scholarly journals Revisão de dois instrumentos clínicos de avaliação para predizer risco de quedas em idosos

2014 ◽  
Vol 17 (1) ◽  
pp. 177-189 ◽  
Author(s):  
Juliana Hotta Ansai ◽  
Soraia Fernandes das Neves Glisoi ◽  
Tamara de Oliveira ◽  
Aline Thomaz Soares ◽  
Kelem de Negreiros Cabral ◽  
...  

Introdução: Quedas são um problema clínico comum nos idosos, que pode reduzir sua mobilidade e independência. O uso de instrumentos simples para detecção do risco de quedas é fundamental para prevenção e tratamento de tais eventos. Não há, porém, consenso quanto aos testes mais adequados para cada situação. Objetivo: Revisar estudos sobre eficácia, sensibilidade e especificidade dos testes Timed Up and Go Test e Berg Balance Scale, a fim de verificar qual é o mais apropriado para predizer quedas em idosos. Métodos: Realizou-se revisão bibliográfica nas bases de dados MEDLINE, PubMed, ISI, LILACS e Portal de Periódicos CAPES, entre os anos de 2001 e 2011. Resultados: Foram selecionados 37 artigos, sendo 17 sobre a Berg Balance Scale e 20 sobre o Timed Up and Go Test. A revisão mostrou que os dois testes podem ser bons preditores de quedas, mas os artigos diferiram quanto à definição de queda e caidor, tipo de estudo, quantidade e característica da amostra e avaliação de quedas, levando a diferentes resultados quanto a nota de corte, sensibilidade, especificidade e predição de quedas. Há controvérsias quanto à capacidade de predição em perfis específicos, como os idosos ativos. Conclusão: Os testes avaliados são eficazes para predição de quedas, desde que adaptados para cada perfil. Novos estudos devem ser realizados com metodologia homogênea, a fim de favorecer a comparação de resultados sobre a eficácia desses testes.

2016 ◽  
Vol 18 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Cinda L. Hugos ◽  
Debra Frankel ◽  
Sara A. Tompkins ◽  
Michelle Cameron

Background: People with multiple sclerosis (MS) fall frequently. In 2011, the National Multiple Sclerosis Society launched a multifactorial fall-prevention group exercise and education program, Free From Falls (FFF), to prevent falls in MS. The objective of this study was to assess the impact of participation in the FFF program on balance, mobility, and falls in people with MS. Methods: This was a retrospective evaluation of assessments from community delivery of FFF. Changes in Activities-specific Balance Confidence scale scores, Berg Balance Scale scores, 8-foot Timed Up and Go performance, and falls were assessed. Results: A total of 134 participants completed the measures at the first and last FFF sessions, and 109 completed a 6-month follow-up assessment. Group mean scores on the Activities-specific Balance Confidence scale (F1,66 = 17.14, P < .05, η2 = 0.21), Berg Balance Scale (F1,68 = 23.39, P < .05, η2 = 0.26), and 8-foot Timed Up and Go (F1,79 = 4.83, P < .05, η2 = 0.06) all improved significantly from the first to the last session. At the 6-month follow-up, fewer falls were reported (χ2 [4, N = 239] = 10.56, P < .05, Phi = 0.21). Conclusions: These observational data suggest that the FFF group education and exercise program improves balance confidence, balance performance, and functional mobility and reduces falls in people with MS.


2014 ◽  
Vol 40 (1) ◽  
pp. 83-88 ◽  
Author(s):  
C Beatriz Samitier ◽  
Lluis Guirao ◽  
Maria Costea ◽  
Josep M Camós ◽  
Eulogio Pleguezuelos

Background:Lower limb amputation leads to impaired balance, ambulation, and transfers. Proper fit of the prosthesis is a determining factor for successful ambulation. Vacuum-assisted socket systems extract air from the socket, which decreases pistoning and probability of soft-tissue injuries and increases proprioception and socket comfort.Objectives:To investigate the effect of vacuum-assisted socket system on transtibial amputees’ performance-based and perceived balance, transfers, and gait.Study design:Quasi-experimental before-and-after study.Methods:Subjects were initially assessed using their prosthesis with the regular socket and re-evaluated 4 weeks after fitting including the vacuum-assisted socket system. We evaluated the mobility grade using Medicare Functional Classification Level, Berg Balance Scale, Four Square Step Test, Timed Up and Go Test, the 6-Min Walk Test, the Locomotor Capabilities Index, Satisfaction with Prosthesis (SAT-PRO questionnaire), and Houghton Scale.Results:A total of 16 unilateral transtibial dysvascular amputees, mean age 65.12 (standard deviation = 10.15) years. Using the vacuum-assisted socket system, the patients significantly improved in balance, gait, and transfers: scores of the Berg Balance Scale increased from 45.75 (standard deviation = 6.91) to 49.06 (standard deviation = 5.62) ( p < 0.01), Four Square Step Test decreased from 18.18 (standard deviation = 3.84) s to 14.97 (3.9) s ( p < 0.01), Timed Up and Go Test decreased from 14.3 (standard deviation = 3.29) s to 11.56 (2.46) s ( p < 0.01). The distance walked in the 6-Min Walk Test increased from 288.53 (standard deviation = 59.57) m to 321.38 (standard deviation = 72.81) m ( p < 0.01).Conclusion:Vacuum-assisted socket systems are useful for improving balance, gait, and transfers in over-50-year-old dysvascular transtibial amputees.Clinical relevanceThis study gives more insight into the use of vacuum-assisted socket systems to improve elderly transtibial dysvascular amputees’ functionality and decrease their risk of falls. The use of an additional distal valve in the socket should be considered in patients with a lower activity level.


2021 ◽  
pp. 026921552199331
Author(s):  
Juliana Zonzini Gaino ◽  
Manoel Barros Bértolo ◽  
Caroline Silva Nunes ◽  
Cecília de Morais Barbosa ◽  
Síbila Floriano Landim ◽  
...  

Objectives: To compare balance, foot function and mobility in patients with rheumatoid arthritis with and without foot orthoses. Design: Randomized controlled trial. Setting: Outpatient rheumatology clinic. Subjects: A total of 94 subjects with rheumatoid arthritis were randomized; of these, 81 were included in the analyses (Intervention group: 40; Control group: 41). Intervention: The Intervention Group received custom-made foot orthoses while the Control Group received none intervention. Main measure: The “Foot Function Index,” the “Berg Balance Scale,” and the “Timed-up-and-go Test” were assessed at baseline an after four weeks. The chosen level of significance was P < 0.05. Results: Average (standard deviation) participant age was 56.7 (±10.6) years old and average disease duration (standard deviation) was 11.4 (± 7.2) years. Groups were similar at baseline, except for comorbidity index and race. After four weeks, significant interaction group versus time was observed for Foot Function Index (change: Intervention group: −1.23 ± 1.58; Control group: −0.12 ± 1.16 – P = 0.0012) and for Berg Balance Scale (change: Intervention group: 2 ± 3; Control group: 0 ± 3 – P = 0.0110), but not for the Timed-up-and-go Test (change: Intervention group: −1.34 ± 1.99; Control group: −0.84 ± 2.29 – P = 0.0799). Conclusion: Foot orthoses improved foot function and balance in patients with rheumatoid arthritis.


Author(s):  
Felicity Langley ◽  
Shylie Mackintosh

Background: For allied health professionals wishing to assess the functional balance of older adults living in the community, the vast number of functional balance tests available makes it difficult to decide which assessment is most appropriate. Objective: To identify the reliability, concurrent validity and clinical practicality of functional balance tests with community dwelling older adults. Methods: A systematic review of published literature relevant to 17 functional balance tests was undertaken. The 17 functional balance tests were identified by a preliminary literature search and through consultation with an expert in the field of functional balance assessment. Studies published in English before January 2007, assessing the use of these functional balance tests with community dwelling adults aged 65 years or above were included. The CINAHL, MEDLINE, Ageline, Amed, PubMed, Cochrane library, PEDro and Joanna Briggs Institute databases were searched. The methodological quality of studies was assessed using a checklist criteria adapted from the Cochrane Working Group for Screening and Diagnostic Tests. Results: Eight databases were searched and 21 studies were included. The majority of studies demonstrated low to moderate methodological quality scores. Despite limitations reported for clinical application with community dwelling older adults, the Berg Balance Scale and the Timed Up and Go Test have been most rigorously tested. Reliability and concurrent validity of the Balance Screening Tool and the Fullerton Advanced Balance Scale had also been established in this population, however only one study was retrieved for each. Conclusion: The Berg Balance Scale and Timed Up and Go Test have published reliability, validity with community dwelling older adults. Further testing of other functional balance tests is required to establish their reliability and validity in this target population.


2013 ◽  
Vol 12 (2) ◽  
pp. 242-248
Author(s):  
Jéssica Mascena de Medeiros ◽  
Yanne Salviano Pereira ◽  
Danilo De Macêdo Moura ◽  
Suenny Marrocos de Lima ◽  
Catarina De Oliveira Sousa ◽  
...  

Introdução: O estado de saúde e os fatores de risco subjacentes para prevenção e tratamento dos agravos em idosos são um tema de destaque na saúde pública. Objetivo: Comparar os efeitos do envelhecimento no equilíbrio funcional de sujeitos saudáveis em três faixas etárias. Métodos: Por meio do Timed Up and Go Test (TUGT) e da Berg Balance Scale (BBS), foi analisado o equilíbrio funcional de 71 sujeitos, divididos em três grupos: jovens (GJ); meia idade (GMI) e idosos (GI). Foi realizada uma Anova one-way, seguida do post hoc de Tukey, considerando um α de 5%. Resultados: No TUGT houve diferença significativa entre GJ x GMI (P


2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Paulina E. Wowiling ◽  
Lidwina S. Sengkey ◽  
Julius H. Lolombulan

Abstract: This study aimed to analyze whether core-strengthening exercise could correct trunk stability and increase balance in post stroke patients. This was an experimental study with a pretest – posttest group design. Subjects were trained to perform the core strengthening exercise for 12 sessions. The trunk stability was evaluated with trunk impairment scale (TIS) and the balance was evaluated with Berg balance scale (BBS) and timed up and go test (TUG). Data were analyzed with the paired T-test and the Wilcoxon test. The results showed that there were 23 subjects that met the inclusion criteria. Of the 23 subjects, only 19 subjects completed the 12 sessions of exercise. The statistical analysis showed that there were significant increases of TIS (P <0.0001), BBS (P <0.0001), and TUG (P <0.0001) after the whole exercise. Conclusion: Core-strengthening exercise improved trunk stability as wel as static and dynamic balance in post stroke patients.Keywords: core-strengthening exercise, trunk stability, static and dynamic balanceAbstrak: Penelitian ini bertujuan untuk menganalisis sejauh mana latihan core-strengthening memperbaiki stabilitas trunkus dan meningkatkan keseimbangan pada pasien pascastroke. Jenis penelitian ini ialah eksperimental dengan pretest–posttest group design. Subjek penelitian ialah 23 pasien pasca stroke yang memenuhi kriteria inklusi. Perlakuan yang diberikan ialah latihan core-strengthening sebanyak12 sesi. Penilaian stabilitas trunkus menggunakan trunk impairment scale (TIS) sedangkan keseimbangan diukur dengan Berg balance scale (BBS) dan timed up and go test (TUG). Data dianalisis menggunakan uji T berpasangan dan uji Wilcoxon. Hasil penelitian memperlihatkan dari 23 subjek penelitian hanya 19 yang menyelesaian 12 sesi latihan, Analisis statistik menunjukkan bahwa setelah dilakukan latihan penguatan trunkus sebanyak 12 sesi didapatkan peningkatan bermakna dari TIS (P <0,0001), BBS (P <0,0001), dan TUG (P <0,0001). Simpulan: Latihan core-strengthening dapat memperbaiki stabilitas trunkus serta keseimbangan statik dan dinamik pada pasien pasca stroke.Kata kunci: Latihan core-strengthening, stabilitas trunkus, keseimbangan statik dan dinamik


2006 ◽  
Vol 72 (5) ◽  
pp. 683-690 ◽  
Author(s):  
Juliana Maria Gazzola ◽  
Monica Rodrigues Perracini ◽  
Maurício Malavasi Ganança ◽  
Fernando Freitas Ganança

Tarefas do dia-a-dia podem ser muito desafiadoras para o equilíbrio do idoso. OBJETIVO: Verificar a associação entre equilíbrio funcional, avaliado pela Berg Balance Scale (BBS) e os dados sociodemográficos, clínicos e de mobilidade (Timed up and go test - TUGT, Dynamic Gait Index - DGI) em idosos vestibulopatas crônicos. MATERIAL E MÉTODO: Estudo de casos com 120 idosos com diagnóstico de disfunção vestibular crônica. Foram utilizados os testes de Mann-Whitney, Kruskal-Wallis seguido do teste de Dunn e Coeficiente de Correlação de Spearman. RESULTADOS: Ocorreram associações =-0,354; e correlações significantes entre a pontuação total da BBS e idade (p<0,001), faixa etária (p<0,001), número de doenças (p=0,030), número de =-0,287; p=0,001), número de medicamentos (p=0,014), número de doenças (=-0,274; p=0,002), quedas recorrentes (p=0,010), tendência a medicamentos (quedas (p=0,002), diagnóstico topográfico de vestibulopatia central (p<0,001) =-0,709; periodicidade da tontura (p=0,039), TUGT (<0,001) e DGI =-0,748; p(<0,001). CONCLUSÕES: O equilíbrio funcional de idosos vestibulopatas crônicos avaliados à BBS é mais comprometido quando associado ao avançar da idade, faixa etária mais idosa (80 anos ou mais), aumento do número de doenças, presença de cinco ou mais doenças, polifarmacoterapia, quedas recorrentes, tendência a quedas, vestibulopatia central, tontura diária, comprometimento da mobilidade e marcha.


2020 ◽  
Vol 40 (01) ◽  
pp. 39-49 ◽  
Author(s):  
Arva Khuzema ◽  
A. Brammatha ◽  
V. Arul Selvan

Background: Individuals with Parkinson’s disease (PD) invariably experience functional decline in a number of motor and non-motor domains affecting posture, balance and gait. Numerous clinical studies have examined effects of various types of exercise on motor and non-motor problems. But still much gap remains in our understanding of various therapies and their effect on delaying or slowing the dopamine neuron degeneration. Recently, Tai Chi and Yoga both have gained popularity as complementary therapies, since both have components for mind and body control. Objective: The aim of this study was to determine whether eight weeks of home-based Tai Chi or Yoga was more effective than regular balance exercises on functional balance and mobility. Methods: Twenty-seven individuals with Idiopathic PD (Modified Hoehn and Yahr stages 2.5–3) were randomly assigned to either Tai Chi, Yoga or Conventional exercise group. All the participants were evaluated for Functional Balance and Mobility using Berg Balance Scale, Timed 10[Formula: see text]m Walk test and Timed Up and Go test before and after eight weeks of training. Results: The results were analyzed using two-way mixed ANOVA which showed that there was a significant main effect for time as F (1, 24) [Formula: see text], [Formula: see text], [Formula: see text] for overall balance in Berg Balance Scale. There was also significant main effect of time on mobility overall as F(1, 24) [Formula: see text], [Formula: see text], [Formula: see text] in Timed up and Go test and F(1, 24) [Formula: see text], [Formula: see text], [Formula: see text] for 10[Formula: see text]m Walk test. There was a significant interaction effect for [Formula: see text] with F(2, 24) [Formula: see text], [Formula: see text], [Formula: see text] for balance. With respect to mobility, the values F(2, 24) [Formula: see text], [Formula: see text], [Formula: see text] in Timed Up and Go test and F(2, 24) [Formula: see text], [Formula: see text], [Formula: see text] in 10[Formula: see text]m Walk test showed a significant interaction. But there was no significant main effect between the groups for both balance and mobility. Conclusion: The findings of this study suggest that Tai Chi as well as Yoga are well adhered and are attractive options for a home-based setting. As any form of physical activity is considered beneficial for individuals with PD either Tai Chi, Yoga or conventional balance exercises could be used as therapeutic intervention to optimize balance and mobility. Further studies are necessary to understand the mind–body benefits of Tai Chi and Yoga either as multicomponent physical activities or as individual therapies in various stages of PD.


2017 ◽  
Vol 27 (4) ◽  
pp. 27400
Author(s):  
Maiara Lohn Farias ◽  
Lisiane Piazza Luza ◽  
Bianca Andrade Sousa ◽  
Ediane Roberge Zampirolo

***Balance, functional mobility and quality of life in eldery participants and non-participants of a community center***AIMS: To evaluate balance, functional mobility and quality of life in elderly participants and non-participants of a senior citizen center.METHODS: Subjects aged 60 or over, participating in a senior citizen center in the city of Santo Amaro da Imperatriz, in Santa Catarina (Participating Group: PG) were evaluated. As a control group for comparison, elderly residents of the same community who did not participate in any senior center (Non-Participating Group: NPG) were included. Subjects with locomotion disabilities, neurological diseases that affected the gait or balance, and inability to understand the general commands indispensable to the tests were excluded. The sample was non-probabilistic intentional. To evaluate the balance, the Berg Balance Scale was applied, and for assess functional mobility we used the Timed Up and Go and the Anterior Functional Scope tests. Quality of life was assessed by the SF-36 questionnaire. The data were treated by descriptive and inferential statistics, considering p≤0.05 as significant.RESULTS: Fifty-six elderly participated, being 28 of PG and 28 of NPG. By means of the Berg Balance Scale, we found a better balance in PG (mean 53.2±2.1 points) compared to NPG (mean 48.8±6.2 points) (p=0.001). In the Timed Up and Go test, PG spent in average less time to perform the test (9.5±1.5 seconds) than NPG (13.1±5.1 seconds) (p=0.001). We observed a better quality of life in all domains of SF-36 in PG when compared to NPG (p<0.05).CONCLUSIONS: Elderly people who participated in a senior citizen center presented better balance, functional mobility and quality of life than elderly people from the same community who did not participate in senior centers.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Elisa Pelosin ◽  
Roberta Barella ◽  
Cristina Bet ◽  
Elisabetta Magioncalda ◽  
Martina Putzolu ◽  
...  

Freezing of gait (FoG) is among the most disabling symptoms of Parkinson’s disease (PD) patients. Recent studies showed that action observation training (AOT) with repetitive practice of the observed actions represents a strategy to induce longer-lasting effects compared with standard physiotherapy. We investigated whether AOT may improve FoG and mobility in PD, when AOT is applied in a group-based setting. Sixty-four participants with PD and FoG were assigned to the experimental (AO) or control groups and underwent a 45-minute training session, twice a week, for 5 weeks. AOT consisted in physical training combined with action observation whereas the control group executed the same physical training combined with landscape-videos observation. Outcome measures (FoG questionnaire, Timed Up and Go test, 10-meter walking test, and Berg balance scale) were evaluated before training, at the end of training, and 4 weeks later (FU-4w). Both groups showed positive changes in all outcome measures at posttraining assessment. Improvements in FoG questionnaire, Timed Up and Go test, and Berg balance scale were retained at FU-4w evaluation only in the AOT group. AOT group-based training is feasible and effective on FoG and motor performance in PD patients and may be introduced as an adjunctive option in PD rehabilitation program.


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