ABSTRACT
Introdução: Cuidados paliativos são descritos como um conjunto de terapêuticas que visam minimizar as implicações negativas das doenças graves que ameaçam a vida e o bem-estar do indivíduo acometido. A progressão da doença e a sintomatologia provocam uma deterioração gradual e generalizada do estado do doente, e os sintomas físicos ocasionam a perda progressiva da capacidade funcional que, associados às manifestações emocionais pelo momento em que o paciente se encontra, impactam a sua qualidade de vida. Objetivo: Correlacionar a capacidade funcional com a qualidade de vida de pacientes oncológicos em cuidados paliativos. Método: Estudo transversal de abordagem quantitativa com 225 indivíduos. Os dados foram coletados por meio de questionário sociodemográfico, do índice de Barthel e do European Organization for Research in the Treatment of Cancer Questionnaire Palliative (EORTC QLQ-C15-PAL). Resultados: Dos 225 indivíduos elegíveis, observou-se homogeneidade entre a porcentagem de homens e mulheres, com média de 55,73±15,14 anos de idade. A análise estatística demonstrou associação positiva entre o escore do índice de Barthel e o escore de qualidade de vida do EORTC QLQ-C15-PAL com coeficiente de 0,74 e nível significância de p<0,05, bem como correlação negativa para as subescalas funcional e de sintomas com coeficiente de -0,702 e -0,544, respectivamente. Conclusão: Há uma correlação significativa entre a capacidade funcional e a qualidade de vida em pacientes oncológicos em cuidados paliativos.
Introduction: Palliative care is described as a set of therapies that aim to minimize the negative implications of severe life-threatening illnesses on the well-being of the individual affected. The progression of the disease and the symptomatology cause a gradual and generalized deterioration of the patient's condition and the physical symptoms cause the progressive loss of the functional capacity which, associated with emotional manifestations due to the moment the patient is living through, impact its quality-of-life. Objective: To correlate the functional capacity with the quality-of-life of cancer patients in palliative care. Method: Quantitative investigation with 225 individuals whose data were collected through sociodemographic questionnaire, Barthel Index and the European Organization for Research in the Treatment of Cancer Questionnaire Palliative (EORTC QLQ-C15- PAL) Results: The sample of 225 eligible individuals consisted in men and women evenly distributed with mean age of 55.73±15.14 years. Statistical analysis showed a positive association of 0.74 between the Barthel Index and the EORTC QLQ-C15-PAL quality-of-life with level of significance of p<0.05, as well as a negative correlation of -0.702 and -0.544 for the subscales functional and symptoms, respectively. Conclusion: There is a significant correlation between functional capacity and quality of life in cancer patients undergoing palliative care
Introducción: Cuidados paliativos se describen como un conjunto de terapias que tienen como objetivo minimizar las implicaciones negativas de enfermedades graves que amenazan la vida y el bienestar del individuo afectado. La progresión de la enfermedad y la sintomatología provocan un deterioro paulatino y generalizado del estado del paciente, los síntomas físicos provocan la pérdida progresiva de la capacidad funcional, asociados a manifestaciones emocionales debido al momento en el que se encuentra el paciente, impactando en la calidad de vida del paciente. Objetivo: Correlacionar la capacidad funcional con la calidad de vida de pacientes oncológicos en cuidados paliativos. Método: Estudio transversal con un enfoque cuantitativo en el que participaron 225 individuos. Los datos se recogieron mediante un cuestionario sociodemográfico, el índice de Barthel y el European Organisation for Research in the Treatment of Cancer Questionnaire Palliative (EORTC QLQ-C15-PAL). Resultados: De los 225 individuos elegibles, se observó homogeneidad de género, con una edad promedio de 55,73±15,14 años. El análisis estadístico mostró una asociación positiva entre la puntuación del índice de Barthel y la puntuación de calidad de vida de la EORTC QLQ-C15-PAL con un coeficiente de 0,74, adoptando una significancia de p<0,05, así como una correlación negativa para las subescalas funcional y de síntomas con un coeficiente de -0,702 y -0,544, respectivamente. Conclusión: Existe una correlación significativa entre la capacidad funcional y la calidad de vida en pacientes oncológicos en cuidados paliativos.
Subject(s)
Palliative Care , Quality of Life , Functional Residual CapacityABSTRACT
Uma das alternativas para manter o idoso ativo a fim de melhorar as capacidades funcionais e a qualidade de vida (QV) é o treinamento de força (TF). Porém, existem variáveis que devem ser consideradas na prescrição do TF como a velocidade de movimento. O objetivo do presente estudo foi realizar uma revisão sistemática para verificar o impacto de programas de TF realizados com diferentes velocidades de movimento na capacidade funcional e qualidade de vida em idosos saudáveis. Após seleção de artigos nas bases de dados Pubmed, Scopus e Web of Science foram encontrados 282 artigos, contudo, após a aplicação dos critérios de inclusão e exclusão foram considerados elegíveis 13 artigos para a revisão. Desses, 10 evidenciaram melhora na funcionalidade do grupo treinamento de força em alta velocidade (TFAV) ou resultado similar comparado ao treinamento tradicional (TT), dois encontraram resultados inalterados para ambos os grupos e um indicou que o grupo TT teve melhoras nos testes funcionais comparado ao TFAV. Quanto à QV, somente dois artigos avaliaram esta variável e foi observado resultado positivo utilizando o TFAV. Assim, foi observado que grande parte dos estudos sugere a realização do TFAV em detrimento do TT visando melhora ou manutenção da funcionalidade e QV. (AU)
One of the alternatives to keep the elderly active in order to improve functional capacities and quality of life (QL) is resistance training (RT). However, there are variables that should be considered in the prescription of RT as the speed of movement. The aim of the present study was to carry out a systematic review to verify the impact of RT programs carried out with different movement speeds on functional capacity and quality of life in healthy elderly people. After selecting articles in the Pubmed, Scopus and Web of Science databases, 282 articles were found, however, after applying the inclusion and exclusion criteria, 13 articles were considered eligible for review. Of these, 10 showed improvement in the functionality of the high-speed resistance training group (HSRT) or similar result compared to traditional training (TT), two found results unchanged for both groups and one indicated that the TT group had improvements in functional tests compared to HSRT. As for QL, only two articles evaluated this variable and a positive result was observed using HSRT. Thus, it was observed that most studies suggest the performance of HSRT at the expense of TT in order to improve or maintain functionality and QL. (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Quality of Life , Aged , Resistance Training , Walking Speed , Accidental Falls , Exercise , Functional Residual Capacity , Muscle Strength , Sarcopenia , Healthy Aging , Heart Disease Risk Factors , MovementABSTRACT
Abstract Aim: To contrast the acute effects of whole-body electromyostimulation (WB-EMS) with sham associated with dynamic exercises on cardiovascular, ventilatory, metabolic, and autonomic responses in men with obesity and controls. Methods: A randomized cross-over and double-blind trial with nine eutrophic (23.6 years; 23 ± 1.4 kg/m2) and ten men with obesity (26 ± 4 years; 38 ± 7 kg/m2), who were randomized to receive WB-EMS-Sham or Sham-WB-EMS with 30 min of rest between protocols. WB-EMS protocol (Miha Bodytec®) was applied at the motor level, frequency = 85 Hz, pulse duration = 350 μs, cycle on = 6′; cycle off = 4′. Sham group performed the same exercises with the electric current turned off. Throughout both protocols, subjects executed two dynamic exercises of 5 minutes each (step-up and step down associated with shoulder flexion, and lunge exercise associated with elbow flexion) in the same order. R-R intervals and breath-by-breath respiratory gases analysis were collected during the protocols. Heart rate variability (HRV) indexes were obtained using linear and nonlinear analysis. The level of statistical significance was set at p < 0.05. Results: Regarding both exercises, participants with obesity presented reduced oxygen uptake, higher ventilation, respiratory rate, blood pressure, and Borg scores (p < 0.05) when contrasted with controls, as expected. However, no significant differences were found for HRV indexes between groups (p > 0.05). In addition, WB-EMS did not increase oxygen uptake or altered autonomic modulation when contrasted with sham in both groups (p < 0.05). Conclusion: Obesity has a negative impact on symptoms and functional capacity. However, WB-EMS did not acutely enhance oxygen uptake or HRV during exercise in a population with obesity.
Subject(s)
Humans , Adult , Oxygen Consumption , Exercise , Functional Residual Capacity , Transcutaneous Electric Nerve Stimulation/methods , Heart Rate , Obesity/physiopathology , Double-Blind Method , Cross-Over StudiesABSTRACT
Resumen A pesar de la amplia evidencia científica de los beneficios de la Rehabilitación Cardiaca (RC) a nivel mundial, la investigación en Costa Rica en esta área continúa siendo escasa. Objetivo: Presentar la evidencia científica de las investigaciones realizadas por programas de RC en Costa Rica. Metodología: se realizó una búsqueda de artículos en las bases de datos "PUBMED""ScienceDirect""SportDiscus" y "Google Académico", utilizando las palabras claves: "Rehabilitación cardiaca en Costa Rica", "Cardiac Rehabilitation AND Costa Rica". Los estudios incluidos fueron publicaciones en revistas indexadas entre los años 2000 a octubre de 2021. Resultados: Se encontraron 14 publicaciones en revistas indexadas, ocho publicaciones en revistas costarricenses y seis internacionales. Los principales resultados de las investigaciones fueron que el VO2máx aumentó entre 19 % a 30 %. La capacidad funcional mejoró entre 31 % a 34 %, la presión arterial sistólica disminuyó entre 4 mmHg y 7,8 mmHg y la presión arterial diastólica se redujo entre 1,2 y 2 mmHg. También, se reportó mejorías en IMC, colesterol total, HDL-C y disminuciones en triglicéridos. Los niveles de estrés percibido disminuyeron el 50 % y los estados de ánimo tuvieron reducciones en la fatiga 58 %, la tensión en 60 % y el vigor aumentó 31 % después de una o varias semanas de RC. Asimismo, la calidad de vida de los pacientes mejoró. Conclusión: Los programas de RC en Costa Rica lograron aumentar el VO2máx, la capacidad funcional, disminuir la presión arterial y mejorar los factores de riesgo coronario de los pacientes con ECV. Además, la RC contribuye psicológicamente, puesto que disminuye el estrés, mejora los estados de ánimo y la calidad de vida de los pacientes cardiacos.
Abstract Despite the extensive scientific evidence regarding the health benefits of Cardiac Rehabilitation (CR) worldwide, research in Costa Rica in this area is still lacking. Objective: To present the scientific evidence of CR research made in Costa Rica. Methods: This systematic review searched articles in electronic databases: "PUBMED" "ScienceDirect" "SportDiscus" y "Google Scholar", using keywords: "Rehabilitación cardiaca en Costa Rica", "Cardiac Rehabilitation AND Costa Rica", The studies included were from years 2000 to October 2021 and publications on indexed journals. Results: A total of 14 publications were found in indexed journals, 8 in Costa Rican journals and 6 on international journals. The main results from these publications were that VO2max increased between 19% to 30%. functional capacity improved 31% to 34%, systolic blood pressure decreased 4 mmHg to 7.8 mmHg and diastolic blood pressure reduced 1.2 to 2 mmHg. Improvements in BMI, total cholesterol, HDL-C and reductions in triglycerides were also found. Perceived stress decreased by 50% and mood states of fatigue reduced 58%, tension 60% and vigor increased 31% after one or several weeks. Conclusión: CR programs in Costa Rica reported improvements in VO2max, functional capacity, reductions in blood pressure, and improvements in coronary risk factors from patients with cardiovascular disease. Furthermore, CR contributes to improving psychological outcomes by reducing stress, improvement of mood states and quality of life in cardiac patients.
Subject(s)
Humans , Evidence-Based Medicine , Exercise Therapy/methods , Cardiac Rehabilitation/methods , Quality of Life , Functional Residual Capacity , Costa RicaABSTRACT
Introduction: Coronary artery bypass grafting (CABG) causes changes in the respiratory musculature that affects functional capacity and postoperative complications (POC). Inspiratory muscle training (IMT) is a tool used for these patients, but it is not known what the best form is to increase strength. Objective: To investigate whether IMT with a linear pressure load device is superior to the inspiratory incentive on functional capacity and muscle strength of patients undergoing CABG. Methods: This is a clinical trial. Patients were assessed preoperatively for inspiratory muscle pressure (MIP), expiratory pressure (MEP), peak expiratory flow (PEF), six-minute walk test (6MWT) and functional independence measure (FIM). After surgery, they were divided into three groups: control group (CG), training group with linear pressure load (IMT) and inspiratory incentive group (IG). On the day of discharge, all patients had their previous variables reassessed. Results: The study included 56 patients, 31 (55.4%) were male and an average age of 55 ± 12 years. There was a significant reduction in all variables, in relation to MIP, the IMT showed a higher value in the postoperative period 83 ± 19 cmH2O, against 70 ± 15 cmH2O in the CG and 80 ± 15 cmH2O in the IG (p < 0.001). The same behavior was observed in MEP, 77 ± 12 cm H2O in IMT, 67 ± 14 cmH2O in CG and 75 ± 10 cmH2O in IG (p < 0.001). Regarding the 6 MWT, there was a lesser loss in the IMT from 434 ± 15 m to 398 ± 20 m in IG (p < 0.001). Conclusion: It is concluded that muscle training with a linear pressure load device is superior to training with incentive on functional capacity and muscle strength in patients undergoing CABG. (AU)
Introdução: A cirurgia de revascularização do miocárdio (CRM) causa alterações na musculatura respiratória que afetam a capacidade funcional e complicações pós-operatórias (DCP). O treinamento muscular inspiratório (TMI) é uma ferramenta utilizada por esses pacientes, mas não se sabe qual é a melhor forma de aumentar a força. Objetivo: Investigar se o TMI com dispositivo de carga de pressão linear é superior ao incentivo inspiratório na capacidade funcional e força muscular de pacientes submetidos à CRM. Métodos: Este é um ensaio clínico. Os pacientes foram avaliados no pré-operatório para pressão muscular inspiratória (PImáx), pressão expiratória (PEF), pico de fluxo expiratório (PFE), teste de caminhada de seis minutos (TC6) e medida de independência funcional (MIF). Após a cirurgia, eles foram divididos em três grupos: grupo controle (GC), grupo treinamento com carga linear de pressão (IMT) e grupo incentivo inspiratório (GI). No dia da alta, todos os pacientes tiveram suas variáveis anteriores reavaliadas. Resultados: O estudo incluiu 56 pacientes, 31 (55,4%) eram do sexo masculino e idade média de 55 ± 12 anos. Houve redução significativa em todas as variáveis, em relação à PImáx, o IMT apresentou valor maior no pós-operatório 83 ± 19 cmH2O, contra 70 ± 15 cmH2O no GC e 80 ± 15 cmH2O no GI (p < 0,001). O mesmo comportamento foi observado na PEmáx, 77 ± 12 cmH2O no IMT, 67 ± 14 cmH2O no GC e 75 ± 10 cmH2O no GI (p < 0,001). Em relação ao TC6, houve menor perda no TMI de 434 ± 15 metros para 398 ± 20 metros no GI (p < 0,001). Conclusão: Conclui-se que o treinamento muscular com dispositivo de carga pressórica linear é superior ao treinamento com incentivo inspiratório na capacidade funcional e da força muscular em pacientes submetidos à CRM. (AU)
Subject(s)
Humans , Physical Therapy Modalities , Muscle Strength , Myocardial Revascularization , Postoperative Period , Functional Residual CapacityABSTRACT
ABSTRACT Objective: To analyze cardiac autonomic modulation response and functional capacity in physically active older women. Methods: Seventy-five older women (60-70 years) from the community were divided into the following groups: sedentary (n=19), hydro-gymnastics (n=18), pilates (n=19), and dance (n=19). Blood pressure, body composition, heart rate variability, and functional capacity were assessed for the characterization of the groups at rest and 48 hours after the last physical exercise session. Results: The sedentary group presented higher waist-to-hip ratio, diastolic blood pressure, and resting heart rate compared to the other groups (p<0.05). It was also observed that the dance group presented better functional capacity and VO2peak scores (all p<0.05). Regarding cardiac autonomic modulation, both dance and pilates groups demonstrated better RMSSD (26.71 ± 9.07 and 29.82 ± 7.16, respectively; p<0.05), LF (45.79 ± 14.81 and 45.95 ± 15.16 n.u., respectively; p<0.05), and LF/HF (0.92 ± 0.56 and 0.58 ± 0.26, respectively; p<0.05) scores. In the symbolic analysis, the dance group had a greater predominance of parasympathetic autonomic modulation than the other groups (p<0.05). Conclusion: These results conclude that physically active elderly women, practicing hydro-gymnastics, pilates or dance, presented physiological benefits, such as better functional capacity and improvements in hemodynamic variables and autonomic cardiac modulation. In addition, the group that practiced dance presented greater parasympathetic modulation, as well as greater functional capacity, when compared to the other modalities. Level of evidence: I; STARD: studies of diagnostic accuracy.
RESUMEN Objetivo: Analizar la respuesta de la modulación autonómica cardíaca y la capacidad funcional en mujeres mayores físicamente activas. Métodos: Setenta y cinco mujeres mayores (60 a 70 años) de la comunidad fueron divididas en los siguientes grupos: sedentaria (n = 19), hidrogimnasia (n = 18), pilates (n = 19) y danza (n = 19). La presión arterial, la composición corporal, la variabilidad de la frecuencia cardíaca y la capacidad funcional fueron evaluadas para la caracterización de los grupos en reposo y 48 horas después de la última sesión de ejercicio físico. Resultados: El grupo sedentario presentó mayor relación cintura-cadera, presión arterial diastólica y frecuencia cardíaca en reposo cuando comparado a los otros grupos (p <0,05). Se observó que el grupo de danza presentó mejores puntajes de capacidad funcional y VO2Pico (todos p <0,05). Con relación a la modulación autonómica cardíaca, los grupos de danza y pilates demostraron mejores puntajes para RMSSD (26,71 ± 9,07 y 29,82 ± 7,16, respectivamente; p <0,05), LF (45,79 ± 14,81 y 45,95 ± 15,16 nu, respectivamente; p <0,05), y LF/HF (0,92 ± 0,56 y 0,58 ± 0,26, respectivamente; p <0,05). En el análisis simbólico, el grupo de danza presentó mayor predominancia de la modulación autonómica parasimpática que los demás grupos (p <0,05). Conclusión: Esos resultados concluyen que las mujeres mayores físicamente activas, practicantes de hidrogimnasia, pilates o danza, tienen beneficios fisiológicos, como mejor capacidad funcional y mejora de las variables hemodinámicas y de la modulación cardíaca autonómica. Además, el grupo que practicaba danza tuvo mayor modulación parasimpática y mayor capacidad funcional cuando comparado con las otras modalidades. Nivel de evidencia: I; STARD: estudios de precisión diagnóstica.
RESUMO Objetivo: Analisar a resposta da modulação autonômica cardíaca e a capacidade funcional em idosas fisicamente ativas. Métodos: Setenta e cinco mulheres idosas (60 a 70 anos) da comunidade foram divididas nos seguintes grupos: sedentária (n = 19), hidroginástica (n = 18), pilates (n = 19) e dança (n = 19). A pressão arterial, a composição corporal, a variabilidade da frequência cardíaca e a capacidade funcional foram avaliadas para a caracterização dos grupos em repouso e 48 horas depois da última sessão de exercício físico. Resultados: O grupo sedentário apresentou maior relação cintura-quadril, pressão arterial diastólica e frequência cardíaca em repouso quando comparado aos outros grupos (p <0,05). Observou-se também que o grupo da dança apresentou melhores escores de capacidade funcional e VO2pico (todos p < 0,05). Com relação à modulação autonômica cardíaca, os grupos de dança e pilates demonstraram melhores escores para RMSSD (26,71 ± 9,07 e 29,82 ± 7,16, respectivamente; p < 0,05), LF (45,79 ± 14,81 e 45,95 ± 15,16 nu, respectivamente; p<0,05) e LF/HF (0,92 ± 0,56 e 0,58 ± 0,26, respectivamente; p < 0,05). Na análise simbólica, o grupo da dança apresentou maior predominância da modulação autonômica parassimpática do que os demais grupos (p < 0,05). Conclusão: Esses resultados concluem que idosas fisicamente ativas praticantes de hidroginástica, pilates ou dança, têm benefícios fisiológicos, como melhor capacidade funcional e melhora das variáveis hemodinâmicas e da modulação cardíaca autonômica. Além disso, o grupo que praticava dança teve maior modulação parassimpática e maior capacidade funcional quando comparado com outras modalidades. Nível de evidência: I; STARD: estudos de precisão diagnóstica.
Subject(s)
Humans , Female , Middle Aged , Aged , Functional Residual Capacity/physiology , Heart Rate/physiology , Exercise/physiology , Cross-Sectional Studies , Exercise Movement Techniques , Dancing/physiology , Sedentary BehaviorABSTRACT
Abstract Background Resistance training is effective in cardiac rehabilitation; however, it is conventionally performed using free weights or machines, which can pose logistic challenges to patients with restricted mobility. For its ease of access and cost-effectiveness, elastic tubing is a particularly appealing alternative, but it remains underutilized for this purpose. Objective To evaluate muscle strength, functional capacity, aerobic capacity, and quality of life in patients with heart disease in phase II of cardiovascular rehabilitation after a resistance training intervention based solely on elastic tubing. Methods Thirteen patients with heart disease (age 63.33±10.80 years) trained with elastic tubing twice weekly for 6 weeks, with progressive load increase every 15 days. The following muscle groups were evaluated and trained: shoulder abductors and flexors, elbow flexors, and knee flexors and extensors. Muscle strength was evaluated using a dynamometer; functional capacity, with a 6-minute walk test and cardiopulmonary exercise test; and quality of life, using the SF-36 questionnaire. Data normality was assessed using the Shapiro-Wilk test. The paired Student's t-test was used for comparisons before and after training, at a significance level of <5%. Results There were significant differences in muscle strength (except for elbow flexion) and functional capacity (485.5 ± 123.3 vs 578.7 ± 110.5; p=0.0399) after the intervention. No statistical differences were found in cardiorespiratory fitness or quality of life. Conclusions Short-term resistance training with elastic tubing improved peripheral muscle strength and functional capacity in patients with heart disease, and should be encouraged for this population. (Int J Cardiovasc Sci. 2020; xx(x):xxx-xxx)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Resistance Training/methods , Cardiac Rehabilitation , Quality of Life , Cardiovascular Diseases/therapy , Exercise , Functional Residual Capacity , Muscle Strength , Cardiorespiratory FitnessABSTRACT
Abstract Aims: Patients with Chagas cardiomyopathy (ChC) could have a significant reduction in functional capacity (FC). This study aimed to report the effect of a 24-week combined physical exercise program on the FC of a patient with ChC. Methods: A woman, 44 years old, with positive serology for ChC in stage B2 has submitted the following assessments: i) Physical assessment: ii) Cardiopulmonary exercise test; iii) Test of 1-maximum Repetition, iv) Evaluation of cardiac autonomic modulation by heart rate variability (HRV). Results: The results obtained revealed a reduction in the anthropometric parameters and the SBP after training. Additionally, we observed an improvement in FC (aerobic and strength condiction) and cardiac autonomic modulation after 24 weeks of combined training. Conclusion: Our findings show that of a 24-week combined physical exercise program improved either FC or HRVof the patient with ChC.
Subject(s)
Humans , Female , Adult , Chagas Cardiomyopathy/pathology , Functional Residual Capacity , Resistance Training , Heart RateABSTRACT
Abstract Introduction: Obesity, characterized by the accumulation of excess body fat, can alter respiratory mechanics and compromise functional capacity. Given its increasing prevalence and the significant morbidity associated with the condition, it is important to investigate techniques that enable rapid, easy measurement of lung function and the possible correlation between obesity and functional capacity. Objective: To assess lung function and functional capacity in obese adults and determine whether there is a correlation between reduced peak expiratory flow and impaired functional capacity. Methods: 30 participants, distributed into two groups: obese (36 ± 13 years) and normal weight (31 ± 9 years) were evaluated based on anthropometric measurements, the six-minute walk test (6MWT) and peak expiratory flow (PEF). Results: The obese individuals showed reduced PEF (382 ± 99 vs. 497 ± 104 L/min, p < 0.01), walked shorter distances in the 6MWT (453 ± 37 vs. 617 ± 50 m, p < 0.01), had higher blood pressure and perceived exertion (p < 0.05) when compared to normal weight participants. Additionally, there was a positive significant association between expiratory flow and distance walked in the 6MWT (r = 0.635 and p < 0.001). Conclusion: Obese individuals exhibited lower PEF and walked shorter distances in the 6MWT, indicating a positive correlation between these two variables. In light of this outcome, the assessment methods used could contribute to improving analysis of respiratory and functional status in this population and aid in exercise prescription.
Resumo Introdução: A obesidade, caracterizada por acúmulo excessivo de tecido adiposo no organismo, pode alterar a mecânica ventilatória, trazendo prejuízos funcionais. Considerando a prevalência crescente da obesidade, bem como a grande morbidade associada a esta condição, torna-se relevante investigar técnicas de mensuração rápidas e fáceis da função ventilatória e a possível correlação com a capacidade funcional. Objetivo: Avaliar a função ventilatória e a capacidade funcional em adultos obesos e determinar se pico de fluxo expiratório reduzido está correlacionado com prejuízo da capacidade funcional. Métodos: 30 participantes, distribuídos em dois grupos: obeso (36 ± 13 anos) e eutrófico (31 ± 9 anos) foram avaliados por meio de medidas antropométricas, do teste de caminhada de seis minutos (TC6´) e da avaliação do pico de fluxo expiratório (PFE). Resultados: Os indivíduos obesos apresentaram reduzido PFE (382 ± 99 vs. 497 ± 104 L/min, p < 0,01) e percorreram menor distância no TC6´ (453 ± 37 vs. 617 ± 50 m, p < 0,01) com maior pressão arterial e percepção de esforço (p < 0,05) quando comparados aos eutróficos. Além disso, foi encontrada correlação positiva e significativa entre fluxo expiratório e distância percorrida (r = 0,635 e p < 0,001). Conclusão: Os indivíduos obesos tiveram menor PFE e menor distância percorrida no TC6´, constatada correlação positiva entre essas duas variáveis. Diante de tal desfecho, a inclusão dos métodos avaliativos utilizados podem contribuir para melhor análise da condição respiratória e funcional dessa população e auxiliar na prescrição de exercícios.
Subject(s)
Humans , Peak Expiratory Flow Rate , Walk Test , Obesity , Functional Residual Capacity , MorbidityABSTRACT
RESUMEN La fibrilación auricular (FA), epidemia esperada en las próximas décadas, es comúnmente causada por la cardiopatía isquémica y la hipertensión arterial, también se asocia con el sobrepeso y la obesidad. El ejercicio físico (EF) se considera una medida que corrige los factores de riesgo cardiovascular y, por tanto, se recomienda en la prevención de las enfermedades cardiovasculares, y forma parte integral de la rehabilitación cardíaca. Aunque se ha señalado que el EF puede incrementar el riesgo de FA, los beneficios cardiovasculares de la actividad física regular son incuestionables. Se ha comprobado un mejor estado de salud y una mayor expectativa de vida en atletas de resistencia. El EF ligero o moderado protege contra la FA, lo que puede estar asociado a un mejoramiento de las funciones sistólica y diastólica del ventrículo izquierdo, así como a una disminución de la rigidez arterial. La rehabilitación cardíaca con EF, es una indicación aprobada actualmente en pacientes con insuficiencia cardíaca crónica, con FA o sin ella, la cual está demostrado que incrementa la capacidad funcional y la calidad de vida, así como que reduce la mortalidad general y las hospitalizaciones.
ABSTRACT Atrial fibrillation (AF), an expected epidemic in the coming decades, is commonly caused by ischemic heart disease and high blood pressure, and it is also associated with overweight and obesity. Physical exercise (PE) is considered a way to correct cardiovascular risk factors and it is therefore recommended in the prevention of cardiovascular diseases. It is also an integral part of cardiac rehabilitation. Although it has been noted that PE can increase the risk of AF, the cardiovascular benefits of regular physical activity are unquestionable. An improved health status and a longer life expectancy have been proven in endurance athletes. Mild or moderate PE protects against AF, which may be associated with an improved left ventricular systolic and diastolic function, as well as with a decreased arterial stiffness. Cardiac rehabilitation with PE is a currently approved indication in patients with chronic heart failure, with or without AF, which is shown to increase functional capacity and life quality, as well as to reduce overall mortality and hospitalizations.
Subject(s)
Physical Education and Training , Atrial Fibrillation , Exercise , Functional Residual Capacity , Cardiac Rehabilitation , Heart FailureABSTRACT
Mulheres submetidas à cirurgia de mastectomia podem apresentar algumas complicações, dentre elas, alterações respiratórias e prejuízo funcional. O objetivo deste estudo foi avaliar a cinemática da parede torácica e a capacidade funcional no pós-operatório de pacientes mastectomizadas sem tratamento neoadjuvante e adjuvante associados. Foram avaliadas 4 mulheres no grupo mastectomia (GM) e 4 mulheres no grupo controle (GC). Todas as participantes foram submetidas aos procedimentos de avaliação antropométrica, função pulmonar, força muscular respiratória, cinemática da parede torácica e capacidade funcional. O GM também foi submetido à avaliação de inspeção e palpação torácica. Os dados foram analisados por meio de estatística descritiva. Foi observado que o GM apresentou menor variação de volume corrente da parede torácica, com delta de variação de 22,03% a menos que o GC, sendo a maior redução de volume corrente evidenciada no compartimento de caixa torácica pulmonar, com redução de 41,57% em relação ao GC. O GM não apresentou alterações de função pulmonar, força muscular respiratória e capacidade funcional, apresentando valores de normalidade nessas avaliações. Portanto, mulheres submetidas ao procedimento cirúrgico de mastectomia, sem tratamento neoadjuvante e adjuvante associados, não apresentaram comprometimento da função pulmonar, da força muscular respiratória e da capacidade funcional, contudo foi verificado redução do volume pulmonar na região do procedimento cirúrgico.
Women submitted to a mastectomy surgery may present some complications, among them, respiratory changes and functional impairment. The purpose of this study was to evaluate the chest wall kinematics and functional capacity in the postoperative period of mastectomized patients without associated adjuvant and neoadjuvant treatment. A total of four (4) women in the mastectomy group (MG) and four (4) in the control group (CG) were evaluated. All participants were submitted to the procedures of anthropometric evaluation, pulmonary function, respiratory muscle strength, chest wall kinematics and functional capacity. Patients in MG were also submitted to an inspection and palpation evaluation of the chest and breasts. Database was analyzed using descriptive statistics. It was observed that the MG presented a smaller variation of tidal volume of the chest wall, with a variation delta of 22.03% less than CG, with the largest reduction in tidal volume evidenced in the pulmonary chest cavity compartment, with a reduction of 41.57% when compared to CG. The MG did not present alterations of pulmonary function, respiratory muscle strength and functional capacity, presenting values of normality in these evaluations. Therefore, women submitted to the surgical procedure of mastectomy without associated neoadjuvant and adjuvant treatment did not present any impairment of pulmonary function, respiratory muscle strength and functional capacity. However, a reduction could be observed in the pulmonary volume in the region of the surgical procedure.
Subject(s)
Humans , Female , Middle Aged , Aged , Postoperative Period , Respiratory Function Tests , Women/psychology , Functional Residual Capacity , Mastectomy/rehabilitation , Surgical Procedures, Operative/rehabilitation , Biomechanical Phenomena , Respiratory Muscles/surgery , Breast Neoplasms/surgery , Tidal Volume , Thoracic Wall/surgery , Muscle Strength , Rib Cage/surgeryABSTRACT
Introdução: O processo de envelhecimento proporciona alterações funcionais, psicossociais e biológicas de caráter progressivo e irreversível, diminuindo a capacidade funcional e pulmonar dos idosos. A fraqueza muscular presente nos idosos pode reduzir o nível de atividades funcionais e do sistema respiratório, favorecendo a inatividade e dependência. Objetivo: Avaliar a correlação entre a capacidade funcional e pulmonar em idosos. Metodologia: Estudo descritivo transversal, no qual foi realizada uma avaliação por meio do Índice de Barthel Modificado, da PI máx, PE máx com a utilização de manuvacuometro, da circunferência da panturrilha (CP) e do teste Timed Up and Go (TUG). A amostra foi de 40 idosos. Resultados: a associação significativa entre achados de força da musculatura inspiratória, CP, teste TUG, Índice de Barthel, PI máx, PE máx e idade, correlaciona a redução da força muscular com menor nível de capacidade funcional em idosos, ainda mais significativa no sexo masculino, com menor tempo para a realização do teste TUG, comparado ao sexo feminino. Conclusão: Houve correlação entre o nível de capacidade funcional e pulmonar de idosos, demonstrando a importância da associação do treinamento da função respiratória associado ao exercício físico.(AU)
Introduction: The aging process provides functional, psychosocial and biological changes of a progressive and irreversible character, reducing the functional and pulmonary capacity of older adults. The muscular weakness present in older persons reduces the level of functional activities and the respiratory system, favoring inactivity and dependence. Objective: Evaluate the correlation between functional and pulmonary capacity in older people. Methodology: A physical therapy evaluation was performed through an evaluation form deve loped by the authors and the Modified Barthel Index. The rating consisted of identification, pulmonary evaluation, calf circumference (CP) and performance the Timed Up and Go test (TUG). The data was collected at a long permanence institution for older adults, located in the interior of Goiás, with a sample of 40 older individuals. Results: The association between inspiratory muscle strength, CP, TUG test, Barthel index, PI max, PE max and age, correlate the reduction of muscle strength with lower level of functional capacity in older adults, even more significant in sex male, with less time to perform the TUG test, compared to the female. Conclusion: Is suggested a correlation between the level of functional and pulmonary capacity of older people, demonstrating the importance of the association of respiratory function training associated to physical exercise.(AU)
Subject(s)
Aging , Total Lung Capacity , Functional Residual CapacityABSTRACT
Abstract Aim: To analyze whether the proposed physiotherapy protocol during hemodialysis (HD) increases knee extensor muscle strength, palmar grip strength, respiratory muscle strength, lung function, and functional capacity of individuals with Chronic Renal Insufficiency (CRI) on HD. Methods: A preliminary results study, in which physical therapy intervention was performed in 11 subjects (49.2 ± 8.6 years) with CRI on HD treatment. Initially, Heart Rate Variability (HRV) was collected, with the individual at rest, for 15 minutes, and later, HRV linear and non-linear analyses were performed using HRV Kubios Premium Software. The protocol was performed in the first two hours of the HD session, three times a week for eight weeks, consisting of respiratory exercises, aerobic exercises, and electrical stimulation associated with progressive resistive exercises. The variables evaluated were respiratory muscle strength, knee extensor muscle strength, palmar grip strength, lung function, and functional capacity. Student's t-tests for paired samples and Wilcoxon's tests for non-parametric samples were used considering a significance level of 5%. Results: There was a significant increase in expiratory muscle strength (p = 0,012; Cohen's d = 0,59), knee extensor muscle strength (p = 0,025; Cohen's d = 0,77), palmar grip strength (P = 0,001; Cohen's d = 0,52) and functional capacity (P = 0,009; Cohen's d = 0,83). Conclusion: The proposed protocol is effective in increasing knee extensor muscle strength, palmar grip strength, expiratory muscle strength, and functional capacity of individuals with CRI on HD.
Subject(s)
Humans , Functional Residual Capacity , Renal Dialysis , Physical Therapy Modalities/standards , Renal Insufficiency, Chronic/physiopathology , Muscle Strength , Non-Randomized Controlled Trials as TopicABSTRACT
Posterior a una extubación programada existe un porcentaje de pacientes que fracasa y requiere reintubación (~20%), este evento es conocido como fracaso de extubación, el cual se asocia con mayor morbimortalidad. Para prevenir el fracaso de extubación se han propuesto terapias como la ventilación no invasiva (VNI) y la cánula nasal de alto flujo (CNAF). Estas terapias son capaces de entregar soporte respiratorio postextubación y justifican su uso en los efectos fisiológicos que son capaces de inducir, en dónde el impacto sobre el esfuerzo respiratorio e intercambio de gases sería fundamental. Con esta racionalidad fisiológica se han desarrollado diversos estudios en diferentes contextos clínicos, esto con el fin de dilucidar cuál terapia es la mejor alternativa. En esta revisión narrativa pretendemos describir y analizar los diversos efectos fisiológicos que induce la VNI y la CNAF
Subject(s)
Humans , Oxygen Inhalation Therapy , Respiratory Insufficiency/therapy , Airway Extubation/methods , Noninvasive Ventilation/methods , Respiratory Insufficiency/physiopathology , Ventilator Weaning , Work of Breathing/physiology , Functional Residual Capacity/physiology , Retreatment , Cannula , Intensive Care Units , Intubation, Intratracheal/methods , Lung Volume Measurements/methodsABSTRACT
Objetivo: Conhecer o perfil pulmonar, muscular e funcional de pacientes com doença renal crônica (DRC) e verificar a relação entre a força muscular periférica e a capacidade funcional desses pacientes. Métodos: 21 pacientes com DRC e 17 saudáveis foram avaliados quanto à antropometria, função pulmonar, força muscular periférica e capacidade funcional. Para comparação entres os grupos foi utilizado o teste t de Student ou U de Mann Whitney. Para correlacionar a força muscular periférica com a capacidade funcional do grupo DRC utilizou-se o coeficiente de Pearson ou Spearman. Resultados: Houve diferença estatisticamente significativa entre os grupos DRC e saudável, respectivamente, nas variáveis da função pulmonar: volume expiratório forçado no primeiro segundo (77,62 ± 18,05% vs. 99,71 ± 16,43%; p = 0,001) e capacidade vital forçada (78,86 ± 17,16% vs. 98,48 ± 16,99%; p = 0,001); e na força muscular periférica de quadríceps direito (127,76 ± 49,77 Nm vs. 170,90 ± 55,38 Nm; p = 0,006) e esquerdo (134,10 ± 55,19 Nm vs. 171,05 ± 57,86 Nm; p = 0,04). O teste de caminhada de 6 minutos foi menor no grupo DRC comparado ao saudável em valor absoluto (419,95 ± 98,51m vs. 616,90 ± 90,01m; p < 0,0001) e em % do predito (66,07 ± 15,04% vs. 94,80 ± 9,35%; p < 0,0001). Observou-se correlação moderada entre a capacidade funcional e a força muscular periférica de quadríceps direito (rho = 0,52; p = 0,01) e quadríceps esquerdo (r = 0,63; p = 0,002) no grupo DRC. Conclusão: Pacientes com DRC apresentam alteração na função pulmonar, redução da força muscular periférica e da capacidade funcional. (AU)
Objective: To study the pulmonary, muscular and functional profile of patients with chronic kidney disease (CKD) and verify the correlation between peripheral muscle strength and functional capacity of these patients. Methods: 21 patients with CKD and 17 healthy individuals were evaluated for anthropometry, pulmonary function, peripheral muscle strength and functional capacity. In the comparison between the groups, the Student t test or the Mann Whitney U test were used. Correlation of peripheral muscle strength with the functional capacity of the CKD group was tested by the Pearson or Spearman coefficient. Results: There was a statistically significant difference between the CKD and healthy groups, respectively, in the pulmonary function variables: forced expiratory volume in the first second (77.62 ± 18.05% vs. 99.71 ± 16.43%, p = 0.001) and forced vital capacity (78.86 ± 17.16% vs. 98.48 ± 16.99%, p=0.001); and right quadriceps muscle strength (127.76 ± 49.77 Nm vs. 170.90 ± 55.38 Nm, p = 0.006) and left quadriceps (134.10 ± 55.19 Nm vs. 171.05 ± 57.86 Nm; p = 0.04). The 6-minute walk test was lower in the CKD group compared to healthy in absolute values (419.95 ± 98.51 m vs. 616.90 ± 90.01 m, p < 0.0001) and in % predicted (66,07 ± 15.04% vs. 94.80 ± 9.35%, p<0.0001). There was a moderate correlation between functional capacity and muscle strength of right quadriceps (rho = 0.52, p = 0.01) and left quadriceps (r = 0.63, p = 0.002) in the CKD group. Conclusion: Patients with CKD have altered pulmonary function, reduced peripheral muscle strength and functional capacity. (AU)
Subject(s)
Humans , Spirometry , Renal Dialysis , Exercise Tolerance , Renal Insufficiency, Chronic , Muscle Strength , Total Lung Capacity , Vital Capacity , Anthropometry , Forced Expiratory Volume , Functional Residual CapacityABSTRACT
Objetivo: Identificar a capacidade funcional de pacientes atendidos no ambulatório de avaliação perioperatória do Hospital Regional do Gama (APA-HRG), no Distrito Federal, bem como estabelecer relação com as estratificações cardíacas utilizadas. Método: Estudo observacional, descritivo, retrospectivo, com coleta de dados dos registros nos prontuários das consultas pré-operatórias de 292 pacientes triados como alto risco, executadas por equipe de médicos anestesiologistas e enfermeiros, realizadas no APA-HRG no período de junho de 2014 a junho de 2016. Resultados: O perfil da amostra constituiu-se, em sua maioria, por indivíduos do gênero feminino (78,77%), maiores de 60 anos (48,35%), não obesos (69,44%), encaminhados principalmente pela clínica ginecológica (39,79%), diagnosticados com hipertensão arterial sistêmica (44,17%) e tabagistas (12,67%). A capacidade funcional foi classificada como excelente em 63,18% (>10 equivalentes metabólicos) dos pacientes. Foi constatada associação significativa entre os equivalentes metabólicos e as estratificações da American Society of Anesthesiologists, do Índice de Risco Cardíaco Revisado e da Classificação Funcional da New York Heart Association. Conclusão: A maioria dos prontuários analisados era de pacientes com excelente capacidade funcional, apresentando associação significativa com as estratificações estudadas.
Objective: To identify the functional capacity of patients attended at the perioperative evaluation outpatient clinic of the Regional Hospital of Gama (APA-HRG), Federal District, as well as establish relationship with the cardiac stratifications employed. Method: Observational, descriptive, retrospective study with data collection of records from preoperative consultations of 292 patients screened as high risk, performed by a team of medical anesthesiologists and nurses, performed in the APA-HRG in the period from June 2014 to June 2016. Results: The sample profile consisted, for the most part, of female subjects (78.77%), of over 60 years of age (48.35%), not obese (69.44%), referred mainly by the gynecological clinic (39.79%), diagnosed with systemic arterial hypertension (44.17%) and smokers (12.67%). Functional capacity was classified as excellent in 63.18% (>10 metabolic equivalents) of patients. There was a significant association between the metabolic equivalents and the stratification of the American Society of Anesthesiologists, the Revised Cardiac Risk Index and the Functional Classification of the New York Heart Association. Conclusion: Most of the charts analyzed were of patients with excellent functional capacity, presenting a significant association with the stratifications studied.
Objetivo: Identificar la capacidad funcional de pacientes atendidos en el ambulatorio de evaluación perioperatoria del Hospital Regional do Gama (APA-HRG), en el Distrito Federal, así como establecer relación con las estratificaciones cardíacas utilizadas. Método: Estudio observacional, descriptivo, retrospectivo, con colecta de datos de los registros en los historiales médicos de las consultas preoperatorias de 292 pacientes seleccionados como alto riesgo, ejecutadas por equipo de médicos anestesistas y enfermeros, realizadas en el APA-HRG en el período de junio de 2014 a junio de 2016. Resultados: El perfil de la muestra se constituye, en su mayoría, por individuos del género femenino (78,77%), mayores de 60 años (48,35%), no obesos (69,44%), encaminados principalmente por la clínica ginecológica (39,79%), diagnosticados con hipertensión arterial sistémica (44,17%) y tabaquistas (12,67%). La capacidad funcional fue clasificada como excelente en un 63,18% (>10 equivalentes metabólicos) de los pacientes. Fue constatada asociación significativa entre los equivalentes metabólicos y las estratificaciones de la American Society of Anesthesiologists, del Índice de Riesgo Cardíaco Revisado y de la Clasificación Funcional de la New York Heart Association. Conclusión: La mayoría de los historiales médicos analizados era de pacientes con excelente capacidad funcional, presentando asociación significativa con las estratificaciones estudiadas.
Subject(s)
Humans , Outpatient Clinics, Hospital , Perioperative Period , Ambulatory Care , Cardiovascular Diseases , Comorbidity , Functional Residual CapacityABSTRACT
Introducción. La obesidad está asociada a un descenso acelerado de la función ventilatoria. Las formas más frecuentes de evaluar el estado nutricional y medir la grasa abdominal y las caderas son el índice de masa corporal (IMC) y el índice cintura-cadera (ICC). Existe escasa evidencia que sugiera su relación con la capacidad residual funcional (CRF). Nuestro objetivo fue determinar la relación entre el IMC, el ICC y la CRF en niños obesos de la ciudad de Talca, Chile. Población y métodos. Se reclutaron niños de ambos sexos (6-12 años). Se evaluaron peso, talla, IMC, ICC y función pulmonar a través de pletismografía corporal. Dependiendo de la distribución de los datos, se utilizó la prueba t de Student o U de Mann-Whitney para muestras independientes y, la prueba r de Pearson o Spearman para establecer la correlación entre ICC y CRF. Resultados. Los niños se dividieron en normopeso (n= 18) y obesos (n= 18). Se reportó una disminución significativa de la CRF (p= 0,025) en niños obesos y una relación inversa entre ICC y CRF, la cual fue moderada en niños normopeso (s= -0,489; p= 0,03) y alta en obesos (r= -0,681; p= 0,001). Conclusiones. Los niños obesos mostraron una menor CRF respecto de los normopeso, que, a su vez, se relacionó con el ICC. Estos resultados indican efectos sistémicos que produce la obesidad en la función ventilatoria en niños y la necesidad de incorporar indicadores de distribución de grasa corporal a temprana edad.
Introduction. Obesity is associated with a rapid decrease in ventilatory function. The most common way of assessing nutritional status and measuring abdominal fat and hips are the body mass index (BMI) and the waist-hip ratio (WHR). There is scarce evidence suggesting their relation to functional residual capacity (FRC). Our objective was to determine the relation among BMI, WHR, and FRC in obese children in the city of Talca, Chile. Population and methods. Male and female children were recruited (6-12 years). Weight, height, BMI, WHR, and pulmonary function were assessed; the latter with body plethysmography. Depending on data distribution, Student's t test or the Mann-Whitney U test were used for independent samples, while Pearson's or Spearman's r test was used to establish the correlation between WHR and FRC. Results. Children were divided into normal weight (n = 18) and obese (n = 18). A significant reduction in FRC (p = 0.025) was reported in obese children, while a reverse association was observed between WHR and FRC, which was moderate in normal weight children (s = -0.489; p = 0.03) and high in obese children (r = -0.681; p = 0.001). Conclusions. Obese children showed a lower FRC compared to normal weight children, which, in turn, was associated with WHR. These results are indicative of the systemic effects caused by obesity on children's ventilatory function and the need to use body fat distribution indicators at an early age.
Subject(s)
Humans , Child , Adolescent , Body Mass Index , Functional Residual Capacity , Waist-Hip Ratio , Abdominal FatABSTRACT
O objetivo do presente estudo foi traduzir o original francês do Examen Géronto-Psychomoteur (EGP) para o português do Brasil e adaptar para uso com idosos brasileiros. A proposta busca suprir a ausência de um instrumento multidisciplinar para avaliação funcional do idoso brasileiro. O EGP é um teste que avalia funções motoras e cognitivas, que são habilidades fundamentais para a manutenção da saúde no envelhecimento. Parâmetros internacionalmente aceitos foram adotados em três etapas: Tradução - duas traduções independentes, síntese, tradução reversa; Comitê de especialistas - cinco juízes avaliaram a equivalência conceitual, semântica e cultural, assim como a clareza da tradução; Pré-teste - foram avaliados 35 voluntários com idade média de 68,66 ± 6,22 anos. O processo de tradução apresentou um documento único na língua portuguesa utilizada no Brasil, que obteve índices de validade de conteúdo quase perfeitos para equivalência e clareza entre 0,86 e 1. Também foi calculado o coeficiente de concordância kappa de Cohen, que apontou uma forte concordância entre as avaliações dos juízes, com valores entre 0,85 e 0,96. O tempo médio de aplicação foi de 52,36 ± 7,48 minutos e a média dos escores dos participantes foi de 91,35 ± 9,85. Os parâmetros obtidos da versão brasileira do EGP mostraramse satisfatórios, indicando que o processo de adaptação do instrumento foi adequado e robusto, o que possibilita a continuidade dos estudos das propriedades psicométricas para validação do Exame Geronto Psicomotor para população idosa brasileira. (AU)
The objective of the present study was to translate the French original of the GérontoPsychomoteur Exam (EGP) into Brazilian Portuguese and adapt it for use with Brazilian elderly. It is a test that assesses motor and cognitive functions, which are fundamental skills for maintaining health in aging. International parameters were adopted in three stages, Translation: two independent translations, synthesis, reverse translation; Expert Committee: Five judges evaluated the conceptual, semantic and cultural equivalence, as well as the clarity of the translation; Pre-test: 35 volunteers with a mean age of 68.66 ± 6.22 years were evaluated. The translation process presented a unique instrument in the Portuguese language used in Brazil, which obtained almost perfect content validity indexes for equivalence and clarity between 0.86 and 1. Cohen's kappa coefficient of agreement was also calculated, which pointed to a strong agreement between the judges' evaluations, with values between 0.85 and 0.96. The mean time of application was 52.36 ± 7.48 minutes and the mean of the participants' scores was 91.35 ± 9.85. The parameters obtained from the Brazilian version of the EGP were satisfactory, indicating that the adaptation process of the instrument was adequate and robust, which allows the continuity of the psychometric properties studies to validate the Geronto Psychomotor Examination for the Brazilian elderly people. (AU)
Subject(s)
Humans , Aged , Translating , Cognition , Motor Skills , Brazil , Aged , Aging , Functional Residual Capacity , Adaptation to DisastersABSTRACT
ABSTRACT Objective: To evaluate the influence of obesity on pulmonary function and exercise tolerance in women with obstructive sleep apnea (OSA). Subjects and methods: A descriptive analytic cross- sectional study was carried out. Thirty-nine (39) sedentary climacteric women, aged 45 to 60 years, were evaluated and submitted to polysomnography. The participants were divided into 4 groups: a) 'eutrophic non-OSA' (n = 13); b) 'eutrophic OSA' (n = 5); c) 'obese non-OSA' (n = 6); d) 'obese OSA' (n = 15). All subjects underwent clinical and anthropometric evaluation, followed by pulmonary function tests and 6-minute walk test (6MWT). Results: There was a significant difference in the predicted percentage values of FEV1/FVC when comparing 'eutrophic OSA' and 'obese OSA' (97.6% ± 6.1% vs. 105.7% ± 5.7%, respectively; p = 0.025). The other spirometric variables did not show any differences between the studied groups. There was no significant difference in the maximum distance walked when the 'eutrophic non-OSA', 'eutrophic OSA', 'obese non-OSA' and 'obese OSA' groups were compared. Conclusion: Considering the results of this study, OSA itself did not influence pulmonary function or functional capacity parameters compared to eutrophic women. However, not only isolated obesity but also obesity associated with OSA can negatively impact sleep quality and lung function.
Subject(s)
Humans , Female , Middle Aged , Functional Residual Capacity/physiology , Exercise Tolerance/physiology , Sleep Apnea, Obstructive/physiopathology , Exercise Test/methods , Obesity/physiopathology , Spirometry , Cross-Sectional Studies , Polysomnography , Sedentary BehaviorABSTRACT
Introdução e justificativa: a família é um importante recurso de apoio em caso de adoecimento de um de seus membros. Entretanto, quando o cuidado é realizado no domicílio, há grande impacto no ambiente familiar, o que pode alterar a dinâmica e fortalecer ou fragilizar as relações familiares. Objetivo: avaliar o impacto do cuidado em famílias de pacientes com incapacidades e dependência em diferentes contextos de vulnerabilidade. Método: pesquisa longitudinal que utilizou dados do Estudo SABE (Saúde, Bem-Estar e Envelhecimento), 2010 e 2015. Os idosos incluídos no estudo foram agrupados em três categorias, de acordo com a dificuldade referida na realização de atividades básicas de vida diária (ABVD): Incidência, Piora e Permanência. Para cada contexto de vulnerabilidade social (baixa e média/alta), foi feita a análise do perfil dos idosos, condição de saúde, dificuldade na realização de ABVD, características da família, rede e apoio social, perfil dos cuidadores, dificuldades enfrentadas e aspectos positivos do cuidado. Foram feitas a análise descritiva dos dados e de regressão logística múltipla hierárquica, para cada grupo de incapacidade funcional, em cada contexto de vulnerabilidade, considerando o peso amostral. Os dados foram analisados utilizando-se o programa Stata versão 15.1 e os resultados foram considerados estatisticamente significativos quando p<5.Resultados: nos contexto de baixa vulnerabilidade social, 61,06% dos idosos foi classificado no grupo Incidência, 19,41% no grupo Piora e 19,53% no grupo Permanência. Já nos contexto de média a alta vulnerabilidade, 54,58% foi incluído no grupo Incidência, 30,93% no grupo Piora e 14,49% no grupo Permanência. Em ambos os contextos e em todos os grupos de incapacidade predominaram idosos que moravam com os filhos, dividiam o domicílio com uma a duas pessoas, tinham boa percepção quanto à funcionalidade familiar e recebiam auxílio nas tarefas domiciliares. O grupo Piora apresentou maior proporção de idosos que contava com um cuidador, em ambos os contextos: 37,83% dos idosos em contextos de baixa vulnerabilidade e 53,47% em contextos de média a alta vulnerabilidade. Os grupos Incidência e Permanência, nos contextos de média a alta vulnerabilidade, apresentaram maior proporção de cuidadores que referiram dificuldade elevada no cuidado ao idoso. Nos contextos de vulnerabilidade baixa, predominaram cuidadores que referiram dificuldade baixa nos grupos Incidência e Piora. A satisfação pelo cuidado prestado foi elevada para os grupos Incidência (baixa vulnerabilidade) e Permanência (média a alta vulnerabilidade). Somente o grupo Permanência (baixa vulnerabilidade) apresentou predomínio de cuidadores que referiram baixa satisfação pelo cuidado realizado. Nos contextos de baixa vulnerabilidade, em 2010, a percepção dos cuidadores sobre a funcionalidade familiar foi boa em todos os grupos de incapacidade funcional; já em 2015, a maior parte dos cuidadores avaliou as famílias como disfuncionais. Nos contextos de vulnerabilidade média a alta, em ambos os anos, predominou a boa funcionalidade familiar. As variáveis associadas à incapacidade funcional variaram entre os grupos, entretanto destaca-se a disfunção familiar e a ausência de cuidador, que apresentaram influência na incapacidade funcional do idoso na maior parte dos grupos, em ambos os contextos de vulnerabilidade. Conclusão: os aspectos que mais influenciaram a incapacidade funcional variaram entre os grupos de incapacidade e os contextos de vulnerabilidade. Assim, além do perfil do idoso, da família e dos cuidadores, o foco da intervenção deve considerar os recursos disponíveis em determinados contextos de vulnerabilidade social, a fim de reduzir a carga do cuidado de todos os envolvidos no processo.
Introduction and justification: The family is an important support resource in case of illness of one of its members. However, when care is provided at home, there is a great impact on the family environment, which can change the dynamics and strengthen or weaken family relationships. Objective: To evaluate the impact of care on families of patients with disabilities and dependence in different contexts of vulnerability. Method: longitudinal survey using data from the SABE Study (Health, Welfare and Aging), 2010 and 2015. The elderly included in the study were grouped into three categories, according to the difficulty reported in performing basic activities of daily living (BADL): Incidence, Decline and Permanence. For each context of social vulnerability (low and medium/high), an analysis was made of the elderlys profile, health condition, difficulty in performing BADL, family characteristics, social network and support, caregivers\' profile, difficulties faced and aspects positive of care. Descriptive data analysis and hierarchical multiple logistic regression were performed for each group of functional disability in each context of vulnerability, considering the sample weight. Data were analyzed using the Stata software version 15.1 and the results were considered statistically significant when p<0,05. Results: in the context of low social vulnerability, 61.06% of the elderly were classified in the Incidence group, 19.41% in the Decline group and 19.53% in the Permanence group. In the medium to high vulnerability context, 54.58% was included in the Incidence group, 30.93% in the Decline group and 14.49% in the Permanence group. In both contexts and in all disability groups, elderly people who lived with their children predominated, shared the household with one to two people, had a good perception of family functionality, and were assisted with household tasks. The Decline group had the highest proportion of elderly people with a caregiver in both contexts: 37.83% of the elderly in low vulnerability context and 53.47% in medium to high vulnerability context. The Incidence and Permanence groups, in the medium to high vulnerability context, presented a higher proportion of caregivers who reported high difficulty in caring for the elderly. In contexts of low vulnerability, predominated caregivers who reported low difficulty in the Incidence and Decline groups. Satisfaction with the care provided was high for the Incidence (low vulnerability) and Permanence (medium to high vulnerability) groups. Only the Permanence group (low vulnerability) showed a predominance of caregivers who reported low satisfaction with the care provided. In low vulnerability context, in 2010, caregivers' perception of family functionality was good in all groups of functional disability; In 2015, most caregivers rated families as dysfunctional. In contexts of medium to high vulnerability, in both years, good family functionality predominated. Variables associated with functional disability varied between groups; however, family dysfunction and the absence of caregivers stand out, which influenced the functional disability of the elderly in most groups, in both contexts of vulnerability. Conclusion: the aspects that most influenced functional disability varied between disability groups and vulnerability contexts. Thus, in addition to the profile of the elderly, family and caregivers, the focus of the intervention should consider the resources available in certain contexts of social vulnerability in order to reduce the burden of care.