scholarly journals Efeitos de um programa de condicionamento físico no equilíbrio e funcionalidade da marcha em indivíduos pós acidente vascular cerebral

2021 ◽  
Vol 22 (5) ◽  
pp. 649-666
Author(s):  
Sabrina Kyoko de Paula Asa ◽  
Elaine Menezes de Oliveira ◽  
Gabriela da Silva Matuti ◽  
Clarissa Barros de Oliveira
Keyword(s):  

O Acidente Vascular Cerebral (AVC) pode gerar diminuição do nível de atividade física, força muscular e capacidade aeróbica e com isso levar à redução da velocidade e à qualidade da marcha. O presente estudo teve como objetivo investigar os efeitos que exercícios aeróbios associados ao fortalecimento de membros inferiores podem ter sobre o equilíbrio e a funcionalidade da marcha em indivíduos que sofreram AVC. Foram avaliados indivíduos submetidos a um protocolo de condicionamento físico na Associação de Assistência à Criança Deficiente (AACD). Foram observadas mudanças em todas as variáveis analisadas (Teste de caminhada de 6 minutos, Teste de caminhada de 10 metros, Timed Up and Go e Mini BEST-test) após o término do protocolo e 3 meses de follow-up. A melhora encontrada no mini BEST-test foi estatisticamente significante. O protocolo de condicionamento físico realizado promoveu melhora no desempenho da marcha e influência significativa no equilíbrio dos indivíduos estudados.

2020 ◽  
Vol 10 (4) ◽  
pp. 1601-1610
Author(s):  
Jaimie A. Roper ◽  
Abigail C. Schmitt ◽  
Hanzhi Gao ◽  
Ying He ◽  
Samuel Wu ◽  
...  

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.


2021 ◽  
Vol 12 ◽  
pp. 204062232110159
Author(s):  
Jung Eun Yoo ◽  
Dahye Kim ◽  
Hayoung Choi ◽  
Young Ae Kang ◽  
Kyungdo Han ◽  
...  

Background: The aim of this study was to investigate whether physical activity, sarcopenia, and anemia are associated an with increased risk of tuberculosis (TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National Screening Program for Transitional Ages for Koreans from 2009 to 2014. At baseline, we assessed common health problems in the older population, including anemia and sarcopenia. The subjects’ performance in the timed up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was determined using claims data from the National Health Insurance Service database. Results: The median follow-up duration was 6.4 years. There was a significant association between the severity of anemia and TB incidence, with an adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI), 1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to severe anemia. Compared with those who had normal TUG times, participants with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR 1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95% CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity reduced the risk of TB. Male sex, lower income, alcohol consumption, smoking, diabetes, and asthma/chronic obstructive pulmonary disease increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia, sarcopenia, and physical inactivity. Physicians should be aware of those modifiable predictors for TB among the older population.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 407
Author(s):  
Laetitia Lengelé ◽  
Olivier Bruyère ◽  
Charlotte Beaudart ◽  
Jean-Yves Reginster ◽  
Médéa Locquet

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).


Author(s):  
Moritz Sharabianlou ◽  
Prerna Arora ◽  
Derek Amanatullah

This study aims to establish the midterm safety and performance for the direct superior approach to minimally invasive surgery total hip arthroplasty (MIS-THA). We used a unicentric, single-surgeon, retrospective, consecutive case series analysis of the first 40 patients who received primary unilateral direct superior MIS-THA. Special attention was given to functional recovery by measuring Harris Hip Score (HHS) and timed-up-and-go (TUG) with a mean follow up of 2.2 ± 0.4 years. A radiologic evaluation was performed. HHS and TUG improved significantly at three months and one year (p < 0.001). All components were placed within the Lewinnek safe zone with no change position or signs of loosening at two years. With a minimum of two years of follow up, the direct superior approach appears to be safe without any obvious or consistent postoperative complications—clinically or radiographically—with excellent functional recovery. Additionally, our subgroup analysis supported no late learning curve effect.


2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Tsuyoshi Asai ◽  
Kensuke Oshima ◽  
Yoshihiro Fukumoto ◽  
Shogo Misu

Abstract Aim To elucidate the association between the occurrence of falls and timed “up and go” (TUG) test score in a dual-task condition among community-dwelling older adults by age group. Methods This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG test (single-TUG) and a TUG test while counting aloud backward from 100 (dual-TUG) were conducted at baseline. The dual-task cost (DTC) value was computed from these results. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. At follow-up, 322 participants had dropped out and six participants had missing data for falls. The final analysis included 658 individuals (follow-up rate: 658/987, 67%) divided into a young-older adult group (aged 60–74 years) and an old-older adult group (aged 75 years or older). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models. Results For old-older adults, there were significant associations between the occurrence of falls and DTC value (odds ratio [OR] 0.981, 95% confidence interval [CI]: 0.963–0.999, p = 0.040) and single-TUG score (OR 1.129, 95% CI: 1.006–1.268, p = 0.039). However, no significant associations were observed for young-older adults. Conclusions Slower single-TUG test score and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual task assessment is useful for predicting falls in TUG fall assessment for old-older adults.


2018 ◽  
Vol 89 (10) ◽  
pp. A33.2-A33
Author(s):  
McNamara Mary ◽  
Segamogaite Ruta ◽  
Shaw Pamela ◽  
McDermott Christopher ◽  
Mazzá Claudia ◽  
...  

BackgroundHSP is characterised by spasticity and progressive gait impairment. There’s no reliable way to monitor gait deterioration during clinics. Optoelectronic systems have demonstrated differing characteristics between gait of HSP patients and controls. They’re expensive and impractical for use in clinic settings. Inertial sensors haven’t been used to characterise HSP gaitObjectivesStudy use of inertial sensors to identify gait characteristics that differentiate mild HSP patients from controls. To identify a gait based biomarker which can be used to monitor disease progression in a longitudinal study.MethodsNeurological examination, SPRS, Modified Ashworth score, brief pain inventory were undertaken. Instrumented timed up and go (iTUG) and instrumented 10 metre walk tests (i10) wearing an inertial sensor during clinic appointments at 6 month intervals.ResultsGait variables differentiating between patients and controls, including those with mild disease, were identified. Parameters differentiating between patients with SPG4 and SPG7 mutations were found. 8 patients were re-assessed after 6 months. Analysis did not show gait deterioration.ConclusionInertial sensors can detect differences between HSP patients and controls, including those mildly affected. They can also differentiate between patients with different mutations. Further follow up data is needed to assess whether inertial sensors can predict future gait deterioration.


2020 ◽  
Vol 9 (3) ◽  
pp. 636
Author(s):  
Mieke R.C. Crutsen ◽  
Spencer J. Keene ◽  
Daisy J.A. Janssen Nienke Nakken ◽  
Miriam T. Groenen ◽  
Sander M.J. van Kuijk ◽  
...  

Background and objective: Exacerbation(s) of chronic obstructive pulmonary disease (eCOPD) entail important events describing an acute deterioration of respiratory symptoms. Changes in medication and/or hospitalization are needed to gain control over the event. However, an exacerbation leading to hospitalization is associated with a worse prognosis for the patient. The objective of this study is to explore factors that could predict the probability of an eCOPD-related hospitalization. Methods: Data from 128 patients with COPD included in a prospective, longitudinal study were used. At baseline, physical, emotional, and social status of the patients were assessed. Moreover, hospital admission during a one year follow-up was captured. Different models were made based on univariate analysis, literature, and practice. These models were combined to come to one final overall prediction model. Results: During follow-up, 31 (24.2%) participants were admitted for eCOPD. The overall model contained six significant variables: currently smoking (OR = 3.93), forced vital capacity (FVC; OR = 0.97), timed-up-and-go time (TUG-time) (OR = 14.16), knowledge (COPD knowledge questionnaire, percentage correctly answered questions (CIROPD%correct)) (<60% (OR = 1.00); 60%–75%: (OR = 0.30); >75%: (OR = 1.94), eCOPD history (OR = 9.98), and care dependency scale (CDS) total score (OR = 1.12). This model was well calibrated (goodness-of-fit test: p = 0.91) and correctly classified 79.7% of the patients. Conclusion: A combination of TUG-time, eCOPD-related admission(s) prior to baseline, currently smoking, FVC, CDS total score, and CIROPD%correct allows clinicians to predict the probability of an eCOPD-related hospitalization.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19605-e19605
Author(s):  
Linda Denehy ◽  
Andrew Murnane ◽  
Meinir Krishnasamy ◽  
Karla Gough ◽  
Catherine Granger ◽  
...  

e19605 Background: People affected by lung cancer maybe highly symptomatic. This study aimed to quantify changes in physical function and health-related quality of life (HRQoL) in patients with advanced NSCLC. Methods: A prospective cohort study was performed. Patients with stage III and IV NSCLC were recruited within one month of starting treatment and assessed at baseline, 2, 4 and 6 months or until they became too unwell. HRQoL and functional status were measured using the EORTC QLQ-C30, the 6-minute walk test (6MWT) and timed up and go test (TUG). Comparisons between baseline and follow-up assessments were carried out by fitting linear mixed models to each outcome separately. Results: 39 patients (21 male) were included in the analysis; median age of 63 (range 40-80). 59% were receiving treatment with curative intent. 28% had stage 4 disease with 26% deceased by 4 months. Response rates at 2 and 4 months were 71.8% and 53.8% for 6MWT and TUG and 87.2% and 64.1% for EORTC. The mean 6MWT at baseline was significantly lower than predicted for the age, sex and height of the cohort (417.9 versus 550.4 metres, p<0.0005). Significant decline in mean 6MWT distance was seen at 2 (decrease of 42.4m, 95%CI -59.0, -25.7, p<0.0005) and 4 month follow-ups (decrease of 63.6m, 95%CI -85.6, -41.5, p<0.0005) compared to baseline. Significant increases in time taken to complete the TUG were also seen at 2 (increase of 0.76 sec, 95%CI 0.54 – 0.98, p<0.0005) and 4 month follow-ups (increase of 1.01 sec, 95%CI 0.76 – 1.27, p<0.0005) compared with baseline. In contrast, global health status and physical functioning as assessed by the QLQ-C30 showed small but significant decreases at the 2 month follow-up compared to baseline (decrease of 8.04, p=0.01 and decrease of 7.67, p=0.024 respectively), but no significant differences between baseline and the 4 month follow-up. Conclusions: Patients with advanced NSCLC show clinically and statistically significant decrements in physical function at commencement of treatment. This continues to decline rapidly and significantly over time, despite small changes in self-reported HRQoL. The 6MWT demonstrated clinically relevant changes in physical function. Interventions to address this problem are urgently needed.


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 &lt; .05, η2 = 0.21), Berg Balance Scale (F1,68 = 23.39, P &lt; .05, η2 = 0.26), and 8-foot Timed Up and Go (F1,79 = 4.83, P &lt; .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 &lt; .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.


2021 ◽  
Author(s):  
Carolina Tsen ◽  
Juliana Ansai ◽  
Grace Gomes ◽  
Décio Neto ◽  
Renata Gerassi ◽  
...  

Background: Telehealth is and alternative to improve functional mobility of elderly with dementia on a pandemic scenario, but still little explored on Brazil. Objective: To analyze the effects of a telehealth program on functional mobility among elderly with dementia. Methods: Ten elderly with dementia were evaluated about functional capacity through physical test Timed Up and Go. After, they were randomized and divided into two groups: telehealth group (TG) and control group (CG). The TG performed systematic physical and cognitive exercises with professional monitoring, while the CG received non-systematized guidance, both for 12 weeks. Participants were evaluated pre, immediately after three-month intervention and with a 12- week follow-up. Results: Of the 10 participants, 5 were allocated to each group. In the pre-intervention evaluation, the CG had a mean of 15.64 +/- 5.04 seconds in the TUG test and the TG had a mean of 19.78 +/- 6.51, that is, above 12.45 seconds means risk of falling. In the post-intervention, the CG had a mean of 16.83 +/- 6.77 and the TG a mean of 25.22 +/- 19.50. After 3 months of follow-up, the CG and the TG showed a mean of 16.08 +/- 2.04 and 17.98 +/- 6.73, respectively. Conclusion: After the intervention period, due to the small number of the sample, it was not possible to verify improvement in either group.


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