Wheelchair basketball improves the treatment of urinary tract infection in people with motor disabilities: a clinical trial

SUMMARY OBJECTIVE: Few studies on physical medicine and rehabilitation analyze the benefit of wheelchair basketball in people with motor disabilities. Given these, this study aimed to investigate the effect of the intervention of wheelchair basketball on urinary tract infection in people with motor disabilities. METHODS: A 12-month experimental follow-up was conducted in a single-center study. A total of 48 male individuals aged 18-55 years were allocated to the control group and experimental group. The experimental group practiced wheelchair basketball for 2 h, twice a week. Intra- and intergroup comparisons were made pre- and post-interventions over urinary tract infection. RESULTS: There was a significant improvement in urinary tract infection and urine culture in pre- and post-intervention antibiograms, respectively. Moreover, the intergroup comparison presented a decrease in infection caused by Klebsiella pneumoniae, as well as an increase in the time variability of partially activated thromboplastin, average corpuscular hemoglobin, and hemoglobin and platelets. In the experimental group, there was an increase in hemoglobin and hematocrit and a decrease in glycated hemoglobin (%HbA1C). On the intragroup comparison, there was a reduction of triiodothyronine (T3), %HbA1C, interleukin-6 pre-intervention, and C-reactive protein post-intervention. CONCLUSIONS: There was a decrease in urinary tract infection and improvement in biochemical, immunological, and microbiological biomarkers evaluated with physical exercise practice by wheelchair basketball, as well as by multiprofessional follow-up and health guidance.

Prevalence and factors associated with depression in the elderly: a cross-sectional study / Prevalência e fatores associados à depressão em idosos: um estudo transversal

ABSTRACT: Introduction: Depression is a psychiatric disease that causes losses in the biopsychosocial aspect of the affected individuals. The prevalence in the elderly population is significant, and identify the factors related to this outcome allows preventive measures and treatment can be early applied. Objective: Assessing the association between depression and sociodemographic and health risk factors in the elderly. Methods: This is a cross-sectional study involving 388 elderly of both genders, aged 65 years and older, urban residents of the city of Cuiabá, state of Mato Grosso (MT), Brazil. A socio-demographic questionnaire, as well as a self-report of chronic diseases and lifestyle, a self-report questionnaire of functional capacity, occurrence of falls, Geriatric Depression Scale, mental state assessment, and anthropometry tests were used. The chi-square test, oddsratio (OR), and multiple logistic regression with 95% confidence interval and p<5% were used in the statistical analysis. Results: There was a predominance of women (64%) who were mulatto/caboclo/brown skin (43%) and married (45%). Depression was significantly associated with: the lowest level of education, <8 years (OR=2.15; p=0.012), partial or total dependence of instrumental activities of daily living (OR=1.85; p=0.003), having five or more diseases (OR=2.93, p=0.002), falls in the last twelve months (OR=1.90; p=0.021), and sleep (OR=2.39; p<0.001) and visual difficulties (OR=2.28; p<0.001). Conclusion: Depression in this group of elderly was associated with modifiable and preventable factors in the health of these people. Thus, the early diagnosis of risk factors associated with depression, the inclusion of social, physical and cognitive activities must be considered for their prevention. (AU)

RESUMO: Introdução: Depressão é uma doença psiquiátrica e provoca prejuízos no aspecto biopsicossocial dos indivíduos acometidos. Sua prevalência na população idosa é expressiva, a identificação dos fatores relacionados a este desfecho permitem que medidas preventivas e de tratamento sejam aplicadas precocemente. Objetivo: Avaliar a associação entre depressão, os fatores sociodemográficos e os riscos para a saúde em idosos. Métodos: Estudo transversal com 388 idosos de ambos os sexos com idade igual ou superior a 65 anos, residentes do município de Cuiabá, estado de Mato Grosso (MT), Brasil. Foram usados questionários sociodemográficos, instrumentos de autorrelato de doenças crônicas, de estilo de vida, ocorrência de quedas e de capacidade funcional, escala de depressão geriátrica, avaliação do estado mental e testes de antropometria. Na análise estatística utilizou-se teste do qui-quadrado, odds ratio (OR) e regressão logística múltipla com intervalo de confiança de 95% e p<5%. Resultados: Encontrou-se predominância de mulheres (64%), sendo mulata/cabocla/parda (43%) e casadas (45%). A depressão foi significativamente associada com: o tercil mais baixo de educação <8 anos (OR=2,15; p=0,012); com dependência parcial ou total de atividades instrumentais da vida diária (OR=1,85; p=0,003); ter cinco ou mais doenças crônicas (OR=2,93; p=0,002), ocorrência de quedas nos últimos doze meses (OR=1,90; p=0,021); dificuldades de sono (OR=2,39; p<0,001) e visual (OR=2,28; p<0,001). Conclusão: A depressão estava associada a fatores modificáveis e que podem ser prevenidos. Desta forma, o diagnóstico precoce destes fatores de risco, a inclusão de atividades socias, físicas e cognitivas devem ser consideradas para sua prevenção. (AU)

Physical and functional aspects of persons with multiple sclerosis practicing Tai-Geiko: randomized trial

OBJECTIVES: This study aimed to verify the influence of Tai-Geiko on the physical and functional aspects of people with multiple sclerosis (MS). METHODS: This was a parallel-group, randomized trial with two arms. People with MS were allocated to an experimental group (EG) (n=10) and control group (CG) (n=09). The participants received multidisciplinary care supervised by a physiotherapist in the Tai-Geiko exercise. Participants underwent the assessments after the intervention. The Expanded Disability Status Scale (EDSS-maximum score of 6.0), strength test (kgf) using a dynamometer, Timed Up and Go mobility test (TUG), and stabilometric balance test (Platform EMG system®) were evaluated. Demographic data were recorded, including age, sex, comorbidities, lifestyle and classification of MS. Clinical Trials (ReBeC): RBR-4sty47. RESULTS: The EG group improved in 12 variables, and the CG improved in 3 variables. The following values were obtained for pre/postintervention, respectively: EG: lumbar force (38/52 kgf), TUG (11/9 s), locomotion velocity (519/393 ms); double task two (53/39 s); platform stabilometric trajectory: traversed get up (39/26 s) and sit (45/29 s); anteroposterior (AP) amplitude rise (11/8 cm) and sit (12.40/9.94 cm) and anteroposterior frequency rise (1.00/1.56 Hz) and sit (0.8/1.25 Hz) (p<0.05); CG: right-hand grip force (26/29 kgf); TUG (9.8 /8.7 s) and AP (11.84 /9.53 cm) stabilometric amplitude at the sitting moment (p<0.05), (3.2/5.99 Hz, p=0.01) and sit (3.47/5.01 Hz, p=0.04). CONCLUSION: Tai-Geiko practice can be suggested as complementary exercise in the rehabilitation of persons with MS.

The effects of physical activity on anxiety, depression, and quality of life in elderly people living in the community / Efeitos da atividade física sobre ansiedade, depressão e qualidade de vida em idosos da comunidade

Abstract Introduction: Health problems may negatively affect the psychological and physical aspects of life, influencing the quality of life of older adults. The objective of this study was to analyze the effects of physical activity on quality of life, anxiety, and depression in the elderly population. Methods: We performed a cross-sectional study of 200 elderly people of both genders. Subjects were divided into two groups: one with 100 senior citizens engaged in physical activities in a social center for the elderly; and another composed of 100 subjects who lived in the community but were not engaged in physical activities. The instruments used to assess physical activities, quality of life, and anxiety and depression were, respectively: the modified Baecke questionnaire; the 36-Item Short Form Health Survey (SF-36); and the Hospital Anxiety and Depression Scale (HADS). The data were analyzed using the Student's t test, Pearson's r, and analysis of variance (ANOVA), with odds ratio and a 5% significance level (p<0.05). Results: We observed that the active group showed higher scores of physical activity and quality of life. Conversely, the sedentary group revealed higher scores of anxiety and depression. Data assessment revealed a strong correlation between the domains quality of life, level of vitality, and mental health (r=0.77). The prevalence ratio showed that physical activity is a protective factor against anxiety and depression in the elderly. Conclusion: The findings suggest a correlation between low levels of physical activity and symptoms of anxiety and depression in the elderly living in the community.

Resumo Introdução: Problemas de saúde podem afetar negativamente nos aspectos físicos e psicológicos, influenciando a qualidade de vida dos idosos. O objetivo deste estudo foi analisar os efeitos da atividade física sobre a qualidade de vida, ansiedade e depressão na população idosa. Métodos: Foi realizado estudo transversal com 200 idosos de ambos os sexos, divididos em dois grupos: um grupo com 100 idosos envolvidos em atividades físicas do centro social para idosos; outro composto por 100 sujeitos que viviam na comunidade, mas não estavam envolvidos em atividades físicas. Os instrumentos utilizados para avaliação das atividades físicas, qualidade de vida, ansiedade e depressão foram, respectivamente: o questionário de Baecke modificado; o Questionário de Qualidade de Vida (SF-36); e a Escala Hospitalar de Ansiedade e Depressão (HADS). Os dados foram analisados por testes t de Student, Pearson (r) e análise de variância (ANOVA), com odds ratio e nível de significância de 5% (p<0,05). Resultados: Observamos que o grupo ativo apresentou maiores escores de atividade física e qualidade de vida. Por outro lado, o grupo sedentário revelou maiores escores de ansiedade e depressão. A avaliação dos dados revelou uma forte correlação entre os domínios qualidade de vida, nível de vitalidade e saúde mental (r=0,77). A razão de prevalência mostrou que a atividade física é fator de proteção contra ansiedade e depressão em idosos. Conclusão: Os achados sugerem uma correlação entre baixos níveis de atividade física e sintomas de ansiedade e depressão em idosos que vivem na comunidade.

Timed up and go test and self-perceived health in elderly: population-based study / Teste TUG e saúde autopercebida em idosos: estudo de base populacional

Abstract Due to the aging process, chronic diseases arise with increased use of medications and there is a need to evaluate the elderly to prevent functional dependence and falls. The aim of this study was to compare gender, sociodemographic characteristics, fall occurrences, self-reported diseases, quantity of drugs with timed up and go test (TUG) and TUG-cognitive, and to associate these factors with the self-perception of health of the elderly in the community. Were selected 513 elderly people, with 384 that completed the TUG test to evaluate the functional capacity. There was difference between the female and male, in the variables: age-group 70 to 79 years (p=0.036) ? 80 years (p=0.013); per capita income in the female ? 1 minimum wage (p=0.005) and >2 (p=0.013), falls (p=0.001), systemic hypertension (p<0.001), arthritis or rheumatism (p=0.033), depression (p=0.048), osteoporosis (p<0.001), medications 3 to 4 (p=0.008), self-perceived health (p=0.030) and in the TUG (p<0.001) and TUG-cognitive (p=0.002). The prevalence by Poisson regression Robust (RPa), the variables associated with health self-perceived: heart disease (p=0,047), stroke (p=<0,001), osteoporosis (p=0,013) and TUG motor (p=0,028). Women had more health problems, weakness and poor physical performance, indicating the need for special attention as the aging aspects. So, TUG test can be useful tool for risk evaluate of falls in the elderly living in the community.

Resumo Devido ao processo envelhecimento, surgem as doenças crônicas com aumento de uso de medicamentos e existe necessidade de avaliar os idosos para prevenir dependência funcional e quedas. O objetivo deste estudo foi comparar as pessoas idosas por gênero, variáveis socioeconômicas, ocorrências de quedas, doenças autorrelatadas, quantidade de medicamentos, saúde autopercebida e teste Timed Up and Go (TUG). Foram selecionadas 513 pessoas idosas, com 384 que completaram o teste TUG para avaliar a capacidade funcional. Existia diferença entre gênero feminino e o masculino, nas variáveis: grupo etário de 70 a 79 anos (p=0,036) ? 80 anos (p=0,013); renda per capita no salário mínimo ? 1 feminino (p=0,005) e> 2 (p=0,013), quedas (p= 0,001), hipertensão sistêmica (p<0,001), artrite ou reumatismo (p=0,048), osteoporose (p <0,001), medicamentos de 3 a 4 (p=0,008), autopercepção de saúde (p=0,030) e no TUG (p<0,001) e TUG-cognitivo (p=0,002). A prevalência por regressão de Poisson robusta (RPa), as variáveis associadas à saúde autopercebida: doença cardíaca (p=0,047), acidente vascular cerebral (p=0,001), osteoporose (p=0,013) e motor TUG (p=0,028). As mulheres tiveram mais problemas de saúde, fraqueza e desempenho físico fraco, indicando a necessidade de atenção especial aos aspectos do envelhecimento. Assim, o teste TUG pode ser uma ferramenta útil para avaliar o risco de quedas nos idosos que vivem na comunidade.

Tontura em idosos da comunidade: estudo de base populacional / Dizziness in community-dewelling older adults: a population-based study

A queixa de tontura é comum em idosos. OBJETIVO: Identificar a prevalência de tontura e os fatores associados em uma amostra de idosos que vivem na comunidade. MATERIAL E MÉTODO: Estudo de coorte histórica prospectivo, com idosos de 65 anos ou mais. Foi utilizado um inquérito multidimensional e uma bateria de testes físico-funcionais. RESULTADOS: A prevalência de tontura foi de 45 por cento. A tontura giratória foi relatada por 70,4 por cento dos idosos e 43,8 por cento disseram já ter tido crises vertiginosas em algum momento da vida. Houve associação significativa entre queixa de tontura e gênero feminino (p=0,004), relato de dificuldade de memória (p=0,015), má percepção de saúde (p=0,001), depressão (p<0,0001), cinco ou mais comorbidades (p=0,021), fadiga autorreferida (p<0,0001), história de quedas recorrentes (p=0,001), sonolência excessiva (p=0,003), medo de cair (p<0,0001), tempo de apoio unipodal esquerdo (p=0,002) e escore do Short Performance Physical Battery (p=0,009). CONCLUSÃO: A tontura é uma queixa comum em idosos e está associada a condições clínicas limitantes, como depressão, fadiga, sonolência excessiva e dificuldade de memória. Ressalta-se a associação com quedas recorrentes, medo de cair e pior desempenho em testes de função motora, que pode comprometer a independência dos idosos. Os dados sugerem a importância de uma abordagem multifatorial da tontura em idosos.

Dizziness is a common complaint among older adults. AIM: To identify the prevalence of dizziness and its related factors in a sample of community-dwelling older adults. METHODS: A prospective population-based study with a representative sample of older adults aged 65 years and over. A multidimensional questionnaire and a battery of measures were used for assessing physical function. RESULTS: The prevalence of dizziness was 45 percent. Vertigo was found in 70.4 percent of older adults with dizziness and 43.8 percent of them referred vertigo crises along life. A significant association was found between dizziness and female gender (p=0.004), memory difficulties complaints (p=0.015), bad health perception (p=0.001), depression (p<0.0001), five or more comorbidities (p=0.021), self-reported fatigue (p<0.0001), recurrent falls (p=0.001), excessive sleepiness (p=0.003), fear of falling (p<0.0001), left leg unipedal stance (p=0.002) and Short Performance Physical Battery score (p=0.009). CONCLUSION: Dizziness is a common complaint among older adults and it is associated with limiting clinical conditions, such as depression, fatigue, excessive sleepiness and impaired memory. It is highlighted the association between dizziness and recurrent falls, fear of falling and lower performance in physical function tests, which can restrict independence. These data suggest the importance of a multifactorial approach to dizziness in older adults.