Influence of Different Dual-Task Conditions During Straight or Curved Walking on Gait Performance of Physically Active Older Women With Cognitive Decline.

Real-world walking requires shifting attention from different cognitive demands to adapt gait. This study aims to evaluate the effect of dual tasking on spatiotemporal gait parameters of older adults. Participants were asked to perform a primary complex single-walking task, consisting of a fast-paced linear and a curved gait. Primary task was performed separately and simultaneously with different motor and cognitive secondary tasks. Spatiotemporal gait parameters, walk ratio, and walk stability ratio were measured. Apart from stride length, which stood relatively unchanged, gait speed and cadence were strongly affected by cognitive dual tasking. Cadence seems to be the most impacted by dual tasking during curved gait as it combines challenges of both primary and secondary tasks. Also, during curved phase, walking ratio was significantly lower and stability ratio was greater demonstrating that participants adopted a cautious gait where maintenance of stability took preference over efficiency.

Conhecimento e expectativas de acadêmicos de fisioterapia sobre a atuação profissional na atenção primária à saúde / Conocimientos y expectativas de estudiantes de fisioterapia sobre la actuación profesional en la atención primaria de salud / Physiotherapy undergraduates' knowledge and expectations of professional practice in primary health care

RESUMO A promulgação do SUS apontou uma nova concepção de saúde não mais focada na ausência de doenças. Fez-se necessário o fortalecimento de ações no nível primário sendo elaborada a Política Nacional de Atenção Básica para promover, proteger e reabilitar a saúde dos indivíduos e coletividades. A Fisioterapia precisa se adequar para se aproximar da Atenção Primária à Saúde (APS) e aos novos modelos de atenção à saúde, o que é recomendado pelas Diretrizes Curriculares Nacionais do Curso de Fisioterapia. O objetivo do estudo é investigar o conhecimento e as expectativas de acadêmicos de Cursos de Fisioterapia de Porto Alegre e região metropolitana sobre a atuação do fisioterapeuta na Atenção Primária à Saúde. Foi realizado estudo observacional, descritivo, transversal, com questionário on-line composto por 13 questões, objetivas e dissertativas. Para verificar as associações, utilizou-se o teste qui-quadrado e adotou-se significância de 5%. 171 acadêmicos de Fisioterapia (90,53% do sexo feminino, com idades entre 18 e 55 anos) participaram do estudo. A minoria dos participantes registrou corretamente as quatro atividades e locais de atuação da Fisioterapia na APS. Para as atividades, foram utilizados termos amplos como "promoção" e "prevenção"; "Unidade de Saúde" foi o local mais frequentemente citado. Do total, 43,2% apontaram se sentirem preparados.

RESUMEN La promulgación del Sistema Único de Salud (SUS) apuntó a una nueva concepción de salud que ya no se centra en la ausencia de enfermedades. Fue necesario fortalecer las acciones en el ámbito primario con el desarrollo de la Política Nacional de Atención Primaria para promover, proteger y rehabilitar la salud de las personas y las comunidades. La fisioterapia necesita adaptarse para acercarse a la Atención Primaria de Salud (APS) y los nuevos modelos de atención sanitaria, según lo recomendado por los Lineamientos Curriculares Nacionales para la Carrera en Fisioterapia. El objetivo de este estudio fue identificar los conocimientos y expectativas de universitarios y Carreras de Fisioterapia de Porto Alegre y región metropolitana sobre el rol del fisioterapeuta en la Atención Primaria de Salud. Se trata de un estudio observacional, descriptivo, transversal, que aplicó un cuestionario on line compuesto de 13 preguntas, tanto de elección única como de ensayo. Para verificar las asociaciones se utilizó la prueba de chi-cuadrado, y se adoptó un nivel de significancia del 5%. En el estudio participaron 171 estudiantes de fisioterapia (el 90,53% mujeres con edades entre 18 y 55 años). La minoría de los participantes contestaron correctamente las cuatro actividades y locales de actuación de la fisioterapia en la APS. Para las actividades, se utilizaron términos amplios como "promoción" y "prevención"; y el local de actuación más citado fue "Unidad de Salud". Del total, el 43,2% afirmaron sentirse preparados.

ABSTRACT The consolidation of SUS led to a new concept of health no longer focused on the absence of diseases. The strengthening of actions at the primary level was necessary, therefore the National Policy of Primary Care was created to promote, protect and rehabilitate people's health. Physiotherapy had to undergo a series of adjustments in order to fit the primary care system and, according to the National Curriculum Guidelines, undergraduate courses should observe the new models of health care. The objective was to assess the knowledge and expectations of Physiotherapy undergraduate students in the Porto Alegre and surrounding cities about the physiotherapist's role in primary care. The study was descriptive, observational, and cross-sectional. An online survey was conducted with 13 objective and dissertation questions. The chi-square test was used to verify associations and significance was found when p≤0.05. A total of 171 Physiotherapy undergraduate students (90.53% females, aging between 18 and 55 years) agreed to participate. A minority of participants correctly registered four activities to be developed and four places of practice for physiotherapists in primary care. Unspecific terms like "promotion" and "prevention" were used to describe the activities, while "Healthcare Units" was the most frequently cited place. Among our sample, 43.2% stated feeling prepared to act in primary care and 53.25% considered as an option to work in primary care. In conclusion, although participants showed limited knowledge about primary care, they mostly feel satisfied with the knowledge acquired on this topic.

Effects of physical exercise on cognitive function of older adults with mild cognitive impairment: A systematic review and meta-analysis.

BACKGROUND AND PURPOSE: Mild Cognitive Impairment (MCI) is associated with a greater risk of dementia for older adults. However, systematic reviews have shown that some physical exercise (PE) seems to improve MCI symptoms and signs. Those reviews and meta-analysis could not explain what possible moderator influenced their results. This meta-analysis aims to identify the effect of PE over older people's cognition with MCI and explore sources of heterogeneity. METHODS: Databases were searched from inception January 2020 for randomized clinical trials that evaluated the effects of PE over cognition of older persons with MCI. Random effect meta-analyses were performed for each cognitive outcome. Subgroup analyses and meta-regressions models explored the potential sources of heterogeneity. RESULTS: A total of 2077 participants (mean age = 71.8 years) from 27 studies were included. PE improves global cognitive function (SMD = 0.348 [95 % CI 0.166 to 0.529]; p = 0.0001), executive function (SMD = 0.213 [95 % CI 0.026 to 0.400]; p = 0.026) and delayed recall (SMD = 0.180 [95 % CI 0.002 to 0.358]; p = 0.047). A trend towards beneficial effects of PE on verbal fluency (SMD = 0.270 [95 %, CI -0.021 to 0.561]; p = 0.069) and attention (SMD = 0.170 [CI -0.016 to 0.357]; p = 0.073) were also observed. Subgroup analyses showed a relationship between modality and intensity of physical exercise and changes observed in global cognitive function, executive function, delayed recall, verbal fluency and working memory. DISCUSSION AND CONCLUSION: PE can ameliorate cognitive deficts of older adults with MCI. The most pronounced effects appear to arise from other types of exercise that included mind-body exercises and moderate intensity.

Associação entre a ocorrência de dor e sobrecarga em cuidadores principais e o nível de independência de idosos nas atividades de vida diária: estudo transversal / Association between the occurrence of pain and caregivers overload on main and the elderly independence level in daily life activities: cross sectional study

Resumo Introdução Cuidar do idoso costuma ser uma tarefa árdua, e as demandas podem extrapolar a capacidade do cuidador, causando sobrecarga e dor. Objetivo Investigar a ocorrência de sobrecarga e dor em cuidadores de idosos, bem como verificar a relação dessas variáveis com o nível de independência do idoso. Método Amostra por conveniência que, a partir de Unidades de Saúde de uma região distrital de Porto Alegre, identificou potenciais idosos e seus cuidadores principais. Estes, em visitas domiciliares, responderam questões referentes ao perfil socioeconômico, à ocorrência de dor (questionário nórdico e escala visual analógica de dor), à sobrecarga do cuidador (Inventário de Sobrecarga do Cuidador) e ao nível de independência do idoso (índice de Katz). Foi realizada correlação de Spearman. Resultados Participaram 14 idosos e 14 cuidadores com idade média de 82,1 (±6,9) e 65,9(±11,3) anos, respectivamente. Dos idosos, 28,6% foram classificados independentes, 50% dependência moderada e 21,4% muito dependentes. Houve correlação forte e inversa entre o nível de independência do idoso e a sobrecarga do cuidador (ρ=-0,619; p=0,018) e com os domínios, separadamente, sobrecarga tempo dependente (ρ=-0,866; p=0,000) e sobrecarga à vida pessoal (ρ=-0,708; p=0,005). Conclusão Quanto mais independente o idoso, menor foi a sobrecarga atribuída ao seu cuidador. Não houve associação entre dor e sobrecarga do cuidador.

Abstract Background Caring for an elderly is often an arduous task, and the care demands go beyond the caregiver's capacity may cause overload and pain. Objective The aim of this study was to investigate the association between independence level of the elderly in daily life activities and the occurrence of pain and overload your primary caregiver. Method The study included 14 elderly residents in adscript territory of health units of the North Zone-Axis Baltazar area Baltazar North axis of the city Porto Alegre and their primary caregivers, in home visits, answered questions regarding the socioeconomic profile, the occurrence of pain (Nordic questionnaire and visual analog pain scale), the caregiver burden (Inventory caregiver overload) and the level of independence of the elderly (Katz index). Results The average age of the elderly is 82.1 years (± 6.9) and caregivers, 65.9 years (± 11.3). Of the 14 elderly, 28.6% were classified as independent, 50% as having moderate dependence and 21.4% as very dependent. There was strong inverse correlation between the old level of independence and caregiver burden (ρ = -0.619; p = 0.018). When evaluating areas of the inventory separately overload time dependent (ρ = -0.866; p = 0.000) and over the personal life (ρ = -0.708; p = 0.005) correlated to the level of independence of the elderly. Conclusion The study showed that the more independent for the elderly, the lower the burden attributed to the caregiver.