Navegando por Palavras-chave "activities of daily living"
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- ItemAcesso aberto (Open Access)Adaptação transcultural da escala de avaliação de incapacidade em demência (Disability Assessment For Dementia - DAD)(Academia Brasileira de Neurologia - ABNEURO, 2007-09-01) Carthery-goulart, Maria Tereza; Areza-fegyveres, Renata; Schultz, Rodrigo R. [UNIFESP]; Okamoto, Ivan [UNIFESP]; Caramelli, Paulo; Bertolucci, Paulo Henrique Ferreira [UNIFESP]; Nitrini, Ricardo; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)The original version of the Disability Assessment for Dementia (DAD) was translated into Portuguese and back translated to English. The divergences of translation were identified and discussed, resulting in a version that was used in a preliminary investigation for cross-cultural adaptation. The final version was administered to 29 patients with mild to moderate probable Alzheimer's disease. The correlation coefficients of DAD were 0.929 and 0.932 for the inter-examiner and test-retest evaluations respectively. The reliability indexes were also high (Kappa 0.72 p<0.001 inter-examiners and 0.85 p<0.001 test-retest). The Brazilian version of DAD was easy to administer and had good reliability to assess the functional status of demented patients. It will contribute to the follow-up of these patients in our population. Moreover, it can be used in transcultural studies on functional abilities in dementia.
- ItemAcesso aberto (Open Access)Atividade física no lazer e sua relação com a evolução da capacidade funcional de idosos que vivem em comunidade(Universidade Federal de São Paulo (UNIFESP), 2019) Ribeiro, Maria Claudia Martins [UNIFESP]; Ramos, Luiz Roberto [UNIFESP]; Sañudo, Adriana; http://lattes.cnpq.br/1676711953464613; http://lattes.cnpq.br/3798829566782422; http://lattes.cnpq.br/1152614954155366; Universidade Federal de São Paulo (UNIFESP)Introduction: Population aging is a worldwide phenomenon and the Brazilian population is aging at a higher speed than the world average. By 2025, Brazil will have the 6th largest elderly population in the world with 32 million people over the age of 60 years. During aging, the high prevalence of chronic diseases increases the loss of functional capacity, an important indicator of health. There is evidence that physical activity reduces disability among the elderly. Objective: To evaluate the influence of leisure-time physical activity on the functional capacity of elderly people living in the community during the follow-up time. Method: Longitudinal study with secondary data of the elderly cohort EPIDOSO Project. The study was developed in two stages: a cross-sectional analysis of the baseline with 907 elderly (≥60 years) and a longitudinal analysis that evaluated 287 individuals aged 60 years or older over an average of 3.5 years of follow-up. The dependent variable was the Functional Capacity (FC) measured by a scale of independence in activities of daily living (ADL). The independent variables were sociodemographic, health and behavioral characteristics such as leisure-time physical activity (LTPA), measured by the International Questionnaire of Physical Activity (IPAQ). For the transversal analysis, a Multinomial Logistic Regression was performed, and for the longitudinal one was performed a Multiple Linear Regression. Results: According to LTPA, the 907 participants in the study were classified as inactive (54.7%), insufficiently active (17.5%) and active (27.8%). LTPA was associated with FC (p <0.01). Among the active ones, 41% were independent (no limitation in ADLs) and inactive individuals presented a twofold higher chance of having severe dependence (more than seven limitations in ADL) when compared to the active ones. FC was also strongly associated with age, BMI and the presence of dysthymia. The advancing age, obesity and the presence of depressive disorder increased the chance of the elderly presenting more limitation. Longitudinal analysis showed that the relationship between LTPA and FC loses significance but remains in the right direction, indicating that when the minutes per week of leisure-time physical activity increase, the number of difficulties in ADL decreases. Functional capacity had a significant relationship with age, BMI, schooling and the number of difficulties in AVD in Wave 1. Conclusions: The results indicate that, a wide network of socio-demographic and health factors influence FC. Knowledge of these factors enables health actions to be better directed to this part of the population. It is noteworthy the relevance of leasure-time physical activity as one of the few behavioral factors that could change and one of the main contributors to an active and healthy aging.
- ItemSomente MetadadadosComparative Postural Control in COPD Patients and Healthy Individuals During Dynamic and Static Activities(Lippincott Williams & Wilkins, 2017) Porto, Elias F. [UNIFESP]; Pradella, Cristiane O. [UNIFESP]; Rocco, Carolina M. [UNIFESP]; Chueiro, Mario, Jr. [UNIFESP]; Maia, Rafaella Q. [UNIFESP]; Gananca, Fernando F. [UNIFESP]; Castro, Antonio A. M.; Nascimento, Oliver A. [UNIFESP]; Jardim, Jose R. [UNIFESP]PURPOSE: Patients with chronic obstructive pulmonary disease (COPD) have body balance deficits, with consequent fall risk. It is possible that body sway in patients with COPD affects their ability to perform daily activities. The purpose of this study was to determine whether body balance is similar in patients with COPD and healthy persons when performing static and dynamic activities. In addition, we wanted to assess whether impairment of balance is related to the presence of falls in patients with COPD. METHODS: This is a cross-sectional study, in which every spirometric classification in patients with COPD (mild, moderate, severe, and very severe degrees) and age-matched healthy subjects was assessed. Subjects who were current smokers and patients who underwent physical training in the last 6 months prior to the start of the study were excluded. Static balance was assessed by computerized posturography and dynamic body balance using the Berg Balance Scale. RESULTS: Ninety-three patients with COPD and 39 healthy persons were evaluated. Mean age was 67.3 (10.8) and 65.1 (9.7) years and mean forced expiratory volume in 1 second (FEV 1) was 50.4 (19.0) and 89.2 (23.6) for patients with COPD and healthy individuals, respectively. The impairment of body balance was higher for the group of patients with COPD (P -.0005). Patients with greater impairment in body balance had greater incidence of falls, and body balance was more affected with age in patients with COPD than in healthy persons. CONCLUSION: Impairment of body balance is more frequent in patients with COPD than in healthy persons while performing dynamic activities, and a greater incidence of falls activities was also found for this group.
- ItemSomente MetadadadosDisability rank in vestibular older adults(Wiley-Blackwell, 2011-01-01) Aratani, Mayra Cristina [UNIFESP]; Perracini, Monica Rodrigues; Caovilla, Heloisa Helena [UNIFESP]; Gazzola, Juliana Maria; Gananca, Mauricio Malavasi [UNIFESP]; Gananca, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Cidade São Paulo; Univ Bandeirante São PauloAim:To analyze the hierarchical structure of activities of daily living (ADL) among vestibular older adults, according to its power to discriminate disability.Methods:An exploratory cross-sectional study was conducted comprising 235 elderly, aged 65 years and older, with chronic vestibular dysfunction. Functional capacity was assessed through the Brazilian version of OARS Multidimensional Functional Assessment Questionnaire which consists of 15 activities of daily living (ADL). the sample was classified in each ADL according to the difficulty level in performing the activity. A multiple correlation analysis technique and discriminant analysis was used to analyze the hierarchical structure of ADL.Results:The sample consisted of 75.3% women, with an average age of 73.55 +/- 5.94 years. the ADL and their respective discrimination measurements were: getting into and out of bed (0.293); eating (0.129); combing hair (0.150); walking on flat surfaces (0.270); having a bath/shower (0.512); getting dressed (0.325); getting to the toilet in time (0.107); climbing stairs (0.338); taking medicines on time (0.035); walking close to home (0.529); shopping (0.503); preparing meals (0.398); cutting toenails (0.242); getting off buses (0.452); and cleaning the house (0.408).Conclusion:The tasks that reflect a higher demand upon the vestibular system were the most impaired, in the following order: walking close to home, having a bath/shower, shopping, getting off buses, cleaning the house, preparing meals, climbing stairs, getting dressed, getting into and out of bed, walking on flat surfaces, cutting toenails, combing hair, eating, getting to the toilet in time, taking medicines on time. Geriatr Gerontol Int 2011; 11: 50-54.
- ItemAcesso aberto (Open Access)Evaluation of properties of the Vestibular Disorders Activities of Daily Living Scale (Brazilian version) in an elderly population(Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia, 2014-05-16) Ricci, Natalia Aquaroni [UNIFESP]; Aratani, Mayra Cristina [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Cohen, Helen S.; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Baylor College of MedicineBackground:The Vestibular Disorders Activities of Daily Living Scale (VADL) is considered an important subjective assessment to evaluate patients suffering from dizziness and imbalance. Although frequently used, its metric characteristics still require further investigation.Objective:This paper aims to analyze the psychometric properties of the Brazilian version of the VADL in an elderly population.Method:The sample comprises patients (≥65 years old) with chronic dizziness resulting from vestibular disorders. For discriminant analysis, patients were compared to healthy subjects. All subjects answered the VADL-Brazil by interview. To examine the VADL validity, patients filled out the Dizziness Handicap Inventory (DHI) and the ABC scale and were tested on the Dynamic Gait Index (DGI). To evaluate the VADL responsiveness, 20 patients were submitted to rehabilitation.Results:Patients (n=140) had a VADL total score of 4.1±1.6 points. Healthy subjects scored significantly less than patients in all the subscales and in the VADL total score. The VADL-Brazil was weakly correlated with the DHI and moderately to the ABC scale and the DGI. Instead of the original 3 subscales, factor analysis resulted in 6 factors. The VADL was capable of detecting changes after rehabilitation, which means that the instrument has responsiveness.Conclusions:This study provided more data about the psychometric properties and usefulness of the VADL-Brazil. The use of such a reliable and valid instrument increases the knowledge about disability in patients with vestibular disorders.
- ItemAcesso aberto (Open Access)Factors associated with functional balance and mobility among elderly diabetic outpatients(Sociedade Brasileira de Endocrinologia e Metabologia, 2009-10-01) Cordeiro, Renata Cereda [UNIFESP]; Jardim, José Roberto [UNIFESP]; Perracini, Monica Rodrigues; Ramos, Luiz Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Cidade de São PauloOBJECTIVES: To characterize balance and mobility among diabetic elderly outpatients and to estimate the extent to which functional balance and mobility abnormalities can be influenced by sociodemographic, clinical and other functional factors in a cross-sectional study. METHODS: Ninety-one elderly (65+ years) outpatients were assessed. Mobility was evaluated by the Timed Up and Go Test (TUGT) and the balance, by the Berg Balance Scale (BS). RESULTS: TUGT mean score was 15.65 ± 5.9 seconds and BS mean score was 49.31 ± 7.3 points. Using linear regression analysis (α < 0.05), significant and independent positive relationships were obtained between TUGT and age, daily activities (ADL/IADL), step strategy, and proprioceptive sensitivity. Factors negatively associated with BS were: ADL/IADL, step strategy, proprioceptive sensitivity, orthostatic hypotension (OH) and conflictive sensory conditions. CONCLUSION: Elderly diabetic outpatients show abnormal balance and mobility related mainly to advanced age, disability, absence of step strategy, absence of proprioceptive sensitivity and presence of OH.
- ItemSomente MetadadadosFunctional Disability in Alzheimer Disease A Validation Study of the Brazilian Version of the Disability Assessment for Dementia (DAD-Br)(Lippincott Williams & Wilkins, 2010-07-01) Bahia, Valeria Santoro; Carthery-Goulart, Maria Teresa; Novelli, Marcia Maria Pires Camargo [UNIFESP]; Kato-Narita, Eliane M.; Areza-Fegyveres, Renata; Caramelli, Paulo; Nitrini, Ricardo; Universidade de São Paulo (USP); Universidade Federal de Minas Gerais (UFMG); Universidade Federal de São Paulo (UNIFESP); MRCBackground: the assessment of activities of daily living (ADL) is important both for the diagnosis and staging of dementia. the objective of this study was to verify the applicability and validity of the Brazilian version of the Disability Assessment for Dementia (DAD-Br).Methods: the DAD was applied to caregivers of 89 patients with probable Alzheimer disease (AD) and to 40 elderly individuals without cognitive impairment (controls). We assessed the construct validity of the scale and its diagnostic accuracy (sensitivity, specificity, and predictive value). in addition, intergroup and intragroup analyses were conducted to characterize patient performance on basic and instrumental ADL and to determine underlying deficits (initiation, planning, or effective execution).Results: AD patients and controls had mean ages of 76.4 +/- 6.9 years and 74.5 +/- 7.3 years (P = 0.08), respectively. Mean Mini-Mental State Examination scores were 17.4 +/- 5.0 and 26.1 +/- 5.1 (P < 0.001) and scores on the DAD were 68.4 +/- 19.0 and 99.8 +/- 0.9 (P < 0.001), for patients and controls, respectively. the DAD scale showed good internal consistency (Cronbach alpha = 0.77) and correlation with the Mini-Mental State Examination (r = 0.44; P < 0.001). the AD group did better on basic ADL than on instrumental ADL (P < 0.001). As expected, controls did not exhibit significant deficits on the items evaluated.Conclusion: the Brazilian version of the DAD is an adequate and reliable tool for assessing functional ability in AD patients.
- ItemAcesso aberto (Open Access)Is there correlation between cognition and functionality in severe dementia? The value of a performance-based ecological assessment for Alzheimer’s disease(Academia Brasileira de Neurologia - ABNEURO, 2014-11-01) Wajman, José Roberto [UNIFESP]; Oliveira, Fabricio Ferreira de [UNIFESP]; Marin, Sheilla de Medeiros Correia [UNIFESP]; Schultz, Rodrigo Rizek [UNIFESP]; Bertolucci, Paulo Henrique Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective Besides significant cognitive decline, patients in later stages of Alzheimer's disease (AD) also present global functional impairment, usually reported by their caregivers. This study searched for preserved activities of daily living by investigating correlations among specific instruments for severe dementia with a performance-based functional scale. Method A sample of 95 moderate to severe AD patients and their caregivers underwent a neuropsychological battery consisting of screening tools, the Functional Assessment Staging Test (FAST), the Severe Mini-Mental State Examination (MMSEsev) and a performance-based ecological scale, the Performance Test of Activities of Daily Living (PADL). Results Consistent findings emerged from the comparisons among tests. PADL showed significant statistical correlation with MMSEsev (ρ<0.001), according to FAST subdivisions. Conclusion Upon suspicion of unreliable caregiver reports, ecological scales may be useful for disease staging. Variable degrees of functionality and cognition may be present even in later stages of AD, requiring proper assessment.
- ItemAcesso aberto (Open Access)Neuropsychological performance in patients with subcortical stroke(Academia Brasileira de Neurologia - ABNEURO, 2012-05-01) Andrade, Silviane Pinheiro Campos de [UNIFESP]; Brucki, Sônia Maria Dozzi; Bueno, Orlando Francisco Amodeo [UNIFESP]; Siqueira Neto, José Ibiapina; Universidade Federal de São Paulo (UNIFESP)Vascular cognitive impairment (VCI) is characterized by cognitive compromise predominantly of executive dysfunction. OBJECTIVES: To assess cognitive functions in VCI, focusing on executive functions, to observe functional losses in relation to activities of daily living (ADLs) and to detect early symptoms prior to the onset of dementia. METHODS: We evaluated healthy subjects matched for gender, education and age to patients with diagnosis of subcortical vascular disease who had a stroke classified into three groups: 1) vascular lesions and no impairment; 2) vascular cognitive impairment with no dementia (VCIND); 3) vascular dementia (VaD). RESULTS AND DISCUSSION: The performance on neuropsychological tests differed among groups, worsening with increased impairment level. The probable VaD group demonstrated impaired performance in memory, processing speed and verbal production, while the VCIND group showed attention deficits. CONCLUSION: Impairment in executive functions and difficulties in ADLs allow us to differentiate levels of impairment in groups of subcortical vascular disease.
- ItemSomente MetadadadosPrevalence and Correlates of Functional Status in an Older Community-Representative Sample in Brazil(Sage Publications Inc, 2010-04-01) Fillenbaum, Gerda G.; Blay, Sergio L. [UNIFESP]; Andreoli, Sergio B. [UNIFESP]; Gastal, Fabio L.; Duke Univ; Vet Adm Med Ctr; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Minas Gerais (UFMG)Objective: Information on dependency level of elderly in rapidly aging developing countries is limited, but this is needed to ascertain the extent of need for help with activities of daily living (ADLs). Method: In-person information was obtained in 1995 from a statewide survey of representative community residents >= 60 years of age in the state of Rio Grande do Sul, Brazil (N = 7,040), on demographic characteristics, health conditions, social ties, health behaviors, and ADL performance. Results: Nearly 40% needed help with one or more ADLs. in controlled analyses, need for help approximately doubled with each succeeding decade. Increased education and income and regular physical activity reduced risk. Selected health conditions (stroke, depression, poor self-rated health) were consistently associated with need for help. Discussion: A large proportion of noninstitutionalized elderly have ADL problems. in addition to health care, interventions promoting equity of access to education and economic opportunity could reduce ADL dependency in coming generations.
- ItemAcesso aberto (Open Access)Qualidade de vida em pacientes com vertigem posicional paroxística benigna e/ou doença de Ménière(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2005-12-01) Handa, Patrícia Rumi [UNIFESP]; Kuhn, Ana Maria Baccari [UNIFESP]; Cunha, Fabiana [UNIFESP]; Schaffleln, Ricardo [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Patients with benign paroxysmal positional vertigo and/or Ménière's disease relate damages in quality of life. AIM: To compare the impact of dizziness on quality of life, in patients with benign paroxysmal positional vertigo and/or Ménière's disease, in crisis and out of crisis, and to evaluate the influence of gender, age and impaired semicircular canal. STUDY DESIGN: clinical with transversal cohort. MATERIAL AND METHOD: The prospective study was realized in 2003/04 at Federal University of São Paulo. The Dizziness Handicap Inventory was applied in seventy patients with positional vertigo, seventy with Ménière's disease and fifteen with both. Two-proportion equality test and the Analysis of variance were employed in this study. RESULTS: When comparing the groups, Dizziness Handicap Inventory results evidenced higher averages in crisis and out of crisis for Ménière's disease group than for positional vertigo group. The same occurred only during the crisis period in the group when comparing with both disorders (p<0,05). No significant statistical differences were observed, when comparing the results considering age, gender and, in the group with positional vertigo, affection of posterior semicircular canal as variables. CONCLUSIONS: Ménière's disease patients presented worse quality of life when compared to BPPV patients, in and out of crisis, and during the crisis when regarding the patients with association of both disorders. The damage on quality of life was independent of gender, age and in the BPPV cases it was independent of posterior canal affection.
- ItemAcesso aberto (Open Access)Revisão sistemática das escalas utilizadas para avaliação funcional na doença de Pompe(Sociedade de Pediatria de São Paulo, 2012-06-01) Savegnago, Alana Karla [UNIFESP]; Silva, Rosangela Maria da [UNIFESP]; Jonhston, Cíntia [UNIFESP]; Martins, Ana Maria [UNIFESP]; Melo, Ana Paula L. de [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: To identify functional assessment scales used in Pompe disease (PD) and to describe their levels of evidence and grades of recommendation. DATA SOURCE: Systematic review of the functional assessment scales used in PD. Review conducted in the databases Medline, Lilacs, Cochrane Central Register of Controlled Trials (CCTR), and SciELO including articles (except review articles) published between 2000 and 2010. The key-words used in Portuguese and English were: glycogen storage disease type II, activities of daily living, assessment. The articles were classified according to their level of evidence and grade of recommendations. DATA SYNTHESIS: 14 studies assessing patients ranging from newborns to adults were included in the present review (total sample=449). The scales found in the literature were: Pediatric Evaluation of Disability Inventory (PEDI) and its adapted version for PD (Pompe-PEDI), Alberta Infant Motor Scale (AIMS), Rotterdam Handicap Scale (RHS), Functional Independence Measure (FIM), Gross Motor Function Measure (GMFM), and Peabody Developmental Motor Scales (PDMS-II). Most studies had level of evidence III because they were non-randomized studies. The grades of recommendation of the scales were C for AIMS and Pompe-PEDI, D for GMFM and PDMS-II; and E for RHS and FIM. CONCLUSIONS: Most functional assessment scales used in PD show low level of evidence and grade of recommendation. The scales showing the highest grade of recommendation (C) were the AIMS and Pompe-PEDI used in Pediatrics.
- ItemSomente MetadadadosStudy of energy expenditure during activities of daily living using and not using body position recommended by energy conservation techniques in patients with COPD(Amer Coll Chest Physicians, 2006-07-01) Velloso, Marcelo [UNIFESP]; Jardim, Jose R. [UNIFESP; Universidade Federal de São Paulo (UNIFESP)Study objectives: To assess the energy spent by COPD patients using or not using energy conservation techniques (ECTs) during activities of daily living (ADL).Method: the patients were evaluated in two different situations. as stated above. for both applications, the following variables were measured during four ADL with or without using postures recommended by ECTs: metabolic (oxygen consumption [V-O2] and carbon dioxide production [V-CO2]), ventilatory (minute ventilation), cardiovascular (heart rate [HR] and oxygen pulse), and dyspnea (Borg score).Participants: Sixteen male COPD patients (mean age, 62 years) with moderate-to-very-severe COPD (mean FEV1, 40%) participated in the study.Measurements and results: the use of ECTs during ADL related to personal hygiene reduced V-O2 (13.4%), V-CO2 (12.8%), HR (13.7%), and Borg score (1 point) [p < 0.05]. Putting on and taking off shoes did not change V-O2, V-CO2, and HR but reduced the Borg score (0.6 point) [p < 0.05]. Storing groceries on high shelves reduced V-O2 (12.2%), V-CO2 (9.9%), HR (5.1%), and Borg score (0.75 point). Storing groceries on low shelves reduced V-O2 (28.1%), V-CO2 (24.3%), HR (5.4%), and Borg score (0.8 point) [p < 0.05].Conclusion: the use of energy conservation techniques in COPD patients during ADL reduces energy cost and dyspnea perception.