institucionalizada, aumentando seu risco de cair.

Avaliação funcional do equilíbrio e da sensibilidade cutânea plantar de idosos moradores na comunidade

Desequilíbrio é um dos muitos fatores de risco que aumenta a susceptibilidade de um idoso a quedas. O equilíbrio pode ser avaliado mediante testes posturais e de sensibilidade plantar. OBJETIVO: Avaliar a ocorrência de desequilíbrio e perda de sensibilidade cutânea plantar em idosos da comunidade e verificar a existência de associação entre ambas as alterações. CASUÍSTICA E MÉTODOS: Estudo transversal descritivo envolvendo 45 idosos submetidos à escala de equilíbrio de Berg (EEB) e ao teste de sensibilidade plantar com monofilamento de nylon. Foram utilizados os testes qui-quadrado e exato de Fisher e elaboradas curvas ROC para estudo da sensibilidade e especificidade da EEB. RESULTADOS: Idosos com alteração do equilíbrio e da sensibilidade cutânea foram em número de 2 e 4, respectivamente. Houve associação significativa entre queixa de desequilíbrio e perda da sensibilidade (p = 0,047) e ocorreu concordância razoável (Kappa: 0,6457) entre a EEB e o teste da sensibilidade. Verificou-se também associação significativa entre 6 dos 14 tarefas da EEB e o teste sensorial. CONCLUSÃO: Idosos vivendo com independência na comunidade, em sua maioria, apresentam equilíbrio e sensibilidade cutânea plantar normais. Quando alteradas estas funções mostram-se associadas de forma que, se os testes forem realizados conjuntamente, a precisão da avaliação do equilíbrio idoso aumenta.

Polinização e dispersão de sementes em Myrtaceae do Brasil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Correlation between balance and the level of functional independence among elderly people

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeitos de um programa de atividade física nas funções cognitivas, equilíbrio e risco de quedas em idosos com demência de Alzheimer

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A controlled clinical trial on the effects of motor intervention on balance and cognition in institutionalized elderly patients with dementia

Purpose: To analyse the effects of two interventions on the cognition and balance of institutionalized elderly people with mixed dementia.Methods: Fifty-four participants were allocated into three groups. Group 1 was assisted by an interdisciplinary programme comprising physiotherapy, occupational therapy and physical education. A physiotherapist alone carried out the intervention in group 2. Group 3 was considered as control. Assessors were blinded to guarantee the absence of bias. Cognitive functions were analysed with the Mini-Mental State Examination and the Brief Cognitive Screening Battery. Balance was assessed with the Berg Balance Scale and the Timed Get-Up-and-Go Test. Multiple analysis of variance (MANOVA) was used to test possible main effects of the interventions.Results: The results showed benefits on the balance of subjects in both groups 1 (F=3.9, P < 0.05) and 2 (F= 3.1, P < 0.05), compared with group 3. MANOVA did not indicate benefits on the cognitive functions between groups 1 and 3 (F= 1.1, P > 0.05) and groups 2 and 3 (F= 1.6, P > 0.05). However, univariate analysis indicated some benefits of the interdisciplinary intervention on two specific domains measured by the Brief Cognitive Screening Battery (F=26.5, P < 0.05; F= 4.4, P < 0.05).Conclusion: Six months of multidisciplinary or physiotherapeutic intervention were able to improve a person's balance. Although global cognition did not improve through treatment, when the intervention was carried out on a multidisciplinary basis we observed an attenuation in the decline of global cognition on two specific cognitive domains. Exercises applied in different contexts may have positive outcomes for people with dementia.

Balance, executive functions and falls in elderly with Alzheimer's disease (AD): A longitudinal study

Elderly individuals with AD are more susceptible to falls, which might be associated with decrements in their executive functions and balance, among other things. We aimed to analyze the effects of a program of dual task physical activity on falls, executive functions and balance of elderly individuals with AD. We studied 21 elderly with probable AD, allocated to two groups: the training group (TG), with 10 elderly who participated in a program of dual task physical activity; and the control group (CG), with 11 elderly who were not engaged in regular practice of physical activity. The Clock Drawing Test (CDT) and the Frontal Assessment Battery (FAB) were used in the assessment of the executive functions, while the Berg Balance Scale (BBS) and the Timed Up-and-Go (TUG)-test evaluated balance. The number of falls was obtained by means of a questionnaire. We observed a better performance of the TG as regards balance and executive functions. Moreover, the lower the number of steps in the TUG scale, the higher the scores in the CDT, and in the FAB. The practice of regular physical activity with dual task seems to have contributed to the maintenance and improvement of the motor and cognitive functions of the elderly with AD. (C) 2011 Elsevier B.V. All rights reserved.

Functional capacity of Brazilian patients with Parkinson's disease (PD): Relationship between clinical characteristics and disease severity

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Functional dependence and caregiver burden in Alzheimer's disease: a controlled trial on the benefits of motor intervention

Background: Cognitive decline has a negative impact on functional activities in Alzheimer's disease. Investigating the effects of motor intervention with the intent to reduce the decline in functionality is an expected target for patients and caregivers. The aim of this study was to verify if a 6-month motor intervention programme promoted functionality in Alzheimer's patients and attenuated caregivers' burden. Methods: The sample comprised 32 community patients with Alzheimer's disease and their 32 respective caregivers. Patients were divided into two groups: 16 participated in the motor intervention programme and 16 controls. Subjects performed 60 minutes of exercises, three times per week during the 6-month period, to improve flexibility, strength, agility and balance. Caregivers followed the procedures with their patients during this period. Functionality was evaluated by the Berg Functional Balance Scale and the Functional Independence Measure. Caregivers completed the Neuropsychiatric Inventory Caregiver Distress Scale and the Zarit Carer Burden Scale. Two-way ANOVA was used to verify the interaction between time (pre- and post-intervention) and the motor intervention program. Results: While patients in the motor programme preserved their functionality, as assessed by the Functional Independence Measure, the controls suffered a relative decline (motor intervention group: from 109.6 to 108.4 vs controls: from 99.5 to 71.6; P= 0.01). Patients from motor intervention also had better scores than the controls on functional balance assessed by Berg scale (F: 22.2; P= 0.001). As assessed by the Neuropsychiatric Inventory and Zarit scale, burden was reduced among caregivers whose patients participated in the motor intervention programme compared with caregivers whose patients did not participate in this programme (Neuropsychiatric Inventory, caregiver's part: F: 9.37; P= 0.01; Zarit: F: 11.28; P= 0.01). Conclusion: Patients from the motor intervention group showed reduced functional decline compared to the controls, and there was an associated decrease in caregivers' burden.

SMase II, a new sphingomyelinase D from Loxosceles laeta venom gland: Molecular cloning, expression, function and structural analysis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Search for B-s(0)->mu(+)mu(-) decays at D0

We report results from a search for the decay B-s(0)->mu(+)mu(-) using 1.3 fb(-1) of p (p) over bar collisions at root s = 1.96 TeV collected by the D0 experiment at the Fermilab Tevatron Collider. We find two candidate events, consistent with the expected background of 1.24 +/- 0.99, and set an upper limit on the branching fraction of B(B-s(0)->mu(+)mu(-))< 1.2x10(-7) at the 95% C.L.

Measurement of the p(p)over-bar -> WZ+X cross section at root s=1.96 TeV and limits on WWZ trilinear gauge couplings

We present measurements of the process p (P) over bar -> WZ + X -> l 'nu(l ')l (l) over bar at root s = 1:96 TeV,where l and l ' are electrons or muons. Using 1 fb(-1) of data from the D0 experiment, we observe 13 candidates with an expected background of 4.5 +/- 0.6 events and measure a cross section sigma(WZ) = 2.7(-1.3)(+1.7) pb. From the number of observed events and the Z boson transverse momentum distribution, we limit the trilinear WWZ gauge couplings to -0: 17 <= lambda(Z) <= 0.21 (Delta k(Z) <= 0.29(lambda(Z) = 0) at the 95% C.L. for a form factor scale Lambda = 2 TeV. Further, assuming that Delta g(1)(Z) = Delta k(Z), we find -0.12 <= Delta k(Z) <= 0.29(lambda(Z) = 0) at the 95% C. L. These are the most restrictive limits on the WWZ couplings available to date.

Search for resonant second generation slepton production at the Fermilab Tevatron

We present a search for supersymmetry in the R-parity violating resonant production and decay of smuons and muon sneutrinos in the channels mu ->chi(0)(1)mu, mu ->chi(0)(2,3,4)mu, and nu(mu)->chi(+/-)(1,2)mu. We analyzed 0.38 fb(-1) of integrated luminosity collected between April 2002 and August 2004 with the D0 detector at the Fermilab Tevatron Collider. The observed number of events is in agreement with the standard model expectation, and we calculate 95% C.L. limits on the slepton production cross section times branching fraction to gaugino plus muon, as a function of slepton and gaugino masses. In the framework of minimal supergravity, we set limits on the coupling parameter lambda(')(211), extending significantly previous results obtained in Run I of the Tevatron and at the CERN LEP collider.

Properties of l=1 B-1 and B*(2) Mesons

This Letter presents the first strong evidence for the resolution of the excited B mesons B-1 and B-2(*) as two separate states in fully reconstructed decays to B+(*())pi(-). The mass of B-1 is measured to be 5720.6 +/- 2.4 +/- 1.4 MeV/c(2) and the mass difference Delta M between B-2* and B-1 is 26.2 +/- 3.1 +/- 0: 9 MeV/c(2), giving the mass of the B-2* as 5746.8 +/- 2.4 +/- 1.7 MeV/c(2). The production rate for B-1 and B-2* mesons is determined to be a fraction (13.9 +/- 1.9 +/- 3.2)% of the production rate of the B+ meson.