RESUMO
OBJECTIVE: To determine the effect of an intervention involving muscular ankle strengthening and feet sensory stimuli to improve gait speed and balance in older adults with diabetes mellitus type 2 (DM2). DESIGN: A clinical trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS: The trial enrolled 66 people 60 years or older with DM2 who were physically independent (did not require assistance with activities of daily living). INTERVENTION: The experimental group performed 12 weeks of plantiflexor and dorsiflexor muscle strengthening exercises with resistance bands, proprioceptive exercises on balance boards and a buoy, and plantar sensory stimulation with bristle brushes and cloths, as well as general foot care instructions. The control group received foot care instructions only. OUTCOME MEASURES: The primary outcome was plantar cutaneous sensibility as measured with Semmes-Weinstein monofilaments. Secondary outcomes included muscular strength (plantar flexion and dorsiflexion torque as measured with an isokinetic dynamometer), gait speed, and balance (total displacement area, mediolateral displacement, anteroposterior displacement, mediolateral displacement speed, and anteroposterior displacement speed) on right and left bipedal and unipedal supports. RESULTS: In comparison with the control group, the experimental group demonstrated improved plantar cutaneous sensibility on the right foot (3.46 points; 95% confidence interval [CI], 3.85-9.80), left foot (3.46 points; 95% CI, 4.06-9.76), and an increase in gait speed (0.15 m/s; 95% CI 0.12-0.42). There were no meaningful changes in participants' ankle muscle strength or balance. CONCLUSIONS: This study showed that plantar cutaneous sensory stimulation can improve foot sensibility and increase the gait speed of older adults with DM2. However, there were no meaningful dorsiflexor or plantiflexor gains after 12 weeks.
Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Neuropatias Diabéticas/etiologia , Neuropatias Diabéticas/terapia , Terapia por Exercício/métodos , Força Muscular/fisiologia , Estimulação Física/métodos , Atividades Cotidianas , Idoso , Intervalos de Confiança , Neuropatias Diabéticas/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Valores de Referência , Índice de Gravidade de Doença , Resultado do Tratamento , Velocidade de CaminhadaRESUMO
Reflecting on the role of the nursing staff in civil construction has paramount importance, because it enables improving knowledge and making discoveries. Such reflection is further useful for managers and workers to jointly develop disease prevention and health promotion strategies. The aim of the present study is to describe a nurse's contributions to a civil construction company. It consists of an experience report according to Callista Roy's adaptation theory. The analyzed experience took place from August 2017 through March 2018. We describe the activities carried out by the nurse jointly with other healthcare workers. We believe that the present study evidences the significance of occupational health nursing actions, particularly within civil construction, as well as the relevance of providing theoretical scientific grounds to such actions to contribute to make working environments healthier for all the involved actors without neglecting the aspect of productivity.
Refletir sobre a atuação da enfermagem em uma empresa da construção civil é de fundamental importância, visto que possibilitará aprimorar conhecimentos e revelar outros. Ainda, permitirá que os gestores em conjunto com os trabalhadores busquem estratégias para prevenção de doenças, promoção da saúde e prevenção de agravos. Dessa forma, esta pesquisa teve como objetivo descrever as contribuições da enfermagem em uma empresa da construção civil. Trata-se de um estudo de relato descritivo ancorado na Teoria da Adaptação de Callista Roy. Tal relato foi vivenciado no período de agosto de 2017 a março de 2018, o qual descreve atividades cotidianas desenvolvidas pela enfermagem com os trabalhadores e profissionais da área médica. Acredita-se que este estudo contribuirá para desvelar a importância das atividades desenvolvidas pela enfermagem do trabalho, especificamente na construção civil, bem como a relevância de apoiá-las em um referencial teórico científico; e, assim, aumentar a qualidade de vida no trabalho, buscando cada vez mais um ambiente laboral saudável para todos os envolvidos sem perder de vista a produção.