Crash Risk Predictors in Older Drivers: A Cross-Sectional Study Based on a Driving Simulator and Machine Learning Algorithms.

The ability to drive depends on the motor, visual, and cognitive functions, which are necessary to integrate information and respond appropriately to different situations that occur in traffic. The study aimed to evaluate older drivers in a driving simulator and identify motor, cognitive and visual variables that interfere with safe driving through a cluster analysis, and identify the main predictors of traffic crashes. We analyzed the data of older drivers (n = 100, mean age of 72.5 ± 5.7 years) recruited in a hospital in São Paulo, Brazil. The assessments were divided into three domains: motor, visual, and cognitive. The K-Means algorithm was used to identify clusters of individuals with similar characteristics that may be associated with the risk of a traffic crash. The Random Forest algorithm was used to predict road crash in older drivers and identify the predictors (main risk factors) related to the outcome (number of crashes). The analysis identified two clusters, one with 59 participants and another with 41 drivers. There were no differences in the mean of crashes (1.7 vs. 1.8) and infractions (2.6 vs. 2.0) by cluster. However, the drivers allocated in Cluster 1, when compared to Cluster 2, had higher age, driving time, and braking time (p < 0.05). The random forest performed well (r = 0.98, R2 = 0.81) in predicting road crash. Advanced age and the functional reach test were the factors representing the highest risk of road crash. There were no differences in the number of crashes and infractions per cluster. However, the Random Forest model performed well in predicting the number of crashes.

The effects of motor adaptation on ankle isokinetic assessments in older drivers.

OBJECTIVES: This study sought to analyze the extent of motor adaptation in ankle plantar flexors and dorsiflexors among older drivers during clinical isokinetic testing. METHODS: One hundred older adults (70.4±5.7 years) participated in two bilateral ankle plantar flexor and dorsiflexor isokinetic assessments at 30°/sec. Peak torque (PTQ), PTQ adjusted for body weight (PTQ/BW), and total work (TW) were analyzed. RESULTS: On the dominant side, PTQ/BW and TW were significantly greater for the second plantar flexion test than were those for the first such test (p<0.001), whereas PTQ, PTQ/BW, and TW (p<0.001) were significantly greater for the second dorsiflexion test than were those for the first such test. On the non-dominant side, plantar flexion PTQ and TW were significantly lower for the second test than were those for the first test (p<0.001). CONCLUSION: Older drivers demonstrated better performance with the dominant limb on the second test. The low variability in test execution showed the existence of a motor adaptation effect for the tested movements, despite the short recovery period between the assessments.

The effects of motor adaptation on ankle isokinetic assessments in older drivers

OBJECTIVES: This study sought to analyze the extent of motor adaptation in ankle plantar flexors and dorsiflexors among older drivers during clinical isokinetic testing. METHODS: One hundred older adults (70.4±5.7 years) participated in two bilateral ankle plantar flexor and dorsiflexor isokinetic assessments at 30°/sec. Peak torque (PTQ), PTQ adjusted for body weight (PTQ/BW), and total work (TW) were analyzed. RESULTS: On the dominant side, PTQ/BW and TW were significantly greater for the second plantar flexion test than were those for the first such test (p<0.001), whereas PTQ, PTQ/BW, and TW (p<0.001) were significantly greater for the second dorsiflexion test than were those for the first such test. On the non-dominant side, plantar flexion PTQ and TW were significantly lower for the second test than were those for the first test (p<0.001). CONCLUSION: Older drivers demonstrated better performance with the dominant limb on the second test. The low variability in test execution showed the existence of a motor adaptation effect for the tested movements, despite the short recovery period between the assessments.

Relation between the Sensory and Anthropometric Variables in the Quiet Standing Postural Control: Is the Inverted Pendulum Important for the Static Balance Control?

UNLABELLED: The aim of this study was to evaluate the relation between the sensory and anthropometric variables in the quiet standing. METHODS: One hundred individuals (50 men, 50 women; 20-40 years old) participated in this study. For all participants, the body composition (fat tissue, lean mass, bone mineral content, and bone mineral density) and body mass, height, trunk-head length, lower limb length, and upper limb length were measured. The center of pressure was measured during the quiet standing posture, the eyes opened and closed with a force platform. Correlation and regression analysis were run to analyze the relation among body composition, anthropometric data, and postural sway. RESULTS: The correlation analysis showed low relation between postural sway and anthropometric variables. The multiple linear regression analyses showed that the height explained 12% of the mediolateral displacement and 11% of the center of pressure area. The length of the trunk head explained 6% of displacement in the anteroposterior postural sway. During eyes closed condition, the support basis and height explained 18% of mediolateral postural sway. CONCLUSION: The postural control depends on body composition and dimension. This relation is mediated by the sensory information. The height was the anthropometric variable that most influenced the postural sway.

Projeto "Convivendo com Idosos": uma experiência do Núcleo de Estudo e Pesquisa do Envelhecimento, da PUC-SP, no Asilo de Inválidos de Santos / Project Living with the Elderly: an experience of the Nucleus for the Study and Research on Aging of the Catholic University of São Paulo at Santos's Home for the Disabled

O projeto "Convivendo com Idosos", elaborado por mestrandos em Gerontologia da PUC-SP no ano 2000, atendendo à solicitação de instituição asilar, concretizou-se em dois cursos básicos de Gerontologia, que possibilitaram novos conhecimentos da academia àqueles que cuidam de idosos sem ter preparo anterior para esse encargo, permitindo-lhes um desempenho de melhor qualidade, na medida em que passaram a percebê-los em sua individualidade e complexidade.

Projeto "Convivendo com Idosos": uma experiência do Núcleo de Estudo e Pesquisa do Envelhecimento, da PUC-SP, no Asilo de Inválidos de Santos / Project "Living with the Elderly": an experience of the Nucleus for the Study and Research on Aging of the Catholic University of São Paulo at Santos's Home for the Disabled

O projeto 'Convivendo com Idosos', elaborado por mestrandos em Gerontologia da PUC-SP no ano 2000, atendendo à solicitação de instituição asilar, concretizou-se em dois cursos básicos de Gerontologia, que possibilitaram novos conhecimentos da academia àqueles que cuidam de idosos sem ter preparo anterior para esse encargo, permitindo-lhes um desempenho de melhor qualidade, na medida em que passaram a percebê-los em sua individualidade e complexidade (AU)

Associaçäo de paralisia diafragmática bilateral e paralisia da cintura escapular após correçäo de aneurisma de aorta: relato de caso / Association between bilateral diaphragmatic paralysis and scapular girdle paralysis after aortic aneurysm correction: case report

A associaçäo de paralisia diafragmática bilateral e paralisia da cintura escapular é uma complicaçäo rara após correçäo de aneurisma de aorta ascendente. Esta associaçäo leva à uma forma grave de insuficiência respiratória cujo sucesso do desmame da ventilaçäo mecânica é dependente da capacidade da musculatura respiratória remanescente em compensar o trabalho respiratório excedente. Fisioterapia respiratória intensiva com treinamento da musculatura, correçäo dos distúrbios metabólicos, tratamento das infecçöes respiratórias associadas à ventilaçäo mecânica e otimizaçäo do suporte nutricional foram fundamentais para o sucesso do desmame