Eletroestimulação e Crioterapia para espasticidade em pacientes acometidos por Acidente Vascular Cerebral

2001 ◽  
Vol 19 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Thais Duarte Felice ◽  
Raphaela Oliveira Ramos Ishizuka ◽  
Jacques Denis Amarilha
Keyword(s):  
Timed Up And Go

Vários recursos fisioterapêuticos podem ser instituídos para tratar pacientes no que se refere o controle da espasticidade. Tanto a crioterapia quanto a estimulação elétrica neuromuscular (EENM) apresentam evidências científicas que postulam a redução da espasticidade. Objetivo. Esta pesquisa teve como objetivo avaliar entre as técnicas de EENM e crioterapia, aquela que obtêm a diminuição da espasticidade muscular e a melhora da atividade funcional. Método. Consistiu um estudo de três casos, onde os sujeitos, acometidos por Acidente Vascular Cerebral (AVC) e com quadro de espasticidade no grupo muscular do quadriceps, foram o seu próprio grupo controle. Estes foram submetidos a dois protocolos de tratamento, onde cada terapêutica teve cinco sessões de tratamento em dias consecutivos. Primeiro foi aplicado o Protocolo A (terapêutica com crioterapia), após dois dias, aplicação do Protocolo B (terapêutica com estimulação elétrica neuromuscular). Resultados. Foi observada redução da atividade elétrica muscular, avaliada através da eletromiografia de superfície, e melhora no desempenho funcional, no teste Timed Up and Go, após os tratamentos. Conclusão. A crioterapia e a EENM promoveram redução da atividade elétrica muscular em quadríceps e melhora no desempenho funcional da marcha. Contudo, a crioterapia sobressai a EENM no desempenho muscular.

Coexistent Osteoarthritis and Parkinson’s Disease: Data from the Parkinson’s Foundation Outcomes Project

2020 ◽  
Vol 10 (4) ◽  
pp. 1601-1610
Author(s):  
Jaimie A. Roper ◽  
Abigail C. Schmitt ◽  
Hanzhi Gao ◽  
Ying He ◽  
Samuel Wu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Study Data ◽  
Functional Mobility ◽  
Quality Improvement Initiative ◽  
Timed Up And Go ◽  
Mobility Performance ◽  
Risk Of Mortality ◽  
The Impact

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.

Treinamento respiratório em paciente com mal formação de Chiari tipo I

2001 ◽  
Vol 18 (1) ◽  
pp. 28-35
Author(s):  
Emília Maria Cordeiro Werneck ◽  
Sílvia Aparecida da Silva ◽  
Vanessa Amaral Mendonça ◽  
Clynton Lourenço Corrêa
Keyword(s):  
Timed Up And Go ◽  
Sf 36 ◽  
Chiari I

O objetivo deste estudo foi avaliar a força da musculatura respiratória por meio das variáveis respiratórias: Pressão Inspiratória Máxima (PImáx), Pressão Expiratória Máxima (PEmáx) e Pico de Fluxo Expiratório (PFE), em uma paciente com mal formação de Chiari I, através de relato de caso descritivo. Foram aplicados os testes funcionais: Timed Up and Go (TUG), Velocidade da marcha, subir escadas e descer escadas. Além disso, foi realizado teste de caminhada de seis minutos (TC6’) e aplicado o questionário de qualidade de vida SF36. Foi aplicado um treinamento muscular inspiratório com o uso de um threshold durante oito semanas, com três sessões semanais de trinta minutos cada. A carga inicial foi de 15% da PImáx inicial, até alcançar a carga de 60%. A PImáx teve um aumento de 100% do valor inicial, a PEmáx teve um aumento de 83,3% e o PFE teve um aumento de 7,1%. Nos testes funcionais, TC6’ e em alguns itens do SF-36 observou-se uma melhora após o treinamento. Pacientes com mal formação de Chiari I poderiam se beneficiar de um programa de treinamento da musculatura respiratória com o intuito de prevenir futuras complicações respiratórias e/ou otimizar a função respiratória.

IDENTIFICAÇÃO DO RISCO DE QUEDAS PELA AVALIAÇÃO DA MOBILIDADE FUNCIONAL EM IDOSOS HOSPITALIZADOS

2012 ◽  
Vol 33 (4) ◽  
pp. 534
Author(s):  
Luciana Queiroz ◽  
Síntia Lira ◽  
Adriana Sasaki
Keyword(s):  
Timed Up And Go

Foram estimados o risco de queda e os fatores associados a este em idosos hospitalizados, na cidade de Salvador, Bahia. Efetuou-se um estudo descritivo, no período de janeiro a março de 2007, com indivíduos acima de 60 anos. A avaliação da propensão à queda foi realizada mediante a aplicação de dois testes de mobilidade funcional: Timed Up and Go (TUG) eAlcance Funcional (AF). Um formulário estruturado foi aplicado para a caracterização da população e avaliação dos fatores de risco para queda, incluindo idade, polifarmácia, uso de auxiliar de marcha e história prévia de quedas. Foram avaliados 40 indivíduos; 26 apresentaram baixo risco para quedas, 7 apresentaram risco moderado e 7, alto risco, em relação à pontuação no TUG. De acordo com o AF, 24 idosos foram incluídos no grupo de baixo risco para quedas, 10, no grupo derisco moderado e 6, no de alto risco. A maioria da população, portanto, revelou baixa propensão a cair, em ambos os testes. Entretanto, a idade avançada e o uso de auxiliar de marcha mostraram-se como fatores associados ao aumento desta propensão.

scholarly journals 346 How Do we Increase Adherence to Home Exercise Programmes? Interviews with Older Adults and Physiotherapists

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Siti Khalijah ◽  
Suzanne Timmons
Keyword(s):  
Older Adults ◽  
Cardiovascular Health ◽  
Home Exercise ◽  
Video Content ◽  
Structured Interviews ◽  
Timed Up And Go ◽  
Convenience Sample ◽  
Improve Compliance ◽  
Exercise Programmes ◽  
Purposive Sample

Abstract Background Regular exercise and physical activity can maintain function and cardiovascular health, and prevent cognitive decline, in older adults. However, studies show that there is often poor adherence to home exercise programmes (HEP). The purpose of this study was to explore how HEP are perceived by both older adults and physiotherapists. Methods A convenience sample of 28 older adults attending outpatient physiotherapy clinics were given an exercise journal to record their adherence to the HEP prescribed by their physiotherapists for six weeks. Subsequently, semi-structured interviews were conducted with a purposive sample, and the corresponding prescribing physiotherapists, to achieve maximal variation in terms of HEP adherence, age and sex. The interviews were audio recorded, transcribed, and simple content analysis performed. Results Fourteen participants returned their exercise journal. Median age was 80; half were female; median Berg Balance Score and Timed-up-and-Go-Test were 49 and 16 seconds respectively. Participants exercised a median 79.8% of the prescribed dose, or 5.6 days per week. Seven older adults were interviewed; about half had a positive attitude towards exercise. They were also moderately positive about their HEP (comments ranged from “doable” and “nothing bad about it” to “enjoyable”). Barriers included time, mood, boredom, remembering to do the HEP, and variable health status. Enablers included simple instructions and design, family encouragement, and sense of achievement. Physiotherapists (n=5) perceived that many older adults aren’t compliant with HEPs, but there was some therapeutic nihilism (“you can’t force them”). Their HEP instructions varied from verbal to written instructions/diagrams; one physiotherapist used individualised video content. Notably, participants with good adherence understood their HEP well in terms of content and purpose, although this may be cause or effect. Conclusion To improve compliance with HEP, healthcare professionals need to take time to motivate the recipient, simplify their instructions, and trouble-shoot potential barriers at the time of prescription.

scholarly journals Minimal shoes improve stability and mobility in persons with a history of falls

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tomasz Cudejko ◽  
James Gardiner ◽  
Asangaedem Akpan ◽  
Kristiaan D’Août
Keyword(s):  
Fall Prevention ◽  
Postural Stability ◽  
Center Of Pressure ◽  
Stability Margin ◽  
Timed Up And Go ◽  
Balance Test ◽  
Margin Of Stability ◽  
Eyes Open ◽  
History Of ◽  
Falls In Older Adults

AbstractPostural and walking instabilities contribute to falls in older adults. Given that shoes affect human locomotor stability and that visual, cognitive and somatosensory systems deteriorate during aging, we aimed to: (1) compare the effects of footwear type on stability and mobility in persons with a history of falls, and (2) determine whether the effect of footwear type on stability is altered by the absence of visual input or by an additional cognitive load. Thirty participants performed standing and walking trials in three footwear conditions, i.e. conventional shoes, minimal shoes, and barefoot. The outcomes were: (1) postural stability (movement of the center of pressure during eyes open/closed), (2) walking stability (Margin of Stability during normal/dual-task walking), (3) mobility (the Timed Up and Go test and the Star Excursion Balance test), and (4) perceptions of the shoes (Monitor Orthopaedic Shoes questionnaire). Participants were more stable during standing and walking in minimal shoes than in conventional shoes, independent of visual or walking condition. Minimal shoes were more beneficial for mobility than conventional shoes and barefoot. This study supports the need for longitudinal studies investigating whether minimal footwear is more beneficial for fall prevention in older people than conventional footwear.

scholarly journals Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study

2021 ◽  
Vol 12 ◽  
pp. 204062232110159
Author(s):  
Jung Eun Yoo ◽  
Dahye Kim ◽  
Hayoung Choi ◽  
Young Ae Kang ◽  
Kyungdo Han ◽  
...  
Keyword(s):  
Physical Activity ◽  
Screening Program ◽  
Chronic Obstructive ◽  
Older Population ◽  
Timed Up And Go ◽  
Obstructive Pulmonary Disease ◽  
Mild Anemia ◽  
Increased Risk ◽  
Male Sex

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.

scholarly journals Assessing elderly’s functional balance and mobility via analyzing data from waist-mounted tri-axial wearable accelerometers in timed up and go tests

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisha Yu ◽  
Yang Zhao ◽  
Hailiang Wang ◽  
Tien-Lung Sun ◽  
Terrence E. Murphy ◽  
...  
Keyword(s):  
Predictive Models ◽  
Cross Validation ◽  
Motor Coordination ◽  
Predictive Accuracy ◽  
Short Form ◽  
Community Dwelling ◽  
Regularized Regression ◽  
Balance Assessment ◽  
Timed Up And Go ◽  
Functional Balance

Abstract Background Poor balance has been cited as one of the key causal factors of falls. Timely detection of balance impairment can help identify the elderly prone to falls and also trigger early interventions to prevent them. The goal of this study was to develop a surrogate approach for assessing elderly’s functional balance based on Short Form Berg Balance Scale (SFBBS) score. Methods Data were collected from a waist-mounted tri-axial accelerometer while participants performed a timed up and go test. Clinically relevant variables were extracted from the segmented accelerometer signals for fitting SFBBS predictive models. Regularized regression together with random-shuffle-split cross-validation was used to facilitate the development of the predictive models for automatic balance estimation. Results Eighty-five community-dwelling older adults (72.12 ± 6.99 year) participated in our study. Our results demonstrated that combined clinical and sensor-based variables, together with regularized regression and cross-validation, achieved moderate-high predictive accuracy of SFBBS scores (mean MAE = 2.01 and mean RMSE = 2.55). Step length, gender, gait speed and linear acceleration variables describe the motor coordination were identified as significantly contributed variables of balance estimation. The predictive model also showed moderate-high discriminations in classifying the risk levels in the performance of three balance assessment motions in terms of AUC values of 0.72, 0.79 and 0.76 respectively. Conclusions The study presented a feasible option for quantitatively accurate, objectively measured, and unobtrusively collected functional balance assessment at the point-of-care or home environment. It also provided clinicians and elderly with stable and sensitive biomarkers for long-term monitoring of functional balance.

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