Implicaciones de la fragilidad en las dimensiones clínica, funcional, social y mental en adultos mayores institucionalizados y su relación con los aspectos del dominio de la terapia ocupacional

La presente investigación se centra en el síndrome de fragilidad considerado de alta prevalencia; se considera que es un estado de prediscapacidad o predependencia; tiene un alto valor predictivo para efectos adversos y es una situación reversible. Se realiza un estudio transversal en el que participan 197 personas, con el objetivo de establecer el impacto del síndrome de fragilidad en el adulto mayor institucionalizado a partir de los datos de las valoraciones clínica, funcional, social y mental que ofrece la valoración geriátrica integral y en relación a los aspectos del dominio de la terapia ocupacional. Los resultados muestran que la fragilidad está asociada a todas las dimensiones de la valoración geriátrica integral. Además, aparecen diferencias significativas entre los grupos robusto, prefrágil, frágil y dependiente. Este estudio aporta evidencias de identificación precoz de la situación de fragilidad posibilitando poner en marcha las intervenciones pertinentes encaminadas a paliar los déficits encontrados y ser capaces de revertir dicha fragilidad.The current research focuses in frailty syndrome considered as a high prevalence situation which presents some specific characteristics such as: it is a pre-disability or pre-dependence situation; it has got a high predictive value for adverse events; and it is a reversible situation. Based on this, a transversal study with 197 participants from old people´s homes has been performed; aimed to establish the impact of frailty syndrome in old institutionalized people from data obtained in clinical, functional, social and mental dimensions of the Integral Geriatric Assessment and related to Occupational Therapy domain aspects. Results show how frailty is associated to all dimensions of the Integral Geriatric Assessment. There are also significant differences between robust, prefrail, frail and dependent groups. In conclusion, this study provides evidences that allow an early identification for people in a frailty situation; so that pertinent interventions can be started directed to palliate specific deficits found in each of the groups and finally, be able to reverse frailty

Terapia ocupacional en fragilidad: una aproximación bibliográfica

Frailty syndrome is a high prevalence situation among elderly people that affects performance; it is also precursor for adverse events, even dependence or death; but, it is also a situation that can be reversed. Occupational therapy, as a discipline that tends to an optimum performance in all activities of daily living, can carry out interventions focused in prevention or reversion of this frailty situation. With the aim to know the research situation about frailty from occupational therapy point of view, a revision is made. After a selection of the articles, 13 that comply established criteria are obtained. It is concluded that research in this field is very scarce although results obtained in studies endorse the effectiveness of occupational therapy interventions in frail elderly.El síndrome de fragilidad es una situación de alta prevalencia entre las personas mayores que afecta a todas las esferas de su funcionamiento; además es precursor de numerosos efectos adversos, incluso la dependencia o la muerte; pero, también se trata de una situación que puede ser revertida. La terapia ocupacional, como disciplina que persigue el funcionamiento óptimo de la persona en todas las actividades de su vida diaria, puede realizar intervenciones encaminadas a prevenir o revertir este estado de fragilidad. Se realiza una revisión con el objetivo de conocer la situación de la investigación en fragilidad desde el prisma de la terapia ocupacional. Tras una selección de artículos, se obtienen 9 que cumplen los criterios establecidos. Se concluye que la investigación en este campo es muy escasa aunque los resultados que ofrecen los estudios avalan la eficacia de las intervenciones de terapia ocupacional en personas mayores frágiles

A Cross-Sectional Study: Determining Factors of Functional Independence and Quality of Life of Patients One Month after Having Suffered a Stroke

Loss of quality of life (QoL) and functional independence are two of the most common consequences of suffering a stroke. The main objective of this research is to study which factors are the greatest determinants of functional capacity and QoL a month after suffering a stroke so that they can be considered in early interventions

Reliability and Validity of the Motor Activity Log (MAL-30) Scale for Post-Stroke Patients in a Spanish Sample

The validation of assessment instruments is of great importance when they are applied in clinical and healthcare settings, since their safe and reliable use is essential for the application of appropriate and high-quality treatments. The motor activity log (MAL-30) is an instrument widely used by professionals in the clinic, which has been validated in different countries, languages and populations. The aim of this study was to determine the reliability and validity of the MAL-30 scale for post-stroke patients in a Spanish sample.This research was funded by the CaixaBank Foundation (CAIXA-UBU002)

Executive Functions in Children and Adolescents with Autism Spectrum Disorder, Grade 1 and 2, vs. Neurotypical Development: A School View

Autism spectrum disorders are neurodevelopmental disorders characterized by deficits in social and communication functioning. Previous studies suggest that people with autism spectrum disorders have deficits in executive functions, having found a relationship with cognitive flexibility, planning, working memory, inhibition or self-control, but it is especially with respect to cognitive flexibility where the greatest dysfunctions have been found. The objective of this research was to compare the executive functioning of a group of children and adolescents diagnosed with autism spectrum disorders with another with neurotypical development in an educational context

Previous falls and risk of falls in relation to fragility

Esta investigación descriptiva transversal estudia la relación entre el número de caídas durante el último mes y el riesgo de caídas de una parte; y la situación de fragilidad en adultos mayores de otra parte; en una muestra de 194 personas mayores institucionalizadas. La fragilidad se mide con la herramienta Short Physical Performance Battery, las caídas previas durante el último mes se recogen de manera numérica y el riesgo de caídas se mide mediante la escala Downton. Los resultados no muestran diferencias significativas entre los grupos de fragilidad en relación al número de caídas previas durante el último mes. Sin embargo, sí que existen diferencias significativas entre los grupos de fragilidad que establece el SPPB y el riesgo de caídas; así, ya desde los resultados descriptivos se observa como las medias obtenidas en riesgo de caídas aumentan según el continumm robusto-prefrágil-frágil-dependiente avanza hacia la dependencia. En relación a las diferencias entre grupos, se encuentra que el grupo dependiente tiene diferencias significativas con todos los demás (p=,001); además, existen diferencias significativas entre frágil y robusto (p=,003). Por el contrario en las relaciones frágil-prefrágil y prefrágil-robusto las diferencias no son significativas. Los resultados obtenidos permiten la detección de la población con mayor riesgo de caídas, lo que posibilitaría implementar intervenciones precoces encaminadas a la prevención de caídas en base a las diferencias encontradas entre los grupos.This descriptive transversal research studies the relationship between number of falls in the last month and fall risk on one side; and frailty situation in older adults on the other side; through a 194 old institutionalized people sample. Frailty is measured with the Short Physical Performance Battery; previous falls in the last month are measured with the number of events, and fall risk with Downton scale. The results do not show any significant differences in frailty groups related to the number of previous falls in the last month. However, significant differences do exist between frailty groups established in SPPB and fall risk; then, since descriptive results, they show how the arithmetical averages in fall risk increase as the continuum robust-prefrail-frail-dependent advances towards dependency. Concerning differences between groups, it is found that dependent group has got significant differences with all other (p=,001), there are significant differences also in frail-robust (p=,003). In opposition, the relation frail-prefrail and frail-robust do not show any significant differences Results allow the detection of high level fall risk population, which enables early intervention implementations aimed to falls prevention based on differences found between groups.peerReviewe

Basic and instrumental activities in relation to the situation of fragility

Esta investigación descriptiva transversal estudia la relación de la situación de fragilidad en adultos mayores y la existencia o no de dependencia para las actividades de la vida diaria divididas en básicas e instrumentales con una muestra de 194 personas mayores institucionalizadas. La fragilidad se mide con la herramienta Short Physical Performance Battery, las actividades básicas de la vida diaria mediante el Índice de Barthel y las actividades instrumentales de la vida diaria con la escala de Lawton y Brody. Los resultados descriptivos muestran como las medias obtenidas en ambas actividades de la vida diaria disminuyen según el continumm robusto-prefrágil-frágil-dependiente avanza hacia la dependencia. Las diferencias en todas las subescalas de la Short Phisical Performance Battery son significativas, al igual que en Barthel y Lawton y Brody (p<,001). En relación al Barthel y los grupos del SPPB se encuentra que todos los grupos obtienen diferencias significativas entre sí (,007>p>,001) excepto en la relación robusto-frágil, en el que las diferencias no son significativas. En cuanto Lawton y Brody las diferencias son significativas (,041>p>,001); exceptuando el caso de los grupos frágil y prefrágil. Las diferencias encontradas entre los grupos permiten un diagnóstico precoz e intervenciones encaminadas a la prevenir o revertir el avance hacia una situación de dependencia.This descriptive transversal research studies frailty situation in older adults and basic and instrumental activities of daily living relationship through a 194 old institucionalized people sample. Frailty is measured with the Short Physical Performance Battery; basic activities of daily living with Barthel Index and instrumental activities of daily living with Lawton and Brody scale. Descriptive results show how the arithmetical averages in both activities of daily living decrease as the continuum robust-prefrail-frail-dependent advances towards dependency. There are significant differences in all subscales of Short Physical Performance Battery, as well as in Barthel and Lawton and Brody (p<,001). Regarding to Barthel and SPPB groups, significant differences among all of them were found (,007>p>,001), except in the robust-prefrail relation, where differences are not meaningful. Concerning Lawton and Brody, differences are significant (,041>p>,001); except in fragil-prefrail relation. The differences found between groups allow an early diagnosis and interventions aimed to prevent or reverse the progress towards a dependency situation.peerReviewe

Ansiedad, depresión y apatía en relación a la situación de fragilidad

This descriptive, transversal research studies the relationship between frailty in institutionalized old people and anxiety, depression and apathy in a 193 old people sample institutionalized in four old people’s homes.Frailty is measured with Short Physical Performance Battery; anxiety and depression with Goldberg scale; and apathy with Dementhia Apathy Interview and Rating.It is about a descriptive and transversal research that does not make any intervention on people participating and aims to establish if there is or there is not a relationship between variables, but not a causality relationship.It is shown that the three variables correlate with total punctuation in frailty scale and with all its subscales; so that, a higher frailty and/or dependency, corresponds to higher levels of anxiety, depression and apathy.There are also significant differences between frail and prefrail people groups in relation to apathy; and between dependent and prefrail groups in relation to anxiety and depression.Esta investigación descriptiva transversal estudia la relación de la situación de fragilidad en adultos mayores institucionalizados y la ansiedad, depresión y apatía en los mismos con una muestra de 193 personas mayores institucionalizadas en cuatro residencias para personas mayores.La fragilidad se mide con la herramienta Short Physical Performance Battery; la ansiedad y la depresión con la escala Goldberg; y la apatía con la escala Dementhia Apathy Interview and Rating.Se trata de un estudio transversal y descriptivo que no realiza ningún tipo de intervención sobre las personas participantes y pretende establecer si existe o no relación entre las variables, pero no una relación de causalidad entre ellas.Se observa que las tres variables correlacionan con la puntuación total de la escala de fragilidad y con cada una de sus subescalas; de manera que, a mayor situación de fragilidad y/o dependencia, mayores niveles de ansiedad, depresión y apatía.Aparecen además diferencias significativas entre el grupo de personas frágiles y prefrágiles en lo referente a la apatía; y entre los grupos dependiente y prefrágil en relación a la ansiedad y la depresión

Functionality, physical activity, fatigue and quality of life in patients with acute COVID-19 and Long COVID infection

A prominent feature of COVID-19, both in the short and long term, is the reduction in quality of life (QoL) due to low functionality scores and the presence of fatigue, which can hinder daily activities. The main objective of this study is to compare the functional status, level of physical activity, fatigue, and QoL of patients with Long COVID to other COVID-19 patients who did not develop persistent illness, and to determine whether there is a relationship between these variables and QoL. A cross-sectional study was conducted with 170 participants who had been infected with COVID-19 or had developed Long COVID. The main variables studied were functionality, physical activity, QoL and fatigue, measured using the PostCOVID-19 Functional Status Scale (PCFS), International Physical Activity Questionnaire (IPAQ), Short Form 12 (SF-12), and Fatigue Severity Scale (FSS). The main findings show a significant relationship (p &lt; 0.001) between reduced functionality, lower physical activity levels, increased fatigue severity, and poorer QoL in Long COVID patients. Furthermore, these variables are also related to worse QoL, but only functional status predicts it. In conclusion, our results have shown highly significant correlations between the group with COVID-19 and Long COVID regarding functional status, level of physical activity, QoL, and fatigue

Executive Functions in Children and Adolescents with Autism Spectrum Disorder in Family and School Environment

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by the presence of difficulties in communication and social interaction, often associated with deficits in executive functions (EF). The EF correct development is related to a more effective functioning in all its daily activities, while being associated with more efficient social relations. The objective of this research is to analyze the level of development of EF in children and adolescents with ASD in school and at home. This is a descriptive, cross-sectional, and multicenter study with 102 participants selected by non-probabilistic sampling, 32 parents of children with ASD, and 70 professionals in the field of education of students with ASD. The study confirms that although children and adolescents with ASD have problems in executive functioning, the perception of informants, parents, and education professionals is similar but not the same in the different contexts: school and home