Vigilância nutricional em idosos: proposta para cuidadores sem específica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Função cognitiva e capacidade funcional são preditoras de qualidade de vida em pacientes idosos com insuficiência cardíaca

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Mão em garra: uma proposta de intervenção terapêutica ocupacional para hansenianos

A hanseníase é uma doença infecciosa crônica, granulomatosa, de curso lento, causada pelo Mycobacterium Leprae. O bacilo acomete principalmente os nervos periféricos, causando lesões na face, mãos e pés, que podem gerar incapacidades físicas severas que contribuem para a instalação de padrões deformantes e incapacidades. A lesão do tipo mão em garra é uma sequela que pode ser observada em pacientes com lesões ao nível dos membros superiores sendo muito incapacitante, dificultando a realização das atividades de vida diária destes indivíduos e consequentemente prejudicando sua qualidade de vida e satisfação pessoal. Estas lesões geram repercussões no contexto de vida do indivíduo contribuindo para a instalação de alterações nos aspectos psicoemocionais, além do estigma próprio da doença. A intervenção terapêutica ocupacional utilizando a tecnologia assistiva de baixo custo para auxílio nas atividades de vida diária de pacientes com mão em garra objetiva a minimização dos déficits funcionais apresentados durante a utilização de adaptações funcionais utilizadas na realização de suas atividades cotidianas como alimentação, higiene pessoal e vestuário. A intervenção realizou-se através da aplicação de um protocolo de avaliação em Terapia Ocupacional conhecido como Medida Canadense de Desempenho Ocupacional (COPM) que mede o grau de desempenho e Satisfação do paciente ao realizar suas atividades de vida diária. O protocolo foi aplicado inicialmente junto aos pacientes coletando dados sobre a realização das suas atividades de vida diária sem a utilização de recursos de tecnologia assistiva. A aplicação do protocolo baseou-se na definição de cinco problemas comuns a todos os participantes, revelando graus muito baixos de desempenho e satisfação obtidos durante a realização das atividades avaliadas. Posteriormente realizou-se o processo de prescrição, confecção e treinamento das adaptações desenvolvidas para cada paciente, somando-se um total de cento e vinte aparelhos (120) desenvolvidos. Aplicou-se novamente o mesmo protocolo com os mesmos pacientes abordando os mesmos problemas após a realização de um período de treinamento das adaptações funcionais desenvolvidas, comparando-se os dados coletados no primeiro e segundo COPM. Comparando-se aos dados iniciais apresentados, os dados coletados na segunda avaliação do COPM apontaram um aumento significativo do grau de desempenho e satisfação dos pacientes além de ganho funcional. Concluí-se com esta pesquisa que a proposta de intervenção terapêutica ocupacional utilizando equipamentos de tecnologia assistiva de baixo custo (adaptações) é viável, possui resultados satisfatórios e favorece um grande alcance social devido à redução de custos dos dispositivos desenvolvidos.

Capacidade funcional como fator preditivo de sobrevivência em idosos

Pós-graduação em Saúde Coletiva - FMB

Integrated analysis environment for the Movement Assessment Battery for Children

Developmental Coordination Disorder (DCD), a chronic and usually permanent condition found in children, is characterized by motor impairment that interferes with a child's activities of daily living and with academic achievement. One of the most popular tests for the quantitative diagnosis of DCD is the Movement Assessment Battery for Children (MABC). Based on the Battery's standardized scores, it is possible to identify children with typical development, children at risk of developing DCD, and children with DCD. This article describes a computational system we developed to assist with the analysis of results obtained in the MABC test. The tool was developed for the web environment and its database provides integration of MABC data. Thus, researchers around the world can share data and develop collaborative work in the DCD field. In order to help analysis processes, our system provides services for filtering data to show more specific sets of information and present the results in textual, table, and graphic formats, allowing easier and more comprehensive evaluation of the results.

Equilíbrio funcional em indivíduos com doença de Parkinson e sua relação com a qualidade de vida

Introduction: Parkinson’s Disease (PD) is characterized by a set of four motor symptoms: tremor, rigidity, bradykinesia and postural instability. These defi cits may predispose individuals to limitations resulting from falls and their secondary consequences. Objective: To evaluate the functional balance and quality of life (QoL) in individuals with PD and determine whether there is correlation between performance on tests of balance with the QoL. Method: The project was referred to the Ethics Committee in Research of Universidade Estadual Paulista “Julio de Mesquita Filho” Campus de Marília and was approved under protocol number 1806/09. Participated in this study with individuals diagnosed with PD between levels one and four in the Hoen and Yahr scale. The subjects were evaluated according to functional balance and QoL, respectively by the instruments: Functional Balance Scale Berg (EEFB), Time Up and Go test (TUG), and Parkinson’s Disease Questionnaire-39 (PDQ-39). To perform the statistical analysis used the GraphPad Prism 5. To perform the correlation analysis for the variables passed normality by the Shapiro-Wilk. Since the variables were non-parametric test was used Spearman. During the analysis the statistical signifi cance level was considered p ≤ 0, 05. Results: We studied 25 individuals aged between 54 and 85 years (71.20 ± 8.50), time of diagnosis between one and 39 years (6.54 ± 7.71) disease. Moderate correlation was found between the EEFB with QoL (r =- 0.6), and TUG with QoL (r = 0.6836). Among the aspects of QoL balance showed a higher correlation with the domains “mobility” (TUG r = 0, 6768; EEFB r = -0.6155) and “Activities of daily living” (TUG r = 0, 7357, and EEFB r = -0.6521). Conclusion: Patients with Parkinson’s disease show defi cits in balance and QoL. The balance disorders have a high correlation among themselves and show how aspects of QoL.

Níveis de sobrecarga, ansiedade e depressão de cuidadores de pacientes com doença de Alzheimer participantes e não participantes de grupos de apoio

Currently , as a result of the significant increase in the number of elderly, one can observe an increase in the number of chronic diseases , among them Alzheimer's disease (AD) , which affects both patients and their caregivers , that due care with the patient , just overwhelmed , anxious and depressed. Therefore, this study aims to draw a profile of caregivers of Alzheimer's patients, correlating the physical activity of patients with levels of overload, anxiety, depression caregivers. For both sample consisted of 40 patients with AD to characterize the physical activity levels and perform activities of daily living. In addition, we evaluated 40 caregivers. Patient assessment was made through a medical history, beyond the score Clinical Dementia Rating (CDR), Mini - Mental State Examination (MMSE), Modified Baecke Questionnaire for Older Adults (MBQ) , Functional Activities Questionnaire PFEFFER (QAFP) , and the Self Perception Performance in Activities of Daily Living (EAPAVD). For assessing the caregiver was also used an interview, then the Neuropsychiatric Inventory (NPI), anxiety and depression scale (HAD) Scale and the Zarit caregiver burden (Zarit). The data were processed using descriptive procedures for the analysis of characterization of samples, such as cognitive screening and physical activity level and profile of caregivers. There was a normal distribution of the data using the Shapiro Wilk, For data with normal distribution were used parametric descriptive procedures using One Way ANOVA to compare groups and applying a post hoc Bonferroni. As for the data that showed the destruction not normal was used to standardize the test by Z -score , and then treated by means of parametric statistical procedures , as presented earlier . The Pearson correlation was used to identify possible associations between variables. It was assumed significance level of 5 % (p ≤ 0.05) for all analyzes. Given these results, we conclude that...

Atividade física e sintomas depressivos em cuidadores de idosos com demência de Alzheimer

The Alzheimer's dementia (AD) is a chronic, neurodegenerative and progressive disorder, characterized by cognitive decline, affecting brain functions like memory, reasoning and communication, occurrence of behavioral disturbances and difficulty in performing activities of daily living (ADLs). These conditions lead to patient’s dependence, which can cause depressive symptoms in caregivers, due to physical and mental burden caused by of the difficulties of the act of caring. Whereupon, it became necessary to find strategies to improve the caregivers’ quality of life. An interesting hypothesis is that physical activity can be considered a non-pharmacological alternative in reducing depressive symptoms, being an important factor for maintaining the physical and mental well-being of the general population, especially on positive changes in mood and social interaction. This study aimed to analyze the effects of a physical activity protocol on depressive symptoms and burden of caregivers of patients with AD. This experimental study, of longitudinal character, comprised a sample of 19 caregivers, of both genders, divided into two groups: a) intervention group – IG (10 caregivers who participated in a physical activity protocol) and b) control group – CG (9 caregivers who didn’t participate in the physical activity protocol). This protocol, which worked the components of functional ability and social interaction of participants, was held three times a week, being 48 sessions of 60 minutes each, for 16 weeks. Data collect was performed at pre and post-intervention for both groups. The assessment instruments used were: a) Zarit Burden Interview, b) Hospital Anxiety and Depression Scale (HAD) and c) battery of motor tests of the American Alliance for Health Physical Education Recreation and Dance (AAHPERD). Nonparametric statistics was used, with intra-group comparison by Wilcoxon test... (Complete abstract click electronic access below)

Cuida e ser cuidado: compreendendo as significações desse processo para famíliares cuidadores e idosos dependentes usuários de um Centro Dia

Pós-graduação em Saúde Coletiva - FMB

Controle motor em pacientes com doença de Parkinson: terapia do espelho, foco de atenção e tarefa dupla

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Diagnósticos de enfermagem prevalentes em geriatria segundo o grau de dependência

This is a quantitative study conducted at the Outpatient Clinic of the Geriatrics and Gerontology Academic League of Botucatu School of Medicine. It aimed at learning about the profile of elderly patients and their level of disability in relation to basic activities of daily living. Based on this information, nursing diagnoses for the population under study were made, and the most frequent diagnosed were selected with the purpose of composing a stage of the instrument for nursing consultation in geriatric. It was found that the disabled elderly patients were predominantly females and widowed. They had a mean age of 81 years and had completed the first 4 grades of elementary school. Chronic pain related to physical disability and impaired ambulation related to the presence of osteoarticular diseases are examples of the most common diagnoses in the studied population. It is important that geriatric nurses implement Nursing Care Systematization based on the knowledge of the population to which they attend by considering the level of disability of elderly patients with respect to basic activities of daily living, so that full and individualized care can be provided and the patients’ remaining autonomy can be preserved.

Avaliação da qualidade de vida dos pacientes submetidos a artroplastia total primária do quadril antes e após a cirurgia

Pós-graduação em Saúde Coletiva - FMB

Avaliação da qualidade de vida dos pacientes submetidos a artroplastia total primária do quadril antes e após a cirurgia

Pós-graduação em Saúde Coletiva - FMB

The relationship between social support and functional capacity in elderly persons with cognitive alterations

The objective of this study was to identify the relationship between social support and the functional capacity of elderly persons with cognitive alterations. It is a descriptive, cross-sectional and quantitative study. The subjects were 101 elderly persons registered in Family Health Centers whose performance in the Mini-Exam for Mental Status was below a certain specified level in a previous study. The Medical Outcomes Study questionnaire, Katz Index and Pfeffer Questionnaire were applied. The dimensions of material, affective, emotional, informational and positive social interaction support resulted in an average final score of 74.32 points, indicating a better level of material and affective support in relation to the other dimensions of support. There was a statistically significant correlation between emotional support and the Katz Index. Knowledge about this relationship favors the development of a nursing care pathway for the elderly which is capable of maintaining their functional capacity and ensuring satisfactory social relations.

Joint loading decreased by inexpensive and minimalist footwear in elderly women with knee osteoarthritis during stair descent

Objective Previous studies indicate that flexible footwear, which mimics the biomechanics of walking barefoot, results in decreased knee loads in patients with knee osteoarthritis (OA) during walking. However, the effect of flexible footwear on other activities of daily living, such as descending stairs, remains unclear. Our objective was to evaluate the influence of inexpensive and minimalist footwear (Moleca) on knee adduction moment (KAM) during stair descent of elderly women with and without knee OA. Methods. Thirty-four elderly women were equally divided into an OA group and a control group (CG). Stair descent was evaluated in barefoot condition, while wearing the Moleca, and while wearing heeled shoes. Kinematics and ground reaction forces were measured to calculate KAM by using inverse dynamics. Results. The OA group experienced a higher KAM during midstance under the barefoot condition (233.3%; P = 0.028), the Moleca (379.2%; P = 0.004), and heeled shoes (217.6%; P = 0.007). The OA group had a similar knee load during early, mid, and late stance with the Moleca compared with the barefoot condition. Heeled shoes increased the knee loads during the early-stance (versus barefoot [16.7%; P < 0.001] and versus the Moleca [15.5%; P < 0.001]), midstance (versus barefoot [8.6%; P = 0.014] and versus the Moleca [9.5%; P = 0.010]), and late-stance phase (versus barefoot [10.6%; P = 0.003] and versus the Moleca [9.2%; P < 0.001]). In the CG, the Moleca produced a knee load similar to the barefoot condition only during the early-stance phase. Conclusion. Besides the general foot protection, the inexpensive and minimalist footwear contributes to decreasing knee loads in elderly women with OA during stair descent. The loads are similar to the barefoot condition and effectively decreased when compared with heeled shoes.