ABSTRACT
CONTEXT: A spinal cord injury or disease (SCI/D) is a devastating condition that affects all areas of a person's life, including quality of life (QoL). Assessing this construct using clinical instruments with adequate measurement properties is fundamental for an effective multi-professional treatment. OBJECTIVE: To identify the clinical instruments for assessing the QoL that present the best recommendation for use in people with SCI based on their measurement properties. METHODS: The overall methodology was conducted according to Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) systematic review guidance and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted up to March 2023 on MEDLINE/PubMed, Web of Science, Scopus, CINAHL, and Embase databases. RESULTS: Seventy-seven studies were included in this review, and 49 instruments were identified. The overall methodological quality of all studies ranged from insufficient to sufficient, and the level of evidence ranged from very low to high confidence. Twenty-six instruments may have the potential to be recommended, and the other 23 should not be recommended. CONCLUSION: None of the QoL instruments can be highly recommended as the most suitable instrument for the construct and population of interest. The generic instruments SF-36, SF-12, QWB, WHOQOL-DIS, WHOQOL-BREF, QLI-SCI, QOLP-PD, LS Questions, Lisat-9, and BRFSS are the clinical instruments that have the best measurement properties tested and have the potential to be the current best recommendation for assessing QoL in individuals with SCI.
Subject(s)
Quality of Life , Spinal Cord Injuries , Humans , Consensus , Psychometrics , Reproducibility of Results , Spinal Cord Injuries/physiopathology , Surveys and QuestionnairesABSTRACT
AIM: To investigate the effects of the water-based exercise on balance, mobility, mobility and functional independence, functional performance, fear of falling and quality of life in people with Parkinson's disease. METHODS: We searched pubmed/MEDLINE, Cochrane Central Register of Controlled Trials, PEDro data base and SciELO to June 2020 for randomised controlled trials that investigated the effects of water-based exercise in people with Parkinson's disease. Two comparisons were made: water-based exercise versus usual care and water-based exercise versus land-exercise. The main outcomes were Balance, Confidence, Mobility, Unified Parkinson's Disease Rating Scale and quality of life. Mean differences (MD) with 95% confidence interval (CI) were calculated, and heterogeneity was assessed using the I2 test. RESULTS: Fifteen randomised controlled trials were found (435 people). Compared to usual care, water-based exercise resulted in improvement in balance MD (9.1, 95% CI: 6.5, 11.8, N = 45). Water-based exercise resulted in improvement in balance MD (3.1, 95% CI: 1.2, 5.0, N = 179), mobility MD (-2.2, 95% CI: -3.3, -1.0, N = 197) and quality of life MD (-5.5, 95% CI: -11, -0.07, N = 98) compared to land-based exercise, but without significant difference in functional performance MD (0.01, 95% CI: -2.6 to 2.7, N = 69). Land-based exercise resulted in improvement in fear of falling MD (-3.5, 95% CI: -5.6, -1.3, N = 58) compared to water-based exercise. CONCLUSION: Water-based exercise was more efficient than land-based exercise and/or usual care in improving balance, mobility and quality of life in people with Parkinson's disease.
Subject(s)
Exercise Therapy/methods , Parkinson Disease/rehabilitation , Quality of Life , Water , Accidental Falls/prevention & control , Humans , Mobility Limitation , Parkinson Disease/physiopathology , Physical Functional Performance , Postural Balance/physiologyABSTRACT
A formação dos profissionais de saúde para a atuação na atenção básica (AB) exige a superação do modelo curativista centrado na doença, ainda hegemônico na universidade e nos serviços de saúde. O objetivo deste relato é descrever a experiência de estudantes de fisioterapia na interface com a AB. Trata-se de relato de experiência de discentes da graduação de fisioterapia da Universidade Federal da Bahia, no componente Fisioterapia em Comunidades, que propõe a realização de atividades de integração entre universidade, Unidade de Saúde da Família e território coberto por esta. O componente acontece no formato de encontros semanais para debates teóricos e vivência prática na AB, em colaboração com equipes de saúde. Foram realizadas atividades de práticas corporais semanais, com grupo de mulheres do território, e intervenções de educação em saúde no formato de salas de espera, com o propósito de promover saúde, cuidados com o corpo e integração social. Também foi realizado um evento de saúde no território, com foco nas práticas corporais e prevenção de distúrbios musculoesqueléticos. As atividades realizadas trouxeram experiências novas e aproximaram os estudantes da AB, permitindo a interação com as reais necessidades e problemas de saúde da população. A experiência proporcionou uma reflexão sobre a importância das habilidades de acolhimento e escuta dos usuários do Sistema Único de Saúde e das competências do trabalho em equipe, o que representou uma oportunidade de formação em saúde voltada para a promoção da saúde e atenção integral na AB.
The training of health professionals to work in primary health care (PHC) requires overcoming the curative and disease-centered model, still hegemonic at the University and health services. The purpose of this report is to describe the experience of Physiotherapy students at the interface with PHC. This is an experience report of physical therapy undergraduate students from the Federal University of Bahia, in the component of physiotherapy in communities, which proposes to carry out integration activities between the University, the Family Health Service and the territory covered by it. The component takes place in the form of weekly meetings for theoretical debates and practical experience in PHC, in collaboration with health teams. Weekly body practice activities were carried out with a group of women from the territory, as well as health education interventions in the form of waiting rooms, with the purpose of promoting health, body care and social integration. A health event was also held in the territory, focusing on body practices and prevention of musculoskeletal disorders. The activities carried out led to new experiences and brought PHC students closer together, allowing for interaction with the real needs and health problems of the population. This activity made them reflect on the importance of the welcoming and listening skills of users of the Brazilian Health System as well as teamwork, which represented an opportunity for health training focused on health promotion and integral care in PHC.
La capacitación de profesionales de la salud para la atención primaria de salud (APS) requiere superar el modelo curativo y centrado en la enfermedad, aún hegemónico en la universidad y los servicios sanitarios. El propósito de este trabajo es describir la experiencia de los estudiantes de fisioterapia en la interfaz con la APS. Este es un informe de experiencia de estudiantes de fisioterapia de la Universidad Federal de Bahía, en el componente de Fisioterapia en Comunidades, que propone llevar a cabo actividades de integración entre la universidad, la Unidad de Salud de la Familia y el territorio cubierto por ella. El componente ocurre en forma de debates teóricos y vivencias semanales en la APS, en colaboración con los equipos de salud. Sucedieron actividades semanales de práctica corporal con un grupo de mujeres del territorio e intervenciones de educación en salud, como salas de espera, con el propósito de promover la salud, el cuidado del cuerpo y la integración social. También se realizó un evento de salud, centrado en las prácticas corporales y la prevención de los trastornos musculoesqueléticos. Las actividades trajeron nuevas experiencias y acercaron a los estudiantes de APS, lo que permitió la interacción con las necesidades reales y los problemas de salud de la población. Además, permitieron reflexionar sobre la importancia de las habilidades de acogida y escucha de los usuarios del Sistema Único de Salud y del trabajo en equipo, lo que representó una oportunidad para la capacitación en salud centrada en la Promoción de la Salud y la atención integral en APS.
