ABSTRACT
O uso de um dispositivo auxiliar da marcha (DAM), como bengala ou andador, pode auxiliar os idosos na realização de suas atividades diárias, mantendo-os funcionalmente independentes e relativamente ativos. Porém, a utilização inadequada, o mau estado e as dimensões incorretas do dispositivo, assim como erros na prescrição do tipo de dispositivo podem aumentar o risco de quedas nos idosos usuários de DAM. Diante da falta de recomendações quanto à sua prescrição, o objetivo desse artigo é discorrer sobre os pré-requisitos para a prescrição de cada dispositivo (bengala e andador), de acordo com a nossa experiência adquirida na Área de Fisioterapia em Gerontologia, no Centro de Reabilitação (CER) do Hospital das Clínicas de Ribeirão Preto, considerando as evidências científicas disponíveis até o momento. Assim, com a difusão das informações contidas nesse artigo para os profissionais da saúde que prestam assistência a idosos, espera-se aprimorar a prática de prescrição do DAM e de educação do idoso, de seus familiares e cuidadores, a fim de que sejam alcançados os benefícios do uso de um DAM e prevenidos os possíveis eventos adversos, como as quedas.
The use of a walking aid device (WAD), such as a cane or walker, can assist older adults in performing their daily activities, keeping them functionally independent and relatively active. However, improper use, poor condition and incorrect dimensions of the device, as well as errors in prescribing the type of device may increase the risk of falls in older people who use a WAD. Given the lack of recommendations on its prescription, the purpose of this article is to discuss the requirements for the prescription of each device (cane and walker), according to our experience obtained in the area of ââGerontology Physiotherapy in the Rehabilitation Center (CER) of the Hospital das Clínicas de Ribeirão Preto, considering the scientific evidence available at the moment. Thus, by disseminating the information contained in this article to health professionals who provide care to older people, it is expected to improve the practice of prescribing WAD and educating the older adults, their families and caregivers, in order to achieve the benefits of use a WAD and prevent possible adverse events such as falls.
Subject(s)
Rehabilitation , Walkers , Aging , Canes , GaitABSTRACT
Resumen Para el proceso de control efectivo de la resistencia, en las disciplinas cíclicas, se ha sugerido la determinación de índices que tengan en cuenta el desarrollo de esta capacidad respecto a la velocidad. Este es uno de los factores fundamentales que incide en su manifestación y que hacen que el nivel de información, sobre este proceso, dependa del resultado de las pruebas utilizadas. Se consideran, además, las particularidades de estas disciplinas deportivas, la edad y nivel de los deportistas. Se desarrolla esta investigación con el objetivo de proponer una prueba de velocidad máxima específica para la marcha deportiva, acorde a las particularidades de las edades entre 12 y 13 años, basada en la carencia de referencias sobre pruebas específicas de velocidad para los marchistas escolares. Esta posee una metodología de aplicación y procesamiento para la determinación del coeficiente de resistencia. Para ello se emplearon métodos del nivel teórico (análisis y síntesis, inducción deducción) y empírico (medición, análisis de documentos y matemáticos estadísticos). Se parte de una población conformada por los 8 atletas de la Escuela de Iniciación Deportiva Escolar (EIDE) Ormani Arenado de Pinar del Río, cuatro de ellos del sexo femenino y a 10 entrenadores como fuente de información. Como propuesta, la prueba de marcha sobre 100 m, se observa el cumplimiento de las exigencias del reglamento competitivo a la correcta ejecución técnica.
Abstract For the process of effective control of endurance in cyclical disciplines, it has been suggested to determine parameters which consider the development of this capacity according to speed. This is one of the fundamental factors that influences its manifestation and that makes the level of information about this process depend on the result of the tests used. In addition to the particularities of these sports, the age and level of the athletes are also considered. This research is developed with the aim of proposing a specific maximum speed test for sport walking, according to the particularities of the ages between 12 and 13 years, based on the lack of references on specific speed tests for school walkers. It has an application and processing methodology for the determination of the endurance coefficient. The methods used were theoretical (analysis and synthesis, induction - deduction) and empirical (measurement, document analysis and statistical mathematics). It is started from a population made up of 8 athletes from "Ormani Arenado" Initiation Sport School (EIDE) in Pinar del Río, four of them women and 10 coaches as a source of information. As a proposal, in the 100 m sport walking test, compliance with the requirements of the competitive regulations to the correct technical execution is observed.
ABSTRACT
Abstract OBJECTIVE Develop and evaluate a low-cost walker with trunk support for senior citizens. METHOD Two-stage descriptive study: development of a walker with trunk support and evaluation with fourth age senior citizens. RESULTS Twenty-three fourth age senior citizens were selected. The evaluated criteria were the immediate influence of the walker on the static stabilometry with baropodometer and the evaluation of gait with accelerometers monitoring time and amplitude of the hip movement. There was a significant decrease in the body oscillation of senior citizens with the use of the developed walker, and there were changes in the joint amplitudes of the hip, but they were not significant. CONCLUSION Using low-cost materials, it was possible to develop and equipment that met resistance and effectiveness requirements. The walker interfered in the balance of the senior citizens, reducing significantly the static body oscillation.
Resumo OBJETIVO Desenvolver e avaliar um andador de baixo custo com sustentação de tronco para idosos. MÉTODO Estudo descritivo de duas fases: desenvolvimento de um andador com suporte de tronco e avaliação com idosos de quarta idade. RESULTADOS Foram selecionados 23 idosos de quarta idade. Os critérios avaliados foram a influência imediata do andador na estabilometria estática com baropodômetro e avaliação da marcha com acelerômetros monitorando tempo e amplitude de movimento de quadril. Houve diminuição significativa da oscilação corporal dos idosos com a colocação do andador desenvolvido e mudanças nas amplitudes articulares do quadril, porém estas não foram significativas. CONCLUSÃO Utilizando materiais de baixo custo, foi possível desenvolver um equipamento que atendeu aos requisitos de resistência e eficácia. O andador interferiu no equilíbrio dos idosos, diminuindo significativamente a oscilação corporal estática.
Resumen OBJETIVO Desarrollar y evaluar un andador de bajo costo con soporte de tronco para ancianos. MÉTODO Estudio descriptivo de dos fases: desarrollo de un andador con soporte de tronco y evaluación con ancianos de cuarta edad. RESULTADOS Se seleccionaron 23 ancianos de cuarta edad. Los criterios evaluados fueron la influencia inmediata del andador en la estabilometría estática con baropodómetro y evaluación de la marcha con acelerómetros monitoreando tiempo y amplitud de movimiento de cadera. Se observó una disminución significativa de la oscilación corporal de los ancianos con la colocación del andador desarrollado y cambios en las amplitudes articulares de la cadera, pero éstas no fueron significativas. CONCLUSIÓN Utilizando materiales de bajo costo, fue posible desarrollar un equipo que cumplió con los requisitos de resistencia y eficacia. El andador interfirió en el equilibrio de los ancianos, disminuyendo significativamente la oscilación corporal estática.
Subject(s)
Humans , Male , Female , Aged, 80 and over , Walkers , Aged, 80 and over , Postural Balance , Low Cost TechnologyABSTRACT
IntroductionNowadays Knee Osteoarthritis (KOA) affects a large percentage of the elderly, and one solution is to perform a Total Knee Arthroplasty (TKA). In this paper, one intends to study the gait and posture of these patients after the TKA, while walking with three assistive devices (ADs) (crutches, standard walker (SW) and rollator with forearm supports (RFS)).MethodsEleven patients were evaluated in 2 phases: 5 days and 15 days after surgery. This evaluation was conducted with two inertial sensors, one attached to the operated leg ankle, to measure spatiotemporal parameters, and the other at the sacrum, to measure posture and fall risk-related parameters. Multivariate analysis of variance (MANOVA) with repeated measures was performed to detect group differences.ResultsThe MANOVA results show that all spatiotemporal parameters are significantly different (p<0.05) between the two phases of study. So, time has a significant influence on such parameters. In relation to the ADs, one observes that there are statistical significant effects on all spatiotemporal parameters, except for swing duration and step length (p>0.05). The interaction between time and ADs only affects significantly the velocity (p<0.05). In terms of fall risk parameters, time only significantly affects the antero-posterior direction (p<0.05) and ADs affects significantly root mean square in medio-lateral direction (p<0.05). In terms of interaction between time and ADs, there are no statistical significant differences.ConclusionThis study concludes that depending on the state of recovery of the patient, different ADs should be prescribed. On the overall, standard walker is good to give stability to the patient and RFS allows the patient to present a gait pattern closer to a natural gait.
ABSTRACT
BACKGROUND:Thoracic spinal cord injury often leads to double lower limb paralysis. Paraplegia walking orthosis can improve lower limb dysfunction, improve the daily living activity, and regain the ability to stand and walk in patients with paraplegia. OBJECTIVE:To discuss the effects of paraplegia walking orthosis on muscle spasticity and recovery of function of the affected lower extremity in patients with thoracic spinal cord injury. METHODS:The 20 patients with thoracic spinal cord injury (T5-12), according to the damage plane by American Spinal Injury Association standard, were divided into complete damage group and incomplete damage group (n=10). Al patients were fitted out paraplegia walking orthosis. They received residual muscle strength training, sitting balance training, and transfer training prior to assembly, and then subjected to standing exercise within paralel bar, balance and transfer training, and walking aid devices training indoor and outdoor, and elbow crutch training on foot after the assembly. RESULTS AND CONCLUSION:Compared with pre-treatment, American Spinal Injury Association score increased at 12 weeks after treatment with paraplegia walking orthosis, and sensation did not obviously alter. Spasm worsened with prolonged course of disease in the complete damage group. At 12 weeks after treatment, American Spinal Injury Association score increased, sensation apparently improved, and the spasm did not change with time in the incomplete damage group. Activities of daily living (modified Barthel index, and functional independence evaluation) evidently improved in both groups. Compared with 2 weeks, the 10-m walking time was noticeably reduced and the 6-minute walking distance was prolonged at 12 weeks in both groups. These results confirm that paraplegia walking orthosis fitted out in patients with thoracic spinal cord injury significantly improves the patient’s motor function, activities of daily living and walking ability, and also has certain influence on muscle spasm control.
ABSTRACT
BACKGROUND:The appropriate choice of orthoses based on hemiplegic patient’s condition can improve motor function recovery in stroke patients. OBJECTIVE:To review the motor function recovery of stroke patients with hemiplegia wearing different types of orthoses. METHODS:Application of different types of orthoses in hemiplegic patients was reviewed through access to literature, as wel as effects of a variety of orthoses on the recovery of motor functions in hemiplegic patients. RESULTS AND CONCLUSION:Orthoses can reduce limb muscle tension and muscle spasms, and improve motor function and overal daily living skil s in stroke patients with hemiplegia, which play a variety of roles, including stable support, fixed protection, correction of deformity and functional compensation. However, the long-term therapeutic effect of orthoses cannot be verified because of fewer cases, shorter time for therapeutic observation, and the lack of long-term fol ow-up. It is necessary to perform long-term fol ow-up for the verification of long-term efficacy of orthoses. Meanwhile, the appropriate timing for removal of orthoses needs further study.
ABSTRACT
OBJECTIVES: To understand the opinion of the parents about the baby walker and compare the age of gait acquisition between infants that used a walker and those that did not. METHODS: In this quali-quantitative study, an interview involving a semi-structured questionnaire was carried out with 26 parents, 14 of whose infants used the equipment (BWG) and 12 of whose infants did not (NBWG) prior to gait acquisition. After extensive content analysis, categories for interpreting the results emerged. For data triangulation, the age of gait acquisition was documented by weekly telephone contact. Student's t-test was used for comparison between groups with a significance level of α=0.05. RESULTS: The following categories were identified in the parents' reports: a) information about the baby walker; b) doubt/decision to use it vs. certainty about not using it; c) beliefs about the use of a baby-walker; and d) benefits and harm from use. The age of independent gait acquisition did not differ between groups (p=0.837): BWG initiated gait at 376.17 (SD=32.62) days and NBWG did so at 378.75 (SD=27.99) days. CONCLUSIONS: The beliefs and feelings that permeate the decision to use a baby walker illustrate the different rationales adopted by parents about the role of this equipment in the child's development of gait and autonomy. The use of a baby walker did not influence the age of gait acquisition. The results broaden the understanding of choices that influence child-rearing practices prior to gait acquisition.
OBJETIVOS: Conhecer a opinião dos pais sobre o uso do andador infantil e comparar a idade de aquisição da marcha independente entre os lactentes que usaram e os que não usaram o andador. MÉTODOS: Neste estudo qualiquantitativo, realizou-se entrevista com questionário semiestruturado com 26 pais, 14 de lactentes que usaram (GUAI) e 12 dos que não usaram o equipamento (GNUAI) antes da aquisição da marcha. Empregou-se análise de conteúdo, a partir da qual, após extensa leitura, emergiram-se as categorias para interpretação dos resultados. Para triangulação dos dados, a idade de aquisição de marcha foi documentada por contato telefônico semanal e, para comparação entre grupos, usou-se o teste t de Student, nível de significância α=0,05. RESULTADOS: Foram identificadas, nos relatos dos pais, as categorias: a) informações sobre o andador infantil; b) dúvida/decisão em usar versus certeza de não usar; c) crenças sobre o uso do andador infantil e d) benefícios e malefícios do uso. A idade de aquisição da marcha independente não foi diferente entre os grupos (p=0,837): GUAI iniciou a marcha com 376,17 (DP=32,62) dias e GNUAI, com 378,75 (DP= 27,99) dias. CONCLUSÕES: As crenças e sentimentos que permeiam a decisão de usar o andador ilustram racionalidades distintas entre os pais sobre o significado desse equipamento para o desenvolvimento da marcha e ganho de autonomia da criança. O uso do andador infantil não influenciou a idade de aquisição da marcha. Os resultados ampliam o entendimento das escolhas que podem influenciar as práticas maternas no período pré-aquisição da marcha.
Subject(s)
Female , Humans , Infant , Male , Culture , Infant Equipment , Parents , Interviews as Topic , WalkingABSTRACT
PURPOSE: Baby-walkers are used by many parents because of the convenience they provide in keeping children occupied, quiet, happy, and in stimulating ambulation. But, these devices have more risks than benefits. Therefore, we performed a study to evaluate the effects of baby-walkers on motor development of human infants according to the hours used in a day, total duration(months), and types of injuries associated with the walkers, and to establish effective methods. METHODS: 1,045 questionnaires were filled out by parents who had a baby whose aged between 8 months and 15 months that visited local pediatric clinics and medical centers in Chonju and Iksan from May 1, 2002 to July 31, 2002. They were analyzed in a control group that didn't use baby- walkers, a low-user group that used baby-walkers less than 2 hours a day and a high-user group that used them more than 2 hours a day. RESULTS: The mean age of the 1,045 babies whose parents responded to the question investigation was 12.6+/-2.4 months. The number of babies who used the baby- walkers were 811(77.6%). Crawling and walking alone were delayed in the high-user group. The parents who knew the side effects of the baby-walkers totalled 392(48.3%). CONCLUSION: The findings of this study revealed that many parents didn't know the effects of baby-walkers on motor development in their infants and the risks associated with baby-walkers. Therefore, we should educate parents on the risks of baby-walkers and recommend reducing the use of baby-walkers.
Subject(s)
Child , Humans , Infant , Parents , Surveys and Questionnaires , Walkers , WalkingABSTRACT
Objective To observe the effect of ankle foot orthoses (AFO) on improving the abnormal gait pattern in hemiparetic patients Methods 106 hemiparetic patients were randomly divided into two groups. AFO was used in one group (52 cases) and not in the control group (54 cases). Both of them accepted conventional physical therapy. Motor function of affected ankle joint and lower extremities, spastic state of ankle joint, standing balance and walking ability were evaluated on each case before and after rehabilitation Results At the end of the trial, spastic state of ankle joint in both groups were decreased. 40 cases reached to degree of ⅠorⅠ + of spastic state and 12 cases to Ⅱ, Ⅲ or Ⅳ in the AFO used group,while the number of cases in the control group were respectively 27 and 27. The effects in AFO used group showed more significant than in the control group ( P 0.05) Conclusion Physical therapy combined with ankle foot orthoses was beneficial to improving the abnormal gait pattern and decreasing the spastic state of ankle joint in hemiparetic patients. However, it might not affect the motor function of ankle joint and lower extremities.