Estudo da confiabilidade de um instrumento de medida de flexibilidade em adultos e idosos

Measurement instruments should be analyzed according to their clinicalapplication and their scientific validity tested in different populations. Thepurpose of the present study was to verify the inter-rater reliability of a Fleximeter in a group of 12 mature adults and asymptomatic elderly subjects using the Intraclass Correlation Coefficient (ICC). Our results showed that the Fleximeter presented high inter-rater reliability for cervical spine rotation, hip flexion in orthostatic position, hip flexion with extended and flexed knee, dorsal and plantar flexion of the ankle, and knee flexion. The reliability of this instrument was moderate for lateral flexion of the cervical spine, forward trunk flexion, elbow flexion and extension, and hip extension in orthostatic position as well as ventral decubitus. Finally, lateral trunk flexion, trunk extension, and knee extension showed low reliability. According with the results of the present study it is not possible to validate the Fleximeter as a reliable instrument to assess the joints of the body. Our results have demonstrated that there was a widevariation of reliability indices among the movements assessed, and the fleximeter was difficult to manage management. Therefore, it is recommended that other studies should be developed to technically improve this instrument and establish its reliability in a more diversified population.Os instrumentos de medidas devem ser analisados quanto a sua utilidadeclínica e respaldo científico em diferentes populações. O objetivo desse estudo foi avaliar a confiabilidade inter-examinadores do flexímetro (Fleximeter®) em um grupo de 12 sujeitos adultos maduros e idososassintomáticos de ambos os sexos, através do índice de Correlação Intraclasses (ICI). Os resultados mostraram que o equipamento apresentou alta confiabilidade interexaminadores nos movimentos de rotação da coluna cervical, flexão de quadril em ortostatismo, flexão do quadril com joelho estendido e fletido, flexão de joelho, flexão dorsal e flexão plantar do tornozelo. A confiabilidade do instrumento foi moderadae baixa nos movimentos de flexão lateral da coluna cervical, na flexão e extensão do cotovelo, na flexão anterior, flexão lateral e extensão do tronco, na extensão do quadril em ortostatismo e em decúbito ventral e na extensão de joelho. A partir dos resultados do presente estudo não é possível afirmar que o Fleximeter seja um instrumento confiável para medidas de flexibilidade do corpo em geral. O fato do instrumentoapresentar diferentes índices de confiabilidade entre os vários movimentos pesquisados e as dificuldades encontradas na sua utilizaçãosugerem que o mesmo necessita de aprimoramento técnico e que outros estudos devam ser realizados, a fim de determinar sua confiabilidade em outras populações

Acesso de pacientes com AVC à telessaúde: quais são as principais barreiras e como são explicadas pelo modelo teórico UTAUT? Uma revisão sistemática

O acidente vascular cerebral (AVC),como condição crônica de saúde, requer monitoramento.Nesse sentido, a telessaúde surge com o objetivo depossibilitar um melhor acesso aos serviços de saúde.Porém, por estar relacionada ao uso de tecnologia,essa modalidade pode enfrentar novas barreiras.O objetivo desta pesquisa foi identificar, por meio de umarevisão sistemática da literatura, as barreiras percebidaspor pacientes com AVC quanto ao acesso à telessaúdee conceituá-las dentro do modelo da Teoria Unificadade Aceitação e Uso de Tecnologia (UTAUT). A revisãosistemática foi realizada nas seguintes bases de dadoseletrônicas: PubMed, MEDLINE, SciELO, LILACS e PEDro;por meio da combinação dos descritores “barreirasde acesso aos cuidados de saúde”, “telerreabilitação”,“telessaúde”, “acidente vascular cerebral” e “modalidadesde fisioterapia”. Inicialmente, foram encontrados298 artigos, sendo 295 por meio da busca em bases dedados e três por meio de busca ativa, e, destes, apenas seisartigos foram incluídos na revisão. Somados, os artigosrevelaram a percepção de mais de 220 indivíduos quesofreram AVC e oito tipos de barreiras, a maioria delasrelacionadas às dimensões de Expectativa de Esforço eCondições Facilitadoras do modelo UTAUT. As barreirasda dimensão Expectativa de Esforço relacionadas aoconhecimento no uso de tecnologias são passíveis deserem superadas, pois treinamentos podem ser realizadospreviamente ao serviço de telessaúde. No entanto,as barreiras relacionadas à dimensão das CondiçõesFacilitadoras no que se refere a aspectos financeiros,internet e contexto domiciliar são difíceis de superar,podendo, portanto, interferir na aceitação do usuárioquanto ao uso da telessaúde.El accidente cerebrovascular (ACV) como una condiciónde salud requiere de monitoreo. En este contexto, la telesaludemerge como una posibilidad que permite un mejor acceso a losservicios de salud. Sin embargo, dado que esta modalidad estárelacionada con el uso de la tecnología, se pueden surgir nuevasbarreras. El objetivo de esta investigación fue identificar, medianteuna revisión sistemática de la literatura, las barreras percibidaspor los pacientes con ACV con respecto al acceso a la telesaludy conceptualizarlas dentro del modelo de la Teoría Unificada deAceptación y Uso de la Tecnología (UTAUT). La revisión sistemáticase realizó en las siguientes bases de datos electrónicas: PubMed,MEDLINE, SciELO, LILACS y PEDro; a partir de la combinaciónde los descriptores “barreras de acceso a la atención médica”,“telerrehabilitación”, “telesalud”, “accidente cerebrovascular”y “modalidades de fisioterapia”. Inicialmente, se encontraron298 artículos, de los cuales se obtuvieron 295 mediante la búsquedaen la base de datos y tres por la búsqueda activa; de estos, solo seisartículos se incluyeron en la revisión. Los artículos revelaron lapercepción de más de 220 sujetos que sufrieron ACV y ocho tiposde barreras; la mayoría de ellas relacionadas con las dimensionesExpectativa de Esfuerzo y Condiciones Facilitadoras del modeloUTAUT. Las barreras de la dimensión Expectativa de Esfuerzo,relacionadas con el conocimiento en el uso de tecnologías, sepueden superar mediante una capacitación previa antes de utilizarla telesalud. Sin embargo, las barreras asociadas con la dimensiónde las Condiciones Facilitadoras respecto a los aspectos financieros,de Internet y el contexto del hogar son difíciles de superar y,por lo tanto, pueden interferir en la aceptación del uso de latelesalud por parte del usuarioStroke is a chronic health condition thatrequires monitoring. In this sense, telehealth emergesas a tool to enable better access. However, since it isrelated to use of technology, this modality might facenew barriers. Our goal was to identify, with a systematicliterature review, the perceived barriers to telehealthaccess by stroke patients and conceptualize them withinthe Unified Theory of Acceptance and Use of Technology(UTAUT) model. The systematic review was carried out in the following electronic databases: PubMed, MEDLINE, SciELO,LILACS, and PEDro; and the combination of descriptors were:“Barriers to Access to Health Care,” “Telerehabilitation,” “Telehealth,”“Stroke,” and “Physical Therapy Modalities.” The included studiesfocused on telehealth barriers perceived by stroke patients. Initially,298 articles were found, 295 via databases search, and threevia active search; of these, only six articles were included in thisreview. Overall, the articles revealed the perception of more than220 stroke patients, with barriers categorized into eight types,most of them related to the dimensions of Effort Expectancy andFacilitating Conditions of the UTAUT model. The barriers of theEffort Expectation dimension that are related to the knowledge inthe use of technologies are likely to be overcome since training canbe carried out before the telehealth service. However, the barriersrelated to the Facilitating Conditions dimension regarding financialaspects, the internet, and home context are difficult to overcome,possibly interfering with user’s acceptance of telehealth

Associação entre a capacidade funcional, transtorno do sono e nível de atividade física em indivíduos com doença de Parkinson durante o período de pandemia de covid-19: um estudo transversal

Resumo Objetivo Avaliar o nível de atividade física, considerando as condições sociodemográficas, clínicas e funcionais, de pessoas idosas com Doença de Parkinson (DP). Método Foi realizado um estudo transversal a partir dos seguintes dados: nível de atividade física (International Physical Activity Questionnaire versão curta - IPAQ curto), transtornos do sono, queixa cognitiva, tempo de doença, grau de dependência para realizar atividades básicas do dia a dia pela escala Schwab & England (S & E) de indivíduos idosos com DP atendidos em um serviço de saúde terciário, durante a pandemia da covid-19. Regressão de Poisson, teste U de Mann-Whitney e teste t de Student foram utilizados para análise estatística. Resultados A cada 10 pontos de elevação na escala de S & E, a razão de prevalência de ser ativo foi maior em 1,04 (IC 95% 1,01 – 1,08) e quem não referiu transtorno de sono teve razão de prevalência de 1,17 (IC95% 1,02-1,34) vez maior de ser ativo. Indivíduos com DP inativos eram mais velhos e tinham maior tempo de doença. Conclusão Ênfase deve ser dada a capacidade funcional e ao sono de indivíduos com DP para o manejo adequado do nível de AF em períodos de restrição social

Postural and Load Distribution Asymmetries in Preschoolers

The aim of the study was to investigate the postural and load distribution symmetries in preschool children. The sample consisted of 67 preschool children with a median age of 54.00 ± 5.06 months. Postural parameters such as the horizontal alignment of the head, the acromion and Antero Superior Iliac Spines (ASIS), the angles between the acromial and ASIS, frontal, Q, knee and ankle and horizontal asymmetry of the scapula in relation to T3 were evaluated by photogrammetry. The baropodometry was used to identify the distribution of plantar pressure, while the medial arch of the foot was analyzed by photographic image. The median, standard deviation and the symmetry ratio were calculated for each parameter considered symmetry values greater than 90%. The Pearson’s or Spearman’s correlation were used between the parameters analyzed. There was asymmetric for postural and load distribution parameters for both genders and a null correlation between the symmetry of the surface and foot morphology and negative weak correlation significant between of the load foot and the front angle of the lower limb symmetries. The presence of asymmetries, postural and/or of load distribution, observed in early childhood suggest the importance of monitoring the postural and foot load parameters in the long term, preventing future postural and biomechanical alterations

Postural and Load Distribution Asymmetries in Preschoolers

The aim of the study was to investigate the postural and load distribution symmetries in preschool children. The sample consisted of 67 preschool children with a median age of 54.00 ± 5.06 months. Postural parameters such as the horizontal alignment of the head, the acromion and Antero Superior Iliac Spines (ASIS), the angles between the acromial and ASIS, frontal, Q, knee and ankle and horizontal asymmetry of the scapula in relation to T3 were evaluated by photogrammetry. The baropodometry was used to identify the distribution of plantar pressure, while the medial arch of the foot was analyzed by photographic image. The median, standard deviation and the symmetry ratio were calculated for each parameter considered symmetry values greater than 90%. The Pearson’s or Spearman’s correlation were used between the parameters analyzed. There was asymmetric for postural and load distribution parameters for both genders and a null correlation between the symmetry of the surface and foot morphology and negative weak correlation significant between of the load foot and the front angle of the lower limb symmetries. The presence of asymmetries, postural and/or of load distribution, observed in early childhood suggest the importance of monitoring the postural and foot load parameters in the long term, preventing future postural and biomechanical alterations

Application of the participatory design in the testing of a baropodometric insole prototype for weight-bearing asymmetry after a stroke: A qualitative study

Introduction Currently studies indicate the need to incorporate the user`s perspective in the testing of new assistive technologies. The objective of this paper is to test a baropodometric insole prototype for monitoring and treatment weight-bearing asymmetry, according to the Participatory Design. Methods We used a qualitative case study approach during the testing phase of the baropodometric insole prototype. The focus group approach addressed topics related to the experience and accessibility of the potential user in conjunction with professionals, researchers, and physiotherapy students. Facilitators, barriers, and requirements for the device were collected through audio recordings of the discussions during and after prototype testing. Results Key steps in the prototype testing process were divided into (1) Test of the prototype according to the Participatory Design, divided into Who, When, How, and Why the potential user was involved in the study; and (2) Facilitators, barriers and requirements to improve the prototype. Conclusions The baropodometric insole prototype can be seen as a promising device for monitoring and treating weight-bearing asymmetry

Effects of a power strength training using elastic resistance exercises on the motor and non-motor symptoms in patients with Parkinson’s disease H&Y 1–3: study protocol for a randomised controlled trial (PARK-BAND Study)

IntroductionParkinson’s disease (PD) is the second most common neurodegenerative disorder in Brazil. Physical activity is a complementary intervention in managing inherent declines associated with the disease like strength, balance, gait, and functionality and benefit health-related outcomes. Here, we report the PARK-BAND Study protocol, which aims to investigate potential benefits of power training using elastic devices in participants with PD. Our intervention will be provided in patients with PD using elastic devices like elastic bands and tubes. Therefore, we used the term Park from Parkinson’s disease and band from elastic bands.Methods and analysisThis randomised single-blind single-centre two-arm parallel, superiority trial will include 50 participants with PD attending the clinical setting. Those who meet the eligibility criteria and provide consent to participate will be randomised in a 1:1 ratio to either the exercise group, which will receive power training programme or the health education group, which will receive the education programme. Randomisation will be performed by permuted block randomisation with a block size of eight. Both groups will receive a 12-week intervention. The exercise group will have two sessions per week and the health education group will have one session per week. Changes from baseline in bradykinesia, as assessed by the Unified Parkinson's Disease Rating Scale motor examination subscore and physical functional performance, will be the primary outcomes. Secondary outcomes include other neurological, neurophysiological and physical variables, as well as the quality of life, depression, cognition, sleep quality and disturbances, assessed before and after interventions. We hypothesise that the exercise group will have greater improvement in primary and secondary outcomes than the health education group.Ethics and disseminationThe study is approved by the Research Ethics Committee of Hospital Universitário Walter Cantidio and all participants will provide their written informed consent (register number 91075318.1.0000.5045).Trial results will be disseminated via peer reviewed journal articles and conference presentations, reports for organisations involved with PD and for participants.Trial registration numberRegistro Brasileiro de Ensaios Clínicos Registry (RBR-5w2sqt); Pre-results