Escala de movilidad ProMover. Un lenguaje unificado para la evaluación de pacientes hospitalizados / ProMover mobility scale. A unified language for the evaluation of hospitalized patients

Resumen La Clasificación Internacional del Funcionamiento (CIF) define la movilidad como la posibilidad de "moverse cambiando la posición o ubicación del cuerpo o moviéndose de un lugar a otro, trans portando, moviendo o manipulando objetos, caminando, corriendo o trepando, y utilizando diversas formas de transporte". La fisioterapia se centra en la evaluación y el tratamiento de los problemas de movimiento. La deter minación del estado de movilidad es un componente central de la evaluación de la salud de los adultos mayores, ya que es un marcador importante de las capacidades físicas y la independencia, y un predictor de morbilidad y mortalidad. Sin embargo, a la fecha no disponemos de escalas que representen el grado de movilidad del paciente con algún tipo de imagen visual que facilite su documentación de forma rápida y fiable por parte de cualquier profesional sanitario que trabaje en el ámbito de la hospitalización. Por estas razones, desarrollamos una escala de movilidad intuitiva basada en iconos que es fácil de administrar en pacientes hospitalizados en diferentes entornos. La escala de movilidad ProMover proporciona a los profesionales de la salud una herramienta unificada para evaluar la movilidad de los pacientes hospitalizados, con el fin de unificar un lenguaje común. Se trata de una herramienta sencilla, práctica, fiable y objetiva y de uso común por todos los profesionales sanitarios.

Abstract. The International Classification of Functionality (CIF) defines mobility as the possibility of "moving by changing the position or location of the body or moving from one place to another, transporting, moving or manipulating objects, walking, running or climbing, and using various forms of transport ". Physical therapy focuses on the assessment and management of movement problems. Determining mobility status is a central component of the health assessment of older adults since it is an important marker of physical abilities and independence, and a predictor of morbidity and mortality. However, to date we did not have scales that represent the degree of mobility of the patient with some type of visual image that facilitates its documentation quickly and reliably by any health professional who works in the field of hospitalization. For these reasons, we developed an intuitive, icon-based mobility scale that is easy to administer in hospitalized patients in different settings. The ProMover mobility scale provides health professionals with a unified tool for evaluating the mobility of hospitalized patients, in order to unify a common language. This is a simple, practical, reliable and objective tool and commonly used by all health professionals.

Fragilidade física e mobilidade funcional em idosos da atenção primária à saúde / Physical frailty and functional mobility in elderly people in primary health care

Resumo: Trata-se de estudo quantitativo de corte transversal, cujo objetivo foi analisar a associação da condição e dos marcadores de fragilidade física à mobilidade funcional de idosos. Participaram-se 389 idosos (?60 anos) assistidos em uma Unidade Básica de Saúde em Curitiba, Paraná. Para a coleta de dados, aplicaram-se questionários sociodemográfico e clínico, testes do fenótipo de fragilidade física e o timed up and go para avaliar a mobilidade funcional. Analisaram-se os dados mediante estatística descritiva, associação (Teste de Qui-quadrado com nível de significância estatístico considerado de p<=0,05 (a=0,05) e de correlação (Teste de Pearson). As chances de associação entre os marcadores de fragilidade e a mobilidade funcional diminuída foram analisados pela Odss Ratio, com intervalo de confiança de 95%. O modelo de regressão final foi elaborado pelo critério da acurácia, sensibilidade, especificidade, coeficientes de correlação linear e ajustado. O estudo foi aprovado pelo Comitê de Ética do Setor de Ciências da Saúde da Universidade Federal do Paraná, sob o parecer n°2918847. Dos 389 idosos, 34 (8,7%) eram frágeis, 186 (47,8%) pré-frágeis, 169 (43,5%) não frágeis, e 330 (84,8%) apresentaram mobilidade funcional diminuída. Os marcadores de fragilidade mais expressivos foram o baixo nível de atividade física (n=82; 21,0%), redução da força de preensão manual (n=82; 21,0%), redução da velocidade da marcha (n=81; 20,8%). Houve associação significativa entre a mobilidade funcional preservada e a condição de não frágeis (p=0,001). Correlacionaram-se à mobilidade funcional diminuída, a fragilidade (r=2,08; p=0,037), pré-fragilidade (r=2,04; p=0,041) e os marcadores redução da força de preensão manual (p=0,026), baixo nível de atividade física (p=0,026) e redução da velocidade da marcha (p<0,001). A razão de chance de idosos frágeis apresentarem mobilidade funcional diminuída é significativamente elevada (RC 9,25) quando comparada aos não frágeis. No modelo preditivo final permaneceram os marcadores redução da força de preensão manual, baixo nível de atividade física e redução da velocidade da marcha. O idoso com redução da força de preensão manual tem 1,96 vezes mais chance de desenvolver MF diminuída, quando comparado aquele FPM preservada (OR 1,968, IC95%, 0,798-4,854, p=0,141), e o idoso com baixo nível de atividade física tem 2,10 vezes mais chances de desenvolver declínio da mobilidade funcional, em relação ao fisicamente ativo (OR 2,101, IC95%, 0,855-5,163, p=0,105). O idosos com redução da velocidade da marcha possui 7,21 vezes mais chances de apresentar diminuição na MF, ao comparar com a condição de não frágil para esse componente (OR 7,213, IC95%, 1,703-30,537, p=0,007). Conclui-se que, os idosos frágeis e com o marcador redução da velocidade da marcha possuem chances elevadas de desenvolverem mobilidade funcional diminuída. Apesar da correlação entre mobilidade funcional e redução da força de preensão manual e baixo nível de atividade física, esses marcadores não se mostraram preditivos para mobilidade funcional diminuída. O presente estudo destaca resultados expressivos para a prática clínica de enfermagem gerontológica, os quais são essenciais para subsidiar estratégias preventivas para a mobilidade funcional do idoso e proporcionar uma visão mais ampla e clara na gestão dos cuidados, sobretudo para a fragilidade marcada pelo componente velocidade da marcha.

Abstract: This is a quantitative cross-sectional study, with the aim of analyzing the association between the condition and the markers of physical frailty and functional mobility in the elderly. Three-hundred and eighty-nine elderly people aged (?60 years) assisted at a Basic Health Unit in Curitiba, Paraná, participated. For data collection, sociodemographic and clinical questionnaires, physical frailty phenotype and timed up and Go tests were used to evaluate functional mobility. Data were analyzed using descriptive statistics, association (Chi-square test) with a level of statistical significance considered of p<=0.05 (a=0.05) and correlation (Pearson test). The chances of an association between frailty markers and decreased functional mobility were analyzed by the Odss Ratio, with a 95% confidence interval. The final regression model was elaborated by the criterion of accuracy, sensitivity, specificity, linear and adjusted correlation coefficients. The study was approved by the Ethics Committee of the Health Sciences Sector of the Universidade Federal do Paraná, under Opinion Report No. 2918847. Of the 389 elderly, 34 (8.7%) were frail, 186 (47.8%) pre-frail, 169 (43.5%) non-frail, and 330 (84.8%) had reduced functional mobility. The most expressive markers of frailty were low level of physical activity (n=82; 21.0%), reduced handgrip strength (n=82; 21.0%), reduced gait speed (n=81; 20.8). Frailty (r=2.08; p=0.037), pre-frailty (r=2.04; p=0.041) and, markers of handgrip strength (p=0.026), level of physical activity (p=0.026) and gait speed (p<0.001) associated to the decreased functional mobility. There was a significant association between preserved functional mobility and the condition of not being frail (p=0.001). The odds ratio for frail elderly people with reduced functional mobility is significantly high (OR 9.25) when compared to non-frail people. In the final predictive model, the markers remained: reduced handgrip strength, low level of physical activity and reduced gait speed. The elderly with reduced handgrip strength is 1.96 times more likely to develop decreased MF when compared to that preserved HGS (OR 1.968, 95%CI, 0.798-4.854, p=0.141), and the elderly with low activity level physical activity is 2.10 times more likely to develop a decline in functional mobility, compared to physically active (OR 2.101, 95%CI, 0.855- 5.163, p=0.105). The elderly with reduced gait speed are 7.21 times more likely to have a decrease in MF, when compared to the condition of non-frail for this component (OR 7.213, 95%CI, 1.703-30.537, p=0.007). It is concluded that the frail elderly and with the marker reduced gait speed have a high chance of developing reduced functional mobility. Despite the correlation between functional mobility and reduced handgrip strength and low level of physical activity, these markers were not predictive for decreased functional mobility. The present study highlights expressive results for the clinical practice of gerontological nursing, which are essential to support preventive strategies for the functional mobility of the elderly and provide a broader and clearer view in the management of care, especially for the frailty marked by the gait speed component.

Effect of Proximal Muscle Strengthening on Distal Muscle Facilitation in Guillain Barre Syndrome

In Guillain Barre Syndrome (GBS), there is symmetrical muscle weakness which ranges from mild weakness to severe palsy of all limbs. The motor symptoms start distally and move proximally. Proximal muscle weakness is primary and common factor in GBS. To overcome the weakness, one has to strengthen the muscle. Muscle activity of proximal segment is necessary for activation of distal segment. In fact, stable activity of distal parts needs controlling of the proximal parts. As distal muscle weakness is a major problem in post GBS individuals, they need to be facilitated with the help of proximal muscle strengthening. MethodsAfter obtaining the ethical committee clearance an experimental study was conducted among a total of 30 GBS subjects selected through convenience sampling. OPD subjects were given proximal muscle strengthening for 6 weeks. Each subject was examined by modified sphygmomanometer test (MST) and functional independence measure scale (FIMS) before and after the study. ResultsResult was calculated by using MST and FIMS. Exercises showed extremely significant difference on MST [p = 0.0001, t = 11.924] on handgrip strength, [p value = 0.0001) t = 12.334] on plantar flexion, [p value = 0.0001, t = 9.558] on dorsiflexion. FIMS [p value = 0.0001, t = 25.699] extremely significant difference was seen. ConclusionsProximal muscle strengthening is found to be effective for distal muscle facilitation in Guillain Barre Syndrome.

Impact of Pressure Ulcers on Therapeutic Outcomes in Inpatient Physiotherapy Services.

Pressure ulcers have been associated with an extended length of hospitalization, sepsis and mortality. Over the last few decades, little has been written about the impact of pressure ulcers on therapeutic outcomes in inpatient physiotherapy services. It is obvious that critically ill patients, who are sedated, ventilated, patients with chronic neurological, musculoskeletal and cardio-respiratory disorders who are bed ridden for prolonged period of time are particularly at risk of developing skin breakdown. This will help in identifying barriers to patient participation and develop strategies to pressure ulcer prevention. We wanted to determine the impact of pressure ulcers on therapeutic outcomes in inpatient physiotherapy services. MethodsThe study was conducted from June 2015 to January 2016. The impact of pressure ulcer on inpatient physiotherapy services was determined by detailed physical assessment, evaluation with Functional Independence Measure score (FIM) and Braden Q Scale. A total 96 subjects were assessed during this time. ResultsThere was statistically significant impact of pressure ulcers on therapeutic outcomes in inpatient physiotherapy services. The FIM takes into consideration self-care, sphincter control, transfers, locomotion, communication social cognition. A poor score denotes poor outcome at discharge. Tissue level assessment was carried out by using Braden Q Scale, a poor score of which again denotes very poor outcome in mobility, activity, sensory perception, moisture, friction – shear, nutrition, tissue perfusion and oxygenation. ConclusionsPressure ulcer is one of the preventable problems; but in majority of cases it becomes the main reason for poor therapeutic outcome.

The effect of home exercise on the posture and mobility of people with HAM/TSP: a randomized clinical trial / Efeitos de exercícios domiciliares sobre a postura e mobilidade de pessoas com HAM/TSP: ensaio clínico randomizado

Abstract Background: Physical therapy has positive results in people with tropical spastic paraparesis (TSP). However, mobility and distance from rehabilitation centers limit the participation in outpatient programs. Objective: To evaluate the impact of a home exercise program on the posture and functional mobility of people with TSP. Methods: A randomized controlled trial comparing three groups of people who performed guided exercises from a guidebook for six months: supervised (SG), unsupervised (WG), and control (CG). Primary outcomes: postural angles (SAPO®) and functional mobility (TUG). Secondary outcomes: gait parameters (CVMob®). Results: The protocol described in the guidebook improved postural angles and functional mobility. There were also positive gait parameter effects (p<0.05). SG presented better responses than WG did, but both were preferable to CG. Conclusion: Home exercises oriented by a guidebook may benefit posture, functional mobility and gait parameters in people with TSP, and physiotherapist supervision can ensure better results.

Resumo Introdução: A fisioterapia apresenta resultados positivos em pessoas com paraparesia espástica tropical (PET). Entretanto, a dificuldade de locomoção e a distância dos centros de reabilitação limitam a participação em programas ambulatoriais. Objetivo: Avaliar o impacto de um programa de exercícios domiciliares na postura e mobilidade funcional de pessoas com PET. Métodos: Um ensaio clínico randomizado comparou três grupos de pessoas que realizaram exercícios guiados por cartilha: com supervisão (GS), sem supervisão (GN) e controle (GC) durante seis meses. Desfechos primários: ângulos posturais (SAPO®) e mobilidade funcional (TUG). Desfechos secundários: parâmetros da marcha (CVMob®). Resultados: O protocolo descrito na cartilha melhorou os ângulos posturais e a mobilidade funcional. Os resultados também foram positivos para os parâmetros da marcha (p<0,05). O GS apresentou melhores respostas que o GN, porém ambos foram preferíveis ao GC. Conclusão: Exercícios domiciliares orientados por cartilha podem ser úteis para beneficiar a postura, mobilidade funcional e parâmetros de marcha em pessoas com PET, e a supervisão do fisioterapeuta possibilita garantir melhores resultados.

The Timed Up-&-Go Test: Preliminary Age- and Sex-related Reference Values for Older Filipino Adults

Objective@#The Timed Up-&-Go Test (TUGT) is a clinically useful measure that has been widely used in practice to assess functional mobility in older people. Interpretation of TUGT scores relies on appropriate reference values. This study aimed to describe preliminary age- and sex-related reference values for the TUGT for Filipinos aged 60–79 years. @*Methods@#This is a descriptive cross-sectional study. We included Filipino adults aged 60–79 years, with no significant disability, and resided in metropolitan areas in the National Capital Region and rural communities in southern Luzon. All participants completed the TUGT. Data were analyzed descriptively and reported as means, standard deviations, and 95% confidence intervals.@* Results@#A total of 156 community-dwelling older adults participated in the study with mean age (SD) of 68 (5) years. The majority were women (103/156, 66%). Mean (SD) TUGT score for all participants was 11.0 (2.4) seconds. Overall, men completed the test faster compared to women, and individuals in the 60–69 years age group had shorter completion times than those in the 70–79 years age group.@*Conclusion@#In the absence of definitive reference values for older Filipino adults, this study provides preliminary guidance for interpreting TUGT performance for the purposes of screening and monitoring functional mobility impairments in this population.

Correlation Between Body Mass Index And Fear Of Fall On Functional Mobility In Elderly

Background: Functional mobility is defined as the ability of a person to move from place to place in the environment in order to participate in the activities of daily living. A person with overweight and obesity have a greater risk of experiencing mobility disability and those patients will have restrictions in activities at home, work, school and in the community thereby having a negative impact on their health related quality of life. Fear of falling in elderly is a major cause of loss of independence, which has an effect on the physical function in them. Purpose of the study: To find out the relationship between BMI and fear of fall on functional mobility in elderly Result: Out of 30 subjects, 15 subjects were overweight and 15 were normal BMI. Out of 15 overweight subjects, 53.3% were males and 46.7% were females. The mean age of overweight participants was 68.46±2.77. The mean scores for BMI were 27.82±1.56, for FOF 4.93±1.09and for FM 21.53±3.99. FOF and FM were negatively correlated with Overweight. The correlation was not significant. Out of 15 subjects with normal BMI, 53.3% were males and 46.7% were females. The mean age of participants with normal BMI was 68.86±3.62. The mean scores for BMI were 21.40±1.61, for FOF 5.93±.883and for FM 19.26±3.55. FOF and FM were positively correlated with normal BMI. The correlation was not significant. Conclusion: The overweight individual have more fear of fall (FOF) compared with individuals with normal BMI. The functional mobility (FM) is decline in overweight individuals than individuals with normal BMI. Implications: A decrease in sedentary lifestyle and regular physical activity can improve health related quality of life of elderly.

Feedback Training Improves Accuracy Of Estimating Upper Extremity Weight Bearing During Functional Tasks – Implications After Open Heart Surgery

Background: Patients often need to use their arms to assist with functional activities, but after open heart surgery pushing with the arms is limited to minimize force across the healing sternum. Objectives: The main purposes of this study were to determine: 1) how accurately patients can estimate arm weight bearing with 10 lb or less of force and 2) if feedback training is effective for improving ability to estimate arm force and reduce pectoralis major muscle contraction during functional activities. Materials and Methods: An instrumented walker was used to measure arm force during functional mobility tasks including walker ambulation and sit-stand transfers. Pectoralis major muscle electromyography (EMG) activity was measured simultaneously in study participants (n = 21). After baseline testing, study participants underwent a brief session of visual and auditory concurrent feedback training. Data analyses included t-tests, ANOVA, and Pearson correlations (P<0.05). Results: Results showed that self-selected arm force was greater than 10 lb for all tasks (11.7-19.0 lb) but after feedback training, it was significantly lower (8.3-9.8 lb). During most trials (67%), study participants used more than 12 lb of arm force. Pectoralis major muscle EMG values were less than 10% of maximal voluntary contractions and were reduced (2.7-3.3%) after feedback training. Conclusions: Results indicate that patients may not be able to accurately estimate upper extremity force used during weight bearing activities, and that visual and auditory feedback improves accuracy. Activation of the pectoralis major muscle during arm weight bearing is minimal, suggesting minor force occurs across the sternum. An instrumented walker and feedback training appear to be very clinically useful for patients recovering from open heart surgery.

Barefooted vs with footwear: functional mobility assessment on community dwelling elders

Background: Affected balance, restricted mobility and probability of fall is more common in elder. Most of the geriatric individuals prefer walking independently as one of the prime function, so maintenances of that even with affecting factors of fall it is essential. Footwear is one extrinsic factor which may affects postural stability and increase risk of fall.Methods: A cross sectional study conducted among community dwelling elders. Participants (n=40) have performed time up and go test (TUG) and ten meter walk test (TMW) in or out of the house with barefoot and two different type of pre-screened footwear. Descriptive statistics were done and ANOVA was performed.Results: The calculated F ratio (0.7817), (1.3100) is lesser than the table F ratio (3.0737), (3.0737) for the TMW and even For TUG so the TUG score for barefoot and two different type of footwear do not differ significantly.Conclusions: Functional mobility is not influenced by routine footwear. Barefooted and with footwear dynamic balance and gait speed is not significantly different from each other.

Motor performance and functional mobility in children with specific learning disabilities

@#Limitations in motor performances among children with specific learning disabilities (SLD) can lead to impaired functional skills. Thus, this study aimed to determine the level of motor performances and functional mobility, and the influence of motor performances on the functional mobility in children with SLD.

Balance, functional mobility, and fall occurrence in patients with human T-cell lymphotropic virus type-1-associated myelopathy/tropical spastic paraparesis: a cross-sectional study

Abstract INTRODUCTION: Human T-cell lymphotropic virus type-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) may lead to reduced functional mobility and balance. It is important to establish specific parameters that identify these changes and predict the risk of falls in these patients. The aim was to compare balance, functional mobility, and occurrence of falls among patients with and without HAM/TSP and to suggest values to predict the risk of falls in these patients. METHODS: A cross-sectional study in patients with and without HAM/TSP involved balance assessments based on the berg balance scale (BBS) and functional mobility evaluation based on the timed up and go (TUG) test. From reports of falls, the sensitivity, specificity, and best cutoff points for the risk of falls assessed by these instruments were established using the receiver-operating characteristic (ROC) curve; 5% alpha was considered. RESULTS: We selected 42 participants: 29 with HAM/TSP and 13 without HAM/TSP. There was a statistically significant difference in the occurrence of falls, balance, and functional mobility between the groups (p<0.05). Good accuracy was determined for the BBS (77%) and TUG test (70%) and the cutoff points for the risk of falls were defined as 50 points for the BBS and 12.28 seconds for the TUG test. CONCLUSIONS: Patients with HAM/TSP present reduced functional mobility and balance in relation to those without HAM/TSP. The risk of falls increased for these patients can be evaluated by the values ​​of 50 points using the BBS and 12.28 seconds using the TUG test.

Knee Associated Problems and Functional Mobility among Adults with Knee Osteoarthritis / Jurnal Sains Kesihatan Malaysia

@#Knee osteoarthritis (KOA) is a major cause of disability and significantly reduce quality of life (QOL). There is limited information about knee associated problems and functional mobility among Malaysian adults with KOA. The aim of our study was to examine knee associated problems and functional mobility among this population. Forty-five (45) adults with KOA with mean age of 65.02 ± 8.083 were recruited from Hospital Canselor Tuanku Muhriz, UKM. Knee associated problems and functional mobility were measured using Knee injury and Osteoarthritis Outcome Scores (KOOS) and Timed-Up and Go (TUG) test respectively. The mean score and standard deviation for TUG test was 11.44 ± 2.69. Median scores (with interquartile ranges [IQR]) for the KOOS subscale domains were; Symptoms: 80.56, (69.44 to 91.67); Pain: 71.43 (50 to 78.57); Functional Activities of Daily Living: 82.3 (67.65 to 86.76); Sports and Recreation Function: 30 (20 to 60); and Knee-Related Quality of Life: 50 (25 to 75). Generally, participants’ TUG test performance showed that time taken to complete the test was higher than the reference values (7.14 to 8.43 seconds) identified among Malaysian community dwelling older adults with low to high risk of falls. The KOOS scores in adults with KOA in our study is similar to previous reports with Sport and Recreation Function and QOL domains been the most affected. It is important to improve functional mobility and balance in order to decrease falls risk and optimise sport and recreation function and QOL among adults with KOA.

Resultado funcional de la cirugía multinivel en pacientes con parálisis cerebral, Instituto Teletón Santiago-Chile / Functional results in single event multilevel surgery in cerebral palsy patients, Teletón Institute Santiago-Chile, 2010-2013

The single event multilevel surgery (SEMLS) is a procedure preferably for patients with cerebral palsy (CP), including several orthopedic surgeries in one surgical time, and involves at least two levels joints of lower extremities, seeking to optimize gait. It is based on biomechanical principles provided by the gait lab (GL). Objective: To evaluate the impact of SEMLS in the gait of patients with CP spastic diplegia, one year after surgery. Patients and Methods: Retrospective study with review of medical records of 61 patients undergoing SEMLS. 23 out of 61 subjects accomplished the inclusion criteria. GL data before and after surgery was summarized in Gait deviation index (GDI), cadence and velocity, as well as functional mobility scale (FMS). Patients were categorized in two groups according to the Gross motor function classification system (GMFCS) as “A” for I-II GMFCS and “B” for III GMFCS. Statistical comparison was performed using Wilcoxon test. Results: The average SEMLS include 6.19 procedures per patient. Overall, significant variations in GDI (p < 0.0001) and cadence (p < 0.007) were found. In the subgroup A, there were significant changes in all GL variables (p < 0.009). In subgroup B, a significant effect was only found for GDI. Although FMS showed improvement, it was not statistically significant for 50 m and 500 m, in both subgroups and the total population (14 patients). Conclusion: Significant improvement was seen in CP spastic diplegic patients, for both cadence and GDI after one year SEMLS, particularly in the subgroup with independent walking...

La cirugía multinivel (CMN), es un procedimiento usado preferentemente en pacientes con parálisis cerebral (PC) que reúne varias cirugías ortopédicas en un tiempo quirúrgico involucrando como mínimo dos niveles articulares de extremidades inferiores, buscando optimizar la marcha. Se basa en principios biomecánicos aportados por el laboratorio de marcha (LM). Objetivo: Evaluar el impacto de CMN en la marcha de pacientes con PC tipo diplejía espástica, a un año postcirugía. Pacientes y Método: Estudio de cohorte única, retrospectivo. Se revisaron fichas de 61 pacientes intervenidos con CMN, 23 cumplieron los criterios de inclusión. Se obtuvo datos de LM pre y a un año postoperatorio, resumidos en cadencia del paso, velocidad, Gait Deviation Index (GDI), y Functional Mobility Scale (FMS); los sujetos se dividieron en subgrupos: “A” con Gross Motor Function Clasification System (GMFCS) I-II y “B” con GMFCS III. Se realizó comparación estadística mediante test de Wilcoxon con p < 0,05. Resultados: En promedio se realizaron 6,19 procedimientos quirúrgicos por paciente. En el grupo total se obtuvo variaciones significativas en GDI (p < 0,0001) y cadencia (p < 0,007). En el subgrupo A hay variaciones significativas en todas las variables de marcha (p < 0,009). En subgrupo B hay variaciones significativas sólo en GDI. Para la escala FMS existió mejoría, sin significancia estadística en 50 m y 500 m, en los 14 pacientes examinados y en los subgrupos. Conclusión: Se observa mejoría en la marcha de pacientes PC tipo diplejía espástica, en cadencia y GDI, tras un año post CMN, particularmente en el subgrupo A, con marcha independiente...

Testes de equilíbrio e mobilidade funcional na predição e prevenção de riscos de quedas em idosos / Balance and mobility functional tests in the prediction and prevention of risks of falls in elderly

INTRODUÇÃO: A prevenção da ocorrência de quedas em idosos é um desafio para os profissionais da área da saúde. Um dos aspectos mais relevantes para tal prevenção é a detecção precoce de fatores de risco para quedas. Dentre estes, destaca-se o declínio do equilíbrio e da mobilidade funcional. OBJETIVOS: Avaliar a ocorrência de quedas e seus fatores associados e identificar os pontos de corte de testes de equilíbrio e mobilidade funcional mais adequados para identificar idosos ativos na comunidade com risco de quedas. METODOLOGIA: Estudo transversal composto por 127 idosos ativos na comunidade de Itabira-MG, avaliados quanto às características clínicas e sociodemográficas e ao equilíbrio e mobilidade funcional testes sentado para de pé, semi-tandem, step teste e velocidade da marcha de seis metros. RESULTADOS: A prevalência de quedas no ano anterior foi 25,2%, sendo 8,6% para quedas recorrentes. A ocorrência de quedas apresentou associação apenas com a variável "gênero", sendo maior a chance de cair entre as mulheres. Os pontos de corte para os testes sentado para de pé, step teste e velocidade da marcha foram 8,5 segundos, 7,5 segundos e 0,98 m/s, respectivamente. CONCLUSÃO: Os resultados demonstraram ser importante adequar os pontos de corte dos testes de equilíbrio e mobilidade ao perfil da população avaliada. Sem essa adequação, os testes têm sua sensibilidade e especificidade comprometidas na identificação de idosos com risco de cair.

INTRODUCTION: The prevention of falls in the elderly is a challenge for health professionals. One of the most important aspects for such prevention is early detection of risk factors for falls. Among these, we highlight the declining balance and functional mobility. OBJECTIVES: To evaluate the occurrence of falls and associated factors and identify the most suitable cutoff points of balance and functional mobility tests to identify active seniors in the community at risk of falling. METHODS: Cross-sectional study comprising 127 active seniors in the community in the city of Itabira-MG, Brazil, evaluated for clinical and demographic characteristics and balance and functional mobility tests seated to standing, semi-tandem, step test and gait speed of six meters. RESULTS: Prevalence of falls in the previous year was 25.2 %, and 8.6% for recurrent falls. Occurrence of falls was associated only with the gender variable, with a higher chance of falling among women. The cutoff points for tests seated to standing, step test and gait speed was 8.5 seconds, 7.5 seconds and 0.98 m/s, respectively. CONCLUSION: The results proved to be important to match the cutoff tests of balance and mobility profile of the population. Without this adjustment, tests have sensitivity and specificity in identifying compromised elderly at risk of falling.

SOME EFFECT OF WATER EXERCISE FREQUENCY ON FUNCTIONAL MOBILITY IN NURSING CARE ELDERLY / 体力科学

The purpose of this study was to evaluate the effectiveness of water exercise, including functional mobility in water, performed either once or twice a week in elderly who require nursing care. Twenty-one subjects were assigned to two groups. Ten subjects trained once a week for 6 months. Eleven subjects trained twice a week for 6 months. Water exercise consisted of warming up on land and walking,ADL exercise,resistance training, stretching and relaxation in water. Functional mobility was evaluated by FIM during pre-exercise,after 3 months and 6 months. There were significant improvements in functional mobility after 6 months compared to pre-exercise in both groups. Functional mobility in the group who trained once a week did not improve at 3 months compared to pre-exercise. Although the group who trained twice a week showed a dramatic improvement in functional mobility after 3 months compared to pre-exercise, and no change after 3 months compared to after 6 months. These results indicate that water exercise once or twice a week for 6 months, including functional mobility in elderly who require nursing care, can improve functional mobility, especially, exercise twice a week could improve it within 3 months.