Factors associated with use of assistive walking devices among older adults in Brazil / Fatores associados ao uso de tecnologia assistiva para auxiliar na mobilidade entre idosos no Brasil

Abstract Background Walking devices and other forms of assistive technology (AT) can benefit older adults by supporting mobility and social interactions, but usage outside of high-income countries is generally low. Objective To examine the factors associated with AT use and whether AT use is associated with higher levels of social participation among older adults in Brazil. Method The 2013 Brazilian National Health Survey interviewed 23,815 individuals 60 years or older. Descriptive and logistic regression analyses were used to examine AT use, including canes and walkers, to assist with walking and social participation. Results Among older adults with mobility difficulty, 34.0% (95% CI 31.2- 36.9) reported using AT. Prevalence of the use of AT for walking increases with age: 21.4% of those 60-69 years reported using AT while 58.5% of those 90 years or older did. AT was negatively associated with participation in social activities. Conclusion Our analyses focused on older adults with mobility limitations who need appropriate transportation and environment adaptations to engage socially. Contrary to studies in more developed countries, among Brazilians, AT use is negatively associated with social interactions. The resulting confinement seems to lead to social isolation.

Resumo Introdução Os dispositivos de tecnologia assistiva (TA) podem ajudar idosos na mobilidade e nas interações sociais, mas o uso fora de países de alta renda é geralmente baixo. Objetivo Analisar os fatores associados ao uso de TA e se o uso de TA está associado a níveis mais elevados de participação social entre idosos no Brasil. Método A Pesquisa Nacional de Saúde - PNS 2013 no Brasil entrevistou 23.815 indivíduos com 60 anos ou mais. Análises descritivas e de regressão logística foram utilizadas para examinar a utilização de TA para auxiliar na mobilidade e participação social. Resultados Entre idosos com dificuldade de locomoção, 34,0% (95% IC 31,2-36,9) relataram uso de TA. A prevalência do uso de TA para se locomover aumenta com a idade: 21,4% dos 60-69 anos relataram usar TA enquanto a proporção aumenta para 58,5% entre os de 90 anos ou mais. Uso de TA está negativamente associado à participação em atividades sociais. Conclusão Entre idosos no Brasil com limitações de mobilidade que necessitam de adaptações adequadas de transporte e meio ambiente para engajar socialmente, o uso de TA foi associado negativamente às interações sociais. Esse resultado difere de estudos em países mais desenvolvidos.

Validation of assistive technology on psychoactive substances for visually impaired people.

PURPOSE: To validate the assistive technology "Drugs: reflection for prevention" to be used with visually impaired people. METHOD: Quantitative and quasi-experimental study, contrasting knowledge before and after the use of the assistive technology with 140 visually impaired people in institutes and associations for people with visual impairment. A questionnaire with identification data, a pre-test, a post-test and a questionnaire to assess the assistive technology were applied. Data were described through means and standard deviations, and analyses included the McNemar test, the exact binomial distribution test, and the intraclass correlation coefficient. RESULTS: Participants were male (65.7%), 84.3% were blind, aged 37.1 years on average and with schooling of 10.1 years on average. There were more correct answers in the post-test (p <.001). The attributes of the assistive technology were considered adequate: objectives, access, clarity, structure and presentation, relevance and efficacy, and interactivity (p <.001). CONCLUSIONS: The assistive technology "Drugs: reflection for prevention" was considered valid and reliable to inform visually impaired people about psychoactive substance abuse. Implications for rehabilitation Created new tool for prevention substance abuse that can be accessed easily. Improved information about substance psychoactive for users of the assistive technology. Improved quality of life for its users.

Uso de dispositivos de assistência por indivíduo com osteoartrite de mãos / Use of assistive devices by individuals with hands osteoarthritis

[{"text": "Introdução: A osteoartrite de mãos é uma doença articular que acarreta dor, rigidez, deformidade e perda\r\nda mobilidade, gerando grande impacto funcional na vida das pessoas, por tornar as atividades comuns do dia a dia\r\ndifíceis e dolorosas, repercutindo negativamente na sua qualidade de vida. Dispositivos de assistência são estratégias\r\nutilizadas por terapeutas ocupacionais para o tratamento sintomático da osteoartrite de mãos. Objetivo: Identificar e\r\ndescrever dispositivos de assistência indicados para indivíduos com osteoartrite de mãos a partir de uma intervenção\r\ndo terapeuta ocupacional. Método: Estudo observacional, descritivo de corte transversal. Realizado em população\r\ndiagnosticada com Osteaoartrite de mãos, no ambulatório de terapia ocupacional de um hospital referência, no\r\nperíodo de agosto a setembro de 2015. Dezesseis participantes responderam a um questionário semiestruturado\r\nelaborado com enfoque na descrição e frequência de uso dos dispositivos de assistência indicados e ofertados em\r\numa pesquisa mestre. A análise de dados ocorreu por estatística descritiva através de medida de tendência central e\r\ndistribuição de probabilidade. Resultados: Os dispositivos de assistência utilizados no dia a dia dos 16 indivíduos\r\nentrevistados foram adaptadores para o vestir, adaptadores para o banho, descascadores, engrossadores, abridores e\r\ncortadores. Foram incluídos na rotina dos participantes 84% destes dispositivos de assistência com frequência diária,\r\nsemanal e mensal. Conclusão: Os dispositivos de assistência utilizados pela população estudada foram adaptadores\r\npara o vestir, adaptadores para o banho, descascadores, engrossadores, abridores e cortadores.", "_i": "pt"}, {"text": "Introduction: Hands osteoarthritis is a joint disease that causes pain, stiffness, deformity and loss of\r\nmobility. It has huge functional and negative impact on people's quality of life by making the common daily\r\nactivities difficult and painful. Assistive devices are strategies used by occupational therapists for the symptomatic\r\ntreatment hands osteoarthritis. Objective: To identify and describe assistive devices indicated for individuals with\r\nhands osteoarthritis through an Occupational Therapy intervention. Method: Cross-sectional study, conducted on\r\nsubjects diagnosed with hands osteoarthritis in an Occupational Therapy clinic at a reference hospital in the state,\r\nfrom August to September 2015. Sixteen participants answered a researcher-developed semi-structured questionnaire,\r\nfocusing on the description and frequency of use of specified assistive devices. Data were analyzed using descriptive\r\nstatistics through measure of central tendency and probability distribution. Results: The assistive devices used in the\r\ndaily lives of the 16 individuals interviewed were: adapters for dressing, adapters for bathing, peelers, thickeners,\r\njar/bottle openers and cutters. were in the routine of individuals 84% of these assistive devices with a daily, weekly\r\nand monthly frequency. Conclusion: In this study, individuals suffering from hand osteoarthritis used adapters for\r\ndressing, adapters for bathing, thickeners, peelers, jar/bottle openers and cutters as assistive devices.", "_i": "en"}]

Assistive devices: an effective strategy in non-pharmacological treatment for hand osteoarthritis-randomized clinical trial.

This study aims to evaluate the use of assistive devices as a strategy in non-pharmacological treatment for hand osteoarthritis (HOA). This is a randomized, prospective, parallel, assessor-blinded clinical trial, in which patients with a diagnosis of HOA were randomly allocated to an intervention group (IG), where they received assistive devices for daily life activities, or to a control group (CG), where they received a guideline leaflet with information on joint protection and disease features. The primary outcomes considered were occupational performance, measured by the Canadian Occupational Performance Measure (COPM), and hand function was evaluated through the Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (SACRAH). The secondary outcomes were pain, measured by the visual analog scale (VAS), and quality of life, measured by the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF). We compared both outcomes before and after interventions and outcomes between groups. Participants from the two groups were assessed at the time of inclusion in the study, 30, and 90 days after initial evaluation. Out of the 39 patients included, 19 were allocated to the IG and 20 to the CG. Only two patients from the CG did not complete the follow-up period. The patients' hand function and occupational performance improved after intervention (30 days-SACRAH-p < 0.05; COPM-p < 0.05; VAS-p < 0.05). When comparing results between the groups, there was a statistical difference in COPM (performance-p < 0.001; and satisfaction-p < 0.001), in the first reevaluation carried out. The use of assistive devices has proved to be an effective alternative in non-pharmacological treatment for HOA. CLINICAL TRIAL REGISTRATION: NCT02667145.

Evaluation of gait performance of knee osteoarthritis patients after total knee arthroplasty with different assistive devices

IntroductionNowadays Knee Osteoarthritis (KOA) affects a large percentage of the elderly, and one solution is to perform a Total Knee Arthroplasty (TKA). In this paper, one intends to study the gait and posture of these patients after the TKA, while walking with three assistive devices (ADs) (crutches, standard walker (SW) and rollator with forearm supports (RFS)).MethodsEleven patients were evaluated in 2 phases: 5 days and 15 days after surgery. This evaluation was conducted with two inertial sensors, one attached to the operated leg ankle, to measure spatiotemporal parameters, and the other at the sacrum, to measure posture and fall risk-related parameters. Multivariate analysis of variance (MANOVA) with repeated measures was performed to detect group differences.ResultsThe MANOVA results show that all spatiotemporal parameters are significantly different (p<0.05) between the two phases of study. So, time has a significant influence on such parameters. In relation to the ADs, one observes that there are statistical significant effects on all spatiotemporal parameters, except for swing duration and step length (p>0.05). The interaction between time and ADs only affects significantly the velocity (p<0.05). In terms of fall risk parameters, time only significantly affects the antero-posterior direction (p<0.05) and ADs affects significantly root mean square in medio-lateral direction (p<0.05). In terms of interaction between time and ADs, there are no statistical significant differences.ConclusionThis study concludes that depending on the state of recovery of the patient, different ADs should be prescribed. On the overall, standard walker is good to give stability to the patient and RFS allows the patient to present a gait pattern closer to a natural gait.