The importance of optimal 25-hydroxyvitamin D levels in the glycemic control of older adults with type 2 Diabetes Mellitus: Data from the study on aging and longevity EELO

INTRODUCTION: Optimal serum levels of vitamin D are of great importance, especially in populations with comorbidities such as Diabetes Mellitus (DM). OBJECTIVE: The study evaluated the relationship between hypovitaminosis D and glycemic control in older adults with type 2 DM. METHODS: Cross-sectional and prospective study, part of the EELO project (Study on Aging and Longevity), conducted in Southern Brazil. Glycated hemoglobin (diabetes ≥6.5%) and serum levels of vitamin D (25(OH)D) were evaluated. Hypovitaminosis D was determined using cutoff points <20 and <30 ng/mL). Multivariate logistic regression was used to assess the risk of having uncontrolled DM. RESULTS: Of the 120 older adults included in the study, aged between 60 and 87 years, 74.2% were women, 66.7% used hypoglycemic medications and 75.8% exhibited uncontrolled diabetes. An inverse correlation was observed between the levels of 25(OH) D and glycated hemoglobin (rS=-0.19, p=0.037), suggesting that low levels of vitamin D are associated with poor glycemic control in diabetic individuals. The prevalence of hypovitaminosis D when using the cutoff points of <20 and <30 ng/mL were 34.2% and 75.0%, respectively. The odds ratio (OR) analysis showed that individuals with 25(OH)D<20ng/mL have almost 4 times more risk of having uncontrolled DM (OR:3.94; CI95%:1.25-12.46, p=0.02) when compared to the older adults with sufficient levels of vitamin D. CONCLUSION: The results indicate that the optimal serum levels currently recommended for 25(OH)D should preferably be 30 ng/mL or higher to contribute to better glycemic control in older adults with type 2 DM.

INTRODUÇÃO: Os níveis séricos ideais de vitamina D são de grande importância, especialmente na população com comorbidades como o Diabetes Mellitus (DM). OBJETIVO: O estudo avaliou a relação entre hipovitaminose D e controle glicêmico em idosos com DM tipo 2. MÉTODOS: Estudo transversal e prospectivo, parte do projeto EELO (Estudo sobre Envelhecimento e Longevidade), no Sul do Brasil. A hemoglobina glicada (diabetes ≥6,5%) e os níveis séricos de vitamina D (25(OH)D) foram avaliados. Hipovitaminose D foi determinada usando ponto de corte <20 e <30 ng/mL. Regressão logística multivariada foi utilizada para avaliar o risco de ter DM descompensado. RESULTADOS: Dos 120 idosos incluídos no estudo, idade entre 60 a 87 anos, 74,2% eram mulheres, 66,7% faziam uso de medicamentos hipoglicemiantes e 75,8% apresentavam diabetes descompensada. Uma correlação inversa foi observada entre os níveis de 25(OH)D e hemoglobina glicada (rS=-0,19; p=0.037), sugerindo que baixos níveis de vitamina D está associado a um pior controle glicêmico em diabéticos. A prevalência de hipovitaminose D quando se utiliza ponto de corte <20 e <30 ng/mL foi de 34,2% e 75,0%, respectivamente. A análise Odds ratio (OR) mostrou que indivíduos com 25(OH)D<20 ng/mL tem quase 4 vezes mais risco de ter DM descompensado (OR:3,94; IC95%:1,25­12,46; p=0,02) quando comparado aos idosos com níveis suficientes de vitamina D. CONCLUSÃO: Os resultados indicam que os níveis sérios ideais atualmente recomendados para 25(OH)D maior ou igual a 30 ng/ml contribuem para o melhor controle glicêmico na população idosa com DM tipo 2.

Hypovitaminosis D, Low Bone Mineral Density, and Diabetes Mellitus as Probable Risk Factors for Benign Paroxysmal Positional Vertigo in the Elderly

Abstract Introduction Studies have found that elderly patients with benign paroxysmal positional vertigo (BPPV) may present low levels of vitamin D (25 (OH) D), changes in bone mineral density, and diabetes mellitus (DM). Objective To investigate the possible association between BPPV, bone mineral density, hypovitaminosis D, 25 (OH) D and DM. Methods The sample consisted of 109 elderly subjects. The BPPV was verified by a standardized questionnaire and the Dix-Hallpike maneuver. Blood samples were collected for the investigation of 25 (OH) D serum levels. The bone mineral density was evaluated by means of a densitometer. Diabetes mellitus verification was performed using a self-reported questionnaire. Results Of the 109 participants, 17 had BPPV. There was a statistically significant difference between BPPV and gender (p= 0.027, phi = 0.222), with female representing 88.2% of those with BPPV. In the group with BPPV, there was a statistically significant difference for the amount of vitamin D found (p= 0.001) and for age (p= 0.001). In the elderly group with DM and BPPV, a difference was found for the standard deviation of the femur (p= 0.022) with posthoc Dunn, identifying the difference between diabetics with and without BPPV (p= 0.047). Conclusion Although no association was found (25 (OH) D levels) with BPPV in the general population of this study, it was observed that there was an association with bone mineral density in the elderly group with DM and BPPV, and, in the group with BPPV, there was an association between the amount of vitamin D and age.

Hypovitaminosis D, Low Bone Mineral Density, and Diabetes Mellitus as Probable Risk Factors for Benign Paroxysmal Positional Vertigo in the Elderly.

Introduction Studies have found that elderly patients with benign paroxysmal positional vertigo (BPPV) may present low levels of vitamin D (25 (OH) D), changes in bone mineral density, and diabetes mellitus (DM). Objective : To investigate the possible association between BPPV, bone mineral density, hypovitaminosis D, 25 (OH) D and DM. Methods The sample consisted of 109 elderly subjects. The BPPV was verified by a standardized questionnaire and the Dix-Hallpike maneuver. Blood samples were collected for the investigation of 25 (OH) D serum levels. The bone mineral density was evaluated by means of a densitometer. Diabetes mellitus verification was performed using a self-reported questionnaire. Results Of the 109 participants, 17 had BPPV. There was a statistically significant difference between BPPV and gender ( p = 0.027, phi = 0.222), with female representing 88.2% of those with BPPV. In the group with BPPV, there was a statistically significant difference for the amount of vitamin D found ( p = 0.001) and for age ( p = 0.001). In the elderly group with DM and BPPV, a difference was found for the standard deviation of the femur ( p = 0.022) with posthoc Dunn, identifying the difference between diabetics with and without BPPV ( p = 0.047). Conclusion Although no association was found (25 (OH) D levels) with BPPV in the general population of this study, it was observed that there was an association with bone mineral density in the elderly group with DM and BPPV, and, in the group with BPPV, there was an association between the amount of vitamin D and age.

Cross-cultural adaptation of wheelchair skills test (version 4.3) for wheelchair users and caregivers to the Portuguese language (Brazil).

Objective: To perform cross-cultural adaptation of the Wheelchair Skills Test of manual wheelchair users and their caregivers into the Brazilian Portuguese language.Methods: The study was composed of translation, synthesis of translations, back-translation, review by an expert committee and pre-test, when the test was applied in the target population. Included were translators, subject specialists and coordinators to carry out the cross-cultural adaptation process, and manual wheelchair users and their caregivers with at least six months of wheelchair experience for the pre-test.Results: Forty-three people participated in the study, 30 for the pre-test and 13 for the stages that preceded the pre-test. The mean age of manual wheelchair users was 40.2 (±10.7) years and of caregivers was 44.2 (±15.7) years. Of the 47 phrases translated in the first stage, 36 discrepancies were found and resolved. During the analysis by the committee of experts the instrument underwent 13 modifications in order to achieve the best possible equivalence between the original version and the final version and was understandable by the people evaluated. The total pre-test scores of wheelchair users and their caregivers were 66.2 (±24.6) and 88.7 (±14.2), respectively.Conclusions: This instrument was able to evaluate the abilities of wheelchair users and their caregivers in Brazil, as well as being useful for training in rehabilitation programs.Implications for rehabilitationThe need to use wheelchair (WC) properly has made clinicians and rehabilitation professionals more concerned with assessing and training users' abilities with their WC.Cross-cultural adaptation allows for the linguistic modification of the original language of the evaluation tool into a new language and enables the comparison of research results in different countries.Immediate use of the instrument for WC users and caregivers in Brazil, both for evaluation and for training, is necessary and may be a means for rehabilitation professionals to improve their evaluations, their treatments and optimize the skills that aim at independence.

Cross-cultural adaptation and face validity of the Wheelchair Skills Test Questionnaire (Version 4.3) for caregivers / Adaptação transcultural e validade face do Wheelchair Skills Test Questionnaire (versão 4.3) para cuidadores

Abstract Introduction: In Brazil, there is a gap of assessment, encompassing the use of assistive technology and functional mobility of wheelchairs users and caregivers. The Wheelchair Skills Program (WSP) is an integrated system that includes elements for testing and training wheelchair users, clinicians and/or their caregivers. Objective: Cross-cultural adaptation of the Portuguese-Brazil version of the Wheelchair Skill Test Questionnaire (WST-Q Version 4.3), a component of the WSP, and to examine its face validity. Method: Interactive steps were applied to produce Portuguese-Brazil versions of the WST-Q. The Cultural, Idiomatic, Semantic and Conceptual Equivalences were evaluated by a Committee of Specialists. Fifteen informal caregivers were evaluated with the WST-Q Brazil. Results: Twenty-eight of the 131 sentences were modified for further understanding. Subsequent semantic analysis reached 96.18% agreement, and language equivalence (100%), cultural (99.2%) and conceptual (100%) agreement. The questionnaire was easily understood between caregivers and the expert committee judged the Brazilian version equivalent to Canadian original. Conclusion: Success was achieved in cross-cultural adaptation of the tool, members of the expert committee judged the Brazilian version equivalent to the original Canadian. The WST-Q Brazil version 4.3 for caregivers contemplated 33 wheelchair transfer skills, mobility outdoor and indoor.

Resumo Introdução: No Brasil, existe uma lacuna de ferramentas de avaliação que avaliem o uso da tecnologia assistiva e a mobilidade funcional de pessoas que usam cadeira de rodas e seus cuidadores. O Wheelchair Skills Program (WSP) é um sistema integrado que inclui instrumentos para a avaliação e o treino de usuários de cadeira de rodas, cuidadores e profissionais. Objetivos: Realizar a Adaptação transcultural para o Português do Brasil do Wheelchair Skill Test Questionnaire (WST-Q Version 4.3) - destinada aos cuidadores, um instrumento componente do WSP, além de avaliar a sua validade de face junto aos respondentes. Método: Foram aplicadas etapas interativas para produção da versão brasileira do WST-Q. Foram avaliadas as Equivalências Cultural, Idiomática, Semântica e Conceitual por um Comitê de Especialistas. Participaram quinze cuidadores informais (n=15), os quais foram avaliados com WST-Q Brasil. Resultados: Vinte e oito, das 131 frases, foram modificadas para maior entendimento. A análise semântica posterior alcançou 96,18% de concordância, e as equivalências idiomática (100%), cultural (99,2%) e conceitual (100%) de concordância O questionário se mostrou prático e de fácil compreensão entre a população alvo e comitê de especialistas. Conclusão: Obteve-se êxito na adaptação transcultural da ferramenta, os membros do comitê de especialistas julgaram a versão brasileira equivalente a original canadense. O WST-Q Brasil versão 4.3 para cuidadores contemplou 33 habilidades em cadeira de rodas de transferência, mobilidade dentro e fora de casa.

Caracterização do Estilo de Vida de Universitários do Ensino Superior a Distância / Characterization of distance Higher Education Lifestyle

O objetivo deste estudo foi avaliar os aspectos do estilo de vida em jovens estudantes universitários da modalidade Ensino a Distância (EaD). Deste estudo transversal, participaram 104 universitários dos seguintes cursos: Pedagogia, Serviço Social e Licenciatura em Educação Física. Os instrumentos utilizados para coleta de dados foram três questionários: geral com a caracterização da população entrevistada, IPAQ para investigar o nível de atividade física habitual e o questionário estilo de vida fantástico. Para a análise estatística foi utilizado o software SPSS versão 20.0, para a descrição das variáveis pelo teste de Kruskal-Wallis para comparação entre os grupos. A média de idade foi de 30±9 anos, prevalecendo o sexo feminino com 63,4%. Em relação ao estilo de vida, 18% apresentaram-se na escala "regular", 54% "bom", 25% "muito bom" e 3% "excelente". Observou-se que mais da metade dos universitários dos cursos de graduação do EaD foi classificada com um bom estilo de vida, porém os muito ativos apresentaram um pior escore. Estes resultados têm implicações para a caracterização do perfil universitário e permitem o desenvolvimento de programas de promoção da saúde específicos para disseminação e conscientização dos jovens adultos a adquirirem comportamentos saudáveis relacionados ao seu estilo de vida.(AU).

The aim of this study was to evaluate the Distance Education (EAD) Youth University Students lifestyle. 104 University students took part of this study belonging to the courses: Pedagogy, Social Work and Physical Education Teaching Degree. To give support to Research three questionnaires were used :General Questionnaire which aims the characterization of the Interviewed population, the International Physical Activity Questionnaire (IPAQ) and a lifestyle questionnaire. The mean age was 30 ± 9 years, prevailing the female gender with 63.4%. Regarding the scale lifestyle, 18% were "regular", 54% "good", 25% "very good" and 3% "excellent". This study analyzed through the questionnaires and statistical analysis program SPSS, that more than half of Undergraduate Distance Universiy courses, were classified asgood lifestyle, however, the very active ones had the worst scores.. These results have implications for the university profile characterization and allow the development of specific health promotion programs for the dissemination and awareness of Young Adults to acquire healthy behaviors concerning their lifestyle.(AU).

Avaliação dos Níveis de Atividade Física em Estudantes Universitários do Ensino a Distância / Evaluation of the Level of Physical Activity in University Students of Distance Education

Atualmente tem se observado que as incidências de mortes são ocasionadas por fatores relacionados ao comportamento humano, como no casoda inatividade física. Esta pesquisa se objetivou em avaliar o nível de atividade física habitual - AF em relação ao índice de massa corpórea -IMC em universitários do Ensino a distância - EaD, por meio do Questionário Internacional de Atividade Física - IPAQ. É um estudo do tipotransversal com o total de 107 universitários do EaD. Para as coletas de dados foi utilizado o questionário geral e o questionário IPAQ. O IMCfoi calculado pela equação IMC= peso corporal (Kg)/ altura (m)2, considerando os valores <18,5 kg abaixo do peso; e entre 18,5-24,9 kg peso normal; 25-29,9 kg sobrepeso; 30-34,9 kg obesidade leve; 35-39,9 kg obesidade moderada e obesidade mórbida >40 kg (CUNHA, 2009). A média de idade foi de 30,1±9,7 anos, prevalecendo o sexo feminino com 61,6%. Dos 107 entrevistados, 64,4% são praticantes de AF. Quanto ao IMC, 6,5% estão abaixo do peso; 46% estão no peso normal; 33% estão com sobrepeso; 9,3% estão com obesidade leve; 2% com obesidade moderada; 3,8% com obesidade mórbida, sendo 1,8%. Através dos dados analisados por meio do questionário GERAL, IPAQ e pelo programa de análise estatística SPSS se verificou que quanto maior o IMC, pior é a classificação quanto ao nível de atividade física. Sendo assim, nota-se a importância de ações voltadas para os universitários praticarem atividade física, além de estratégicas voltadas para a promoção da saúde e prevenção de doenças provenientes do sedentarismo.(AU);

It has now been observed that the incidence of deaths is caused by factors related to human behavior, as in the case of physical inactivity. This study aimed to evaluate the level of habitual physical activity (FA) in relation to the body mass index (BMI) in distance learning university students (EAD), through the International Questionnaire of Physical Activity (IPAQ). It is a cross-sectional study with a total of 107 university students. For data collection, the general questionnaire and the IPAQ questionnaire were used. The BMI was calculated by the equation BMI = body weight (kg) / height (m) 2, considering values <18.5 kg below weight; And between 18.5-24.9 kg normal weight; 25-29.9 kg overweight; 30-34.9 kg light obesity; 35-39.9 kg moderate obesity and morbid obesity> 40 kg (CUNHA, 2009). The mean age was 30.1 ± 9.7 years, prevailing the female sex with 61.6%. Of the 107 interviewees, 64.4% are AF practitioners. Regarding BMI 6.5% are underweight; 46% are in normal weight; 33% are overweight; 9.3% are lightly obese; 2% with moderate obesity; 3.8% with morbid obesity, being 1.8%. Through the data analyzed through the questionnaire GENERAL, IPAQ and the program of statistical analysis SPSS, it was verified that the higher the BMI, the worse the classification concerning the level of physical activity. Thus, we notice the importance of actions aimed at university students to practice physical activity, as well as strategies aimed at health promotion and prevention of sedentrary individuals' diseases.(AU);

Is There a Possible Association between Dietary Habits and Benign Paroxysmal Positional Vertigo in the Elderly? The Importance of Diet and Counseling

Introduction Poor diet habits and inadequate intake of nutrients are a concern in the elderly. Nutritional education with guidance may improve the results of the treatment of vertigo. Objective Evaluate the presence of benign paroxysmal positional vertigo (BPPV) associated with feeding habits. Methods Cross-sectional study with elderly people living independently.We evaluated nutritional habits through themethod of dietary 24-hour recall andmanipulation of Dix-Hallpike. Results Based on a sample of 487 individuals, 117 had BPPV. Among the 117 elderly patients with BPPV, 37 (31.62%) had inadequate feeding. From those 370 individuals without BPPV, 97 (26.21%) had inappropriate feeding. No significant association between nutritional habits and BPPV in the total population was observed (p = 0.3064). However, there was significant relation between BPPV and inadequate carbohydrate intake (p = 0.0419) and insufficient fiber intake (p = 0.03), and the diet of these subjects was rich in polyunsaturated fatty acids (p = 0.0084). Conclusion These data correlate with the dyslipidemia and hypertriglyceridemia status, making it extremely important to reduce the intake of fats and carbohydrates and increase the fiber intake to stabilize triglycerides and thus minimize harmful effects on the inner ear. Food readjustment is suggested in patients with BPPV, along with the work of a multidisciplinary team to improve the quality of the elderly.(AU)

Is There a Possible Association between Dietary Habits and Benign Paroxysmal Positional Vertigo in the Elderly? The Importance of Diet and Counseling.

Introduction Poor diet habits and inadequate intake of nutrients are a concern in the elderly. Nutritional education with guidance may improve the results of the treatment of vertigo. Objective Evaluate the presence of benign paroxysmal positional vertigo (BPPV) associated with feeding habits. Methods Cross-sectional study with elderly people living independently. We evaluated nutritional habits through the method of dietary 24-hour recall and manipulation of Dix-Hallpike. Results Based on a sample of 487 individuals, 117 had BPPV. Among the 117 elderly patients with BPPV, 37 (31.62%) had inadequate feeding. From those 370 individuals without BPPV, 97 (26.21%) had inappropriate feeding. No significant association between nutritional habits and BPPV in the total population was observed (p = 0.3064). However, there was significant relation between BPPV and inadequate carbohydrate intake (p = 0.0419) and insufficient fiber intake (p = 0.03), and the diet of these subjects was rich in polyunsaturated fatty acids (p = 0.0084). Conclusion These data correlate with the dyslipidemia and hypertriglyceridemia status, making it extremely important to reduce the intake of fats and carbohydrates and increase the fiber intake to stabilize triglycerides and thus minimize harmful effects on the inner ear. Food readjustment is suggested in patients with BPPV, along with the work of a multidisciplinary team to improve the quality of the elderly.

Influência do tratamento com fármacos antivertiginosos sobre o equilíbrio postural e qualidade de vida de indivíduos com queixas de tontura / Influence of antivertigo drugs on postural balance and health-related quality of life of individuals with dizziness complaints

Resumo:OBJETIVO:avaliar a influência do tratamento com fármacos antivertiginosos sobre a qualidade de vida e o equilíbrio postural de adultos e idosos com queixas de tontura.MÉTODOS:estudo transversal, com amostra de 51 indivíduos portadores de queixas de tontura, divididos em dois grupos, de acordo com o uso (grupo medicado, n=25) ou não (grupo não medicado, n=26) de fármacos antivertiginosos. Foram coletadas informações sobre: caracterização dos sintomas (ficha elaborada pelos pesquisadores), autopercepção de qualidade de vida (Dizziness Handicap Inventory),intensidade de tontura (escala visual analógica de tontura) e equilíbrio postural (plataforma de força).RESULTADOS:verificou-se intensidade moderada de tontura (Média: 4,6 ± 2,8) e impacto negativo das vestibulopatias sobre a qualidade de vida (Média: 47,3 ± 22,4) na amostra total. Quando comparados os dois grupos, não houve diferença estatisticamente significante na intensidade da tontura (p=0,74) ou qualidade de vida (p=0,79), e também, nos parâmetros da estabilometria, em quatro tarefas (teste t independente, p>0,05). Contudo, após a inclusão do tempo de utilização de fármacos antivertiginosos como uma covariável do estudo, foi verificado pior desempenho nas diferentes tarefas da estabilometria no grupo medicado (ANCOVA, p<0,05).CONCLUSÃO:o uso de fármacos antivertiginosos não melhora a qualidade de vida de indivíduos com queixas de tontura e o equilíbrio postural esteve alterado no grupo medicado.

Abstract:PURPOSE:this study aimed to identify the influence of anti-vertigo drugs on the health-related quality of life and balance in adults and elder individuals with dizziness complaints.METHODS:51 individuals with dizziness complaints were enrolled at this cross-sectional study. The sample was divided into two groups according to chronic use of antivertigo drugs (medicated group, n=25 or non-medicated group, n=26). Information regarding vertigo-related symptoms, health-related quality of life (through Dizziness Handicap Inventory), dizziness intensity (measured by dizziness visual analogue scale) and postural balance (using a force platform) were assessed in all subjects recruited.RESULTS:a moderate intensity of dizziness was observed (Mean: 4.6 ± 2.8) as well as negative impact on health-related quality of life (Mean: 47.3 ± 22.4) at this sample. When medicated and non-medicated groups were compared, no statistically differences were observed concerning dizziness intensity (p=0.74) and health-related quality of life (p=0.79). Similar results were observed regarding balance parameters (Unpaired t test, p > 0.05). However, after including the time duration of antivertigo drugs' use as a covariable of this study, a worse balance in different balance tasks was observed at the medicated group (ANCOVA, p<0.05).CONCLUSION:no benefits concerning the symptoms or health-related quality of life were observed after chronic treatment with anti-vertigo drugs. On the other hand, worse balance control was observed in medicated group.

Effectiveness of a vestibular rehabilitation protocol to improve the health-related quality of life and postural balance in patients with vertigo

Introduction Dizziness can be characterized as a balance disorder that causes discomfort, leading to several functional limitations. Currently, vestibular rehabilitation has been highlighted as a possible treatment. Objective Analyze the effects of completing a vestibular rehabilitation treatment protocol on quality of life and postural balance in patients with vestibular complaints, as well as to compare these effects between the patients taking or not taking antivertigo drugs. Methods A nonrandomized controlled trial was performed with 20 patients previously diagnosed with vestibular diseases. Information regarding vertigo symptoms, quality of life as assessed through the Dizziness Handicap Inventory, visual analog scale of dizziness, and stabilometry using force platform was collected. Patients were treated for 12 weeks by a customprotocol. The sample was divided into two groups according to the use (medicated group, n = 9) or not (control group, n = 11) of antivertigo drugs. Results There was improvement in quality of life (p < 0.001) and intensity of dizziness (p = 0.003) with the intervention. An improvement of postural balance was observed through functional tests. However, no statistically significant difference was noted in stabilometry. When both groups were compared, no statistically significant differences between the variations of the variables analyzed were found in the re-evaluation session. Conclusion Quality of life and postural balance are improved with intervention. However, this improvement is not associated with pharmacologic treatment.

Effectiveness of a Vestibular Rehabilitation Protocol to Improve the Health-Related Quality of Life and Postural Balance in Patients with Vertigo.

Introduction Dizziness can be characterized as a balance disorder that causes discomfort, leading to several functional limitations. Currently, vestibular rehabilitation has been highlighted as a possible treatment. Objective Analyze the effects of completing a vestibular rehabilitation treatment protocol on quality of life and postural balance in patients with vestibular complaints, as well as to compare these effects between the patients taking or not taking antivertigo drugs. Methods A nonrandomized controlled trial was performed with 20 patients previously diagnosed with vestibular diseases. Information regarding vertigo symptoms, quality of life as assessed through the Dizziness Handicap Inventory, visual analog scale of dizziness, and stabilometry using force platform was collected. Patients were treated for 12 weeks by a custom protocol. The sample was divided into two groups according to the use (medicated group, n = 9) or not (control group, n = 11) of antivertigo drugs. Results There was improvement in quality of life (p < 0.001) and intensity of dizziness (p = 0.003) with the intervention. An improvement of postural balance was observed through functional tests. However, no statistically significant difference was noted in stabilometry. When both groups were compared, no statistically significant differences between the variations of the variables analyzed were found in the re-evaluation session. Conclusion Quality of life and postural balance are improved with intervention. However, this improvement is not associated with pharmacologic treatment.

Prevalence of risk factors for the occurrence of strokes in the elderly / Prevalência de fatores de risco para a ocorrência de acidente vascular encefálico em idosos

Introduction Stroke (CVA) is a multifactorial disease, where the combination of risk factors may be associated with and contribute to its development. Objectives The objective of this study was to evaluate the prevalence of risk factors for stroke in the physically independent elderly in the city of Londrina, Brazil. Materials and methods This study was composed of the elderly individuals participating in the EELO project (Age and Ageing Study, Londrina, State of Paraná, Brazil). In order to identify the risk factors for stroke, one used a structured questionnaire with information about socio-demographic and anthropometric data as well as lifestyle variables, such as physical inactivity and smoking, presence of comorbidities, and laboratory tests for diagnosis of diabetes and dyslipidemia. Results The study included 454 elderly with mean age of 69.7 years. There was a significant relationship between the number of risk factors and gender (p = 0.01), with higher prevalence among women. In separate analysis, the elderly between 60 and 69 years had a higher incidence of obesity (p = 0.03) and dyslipidemia (p = 0.04). Regarding gender, obesity (p = 0.01), smoking (p = 0.0001), vascular disease (p = 0.0001) and heart disease in the family (p = 0.01) higher incidence was shown in females, according toChi Square’s test. Conclusions It is concluded that elderly people aged less than 70 years and older women were those with the highest number of risk factors for CVA. Therefore, it may be suggested the development of primary care programs in order to promote information on the prevention of these risk factors and thus reduce the occurrence of stroke.

Introdução O Acidente Vascular Encefálico (AVE) é uma doença multifatorial, de modo que a combinação de fatores de risco pode contribuir para o seu desenvolvimento. Objetivo O objetivo deste estudo foi avaliar a prevalência dos fatores de risco para o AVE na população idosa fisicamente independente do município de Londrina. Materiais e métodos O estudo foi composto por idosos integrantes do projeto EELO (Estudo sobre o Envelhecimento e Longevidade – Londrina (PR), Brasil). Para identificação dos fatores de risco do AVE, utilizou-se um questionário estruturado com informações sobre dados sociodemográficos, dados antropométricos, variáveis de estilo de vida como sedentarismo e hábito de fumar, análise da presença de comorbidades e avaliação laboratorial para o diagnóstico de diabetes e dislipidemias. Resultados Participaram deste estudo 454 idosos com idade média de 69,7 anos. Observou-se relação significativa entre o número de fatores de risco e o gênero (p = 0,01), com maior prevalência entre as mulheres. Em análise isolada, idosos entre 60 e 69 anos apresentaram maior incidência de obesidade (p = 0,03) e dislipidemias (p = 0,04). Em relação ao gênero, a obesidade (p = 0,01), tabagismo (p = 0,0001), doença vascular (p = 0,0001) e doença cardíaca na família (p = 0,01) apresentaram maior incidência no sexo feminino, segundo teste Qui Quadrado. Conclusões Conclui-se que os idosos com idade menor que 70 anos e mulheres idosas foram os que apresentaram maior número de fatores de risco para o AVE. Desta forma sugere-se a elaboração de programas de atenção primária com o objetivo de promover informações sobre a prevenção destes fatores de risco e a redução da ocorrência do acidente vascular encefálico.

A cadeira de rodas e seus componentes essenciais para a locomoção de pessoas com tetraplegia por lesão da medula espinhal / The wheelchair and its essential components for the mobility of quadriplegic persons with spinal cord injury

Objetivo: Compreender quais itens são essenciais à cadeira de rodas (CR) na perspectiva dapessoa tetraplégica por lesão da medula espinhal (LME). Método: O estudo qualitativo foi comentrevista semi-estruturada e análise de discurso, bem como, checklist da CR em uso e do SistemaÚnico de Saúde (SUS). Resultados: No total foram dez entrevistados: nove homens e uma mulher,média de idade de 42,3 anos (± 9,23), dois advogados, um economista e demais aposentados.As causas da LME foram acidente automobilístico (60%), mergulho em águas rasas (30%) eatropelamento (10%), respectivamente. O tempo de lesão foi em média 16,3 anos (± 7,14) e todosrealizavam fisioterapia. Os números de CR, até a adequada, foram duas a cinco e todos praticavamesporte adaptado ou lazer com CR. O checklist apontou itens insuficientes na CR do SUS e daanálise dos discursos resultaram em quatro categorias: Itens, materiais e condições necessárias;A conquista da funcionalidade; Vantagens e desvantagens da CR; e Sentimentos vivenciados. A CRé essencial para a locomoção das pessoas com tetraplegia e conhecer modelos, experimentar eter orientações sobre os itens adequados são importantes para a aquisição. Os itens adequadosfacilitam a aceitação, melhor adaptação, locomoção e autonomia. Conclusão: A cadeira do SUSmostrou-se insuficiente, o que leva ao abandono. A adquirida por funcionalidade, com itensessenciais, o que responde a individualidade e ao gosto do usuário, mostrou-se útil e adequadaapesar de seu elevado custo.

Objective: This study sought to understand which items are essential to the wheelchair from the perspective of a person with quadriplegic spinal cord injury (SCI). Method: The study was qualitative with semi-structured interviews and discourse analysis, as well as a checklist of the wheelchair being used and the wheelchair provided by the government's Unified Health System (SUS). Results: The causes of SCI were motor vehicle accidents (60%), diving into shallow waters (30%) and being struck by a vehicle (10%), respectively and the injury time averaged 16.3 years (± 7.14). All of the subjects were in physiotherapy. The number of wheelchairs tested before finding the proper one were two to five and some participants practiced adapted sports with the wheelchair. The checklist showed that the government wheelchair had insufficient items and the discourse analysis resulted in four categories: Items, materials, and conditions; Learning functionality; Advantages and disadvantages of the wheelchair; and Feelings experienced. The wheelchair is essential to acquiring mobility for people with quadriplegia and trying out different models and getting orientation on the items are important for their acquisition. Suitable items facilitate acceptance, better adaptation, mobility and enable autonomy. Conclusion: The wheelchair from the government's health system was insufficient, leading to its being abandoned, and wheelchairs acquired for their functionality, with essential items, responsive to the user's individuality and taste proved to be useful and appropriate, despite their high cost.

Prevalência e associações da vertigem posicional paroxística benigna em idosos / Prevalence and association of benign paroxysmal positional vertigo in the elderly

OBJETIVO: verificar a prevalência da vertigem posicional paroxística benigna e identificar suas prováveis associações em uma população de idosos. MÉTODOS: estudo transversal realizado em idosos, submetidos à avaliação audiológica, questionário e à Manobra de Dix-Hallpilke. Aplicaram-se os testes não paramétricos: Qui-quadrado e regressão multivariada com intervalo de confiança de 95%. RESULTADOS: a amostra final foi de 494 indivíduos, com mediana de idade de 69(64,75- 74,00) anos. Observou-se a prevalência de 23,9% de vertigem posicional paroxística benigna e 51,6% de dor cervical e 37,9% de cefaléia. Houve associação estatisticamente significante entre a vertigem posicional paroxística benigna e dor cervical, gênero e cefaléia nesta população. CONCLUSÃO: conclui-se que nesta população de idosos a prevalência da vertigem posicional paroxística benigna foi de 23,9% e da dor cervical foi de 51,6% e houve associação significante entre a vertigem posicional paroxística benigna com a dor cervical e com o gênero feminino. .

PURPOSE: to determine the prevalence of benign paroxysmal positional vertigo and identify their associations in an elderly population. METHODS: a cross-sectional study in elderly patients evaluated by audiological evaluation, comorbidity questionnaireand Dix-Hallpike maneuver Were applied nonparametric tests: Chi-square and multivariate regression with a confidence interval of 95%. RESULTS: the final sample consisted of 494 individuals, with a median age of 69 (64.75 to 74.00) years. Observed prevalence of 23.9% of benign paroxysmal positional vertigo and 51.6% of neck pain and headache 37.9%. There was a statistically significant association between benign paroxysmal positional vertigo and neck pain, headache and gender in this population. CONCLUSION: it is concluded that this elderly population the prevalence of benign paroxysmal positional vertigo was 23.9% and the neck pain was 51.6% and there was a significant association between benign paroxysmal positional vertigo with neck pain and female gender. .

Physical activity in the prevention of benign paroxysmal positional vertigo: probable association.

Introduction Physical inactivity is an important risk factor for many age-related diseases and symptoms such as dizziness and vertigo. Objective The aim of the study was to investigate the possible association between benign paroxysmal positional vertigo (BPPV) and regular physical activity in elderly subjects. Methods This cross-sectional study included 491 elderly individuals who lived independently. Physical exercise was assessed through a questionnaire and BPPV by history and the Dix-Hallpike maneuver. Results The present study indicates no significant association between BPPV with lack of physical activity in men and in the total population. We have confirmed associations between BPPV with lack of physical activity in women (p = 0.01). Women with a sedentary lifestyle who do not practice physical activity are 2.62 more likely to have BPPV than those with regular physical activity. Conclusion These results highlight the importance of identifying risk factors for BPPV that can be modified through specific interventions. Regular physical activity is a lifestyle with potential to decrease the risk of vertigo in women.

Physical Activity in the Prevention of Benign Paroxysmal Positional Vertigo: Probable Association

Introduction Physical inactivity is an important risk factor for many age-related diseases and symptoms such as dizziness and vertigo. Objective The aim of the study was to investigate the possible association between benign paroxysmal positional vertigo (BPPV) and regular physical activity in elderly subjects. Methods This cross-sectional study included 491 elderly individuals who lived independently. Physical exercise was assessed through a questionnaire and BPPV by history and the Dix-Hallpike maneuver. Results The present study indicates no significant association between BPPV with lack of physical activity in men and in the total population. We have confirmed associations between BPPV with lack of physical activity in women (p = 0.01). Women with a sedentary lifestyle who do not practice physical activity are 2.62 more likely to have BPPV than those with regular physical activity. Conclusion These results highlight the importance of identifying risk factors for BPPV that can be modified through specific interventions. Regular physical activity is a lifestyle with potential to decrease the risk of vertigo in women...

Interferência da Prática de Tai Chi Chuan na Saúde Mental de Pessoas Com Lesão da Medula Espinhal / Interference of Tai Chi Chuan practice in the mental health of spinal cord injury people

Este estudo constou de um experimento descritivo de car�ter quali-quantitativo, com objetivo de avaliar a interfer�ncia da pr�tica do Tai Chi Chuan na sa�de mental de pessoas com les�o da medula espinhal nos par�metros autoestima, ansiedade e depress�o. Foi composto por um grupo de interven��o constitu�do de oito pessoas com les�o da medula espinhal que praticaram aulas de Tai Chi Chuan por um per�odo de seis meses, e grupo controle com oito integrantes que apenas realizavam o tratamento de fisioterapia. Os resultados demonstraram-se significativos para o grupo de interven��o quanto � ansiedade e depress�o (p= 0,021) e autoestima (p=0,015). Os benef�cios da pr�tica do Tai Chi Chuan t�m significado importante na melhora da sa�de mental e f�sica de pessoas com defici�ncia f�sica causada por les�o da medula espinhal. Desta forma, sugerimos mais estudos sobre a interven��o da pr�tica do Tai Chi Chuan como complemento no processo de reabilita��o da popula��o.

This study consisted of a quali-quantitative descriptive experiment aimed at assessing the interference of Tai Chi Chuan practice in the mental health of people with spinal cord injury, regarding the parameters self-esteem, anxiety and depression. It was composed by a intervention group consisting of eight people with spinal cord injury, who practiced Tai Chi Chuan classes for a period of six months, and a control group with eight members that just performed the physiotherapy treatment. There were significant results for the intervention group regarding the anxiety and depression (p=0,021) and self-esteem (p=0,015). We conclude that the practice of Tai Chi Chuan has an important meaning in improving the mental health of people with physical disabilities caused by a spinal cord injury. Thus, we suggest more studies on the practice of Tai Chi Chuan as complement of the rehabilitation process of the population.

Zumbido: possível associação com alterações cervicais em idosos / Tinnitus: probable association with the elderly's cervical alterations

INTRODUÇÃO: O zumbido é um sintoma prevalente e de alto impacto na qualidade de vida do paciente idoso. A presença de cervicalgia e alterações na coluna cervical são comuns em pacientes com queixa de zumbido. OBJETIVO: Avaliar a prevalência do zumbido e cervicalgia em um grupo de idosos e verificar a possível associação entre zumbido, cervicalgia e restrição de amplitude de movimento cervical. MÉTODO: Estudo transversal retrospectivo com avaliação da amplitude de movimento cervical através de goniometria e do zumbido e da cervicalgia através da aplicação de questionário padronizado. RESULTADOS: A amostra foi constituída por 147 indivíduos, com idade média de 69,22 anos sendo 61,90 por cento mulheres. Desses indivíduos, 42,85 por cento apresentaram queixa de zumbido 51 por cento dos indivíduos relataram queixa de dor cervical. Não houve associação entre zumbido e dor cervical e nem associação entre zumbido e restrição de amplitude de movimento cervical. CONCLUSÃO: Embora não tenha sido constatada associação entre zumbido e dor cervical e entre zumbido e restrição de amplitude de movimento, observou-se grande prevalência de queixa de zumbido, de cervicalgia e de diminuição na amplitude de movimento cervical na população de idosos. Os resultados da presente pesquisa, por meio da constatação desta grande prevalência do zumbido em toda a população de estudo, servirão de base a uma integração entre profissionais da área de saúde envolvidos com tais alterações.

INTRODUCTION: Tinnitus is a prevailing symptom that highly jeopardizes the elderly patient's quality of life. Neck pain and cervical column alterations are frequent in patients complaining about tinnitus. OBJECTIVE: Evaluate the prevalence of both tinnitus and neck pain on an elderly group, and verify the likely association between tinnitus, neck pain and the constraint to make wide cervical movements. METHODS: Retrospective transversal study, evaluating both the width of cervical movement by way of a goniometry and the tinnitus and neck pain by requesting a standard questionnaire to be filled out. RESULTS: Sample was comprised of 147 individuals aged between 69. 22, 61. 90 percent of whom were female. Among these individuals, 42. 85 percent showed a buzz complaint and 51 percent of these individuals claimed to have a neck pain. Neither was association found between tinnitus and neck pain nor it was between tinnitus and the width constraint of cervical movements. CONCLUSION: Despite not finding an association between tinnitus and neck pain or between tinnitus and the width constraint of cervical movements, there was a significant prevalence of tinnitus, neck pain and a reduction in the width of cervical movements on the elderly people. The results hereof, by finding this important prevalence of tinnitus in all the individuals of this study, will be the basis to integrate health professionals engaged in such alterations.

Social representations of the wheelchair for people with spinal cord injury.

In seeking to understand the social representation of the use of the wheelchair through the analysis of interviews with ten people who have suffered spinal cord injury, the construction of five representations was elaborated. The phenomenon experienced regarding the wheelchair provided a route of meanings and symbologies: essential equipment, after the person perceive the inability to walk; a symbol of disability when the person experienced functional dependence; means of locomotion and transport after the rescue of their potential functional; becoming an integral part or all of their body and, finally, the concept of autonomy on four wheels by adjusting to their new ability to walk emerges. The wheelchair as an extension of the modified body for spinal cord injury, returns them the right of locomotion, presents them not only with autonomy for various acts of life, but also restores their dignity, so essential to human life.