Versión chilena de la Functional Status Score for the Intensive Care Unit: traducción y adaptación transcultural / Chilean version of the Functional Status Score for the Intensive Care Unit: a translation and cross-cultural adaptation

INTRODUCCIÓN: La Functional Status Score for the Intensive Care Unit (FSS-ICU) es un instrumento válido y confiable para medir funcionamiento físico en unida-des de cuidados intensivos. Sin embargo, la traducción y adaptación trans-cultural de la FSS-ICU en Chile no ha sido publicada. OBJETIVO: Traducir y adaptar transculturalmente todos los documentos asociados de la FSS-ICU original para Chile. MÉTODO: Se utilizó como punto de partida la versión en español de la FSS-ICU, disponible en www.ImproveLTO.com. Esta versión se tradujo previamente junto a los desarrolladores originales de la FSS-ICU, siguiendo las recomen-daciones establecidas para este proceso. La versión de bolsillo chilena se desarrolló recientemente en base a la versión original en inglés. Se realizaron entrevistas cognitivas a kinesiólogos de la unidad de cuidados intensivos para evaluar la comprensión de la FSS-ICU y versión de bolsillo. Las adaptaciones se realizaron cuando el acuerdo entre los kinesiólogos fue inferior al 80%. RESULTADOS: Se realizaron las entrevistas cognitivas de la FSS-ICU en español (85 ítems) y versión de bolsillo (18 ítems) en 30 kinesiólogos chilenos provenientes de 18 diferentes hospitales (14 públicos y 4 privados). Durante las entrevistas se realizaron adaptaciones principalmente en las guías generales e instrucciones específicas para tres ítems de la FSS-ICU y dos ítems de la versión de bolsillo. Finalmente, se desarrollaron las preguntas frecuentes, la versión de bolsillo y la versión completa de la FSS-ICU. Todas las adaptaciones fueron aceptadas por los desarrolladores originales. CONCLUSIONES: La versión chilena de la FSS-ICU fue fácil de entender por los kinesiólogos. La FSS-ICU está disponible gratis para uso clínico e investigación no comercial en Chile.

BACKGROUND: The Functional Status Score for the Intensive Care Unit (FSS-ICU) is a valid and reliable instrument to measure physical functioning in the intensive care unit setting. Translation and cross-cultural adaptation in Chile has not been published for the FSS-ICU. AIM: To translate and cross-culturally adapt all associated documents of the original FSS-ICU for Chile. METHOD: The Spanish version of FSS-ICU, available at www.ImproveLTO.com, was used as the starting point. This version was previously translated, with the original FSS-ICU developers, following established guidelines for this process. The Chilean pocket card version was newly developed based on the English version at www.ImproveLTO.com. Cognitive interviews were conducted for the adaptation of the FSS-ICU and pocket card version to assess understanding of relevant stakeholders (i.e., Chilean intensive care unit physiotherapists). Adaptations to the translation were made when agreement among the physiotherapists was less than 80%. RESULTS: Cognitive interviews of the Chilean FSS-ICU (85 items) and pocket card version (18 items) were performed with 30 Chilean physiotherapists from 18 hospitals (14 public and 4 private). During the interviews, modest adaptations mainly made in the general guidelines and specific instructions for three items of the FSS-ICU and two items of the pocket card. Finally, the frequently asked questions, pocket card and full version of the FSS-ICU were developed. The original developers accepted all adaptations. CONCLUSIONS: The Chilean version of the FSS-ICU was easy to understand by the physiotherapists. The FSS-ICU is freely available for non-commercial clinical and research use by Chilean Spanish-speakers.

Walking economy and aerobic power in Parkinson's disease after endurance exercise training: A pilot study / Economia de caminhada e potência aeróbia na doença de parkinson após programa de treinamento de endurance: um estudo piloto

OBJECTIVE: To verify the effect of an endurance exercise program in middle stages of Parkinson's disease. METHODS: The patients were two women and seven men with Parkinson's disease, aged 56 to 74 years, classified at Hoehn and Yahr stages 2 to 2.5. The study was designed as an open long-term pilot trial over three months of supervised treadmill exercise training. Cardiopulmonary exercise test evaluations were performed before the start of the study (test 1) and after three months (test 2). The main outcome measure was walking economy (i.e., the rate of oxygen consumption during gait) measured between VT1 and VT2 speeds and Oxygen consumption (VO2). RESULTS: No changes (p=0.551) were observed for maximal oxygen uptake (VO2max, 24.6 vs 23.6 mL.kg-1.min-1) between tests. The walking economy was 20% better (p<0.001) after three months of aerobic endurance training (266.7 vs 212.6 mL.kg-1.km-1, pre- vs. post-training); the Cohen's "d" effect size (ES) was 0.99, a very large effect. CONCLUSION: Evidence from this pilot study in individuals with Parkinson's disease suggests that gains in walking economy occurs with a treadmill-training program without gain in aerobic power, but which may positively reduce the energy expenditure of activities of daily living in these patients.

OBJETIVO: Verificar o efeito de um programa de treinamento físico aeróbio em estágios intermediários da doença de Parkinson (PD). MÉTODOS: Os pacientes eram duas mulheres e sete homens com PD, com idade entre 56 e 74 anos, classificados como estágios Hoehn e Yahr 2 a 2,5. O estudo foi concebido como um ensaio piloto aberto de longo prazo durante três meses de treinamento supervisionado e realizado em esteira ergométrica. As avaliações da troca gasosa pelo teste de exercício cardiopulmonar foram realizadas antes do início do estudo (teste 1) e após três meses (teste 2). A determinação da economia de caminhada (taxa de consumo de oxigênio durante a marcha) foi medida entre as velocidades do primeiro e do segundo limiar (LV1 e LV2) e do consumo de oxigênio (VO2) entre as duas velocidades por interpolação. RESULTADOS: Não foram observadas alterações (P = 0,153) para o consumo máximo de oxigênio (VO2max: 26,7 vs. 24,2 mL.kg-1.min-1) após o período de intervenção. A economia de caminhada foi 23% maior (P <0,001) após três meses de treinamento físico aeróbio (273,4 vs. 209,4 mL.kg-1.km-1, ES = 0.99, muito alto). CONCLUSÃO: Evidências deste estudo piloto em indivíduos com DP sugerem que os ganhos na economia de caminhada podem ocorrer com um programa de treinamento de "endurance" aeróbica na esteira sem ganho na potência aeróbia, mas que positivamente pode reduzir o gasto de energia das atividades da vida diária nesses pacientes.

Condición física funcional de adultos mayores de Centros Día, vida, promoción y protección integral, Manizales / Functional physical condition of the elderly in daycare centers, life centers, and comprehensive promotion and protection centers- Manizales / Condicição física funcional de idosos de centros día, vida, promoção e proteção integral, Manizales

Objetivo: Determinar la condición física funcional de adultos mayores de los Centros Día, Centros Vida y Centros de Promoción Protección Integral al Adulto Mayor del área urbana del municipio de Manizales. Materiales y métodos: Estudio transversal, descriptivo, comparativo; evaluó variables de condición física funcional: fuerza muscular, flexibilidad, resistencia aeróbica, equilibrio y agilidad e índice de masa corporal; análisis de datos univariado y bivariado, procesamiento mediante programa estadístico SPSS®, versión 22, licenciado por Universidad Autónoma de Manizales. Resultados: Edad promedio 74,13 ± 8,18 hombres y 71,2 ± 7,02 mujeres. Un 78,7% de mujeres practican actividad física 3 a 4 veces por semana y solo 21,3% de hombres lo hace. En Centros Día hay asociación estadísticamente significativa entre resistencia aeróbica y frecuencia de actividad física, con magnitud de fuerza de asociación nula 0,02. Al aplicar el Chi-cuadrado se encuentra asociación estadísticamente significativa entre género y fuerza de MMII: 0,103, y de MMSS, con fuerza de asociación nula: 0,124. Conclusiones: La condición física funcional, en los participantes de Centros Día y Centros Vida mostró mayor compromiso de flexibilidad en miembros superiores; Centros de Promoción y Protección se evidenció compromiso de flexibilidad de miembros superiores e inferiores, fuerza muscular de miembros inferiores, resistencia aeróbica, equilibrio y agilidad. Índice de masa corporal en Centros de Promoción y Protección tiende a clasificarse como peso insuficiente; Centros Día peso normal, seguido por sobrepeso y obesidad; Centros Vida distribución similar entre peso normal y sobrepeso, que puede relacionarse con hábitos, estilos de vida y condiciones de salud asociadas.

Objective: To determine the functional physical condition of the elderly in Daycare Centers, Life Centers and Comprehensive Promotion Protection Centers in the urban area of the Municipality of Manizales. Materials and methods: A cross sectional, descriptive, comparative study was conducted that evaluated functional physical condition variables: muscle strength, flexibility, anaerobic endurance, balance, agility and body mass index. Univariate and bivariate data analysis was performed by using SPSS® statistics software, version 22, licensed by Universidad Autónoma de Manizales. Results: The mean age for males was 74.13 ± 8.18 and 71.2 ± 7.02 for females. A 78.7% of women practice physical activity 3 to 4 times a week and only 21.3% of men do it. There is statistically significant association between aerobic resistance and physical activity frequency in day centers, with void magnitude of association strength of only 0.02. When applying the chi-square, a statistically significant association between gender and strength of LMW: 0.103, and of LMSS, with void association strength, 0.124 is found. Conclusions: The functional physical condition in participants of daycare centers and life centers showed greater involvement of upper limbs flexibility. In promotion and protection centers results exhibited involvement of upper and lower limbs flexibility, lower limb muscle strength, aerobic endurance, balance, and agility. The body mass index in promotion and protection centers tended to be classified as underweight, in day centers participants showed normal weight, followed by overweight and obesity, and in life centers there was similar distribution of normal weight and overweight which might be related to their habits, lifestyle and health conditions as well.

Objetivo: Determinar a condição física funcional de idosos dos Centros Dia, Centros Vida e Centros de Promoção Proteção Integral ao Idoso da área urbana do município de Manizales. Materiais e métodos: Estudo transversal, descritivo, comparativo; avaliou variáveis de condição física funcional: força muscular, flexibilidade, resistência aeróbica, equilíbrio e agilidade e índice de massa corpórea; analise de dados univariado e bivariado, processamento mediante programa estadístico SPSS®, versão 22, licenciado por Universidade Autônoma de Manizales. Resultados: Idade meia 74,13 ± 8,18 homens e 71,2 ± 7,02 mulheres. Um 78,7% de mulheres praticam atividade física 3 a 4 vezes por semana e só 21,3% de homens o faz. Em Centros Dia há associação estatisticamente significativa entre resistência aeróbica e freqüência de atividade física, com magnitude de força de associação nula 0,02. Ao aplicar o Quadrado se encontra associação estatisticamente significativa entre gênero e força de MMII: 0,103, e de MMSS, com forças de associação nula: 0,124. Conclusões: A condição física funcional, nos participantes de Centros Día e Centros Vida amostraram maior compromisso de flexibilidade em membros superiores; Centros de Promoção e Proteção se evidenciou compromisso de flexibilidade de membros superiores e inferiores, força muscular de membros inferiores, resistência aeróbica, equilíbrio e agilidade. Índice de massa corporal em Centros de Promoção e Proteção tende a classificar como peso insuficiente; Centros Dia peso normal, seguido por sobrepeso e obesidade; Centros Vida distribuição similar entre peso normal e sobrepeso, que podem relacionar-se com hábitos, estilos de vida e condições de saúde associadas.

Relationship between Demographic and Clinical Factors with Physical Functioning of Stroke Patients / Jurnal Sains Kesihatan Malaysia

Stroke is a causal factor that commonly caused physical impairments and activity limitations among patients to perform daily activities until at certain level stroke patients will experience disability. The aim of this study is to examine the relationship of each demographic and clinical factors that is believed to associate with physical functioning of patients those who experienced stroke. This present study also try to compare physical functioning of patients with associated factors and then examine the correlation between those factors with physical functioning. A total of 147 respondents that pass for cognitive screening test involved in this study. Barthel Index (ADL) was administered to the respondents after 6 weeks of stroke attack in order to measure their physical functioning status. Results found that there was a significant difference [F(3, 143) = 4.06; p < 0.01] between level of educations with physical functioning of patients. With respect to clinical factors also showed a significant difference (p < 0.01) was higher in physical functioning when stroke attack occurred at right hemisphere of brain. There was a significant difference (p < 0.01) in physical functioning with respect to belief of recovery. Furthermore, number of stroke attack also showed a significant difference [F(1, 145) = 11.19; [p < 0.01] in physical functioning of patients. Correlation test that was carried out found a positive significant correlation (r = 0.24; p < 0.01) between physical functioning with respect to the affected lesion side. In conclusion, demographic and clinical factors also played the roles to determine level of physical functioning among stroke patients and thus these factors should be considered in any studies that intended to enhance physical functioning of patients in future.

Clinical Usefulness of Long-term Application of Fentanyl Matrix in Chronic Non-Cancer Pain: Improvement of Pain and Physical and Emotional Functions

BACKGROUND: Opioids are recently recommended for those who do not gain adequate pain relief from the use of acetaminophen or nonsteroidal anti-inflammatory drugs. Medical opioids are administered in various routes, and transdermal opioid products that can make up for the weaknesses of the oral or intravenous products have been developed. This study is to evaluate the clinical usefulness of fentanyl matrix in terms of the long-term improvement in pain and physical and mental functions. METHODS: This was a multicenter, open, prospective, observational study that was conducted in 54 institutions in Korea. Patients with non-cancerous chronic pain completed questionnaires, and investigators also completed questionnaires. A total of 1,355 subjects participated in this study, and 639 subjects completed the study. Subjects received transdermal fentanyl matrix (12 µg/hr, 25 µg/hr, or 50 µg/hr depending on the patient's response and demand). Subjects visited at 29 ± 7 days, 85 ± 14 days, and 169 ± 14 days after administration, respectively, to receive drug titration and fill out the questionnaires. The results were analyzed using the intention-to-treat (ITT) analysis, full analysis set (FAS), and per-protocol (PP) analysis. The FAS analysis included only 451 participants; the PP analysis, 160 participants; and the ITT analysis, 1,355 participants. RESULTS: The intensity of pain measured by the Numeric Rating Scale decreased from 7.07 ± 1.78 to 4.93 ± 2.42. The physical assessment score and mental assessment score of the Short-Form Health Survey 12 improved from 28.94 ± 7.23 to 35.90 ± 10.25 and from 35.80 ± 11.76 to 42.52 ± 10.58, respectively. These differences were significant, and all the other indicators also showed improvement. Adverse events with an incidence of ≥ 1% were nausea, dizziness, vomiting, and pruritus. CONCLUSIONS: The long-term administration of fentanyl matrix in patients with non-cancerous pain can reduce the intensity of pain and significantly improves activities of daily living and physical and mental capabilities.

Fear of Falling, ADL and Physical Functioning among Senior Citizens / 재활간호학회지

PURPOSE: The objectives of this study were to explore the relationships between the fear of falling and daily activities, and physical functioning of older people in community. METHOD: A descriptive study design was used in this study. 295 people aged over 65 and living in community participated. Data of demographic characteristics, fear of falling, activity daily living, physical functioning were collected. RESULT: 13.2% of the participants reported that they have falling accident last one year. 75.6% of participants reported fear of falling. 67.7% of them expressed restricting activity because of fear of falling. There were no significant relationship between fear of falling and BADL(Basic Activity Daily Living) but fear of falling and IADL(Instrumental Activity Daily Living) were related. It was also found that older people with higher fear of falling expressed more pain and uncomfortable feelings especially on their lower body and had higher scores of morbidity of neurologic diseases such as neuralgia and cerebrovascular diseases. CONCLUSION: There were significant relationships between fear of falling and IADL, and physical functioning on lower body, and morbidity of neurologic diseases such as neuralgia and cerebrovascular diseases.