ABSTRACT
Exercising with the Pilates method may be a beneficial treatment to improve balance and decrease the number of falls. To ascertain this, our search in 7 databases included 15 randomized controlled trials in which Pilates was the primary intervention. Participants were over 60 years of age; the outcomes were related to balance and falls. The Cochrane tool and PEDro scale were used to assess risk of bias and quality of individual studies. Current evidence supported the view that exercising with the Pilates method improves the balance of older adults with a high practical effect in terms of the dynamic (SMD = 0.75 [0.17;1.32]), static (SMD = 1.33 [0.53;2.13]), and overall balance (SMD = 0.96[0.00;1.91]). Pilates also produced greater improvements with a moderate effect in terms of the dynamic (SMD = 0.37[-0.36;1.11]) and overall balance (SMD = 0.58[0.19;0.96]) compared to other training approaches oriented to the same end. Literature evaluating the effects on falls is scarce, and results were not conclusive.
Subject(s)
Accidental Falls/prevention & control , Exercise Movement Techniques , Postural Balance , Aged , Humans , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND AND PURPOSE: Sensorimotor training has proven to be an efficient approach for recovering balance control following total knee replacement (TKR). The purpose of this trial was to evaluate the influence of specific balance-targeted training using a dynamometric platform on the overall state of balance in older adults undergoing TKR. METHODS: This was a randomized controlled clinical trial conducted at a university hospital rehabilitation unit. Patients meeting the inclusion criteria were randomly assigned to a control group or an experimental group. Both groups participated in the same 4-week postoperative rehabilitation training protocol. Participants in the experimental group performed additional balance training with a dynamometric platform consisting of tests related to stability challenges, weight-shifting, and moving to the limits of stability. The primary outcome measure was the overall state of balance rated according to the Berg Balance Scale. Secondary outcomes in terms of balance were the Timed Up and Go Test, Functional Reach Test, and Romberg open and closed-eyes tests. Data processing included between-group analysis of covariance, minimal detectable change assessment for the primary outcome measure, and effect size estimation. Confidence intervals (CIs) were set at 95%. RESULTS: Forty-three participants meeting the inclusion criteria and having signed the informed consent were randomly assigned to 2 groups. Thirty-seven completed the training (86.1%). Significant between-group differences in balance performance were found as measured with the Berg Balance Scale (P = .03) and Functional Reach Test (P = .04) with a CI = 95%. Significant differences were not recorded for the Timed Up and Go Test or Romberg open and closed-eyes tests (P > .05). Furthermore, Cohen's effect size resulted in a value of d = 0.97, suggesting a high practical significance of the trial. DISCUSSION AND CONCLUSIONS: According to the Berg Balance Scale and Functional Reach Test, participants with TKR who have followed a 4-week training program using a dynamometric platform improved balance performance to a higher extent than a control group training without such a device. The inclusion of this instrument in the functional training protocol may be beneficial for recovering balance following TKR.
Subject(s)
Arthroplasty, Replacement, Knee/rehabilitation , Exercise Therapy/methods , Postural Balance/physiology , Aged , Disability Evaluation , Female , Hospitals, University , Humans , Male , Middle Aged , Muscle Strength Dynamometer , Treatment OutcomeABSTRACT
El consumo de sustancias adictivas está relacionado con diversos factores de carácter individual y social. La edad no es una causa directa de consumo, sin embargo, constituye una variable que puede influir a que la persona se inicie o se mantenga. Los jóvenes que abusan del consumo de sustancias tóxicas pueden solicitar al profesional de la salud tratamiento asistencial y curativo, con la finalidad de combatir la adicción. En este sentido, hay quien puede oponerse a que sus representantes legales sean conocedores de los datos relativos a su situación adictiva. Siendo así, la cuestión desemboca en un enfrentamiento entre el derecho a la intimidad del adolescente y el deber de velar por el interés de éste tanto por los representantes legales como por el profesional de la salud. De acuerdo con ello, el objetivo de análisis es examinar el alcance del ejercicio del derecho a la intimidad del menor de edad frente a la posibilidad de intervención de los representantes legales ante el consumo de sustancias adictivas
The consumption of addictive substances such as alcohol, tobacco or other non-institutionalized drugs is related to several factors of individual and social nature. Despite the fact that age is not a direct cause of the consumption of these substances, it is an important variable that may influence the person to initiate or go on with their use. Young people who abuse toxic substances can request therapeutic treatment and healthcare intervention from the healthcare professional with the aim of fighting the addiction. However, some people may decline to give information about the addiction situation to their legal representatives. In such cases, the question leads to a conflict between the adolescents right to privacy versus the duty of the legal representatives and the healthcare professional to safeguard his or her interests. The aim of this work is thus to analyze the extent of the minors right to privacy, versus the possibility of the legal representatives intervention in view of the use of addictive substances
Subject(s)
Adolescent , Female , Humans , Male , Young Adult , Child Advocacy/education , Child Advocacy/legislation & jurisprudence , Substance-Related Disorders/genetics , Substance-Related Disorders/psychology , Confidentiality/psychology , Substance-Related Disorders/metabolism , Spain/ethnology , Child Advocacy/psychology , Child Advocacy/standards , Substance-Related Disorders/rehabilitation , Substance-Related Disorders/therapy , Confidentiality/ethicsABSTRACT
El consentimiento informado en la minoría de edad está regulado en la legislación relativa a la autonomía de la voluntad del paciente, la cual, introduce la figura del menor maduro. Ahora bien, el tenor de la norma ha suscitado diversas interpretaciones entorno a la prestación del consentimiento informado, lo que conlleva a plantearse la siguiente cuestión: ¿A quién le corresponde la toma de decisión?. Para dar respuesta a esta pregunta, el artículo aborda el marco jurídico del consentimiento informado diferenciando dos situaciones con base en la legislación vigente. En primer lugar, la capacidad del niño para decidir en este área. En segundo lugar, la competencia de los representantes legales y en consecuencia, las pautas que deben seguir en su actuación (AU)
The informed consent of the minor is regulated by the legislation relating to the autonomy of the will and choice of the patient, which includes the figure of the mature minor. Having said that, if the legislation is taken into consideration in a literal way, the following question has to be considered: Whose is the responsibility to take the decision? To answer this question, and based on the current legislation, this paper presents the legal framework of the informed consent by differentiating two possible situations. Firstly, the capacity of the minor to make his own decision. Secondly, the actual competence of his legal representatives. In such case, the actuation procedure may be established (AU)
