Physical Therapy in Tension-Type Headache: A Systematic Review of Randomized Controlled Trials.

(1) Objective: The aim of this study is to synthesize the effects of physical therapy on pain, frequency, or duration management in the short, medium, and long term in adult patients diagnosed with Tension-type headache (TTH). (2) Background: Tension-type headache (TTH) is the most common headache with migraine and its pathophysiology and treatment has been discussed for years without reaching a consensus. (3) Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was registered in PROSPERO (CRD42020175020). The systematic search for clinical trials was performed in the databases PubMed, CINAHL, Cochrane Central Register of Controlled Trials, PEDro, Scopus, SciELO and Dialnet. Articles were selected according to the inclusion and exclusion criteria, regarding the effectiveness of physical therapy interventions on adult patients with TTH published in the last 11 years with a score ≥ 6 in the PEDro Scale (Physiotherapy Evidence Database). (4) Results: In total, 120 articles were identified, of which 15 randomized controlled trials were finally included in order to determine the inclusion criteria. Changes in pain intensity, headache frequency or headache duration of individual studies were described (5) Conclusions: This systematic review shows that there is no standardized physical therapy protocol for the approach to tension headache, although all the techniques studied to date address in one way or another the cranio-cervical-mandibular region. The approach to the cranio-cervical-mandibular region reports significant effects in terms of decreasing the intensity of pain and frequency of headache episodes in the short and medium term. More long-term longitudinal studies are needed.

The Impact of Depression on the Functional Outcome of the Elderly Stroke Victim from a Gender Perspective: A Systematic Review.

(1) Background: The aim of this systematic review focused on analyzing the impact of depression on the functional outcome of the elderly stroke victim and how this disorder affects both the female and the male population. (2) Methods: We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was registered in PROSPERO (ID 346284). The systematic search for clinical trials was performed in the databases Pubmed, Otseeker, Scopus, Web of Science, Psycinfo, Medline Complete, ScienceDirect, SciELO, and Dialnet. Articles were selected according to the inclusion and exclusion criteria, including those dealing with post-stroke depression in adults whose psychological status had changed. Studies that only assessed the psychological state of caregivers were excluded. (3) Results: In total, 609 articles were identified, of which 11 randomized controlled trials were finally included in the review. The results indicate that post-stroke depression influences the recovery of functionality and quality of life. In addition, the need to detect the mood of the adult population after the stroke and to provide individualized treatment according to the characteristics of the person is highlighted. (4) Conclusions: This systematic review shows how early detection of post-stroke depressive symptoms can improve the degree of disability and quality of life of the person, especially in women.

Interventions within the Scope of Occupational Therapy in the Hospital Discharge Process Post-Stroke: A Systematic Review.

Stroke is one of the main causes of disability in adulthood. Its rehabilitation is a complex process that requires a multidisciplinary team of specialised professionals. The main goal of this review was to determine the impact of occupational therapy intervention post-stroke on the home discharge process. A systematic search was carried out of the following databases: Pubmed, Web of Science, PsycINFO, Scopus, Otseeker, and Dialnet. A screening was performed taking into account the type of article, including exclusively RCT, and type of intervention, only including interventions within the scope of occupational therapy that take place during the process of hospital discharge post-stroke. A total of 2285 citations were identified in the search from which 13 articles met the inclusion criteria. Comparisons of the groups indicated that early occupational therapy intervention during the process of hospital discharge can be effective in terms of functional recovery and can lead to the caregiver seeing improvements in self-efficacy and fatigue. In addition, the inclusion of a caregiver in the intervention influences the patient's adherence to treatment, leading to a reduction in the cost of treatment and rehabilitation.

Early Occupational Therapy Intervention in the Hospital Discharge after Stroke.

Stroke is the leading cause of acquired disability in adults which is a cerebrovascular disease of great impact in health and social terms, not only due to its prevalence and incidence but also because of its significant consequences in terms of patient dependence and its consequent impact on the patient and family lives. The general objective of this study is to determine whether an early occupational therapy intervention at hospital discharge after suffering a stroke has a positive effect on the functional independence of the patient three months after discharge-the patient's level of independence being the main focus of this research. Data will be collected on readmissions to hospitals, mortality, returns to work and returns to driving, as well as an economic health analysis. This is a prospective, randomized, controlled clinical trial. The sample size will be made up of 60 patients who suffered a stroke and were discharged from the neurology unit of a second-level hospital in west Malaga (Spain), who were then referred to the rehabilitation service by the joint decision of the neurology and rehabilitation department. The patients and caregivers assigned to the experimental group were included in an early occupational therapy intervention program and compared with a control group that receives usual care.

Evidence of Animal-Assisted Therapy in Neurological Diseases in Adults: A Systematic Review.

BACKGROUND: In recent years, the possibility of intervening humans with animal-assisted therapy (AAT) has been growing due to numerous physical, psychological, and social benefits provided to humanity, enabling them to maintain or improve their quality of life. There exist different animals through which this therapy can be performed. The purpose of this systematic review will focus on the effects of AAT in several neurological diseases. METHODS: The search of clinical trials was carried out in the PubMed, Scielo, Embase and PEDro databases. The selection of articles was made according to the different inclusion and exclusion criteria, incorporating those that approached neurological diseases to be reviewed. RESULTS: Twenty-five clinical trials were identified, seventeen of which were finally included in the review. The results indicate that animal-assisted therapy (AAT) in different neurological diseases has many benefits in several areas, for example, in motor and physical ability as well as in mental and behavioural health. CONCLUSIONS: This systematic review provides occupational therapy practitioners with evidence on the use of activity based on animal-assisted therapy as a novel field of intervention that can complement other therapies and obtain benefits in different populations.

Changes in Resilience in Students of Occupational Therapy After Their First Exposure to Practice Placement Education.

Introduction: Resilience is a multidimensional and dynamic construct associated with positive growth and the capacity to transform stressful and negative factors into opportunities of personal development and self-improvement when faced with difficult experiences. The resilience process of each individual integrates multiple analysis levels, which range from genetic-environmental interactions to a complex process of adaptation between the individual and his/her family, friends, co-workers, society, and culture. Objective: To determine whether resilience improves in students of occupational therapy when exposed for the first time to practice placement education. Methodology: Quasi-experimental, prospective, observational, multi-center study with a sample composed of students from the Degree of Occupational Therapy of the public universities of Málaga (UMA) and Castilla-La Mancha (UCLM) (Spain). Two weeks prior to the beginning of the practice education period, the participants completed a questionnaire that included sociodemographic data and the area of their internships. They were also given the Spanish version of the Connor-Davidson's resilience scale (CD-RISC). All these instruments were also completed 1 week after the end of the clinical practice. Results: There were statistically significant differences between the variables that make up resilience and the different internship areas. On the other hand, there was a significant improvement of global resilience after the clinical practice period, in both women (13.85 points; p < 0.001) and men (7.72 points; p < 0.035), when the internship area was not considered. Conclusions: The results show that resilient students are more optimistic and work to improve a situation beyond doing simply what is expected of them, knowing how to control their feelings. This is beneficial for students in practice education, since, during these, they face difficult situations that require a resilient pattern, which helps reduce stress and the burnout syndrome.

Effectiveness of Virtual Reality-Based Interventions for Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis.

This review aims to evaluate the effectiveness of virtual reality-based interventions (VR-based interventions) on cognitive deficits in children with attention deficit hyperactivity disorder (ADHD). A systematic review and meta-analysis were performed according to the PRISMA statement and the Cochrane Handbook guidelines for conducting meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the quality of the evidence. Clinical trials published up to 29 October 2020, were included. The meta-analysis included four studies, with a population of 125 participants with ADHD. The magnitude of the effect was large for omissions (SMD = -1.38; p = 0.009), correct hits (SMD = -1.50; p = 0.004), and perceptual sensitivity (SMD = -1.07; p = 0.01); and moderate for commissions (SMD = -0.62; p = 0.002) and reaction time (SMD = -0.67; p = 0.03). The use of VR-based interventions for cognitive rehabilitation in children with ADHD is limited. The results showed that VR-based interventions are more effective in improving sustained attention. Improvements were observed in attentional vigilance measures, increasing the number of correct responses and decreasing the number of errors of omission. No improvements were observed in impulsivity responses.

Velocidad de la marcha y cognición en adultos mayores en atención secundaria de salud / Velocidade da marcha e cognição em idosos da atenção secundária em saúde / Gait speed and cognition in elderly users of secondary care service

Objetivo: analizar la asociación entre la velocidad de la marcha y la cognición de adultos mayores que se encuentran en asistencia ambulatoria geriátrica y gerontológica. Materiales y método: estudio cuantitativo transversal realizado con 407 adultos mayores (≥ 60 años) atendidos en el Centro Ambulatorio de Geriatría y Gerontología del municipio de São José dos Pinhais, Paraná (Brasil). La condición de fragilidad física se evaluó utilizando el fenotipo de fragilidad y el cribado cognitivo mediante el Mini-Mental State Examination y el test de fluencia verbal semántica. El análisis univariado se realizó mediante una prueba de chi-cuadrado con nivel de significación estadístico de p ≤ 0,05. Resultados: del total de participantes, se observaron 226 (55,5 %) adultos mayores prefrágiles, 238 (58,5 %) reportaron deterioro cogntivo, 90 (22 %) de la fluidez verbal semántica y 205 (50,4 %) presentaron velocidad de la marcha reducida, variable que registró una asociación significativa con el deterioro cognitivo (p = 0,003) y las alteraciones de la fluencia verbal semántica (p < 0,001).Conclusiones: los resultados señalan la necesidad de implementar la evaluación de la velocidad de la marcha en adultos mayores como parte de la práctica clínica de geriatría y gerontología. Este componente revela un posible deterioro cognitivo y permite la realización de acciones que puedan perfeccionar el manejo de los cuidados ante la fragilidad física en adultos mayores.

Objetivo: analisar a associação entre a velocidade da marcha e a cognição de idosos em assistência ambulatorial de geriatria e gerontologia. Materiais e método: estudo quantitativo transversal, realizado com 407 idosos (≥ 60 anos), atendidos no Ambulatório de Geriatria e Geron-tologia, do município de São José dos Pinhais, Paraná, Brasil. A condição de fragilidade física foi avaliada mediante o fenótipo de fragilidade e o rastreio cognitivo pelo Mini-Exame do Estado Mental e Teste de Fluência Verbal Semântica. A análise univariada foi realizada por teste de quiquadrado com nível de significância estatístico de p ≤ 0,05. Resultados:do total de participantes, foram observados 226 (55,5 %) idosos pré-frágeis, 238 (58,5 %) apresentaram declínio cognitivo, 90 (22 %) comprometimento na fluência verbal semântica e 205 (50,4 %) velocidade da marcha reduzida, variável que registrou associação significativa com o comprometimento cognitivo (p = 0,003) e alterações da fluência verbal semântica (p < 0,001). Conclusões: os resultados apontam para a necessidade de implementar na prática clínica de geriatria e gerontologia a avaliação da velocidade da marcha em idosos. Esse componente revela possibilidades de comprometimento cognitivo e faculta ações que possam aprimorar a gestão de cuidados diante da fragilidade física em idosos

Objective: To study the association between gait speed and cognition in elderly patients undergoing geriatric and gerontological outpatient treatment. Materials and method:Quantitative and cross-sectional study with 407 elderly patients (≥60 years) treated at the Geriatrics and Gerontology Outpatient Clinic in the town of São José dos Pinhais, Paraná (Brazil). Physical frailty condi-tion was assessed using the frailty phenotype and the cognitive assessment by means of the Mini Mental State Examination and the Semantic Verbal Fluency Test. The univariate analysis was performed using a chisquare test with a level of statistical significance of p ≤ 0.05. Results: Out of the total participants, we observed that 226 (55.5%) elderly patients were pre-frail, 238 (58.5%) had cognitive impairments, 90 (22%) showed impaired semantic verbal fluency, and 205 (50.4%) decreased gait speed. This last variable showed a significant association with cognitive decline (p = 0.003) and changes in semantic verbal fluency (p < 0.001). Conclusions: Our results indicate the need of implementing gait speed assessment in elderly patients in the geriatrics and gerontology clinical practice. This component reveals a possible cognitive deterioration and enables us to develop actions that may improve care management in the face of physical frailty in elderly individuals.

Associação entre cognição, velocidade da marcha e habilitação veicular em idosos / Relación entre cognición, velocidad de la marcha y licencia de conducir en adultos mayores / Association between cognition, gait speed and vehicle habilitation in elderly people

Resumo Objetivo: Investigar a associação entre cognição, velocidade da marcha e resultado final da habilitação veicular de idosos candidatos à Carteira Nacional de Habilitação. Métodos: Estudo quantitativo de corte transversal desenvolvido em 12 clínicas de trânsito de Curitiba/Paraná/Brasil. A amostra do tipo probabilística foi constituída por 421 idosos (≥ 60 anos). Para a coleta de dados foram aplicados o Mini-Exame do Estado Mental (MEEM), teste de velocidade da marcha e realizadas consultas ao formulário Registro Nacional de Condutores Habilitados. A relação entre as variáveis foi identificada por meio do teste de regressão linear múltipla, método stepwise, utilizando-se o programa estatístico R versão 3.4.0. Resultados: Observou-se que, ao aumentar o escore no MEEM em uma unidade a chance do idoso ser considerado inapto temporariamente para dirigir diminui em 54,96% (95%; IC 28,47% - 92,69%; p<0,0001), e ao aumentar uma unidade no escore do MEEM houve um aumento na velocidade da marcha (VM) de 0,0091 (95%; IC 0,0005 - 0,0174; p=0,0366). Conclusão: O elevado escore no MEEM diminuiu a probabilidade do idoso ser considerado inapto temporariamente para dirigir veículos automotores e houve uma tendência de aumento da VM com o aumento dos escores do MEEM. A VM é um importante indicador a ser avaliado em idosos motoristas, logo, é um tópico a ser incluído nas avaliações das clínicas de trânsito, assim como o rastreamento cognitivo, fundamental para avaliar um conjunto de atividades mentais necessárias à direção veicular segura.

Resumen Objetivo: Investigar la relación entre cognición, velocidad de la marcha y obtención del permiso de conducir en adultos mayores que tramitan la licencia de conducir. Métodos: Estudio cuantitativo de corte transversal llevado a cabo en 12 centros médicos de evaluación de tránsito de Curitiba, estado de Paraná, Brasil. La muestra probabilística fue formada por 421 adultos mayores (≥ 60 años). Para la recolección de datos se aplicó el Mini Examen del Estado Mental (MEEM), la prueba de velocidad de la marcha y se realizaron consultas al formulario del Registro Nacional de Conductores Habilitados. La relación entre las variables fue identificada mediante la prueba de regresión lineal múltiple, método stepwise, con el programa de estadística R versión 3.4.0. Resultados: Se observó que, al aumentar la puntuación del MEEM una unidad, la probabilidad de que el adulto mayor sea considerado no apto temporalmente para conducir se redujo un 54,96 % (95 %; IC 28,47 % - 92,69 %; p<0,0001), y al aumentar una unidad la puntuación del MEEM, hubo un aumento en la velocidad de la marcha (VM) de 0,0091 (95 %; IC 0,0005 - 0,0174; p=0,0366). Conclusión: La puntuación del MEEM elevada redujo la probabilidad de que el adulto mayor sea considerado no apto temporalmente para conducir automóviles y hubo una tendencia de aumento de la VM con un aumento de la puntuación del MEEM. La VM es un indicador importante que debe ser evaluado en adultos mayores conductores. Por lo tanto, es un tema que deberá ser incluido en las evaluaciones de los centros médicos de evaluación de tránsito, así como también el rastreo cognitivo, fundamental para analizar un conjunto de actividades mentales necesarias para una conducción vehicular segura.

Abstract Objective: To investigate the association between cognition, gait speed and the result of vehicle habilitation of elderly candidates for the National Driver's License. Methods: Quantitative cross-sectional study developed in 12 traffic agencies in Curitiba, state of Paraná, Brazil. The probabilistic sample consisted of 421 elderly people (≥ 60 years). The Mini-Mental State Examination (MMSE), gait speed testing and consultations to forms of the National Qualified Drivers Registration were used for data collection. The relationship between variables was identified through the multiple linear regression test, stepwise method, using the statistical program R, version 3.4.0. Results: When increasing a unit in the MMSE score, the chance of the elderly person being considered as temporarily unfit to drive decreased by 54.96% (95% CI; 28.47% - 92.69%I; p<0.0001). When increasing a unit in the MMSE score, there was an increase in gait speed (GS) of 0.0091 (95% CI: 0.0005 - 0.0174; p=0.0366). Conclusion: The high MMSE score decreased the probability of the elderly participant being considered temporarily unfit to drive motor vehicles. There was a trend of higher GS with the increase in MMSE scores. As GS is an important indicator to be assessed in elderly drivers, this topic should be included in evaluations of traffic agencies, as well as cognitive screening, which is essential to assess a set of mental activities necessary for safe driving.

Asociación entre el nivel de soledad percibido y el uso de Internet en las personas sin hogar / Association between perceived loneliness and Internet use among homeless people

Resumen El objetivo de este estudio fue explorar la asociación entre los niveles de soledad percibida y el acceso a Internet en personas sin hogar. La muestra estuvo compuesta por un total de 129 personas sin hogar que asistieron a un albergue en Monterrey, México (n=129). Para medir las variables del estudio (uso de Internet y niveles de soledad de las personas sin hogar que asisten a albergues) se administró un cuestionario a cada participante, que contenía tres secciones principales: (1) datos de control; (2) uso de Internet y tecnologías de información; y (3) niveles de soledad social y emocional. Los resultados mostraron que: (1) los niveles de soledad están muy por encima del promedio reportado en estudios con otras poblaciones vulnerables; (2) el 51.9% de los participantes han usado Internet en algún momento y lo usan principalmente para contactar a familiares y amigos; y (3) existe una diferencia nominal, aunque no estadísticamente significativa, entre los niveles de soledad de los que usan Internet y los que no. Los resultados de esta investigación sugieren que proporcionar acceso a Internet en los albergues tiene potencial de impactar positivamente la calidad de vida de sus beneficiarios.

Abstract This study aimed to identify the association between the level of perceived loneliness and Internet use among homeless people. The sample consisted of 129 homeless people who were assisted at a shelter in Monterrey (Mexico). To measure the variables of the study, a survey with three main sections was conducted: demographic data, use of Internet and information technologies, and perceived levels of emotional and social loneliness. The results showed: (1) their levels of loneliness were above the average reported in studies with other vulnerable populations; (2) 51.9% of participants have used the Internet at some point in time and use it mainly to contact family and friends; (3) there is a nominal difference, although not statistically significant, between the levels of loneliness of those who use the Internet and those who do not. These results suggest that providing Internet access in shelters may positively influence the quality of life of its beneficiaries.

Gait speed associated factors in elderly subjects undergoing exams to obtain the driver's license. / Fatores associados à velocidade da marcha em idosos submetidos aos exames para habilitação veicular.

OBJECTIVE: to analyze the factors associated with gait speed in elderly subjects undergoing physical and mental fitness tests to obtain a driver's license. METHOD: a cross-sectional quantitative study conducted in transit agencies. The probabilistic sample included 421 elderly (≥ 60 years old). The study was developed through application of questionnaires and tests that assess the frailty phenotype. For evaluating gait speed, the time spent by each participant to walk a 4.6 meter distance at normal pace on a flat surface was timed. Data were analyzed by using multiple linear regression and the stepwise method. The R statistical program version 3.4.0 was adopted. RESULTS: there was a significant association between gait speed and paid work (<0.0000), body mass index (<0.0000), Mini-Mental State Examination (=0.0366), physical frailty (pre-frail =0.0063 and non-frail <0.0000), age (<0.0000), sex (=0.0255), and manual grip strength (<0.0000). CONCLUSION: elderly drivers who do not work, women of advanced age, high body mass index, low score in the Mini-Mental State Examination, low hand grip strength, and frail tend to decrease gait speed and should be a priority of interventions.

Fatores associados à velocidade da marcha em idosos submetidos aos exames para habilitação veicular / Gait speed associated factors in elderly subjects undergoing exams to obtain the driver's license / Factores asociados a la velocidad de la marcha en los adultos mayores sometidos a los exámenes para habilitación vehicular

Objetivo analisar os fatores associados à velocidade da marcha em idosos submetidos aos exames de aptidão física e mental para habilitação veicular. Método estudo quantitativo de corte transversal realizado nas clínicas de trânsito, no qual fizeram parte da amostra do tipo probabilística 421 idosos (≥ 60 anos). O estudo foi desenvolvido mediante aplicações de questionários e testes que constituem o fenótipo da fragilidade. Para avaliar a velocidade da marcha, cronometrou-se o tempo gasto pelo participante para percorrer uma distância de 4,6 metros, de maneira habitual e em superfície plana. Os dados foram analisados utilizando a regressão linear múltipla por meio do método stepwise. Adotou-se o programa estatístico R versão 3.4.0. Resultados houve associação significativa entre velocidade da marcha e trabalho remunerado (<0,0000), índice de massa corporal (<0,0000), escore do Mini-Exame de Estado Mental (=0,0366), fragilidade física (pré-frágeis =0,0063 e não frágeis <0,0000), idade (<0,0000), sexo (=0,0255) e força de preensão manual (<0,0000). Conclusão idosos motoristas que não trabalham, mulheres, com idade avançada, elevado índice de massa corporal, baixo escore no Mini-Exame de Estado Mental, baixa força de preensão manual e frágeis possuem tendência de diminuição da velocidade da marcha e devem ser prioridade das intervenções.

Objective to analyze the factors associated with gait speed in elderly subjects undergoing physical and mental fitness tests to obtain a driver's license. Method a cross-sectional quantitative study conducted in transit agencies. The probabilistic sample included 421 elderly (≥ 60 years old). The study was developed through application of questionnaires and tests that assess the frailty phenotype. For evaluating gait speed, the time spent by each participant to walk a 4.6 meter distance at normal pace on a flat surface was timed. Data were analyzed by using multiple linear regression and the stepwise method. The R statistical program version 3.4.0 was adopted. Results there was a significant association between gait speed and paid work (<0.0000), body mass index (<0.0000), Mini-Mental State Examination (=0.0366), physical frailty (pre-frail =0.0063 and non-frail <0.0000), age (<0.0000), sex (=0.0255), and manual grip strength (<0.0000). Conclusion elderly drivers who do not work, women of advanced age, high body mass index, low score in the Mini-Mental State Examination, low hand grip strength, and frail tend to decrease gait speed and should be a priority of interventions.

Objetivo analizar los factores asociados a la velocidad de la marcha en adultos mayores sometidos a los exámenes de aptitud física y mental para habilitación vehicular. Método estudio cuantitativo de corte transversal realizado en las clínicas de tránsito, en el cual hicieron parte de la muestra del tipo probabilística 421 adultos mayores (≥ 60 años). El estudio fue desarrollado mediante aplicaciones de cuestionarios y pruebas que constituyen el fenotipo de fragilidad. Para evaluar la velocidad de la marcha fue cronometrado el tiempo gasto por el participante para andar una distancia de 4,6 metros, de manera habitual y en una superficie plana. Los datos fueron analizados utilizándose la regresión linear múltiple por medio del método stepwise. Fue adoptado el programa estadístico R versión 3.4.0. Resultados hubo una asociación significativa entre velocidad de la marcha y trabajo remunerado (<0,0000), índice de masa corporal (<0,0000), puntaje del Mini-Examen de Estado Mental (=0,0366), fragilidad física (pre-frágiles =0,0063 y no frágiles <0,0000), edad (<0,0000), sexo (=0,0255) y fuerza de prensión manual (<0,0000). Conclusión adultos mayores conductores que no trabajan, mujeres, con edad avanzada, elevado índice de masa corporal, bajo puntaje en el Mini-Examen de Estado Mental, baja fuerza de prensión manual y frágil poseen tendencia de disminución de la velocidad de la marcha y deben ser prioridad de las intervenciones.

Physical frailty and gait speed in community elderly: a systematic review. / Fragilidade física e velocidade da marcha em idosos da comunidade: uma revisão sistemática.

OBJECTIVE: To identify the outcomes of studies on gait speed and its use as a marker of physical frailty in community elderly. METHOD: Systematic review of the literature performed in the following databases: LILACS, SciELO, MEDLINE/PubMed, ScienceDirect, Scopus and ProQuest. The studies were evaluated by STROBE statement, and the PRISMA recommendations were adopted. RESULTS: There were 6,303 studies, and 49 of them met the inclusion criteria. Of the total number of studies, 91.8% described the way of measuring gait speed. Of these, 28.6% used the distance of 4.6 meters, and 34.7% adopted values below 20% as cutoff points for reduced gait speed, procedures in accordance with the frailty phenotype. Regarding the outcomes, in 30.6% of studies, there was an association between gait speed and variables of disability, frailty, sedentary lifestyle, falls, muscular weakness, diseases, body fat, cognitive impairment, mortality, stress, lower life satisfaction, lower quality of life, napping duration, and poor performance in quantitative parameters of gait in community elderly. CONCLUSION: The results reinforce the association between gait speed, physical frailty and health indicator variables in community elderly.

Fragilidade física e velocidade da marcha em idosos da comunidade: uma revisão sistemática / Fragilidad física y velocidad de la marcha en personas mayores de la comunidad: una revisión sistemática / Physical frailty and gait speed in community elderly: a systematic review

RESUMO Objetivo: Identificar os desfechos dos estudos sobre velocidade da marcha e seu emprego como marcador de fragilidade física em idosos da comunidade. Método: Revisão sistemática da literatura realizada nas bases de dados LILACS, SciELO, MEDLINE/ PubMed, ScienceDirect, Scopus e ProQuest. Os estudos foram avaliados pelo STROBE e adotaram-se as recomendações do PRISMA. Resultados: Obtiveram-se 6.303 estudos, e 49 deles atenderam aos critérios de inclusão. Do total de estudos, 91,8% descreveram a forma de mensuração da velocidade da marcha. Desses, 28,6% utilizaram a distância de 4,6 metros, e 34,7% adotaram valores abaixo de 20% como pontos de corte para velocidade da marcha reduzida, procedimentos que seguem o fenótipo de fragilidade. Quanto aos desfechos, em 30,6% dos estudos houve associação entre a velocidade da marcha e as variáveis incapacidades, fragilidade, sedentarismo, quedas, fraqueza muscular, doenças, gordura corporal, comprometimento cognitivo, mortalidade, estresse, menor satisfação com a vida, menor qualidade de vida, duração dos cochilos e baixo desempenho em parâmetros quantitativos da marcha em idosos da comunidade. Conclusão: Os resultados reforçam a associação da velocidade da marcha, fragilidade física e variáveis indicadoras de saúde em idosos da comunidade.

RESUMEN Objetivo: Identificar los resultados de los estudios acerca de la velocidad de la marcha y su empleo como marcador de fragilidad física en personas mayores de la comunidad. Método: Revisión sistemática de la literatura realizada en las bases de datos LILACS, SciELO, MEDLINE/PubMed, ScienceDirect, Scopus y ProQuest. Los estudios fueron evaluados por el STROBE y se adoptaron las recomendaciones del PRISMA. Resultados: Se lograron 6.303 estudios, y 49 de ellos atendieron a los criterios de inclusión. Del total de estudios, el 91,8% describieron la forma de medición de la velocidad de la marcha. De esos, el 28,6% utilizaron la distancia de 4,6 metros, y el 34,7% adoptaron valores por debajo del 20% como puntos de corte para velocidad de la marcha reducida, procedimientos que siguen el fenotipo de fragilidad. En cuanto a los resultados, en el 30,6% de los estudios hubo asociación entre la velocidad de la marcha y la variables incapacidades, fragilidad, sedentarismo, caídas, debilidad muscular, enfermedades, grasa corporal, compromiso cognitivo, mortalidad, estrés, menor satisfacción con la vida, menor calidad de vida, duración de las siestas y bajo desempeño en parámetros cuantitativos de la marcha en personas mayores de la comunidad. Conclusión: Los resultados refuerzan la asociación entre la velocidad de la marcha, la debilidad física y las variables indicadoras de salud en personas mayores de la comunidad.

ABSTRACT Objective: To identify the outcomes of studies on gait speed and its use as a marker of physical frailty in community elderly. Method: Systematic review of the literature performed in the following databases: LILACS, SciELO, MEDLINE/PubMed, ScienceDirect, Scopus and ProQuest. The studies were evaluated by STROBE statement, and the PRISMA recommendations were adopted. Results: There were 6,303 studies, and 49 of them met the inclusion criteria. Of the total number of studies, 91.8% described the way of measuring gait speed. Of these, 28.6% used the distance of 4.6 meters, and 34.7% adopted values below 20% as cutoff points for reduced gait speed, procedures in accordance with the frailty phenotype. Regarding the outcomes, in 30.6% of studies, there was an association between gait speed and variables of disability, frailty, sedentary lifestyle, falls, muscular weakness, diseases, body fat, cognitive impairment, mortality, stress, lower life satisfaction, lower quality of life, napping duration, and poor performance in quantitative parameters of gait in community elderly. Conclusion: The results reinforce the association between gait speed, physical frailty and health indicator variables in community elderly.

La terapia ocupacional en personas con trastorno bipolar / Occupational therapy in bipolar disorder

El trastorno bipolar cursa como una enfermedad crónica, es un trastorno mental grave, caracterizado por presentar episodios cíclicos extremos en el estado de ánimo. Esto lleva a la persona a experimentar una sintomatología diversa y variable, que altera el desarrollo normal de las actividades de la vida cotidiana, disminuyendo la calidad de vida de las personas que padecen este trastorno. El objetivo de esta revisión es conocer las intervenciones que puede llevar acabo el Terapeuta Ocupacional en el trastorno bipolar, desde un enfoque psicosocial. Para ello, se ha realizado una revisión bibliográfica en las bases de datos científicas de procedencia sanitaria: Cochrane Plus, Dialnet, LILACS y PubMed. Se identificaron 32 artículos, de los cuales se evalúan los 9 artículos que cumplen con los criterios de inclusión a través de la lectura crítica CASPe (Critical Appraisal Skills Programme). Cabe destacar que los estudios existentes sobre el tratamiento del trastorno bipolar son limitados, las intervenciones psicológicas son tan eficaces como el uso de medicamentos en el tratamiento del trastorno depresivo mayor y pueden mejorar la eficacia de los medicamentos en el tratamiento del trastorno bipolar. Dentro de las intervenciones, la psicoterapia aporta beneficios en resultados sintomáticos y funcionales del trastorno bipolar. A través de la aplicación de distintas terapias, podemos intervenir en diferentes áreas ocupacionales de la vida de personas con trastorno mental. El tratamiento que genera mayor eficacia combina tratamientos farmacológicos, junto a terapias cognitivo - conductuales o psicosociales.

Introduction: Bipolar disorder attends as a chronic disease is a severe mental disorder, characterized by extreme cyclical episodes in the mood. For that reason, people experience diverse and variable symptoms, disrupting the normal development of activities of daily living, decreasing the quality of life of people with this disorder. The purpose of this revision is to determine the role of Occupational Therapy intervention in bipolar disorder, from a psychosocial approach. A literature review was carried out, using some scientific databases of healthcare: Cochrane, Dialnet, LILACS and PubMed. Thirty two articles were identified, of which 9 items that meet the criteria for inclusion through critical reading CASPe (Critical Appraisal Skills Programme) are evaluated. It is necessary consider that the studies on the treatment of bipolar disorder are limited, psychological interventions are as effective as the use of drugs in the treatment of major depressive disorder and can improve the efficacy of drugs in the treatment of bipolar disorder. With respect the intervention, Psychotherapy provides symptomatic and functional benefits of bipolar disorder. Through the application of different therapies, we can intervene in different occupational areas of life in people with mental disorders. The treatment produces more effective drug treatments combined, with cognitive or behavioral therapies.

Vocación ocupacional y género en estudiantes universitarios de ciencias de la salud / Ocupational vocation and gender in health sciences students / Vocação ocupacional e gênero em estudantes do ensino superior de ciências da saúde

El proceso de elección vocacional está conformado por varios elementos, tales como rasgos de personalidad, intereses vocacionales, aptitudes y habilidades. El objetivo de este estudio es conocer la relación entre la vocación y el género en una muestra española de 156 estudiantes de primer curso de las titulaciones de Ciencias de la Salud de Enfermería, Fisioterapia, Podología y Terapia Ocupacional de la Universidad de Málaga. La metodología es cuantitativa y el alcance de esta investigación es descriptivo. El instrumento utilizado fue el cuestionario The Oregon Vocational Interest Scales (Orvis). Los resultados indicaron que hay diferencias significativas en algunas dimensionestrasrealizarla prueba T-Student: Liderazgo (F=6.532; p=0.012), Organización (F=3.818; p=0.05) y Aventura (F=4.211; p=0.029). No obstante, discutimos la necesidad de realizar estudios que contemplen otras variables que puedan influir.

The process of choosing a vocation consists of several elements,such as personality traits, vocational interests, aptitudes and abilities. The aim of this study is toexamine the association between vocation and gender in a sample of 156 first-year Health Sciencesstudents in Spain studying Nursing, Physiotherapy, Podiatry and Occupational Therapy degrees atthe University of Malaga. The methodology used in the study is quantitative and the scope of thisresearch is descriptive. The instrument used by the researchers was the Oregon Vocational InterestScales (ORVIS) questionnaire. The results indicated that significant differences were found in certain dimensions after performing the T-Student test: Leadership (F=6.532; p=0.012), Organization(F=3.818; p=0.05) and Adventure (F=4.211; p=0.029). However, the authors conclude that it isnecessary to study the influence of other variables.

O processo de escolha profissional é composto por vários elementos, tais como traços de personalidade, interesses profissionais, aptidões e habilidades.Este estudo pretende analisar a associação entre o gênero e a vocação numa amostra espanhola de 156 estudantes de Ciências da Saúde do primeiro ano de Enfermagem, Fisioterapia, Podologia e Terapia Ocupacional da Universidade de Málaga .O instrumento utilizado foi o questionário Oregon Vocational Interest Scales (ORVIS). Os resultados mostram que existem diferenças no gênero em algumas dimensões após realizado o teste de T-Student: Liderança (F=6.532; p=0.012), Organização (F=3.818; p=0.05)e Aventura (F=4.211; p=0.029). Não obstante, discutimos a necessidade de realizar estudos que contemplem outras variáveis de influencia.

instant "base-promoted" generation of roper's-type Ru(0) complexes Ru(CO)2(PR3)3 from a simple carbonylchlororuthenium(II) precursor.

An uncommon synergism in the concerted action of OH- and PR3 toward the simple Ru(II) complex Ru(CO)3Cl2(thf) allows a highly efficient reduction of the metal in ethanol or acetonitrile solution at 0 degrees C, with selective production of the corresponding Roper's-type Ru(0) complexes Ru(CO)2(PR3)3 in high yields within 10 min.

[Family involvement in the critically ill patient basic care]. / Implicación familiar en los cuidados del paciente crítico.

UNLABELLED: Objectives. Implementation and valuation of the family member participation in the critically ill patient care.Methodology. Experimental, longitudinal and prospective study, temporal series, with a random control group. This family implication program will be valued according to three dependent parameters: patient, family carer and nursing staff. PATIENT: cognitive state, measured by using the Mini-mental state examination test. Family visitor: family principal carer anxiety state levels, measured using STAI test. Nursing staff: nurses' beliefs about changes introduced in the ICU, valued using attitude Likert type scale.Hypothesis. A family participation program design and implementation in the basic care in the critic patient has positive and significantly influence in the patient, family career and nursing staff.Results. The sample was of 117 cases; 49 in control group, 49 in experimental group and 19 no valid. The STAI test obtained in the experimental group a mean of 23.57 against control group of 31.22 (p <.005). Minimental test was a mean of 23.43 for control group and 24.61 for experimental group. Nursing staff thinks the open visit provides emotional support (p =.005). Although they think the pain perception is great with the family presence (p =.013). The family satisfaction grows up (p =.026). Nursing staff thinks they are more prepared to have a better relationship with the family (p =.021). The belief that the open visit produces a bigger physics and psychic burden is decreasing (p =.03).Conclusions. The anxiety levels are decreasing significantly. The cognitive state is not modified in the experimental group against the control group after the intervention. The nursing staff believes are better respect the open visit.

Implicación familiar en los cuidados del paciente crítico / Family involvement in the critically ill patient basic care

Objetivo. Implementación y valoración de un programa de participación familiar en los cuidados del paciente crítico. Diseño. Estudio experimental, longitudinal y prospectivo, de series temporales y grupo de control aleatorio con tres variables dependientes: paciente, cuidador principal y personal sanitario. Paciente: estado cognitivo del enfermo evaluado con Minimental State Examination Test. Cuidador principal: niveles de ansiedad estado de los cuidadores principales (STAI).Personal: opinión de las enfermeras sobre los cambios introducidos medidos mediante escala tipo Likert. Hipótesis. El diseño y la implementación de un programa de participación familiar en los cuidados básicos del paciente crítico, influyen positiva y significativamente en el enfermo, el familiar y los profesionales implicados en él. Se realizó un muestreo aleatorio sistemático hasta alcanzar el tamaño muestral establecido. Resultados. Muestra de 117 casos, 49 grupo control, 49 grupo experimental y 19 no válidos. El test de STAI obtuvo una media en el grupo experimental de 23,57 frente a 31,22 del grupo control (p < 0,005 para la diferencia). En el test Minimental se obtuvo una media de 23,43 para el grupo control y 24,61 para el grupo experimental, después de la intervención. Según el personal de enfermería la visita abierta proporciona apoyo emocional (p = 0,05), la percepción del dolor es mayor con la presencia de la familia (p = 0,013), aumenta la satisfacción de la familia (p = 0,026) y creen estar más preparados para relacionarse (p = 0,021). Disminuye la creencia de que la visita abierta produce una mayor carga física y psíquica (p = 0,03). Conclusiones. Disminución significativa del grado de ansiedad. No se modifica el estado cognitivo en el grupo experimental frente al grupo control después de la intervención. Mejoría progresiva de las creencias del personal de enfermería con respecto a la visita abierta (AU)