Reabilitação funcional e barreiras para atividade física na COVID-longa: um ensaio clínico randomizado / Functional rehabilitation and barriers to physical activity after COVID-19: a randomized clinical trial

O estudo teve como objetivo analisar as barreiras percebidas à prática de atividade física durante um programa de treinamento multicomponente em adultos e idosos pós infecção por COVID-19. Realizou-se um ensaio clínico randomizado com 40 participantes (19 grupo controle e 21 grupo intervenção). Foram coletadas informações sociodemográficas, de saúde e de barreiras para a prática de atividade física, antes, 12 e 24 semanas após o início da intervenção. A medida das barreiras para a prática de atividade física foi obtida por meio de uma escala válida composta por 16 itens. As diferen-ças de barreiras entre os grupos e ao longo de tempo foi analisada a partir das Equações de Estimativa Generalizada, α = 0,05. As barreiras mais citadas pelos dois grupos na linha de base foram "Preguiça, cansaço ou desânimo" (71%), "Dores, lesões ou incapacidade" (38%) e "Falta de motivação" (48%). As análises principais indicaram que ambos os grupos tiveram redução na frequência da barreira "Pre-guiça, cansaço ou desânimo" na 12ª semana (p = 0,003), porém voltando aos valores iniciais na 24ª semana (p = 0,441). Já a barreira "Por causa da epidemia de coronavírus" foi reduzida na 12ª semana (p = 0,704) e ainda mais reduzida na 24ª semana (p = 0,158), comportamento também similar entre os grupos. Como principal conclusão, barreiras para atividade física podem ser reduzidas pela parti-cipação em programas de exercício supervisionado e recomendação para a prática de atividade física

The study aimed to analyze perceived barriers to physical activity during a multicomponent training pro-gram in adults and seniors post-COVID-19 infection. A randomized clinical trial was conducted with 40 participants (19 control group and 21 intervention group). Sociodemographic, health, and barriers to physical activity information were collected before, 12 and 24 weeks after the start of the intervention. The measure of barriers to physical activity was obtained through a valid scale composed of 16 items. Differences in barriers between groups and over time were analyzed using Generalized Estimating Equations, α = 0.05. The most frequently mentioned barriers at baseline by both groups were "Laziness, fatigue, or lack of enthusiasm" (71%), "Pain, injuries, or disability" (38%), and "Lack of motivation" (48%). The main analyses indicated that both groups had a reduction in the frequency of the barrier "Laziness, fatigue, or lack of enthusiasm" at week 12 (p = 0.003), but returned to initial values at week 24 (p = 0.441). The barrier "Because of the coronavirus epidemic" was reduced in week 12 (p = 0.704) and further reduced in week 24 (p = 0.158), with a similar pattern between groups. The key conclusion is that barriers to physical activity can be reduced through participation in supervised exercise programs and recommendations for physical activity

Validation and reproducibility of the Glittre activities of the daily living test for evaluation of functional capacity after a stroke.

METHODS: Thirty patients with hemiparesis stemming from a stroke and 20 healthy peers were evaluated. Reproducibility was determined using the intraclass correlation coefficient (ICC), standard measurement error (SME), minimum detectable change (MDC), and Bland-Altman analysis. For construct validity, the Glittre ADL test was correlated with the Six-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), and Functional Independence Measure (FIM), and analyzed based on convergent validity and the comparison of known groups (stroke survivors and healthy peers). RESULTS: Intra- and inter-observer reliability were excellent (ICC3,1 = 0.98; 0.96, respectively). Intra-observer SME ranged from 0.27 to 0.31 minutes and inter-observer SME was 0.45 minutes. Intra-observer MDC ranged from 1.44 to 1.54 minutes and inter-observer MDC was 1.86 minutes. Strong statistically significant correlations were found between time on the Glittre ADL test and time on the 6MWT (rh = -0.91; p < .001) and TUG test (rh = 0.82; p < .001), whereas a moderate correlation was found with the FIM (rh = -0.47; p < .008). CONCLUSIONS: The Glittre ADL test is valid for assessing functional capacity in stroke patients. It demonstrated good convergent and construct validity and excellent intra- and inter-observer reproducibility.