Falls and associated factors among older workers in a university

Objetivo: Analisar fatores associados a quedas em idosos servidores de uma instituição de ensino superior pública. Métodos: Estudo transversal, com idosos trabalhadores de idade igual ou superior a 60 anos. Foi utilizado um questionário estruturado abordando aspectos sociodemográficos, ocupacionais e ocorrência de quedas nos últimos 12 meses. Instrumentos utilizados: Escala de Depressão Geriátrica, Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire, Timed Up and Go Test, Teste de “Sentar e Levantar” da cadeira 5 vezes, Velocidade da Marcha, Equilíbrio Estático e Força de Preensão Manual. Resultados: Participaram do estudo 254 idosos trabalhadores, 76% pertenciam à faixa etária entre 60 a 64 anos e 58,7% eram do sexo masculino. A amostra foi dividida em dois grupos, caidores e não caidores e a prevalência de quedas nos últimos doze meses foi de 21,3% ± 2,72 (IC 95% = 15,92-26,58). Verificou-se associação significativa entre queda e sexo (p = 0,043), hospitalização nos últimos 12 meses (p = 0,000) e velocidade da marcha (p = 0,007). No modelo de regressão Poisson permaneceram as três variáveis associadas à queda: sexo masculino (RPaj = 0,62 IC 95% 0,40-0,98); velocidade da marcha adequada (RPaj = 0,46 IC 95% 0,26-0,81) e hospitalização nos últimos 12 meses (RPaj = 2,79 IC 95% 1,80-4,32). Conclusão: Estudo identificou uma menor prevalência de quedas nesta população e verificou a relação positiva entre trabalho e envelhecimento, no qual os idosos que continuam trabalhando tendem a apresentar melhores condições de saúde que a população de idosos em geralObjective: To analyze factors associated with falls among older workers in a public university. Methods: Cross-sectional study, with workers aged 60 or more. A structured questionnaire was used to cover socio-demographic and occupational characteristics and the occurrence of falls over the last 12 months. Instruments used: Geriatric Depression Scale, Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire, Timed Up and Go Test (TUG), Sitting-Rising Test (SRT), Gait Speed, Static Balance, and Grip strength. Results: The study included 254 older workers, 76% belonged to the age group between 60-64 years and 58.7% were male. The sample was divided into two groups, fallers and non-fallers, and the prevalence of falls over the last twelve months was 21.3% ± 2.72 (95% CI = 15.92-26.58). There was a significant association between falls and gender (p = 0.043), hospitalization over the last 12 months (p = 0.000), and gait speed (p = 0.007). In the Poisson regression model the three variables remained associated with falling: male gender (PRaj = 0.62, CI = 95% 0.40-0.98); suitable gait speed (PRaj = 0.46, CI = 95% 0.26-0.81), and hospitalization over the last 12 months (PRaj = 2.79, CI = 95% 1.80-4.32). Conclusion: The study identified a lower prevalence of falls in this group and found a positive relationship between work and the aging process, which proves that seniors who keep on working are healthier than the general population of the elderl

Assessment of fatigue in multiple sclerosis: methodological quality of adapted original versions available in Brazil of self-report instruments

La evaluación de fatiga en la esclerosis múltiple es una tarea difícil y sus instrumentos no disponen de uniformidad cuanto a los parámetros de evaluación metodológica para garantir la validad y confiabilidad de sus inferencias. El objetivo de eso estudio fue analizar la cualidad metodológica del desarrollo, de la adaptación transcultural para el idioma portugués (Brasil) y de las propiedades psicométricas de los instrumentos de autoinforme que evalúan la fatiga en la esclerosis múltiple y están disponibles en Brasil. Se realizó una búsqueda electrónica en las bases de datos LILACS, MEDLINE, Embase, PsycINFO, CINAHL, SciELO e SPORTDiscus, con un análisis de los instrumentos seleccionados por el consenso de parámetros para seleccionar instrumentos en el área de la salud. Fueron inclusos diez artículos y presentados la Fatigue Severity Scale (FSS), la Modified Fatigue Impact Scale (MFIS), la escala de fatiga cognitiva y física en la esclerosis múltiple (CPF-MS), la escala de incapacidad neurológica de Guy (GNDS), la Functional Assessment of Multiple Sclerosis (FAMS) y sus respectivas versiones ajustadas en Brasil. La mayoría de los instrumentos es multidimensional, específica, con documentada adaptación transcultural y predominio de la evaluación del dominio físico de la fatiga y evidencia de la confiabilidad adecuada. Hubo dificultad en identificarse un instrumento de autoinforme, que haga una evaluación adecuada de la fatiga en la esclerosis múltiple y sea ejemplo de los estándares metodológicos y psicométricos en su concepción y administración.A avaliação da fadiga na esclerose múltipla é uma tarefa difícil e seus instrumentos não dispõem de uniformidade quanto aos parâmetros de avaliação metodológica para assegurar validade e confiabilidade de suas inferências. O objetivo deste estudo foi analisar a qualidade metodológica do desenvolvimento, da adaptação transcultural para a língua portuguesa (Brasil) e das propriedades psicométricas dos instrumentos de autorrelato que avaliam a fadiga na esclerose múltipla e estão disponíveis no Brasil. Foi realizada uma busca eletrônica nas bases de dados LILACS, MEDLINE, Embase, PsycINFO, CINAHL, SciELO e SPORTDiscus, com análise dos instrumentos selecionados pelo consenso de parâmetros para selecionar instrumentos na área da saúde. Foram incluídos dez artigos e apresentados os instrumentos Fatigue Severity Scale (FSS), Modified Fatigue Impact Scale (MFIS), escala de fadiga cognitiva e física na esclerose múltipla (CPF-MS), escala de incapacidade neurológica de Guy (GNDS), Functional Assessment of Multiple Sclerosis (FAMS) e suas respectivas versões adaptadas no Brasil. A maioria dos instrumentos é multidimensional, específica, com documentada adaptação transcultural e predomínio de avaliação do domínio físico da fadiga e evidência de confiabilidade adequada. Houve dificuldade em se identificar um instrumento de autorrelato, que avalie adequadamente a fadiga na esclerose múltipla e seja exemplo de padrões metodológicos e psicométricos em sua concepção e administração.Assessment of fatigue in multiple sclerosis is a difficult task and its instruments have no uniformity regarding the methodological evaluation parameters to ensure validity and reliability of its inferences. The objective of this study was to analyze the methodological quality of development, cross-cultural adaptation to Portuguese language (Brazil), and psychometric properties of self-report instruments that assess fatigue in multiple sclerosis and are available in Brazil. A search was conducted in the electronic databases LILACS, MEDLINE, Embase, PsycINFO, CINAHL, SciELO and SPORTDiscus with analysis of the selected instruments by consensus-based standards for the selection of health measurement instruments. It was included 10 articles and presented the instruments Fatigue Severity Scale (FSS), Modified Fatigue Impact Scale (MFIS), Cognitive and Physical Fatigue in Multiple Sclerosis Scale (CPF-MS), Guy's Neurological Disability Scale (GNDS), Functional Assessment of Multiple Sclerosis (FAMS), and their adapted versions in Brazil. Most instruments present a multidimensional structure with documented cross-cultural adaptation in Brazil and emphasize the physical domain and adequate reliability. There is difficulty in identifying a self-report instrument to adequately assess fatigue in multiple sclerosis and that is an example of methodological and psychometric standards in their design and management

Efeito da tração manual sobre o comprimento da coluna cervical em indivíduos assintomáticos: estudo randomizado controlado

THE Objectives of the study were to measure the length of the cervical spine when submitted to manual traction and to verify changes in the cervical spine after 10 consecutive sessions. In this randomized controlled study 64 participants were submitted to two radiological procedures: one before and another during traction. The distances between the anterior and posterior vertebrae edges of C2 the C7 were measured and compared. In the first stage it was shown that measures of the anterior distance was 8.40 to 8.50 cm (POs objetivos do estudo foram o de mensurar o comprimento da coluna cervical quando submetida à tração manual, e o de verificar as alterações da cervical após um período de 10 sessões consecutivas. Trata-se de estudo randomizado controlado, no qual 64 participantes foram submetidos a dois procedimentos radiológicos, antes e durante a tração. As distâncias das bordas anteriores e posteriores do corpo vertebral C2 até as do corpo vertebral de C7 foram mensuradas e comparadas. Na primeira etapa as medidas das bordas anteriores foi de 8,40 para 8,50 cm (

Desenvolvimento e validação de um questionário de qualidade de vida em indivíduos com lesão da medula espinal

Objective: Create and test the psychometric proprieties of the specific instrument for the quantification of the quality of life in subjects with spinal cord injuries. Methods: From the existing consensus methods was chosen the Delphi technique for the creation of the questionnaire and the SF-36 for criteria method. Results: The internal consistence was α=0,827. The intra and inter evaluators confidence shows itself high by the intra class correlation coefficient and the Brand and Altman test by the difference of average. Can be observed strong correlations between the QVLM and SF-36 in the functional capacity and physical aspects domains and moderate correlation in the health state and emotional aspects domains. There was a significant difference between the four applications of QVLM, demonstrating that the questionnaire is sensible to change. Conclusion: The QVLM was created with a suitable methodology and the evaluation of the psychometrics proprieties turn out to be on a valid, reliable, consisting and sensible to changes instrumentObjetivo: Criar e testar as propriedades psicométricas de um instrumento específico para quantificação da qualidade de vida de indivíduos com lesão da medula espinal. Método: A partir dos métodos de consenso existentes, foi escolhida a técnica Delphi para criação do questionário e o SF-36 como método critério. Resultados: A consistência interna foi α=0,827. A confiabilidade intra e interavaliadores se mostram alta pelo coeficiente de correlação intraclasse e teste de bland e altman pela diferença da média. Pode-se observar correlações fortes entre o QVLM e SF-36 nos domínios capacidade funcional e aspectos físicos e correlação moderada nos domínios estado de saúde e aspectos emocionais. Houve diferença significante entre as quatro aplicações do QVLM demonstrando que o questionário é sensível à mudança. Conclusão: O QVLM foi criado com metodologia adequada e a avaliação das propriedades psicométricas traduzem em um instrumento válido, confiável, consistente e sensível a mudança

The efficacy of aerobic physical training of prevention of urinary tract infection in spinal cord injuries patients: clinical trial randomized

Eficacia do treinamento fisico aerobio na prevencao de infeccoes do trato urinario em individuos com lesao da medula espinhal: ensaio clinico randomizado. Edson Lopes LAVADO. Disciplina de Fisioterapia Aplicada a Neurologia do Departamento de Fisioterapia da Universidade Estadual de Londrina. Av. Robert Kock, 60 bairro cervejaria - Londrina - Pr. Fone: OXX43 3712288 - e-mail: [email protected] Local: Ambulatorio e Laboratorio de Fisioterapia do Hospital Universitario Regional do Norte do Parana e ambulatorio de Fisioterapia da UNOPAR. Contexto: Dentre as complicacoes mais frequentes encontradas em portadores de lesao medular, a infeccao do trato urinario tem grande risco de desenvolvimento devido a fatores estruturais e fisiologicos como a bexiga neurogenica, refluxo vesicoureteral, amplo volume residual pos esvaziamento vesical e calculos no trato urinario. Com a pratica da atividade fisica aerobia, espera-se reduzir a frequencia de infeccoes urinarias sintomaticas e diminuir a bacteriuria. Diante desta problematica e da necessidade de avaliar os efeitos beneficos do condicionamento fisico aerobio neste cenario, e proposto este ensaio clinico. Objetivo: Avaliar a seguranca e a eficacia do treinamento fisico aerobio em individuos com lesao medular como preventivo de infeccoes urinarias sintomaticas e bacteriuria assintomatica cronica. A hipotese levantada e que o condicionamento fisico aerobio e seguro e eficiente. Tipo de Estudo: Ensaio clinico randomizado com 18 meses de seguimento. Participantes: Individuos com lesao medular compreendida entre os niveis C5 e L,' (inclusive)...(au)BV UNIFESP: Teses e dissertaçõe

Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

ABSTRACT The Neurological Fatigue Index for Multiple Sclerosis (NFI-MS) is a new fatigue assessment instrument. The aim of this study was to cross-culturally adapt and assess the psychometric properties of the Brazilian version of the NFI-MS (NFI-MS/BR). Method Two hundred and forty subjects with MS were recruited for this study. The adaptation of the NFI-MS was performed by translation and back translation methodology. In psychometric analysis was performed the administration of the questionnaires Epworth Sleep Scale, Fatigue Severity Scale, Modified Fatigue Impact Scale, Multiple Sclerosis Impact Scale-29, NFI-MS/BR and Pittsburgh Sleep Quality Index with retest of the NFI-MS/BR after 7 days. Results Reliability was assessed (intraclass correlation coefficients between 0.77 and 0.86), and validity by testing 41 hypotheses about expected correlations between subscales and confirmed 36. The majority of correlations were demonstrated. Conclusion The NFI-MS/BR is a cross-culturally adapted, valid, and reliable instrument for assessing MS fatigue among Brazilian subjects

Cross-Cultural and Psychometric Properties Assessment of the Exercise Self-Efficacy Scale in Individuals with Spinal Cord Injury

Introduction: The Exercise Self-Efficacy scale (ESES) is a reliable measure, in the English language, of exercise self-efficacy in individuals with spinal cord injury. The aim of this study was to culturally adjust and validate the Exercise Self-Efficacy scale in the Portuguese language. Material and Methods: The Exercise Self-Efficacy scale was applied to 76 subjects, with three-month intervals (three applications in total). The reliability was appraised using the intra-class correlation coefficient and Bland-Altman methods, and the internal consistency was evaluated using Cronbach´s alpha. The Exercise Self-Efficacy scale was correlated with the domains of the Quality of life Questionnaire SF-36 and Functional Independence Measure and tested using the Spearman rho coefficient. Results: The Exercise Self-Efficacy scale-Brazil presented good internal consistency (alpha 1 = 0.856; alpha 2 = 0.855; alpha 3 = 0.822) and high reliability in the test-retest (intra-class correlation coefficient = 0.97). There was a strong correlation between the Exercise Self-Efficacy scale-Brazil and the SF-36 only in the functional capacity domain (rho = 0.708). There were no changes in Exercise Self-Efficacy scale-Brazil scores between the three applications (p = 0.796). Discussion: The validation of the Exercise Self-Efficacy scale questionnaire permits the assessor to use it reliably in Portuguese speaking countries, since it is the first instrument measuring self-efficacy specifically during exercises in individuals with spinal cord injury. Furthermore, the questionnaire can be used as an instrument to verify the effectiveness of interventions that use exercise as an outcome. Conclusion: The results of the Brazilian version of the Exercise Self-Efficacy scale support its use as a reliable and valid measurement of exercise self-efficacy for this population

Quality of life of primary caregivers of spinal cord injury survivors Calidad de vida de cuidadores familiares de personas con lesión de medula espinal Qualidade de vida de cuidadores familiares de pessoas com lesão da medula espinal

The aim of this study was to analyze quality of life of caregivers who are relatives of patients with spine cord injury (SCI). Fourteen women (seven caregivers and seven controls) were evaluated by the Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) and the Caregiver Burden Scale (CBS) Questionnaires. The data from both questionnaires were compared using the Mann-Whitney U testing procedure for differences between caregivers and controls (p0.05), characterized by the percentage difference of 62%, 66.7%, 55%, 50%, 57% and 63% for tension, isolation, disappointment, emotional involvement, environment and overall score, respectively. The CBS questionnaire was more adequate for verifying quality of life of caregivers of SCI patients, and caregiving may have a negative impact on their quality of life.Este estudio objetivó evaluar la calidad de vida de los cuidadores familiares de pacientes con Lesión de Médula Espinal (LM). Catorce mujeres (siete cuidadores familiares y 7 controles) se sometieron a la evaluación del cuestionario SF-36 y el cuestionario CBS. Para la comparación entre los grupos acerca de los cuestionarios se utilizó el test de Mann-whitney (p0,05), por la diferencia de porcentaje del del 62 %, 66,7 %, 55 %, 50 %, 57 % y 63 %, para una tensión general, aislamiento, decepción, implicación emocional, el medio ambiente y puntuación global, respectivamente. El cuestionario CBS ha demostrado ser apropiado para comprobar la calidad de vida de los cuidadores de personas con LM y el ato de cuidar produce un impacto negativo sobre la calidad de vida de estos.Este estudo objetivou avaliar a qualidade de vida de cuidadores familiares de pacientes com Lesão da medula espinal (LM). Quatorze mulheres (sete cuidadoras familiares e sete controles) foram submetidas à avaliação pelo questionário Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) e pelo questionário Caregiver Burden Scale (CBS). Utilizou-se o Teste de Mann-Whitney (p0,05), caracterizada pela diferença percentual de 62%, 66,7%, 55%, 50%, 57% e 63%, para tensão geral, isolamento, decepção, envolvimento emocional, ambiente e escore global, respectivamente. O questionário CBS mostrou-se adequado para verificar a qualidade de vida dos cuidadores de pessoas com LM e o ato de cuidar produz um impacto negativo sobre a qualidade de vida destes

Quality of life of primary caregivers of spinal cord injury survivors

The aim of this study was to analyze quality of life of caregivers who are relatives of patients with spine cord injury (SCI). Fourteen women (seven caregivers and seven controls) were evaluated by the Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) and the Caregiver Burden Scale (CBS) Questionnaires. The data from both questionnaires were compared using the Mann-Whitney U testing procedure for differences between caregivers and controls (p<0.05). The results from SF-36 were not statistically significant between groups, however, for the CBS data, there were significant differences between groups (p>0.05), characterized by the percentage difference of 62%, 66.7%, 55%, 50%, 57% and 63% for tension, isolation, disappointment, emotional involvement, environment and overall score, respectively. The CBS questionnaire was more adequate for verifying quality of life of caregivers of SCI patients, and caregiving may have a negative impact on their quality of life