Navegando por Palavras-chave "capacidade funcional"
Agora exibindo 1 - 7 de 7
Resultados por página
Opções de Ordenação
- 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 MetadadadosAvaliação da efetividade do treinamento resistido em pacientes com artrite psoriásica: um estudo controlado e randomizado(Universidade Federal de São Paulo (UNIFESP), 2014-11-12) Silva, Diego Roger [UNIFESP]; Natour, Jamil Natour [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)A artrite psoriásica (APS) é uma artrite inflamatória crônica, definida como a associação de artropatia inflamatória e psoríase. A literatura ainda é muito escassa em relação a tratamentos não farmacológicos para os pacientes com APS, especialmente o exercício físico. Objetivo: O objetivo deste estudo foi avaliar a eficácia do treinamento de resistência na melhoria da capacidade funcional, força muscular, qualidade de vida e atividade da doença em pacientes com PSA. Métodos: Quarenta e um pacientes com idade entre 18 e 65 anos com diagnóstico de artrite psoriásica foram selecionados para este estudo., Oos pacientes foram randomizados em dois grupos: grupo de intervenção e o grupo controle. O grupo de intervenção (GI) foi submetido a exercícios de resistência duas vezes por semana, durante 12 semanas. O grupo controle manteve-se na lista de espera com a terapia medicamentosa convencional. As medidas de desfecho foram: BASFI e HAQ-S para a capacidade funcional, teste de uma repetição máxima (!RM)para a força muscular, questionário SF-36 para a qualidade de vida em geral; e BASDAI e DAS-28 para a atividade da doença. As avaliações foram feitas por um avaliador cego na linha de base (T0), seis semanas (T6) e 12 semanas (T12) após o início do estudo. Resultados: Na avaliação inicial os grupos foram homogêneos quanto às características clínicas e demográficas. A capacidade funcional medida pelo HAQ-S e a atividade da doença medida pelo BASDAI, melhoraram significantemente no GI quando comparado ao GC, na semana 12. Em relação à qualidade de vida, o IG melhorou a domínios "dor" e "estado geral de saúde" em comparação com CG. (p <0,05). Houve melhora na força muscular em quase todos os exercícios no GI, exceto no exercício para o bíceps. No GC, a melhora na força foi observada apenas nos exercícios "crucifixo" e "extensão da perna" (bilateral) (bilateral). No entanto, houve diferenças estatísticas entre os grupos apenas no exercício "extensão da perna" (lado direito) em favor da GI. Conclusão: O treinamento de resistência é eficaz em melhorar a capacidade física, a atividade da doença e a qualidade de vida de pacientes com artrite psoriásica. As melhorias clínicas não expressaram mudanças significativas na força muscular.
- ItemAcesso aberto (Open Access)Correlation and adaptation among functional and cognitive instruments for staging and monitoring Alzheimer?s disease in advanced stages(Faculdade de Medicina da Universidade de São Paulo, 2014-04-01) Wajman, José Roberto; Schultz, Rodrigo Rizek; Marin, Sheilla de Medeiros Correia [UNIFESP]; Bertolucci, Paulo Henrique Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Although Alzheimer’s disease (AD) is the most prevalent form of dementia, little is known about cognitive and functional aspects in its advanced stages. Objective: This study aimed the adaptation and correlation among specific instruments for AD in advanced stages with regard to cognition objectively weighted, besides the comparison between static and ecological aspects of functional capacity. Method: 95 moderate, moderatly severe and severe AD patients (33 men and 62 women) underwent the scales CDR (Clinical for Dementia Rating), FAST (Functional Assessment Scale), MMSE (Mini-Mental State Exame), MMSEsev (Severe Mini-Mental State Examination), SIB-8 (Severe Impairment Battery) and TSI (Test for Severe Impairment), for the comparison with a golden-standard ecological scale the PADL (Performance Activities of Daily Living). Result: The evidence suggests an increasing and statistically significant linear correlation between the ecological functional scale and cognitive tests according to the stratification of AD stages once weighted by static functional scale. Discussion: The results indicate that for patients in advanced stages of AD, appropriate cognitive tests and performance-based functional scales are useful in more accurate assessment of disease staging and monitoring its progression.
- ItemSomente MetadadadosEfeitos de um programa de exercícios progressivos na capacidade funcional e qualidade de vida em pacientes pós-infarto agudo do miocárdio submetidos à reabilitação cardiovascularEnsaio clínico controlado e randomizado(Universidade Federal de São Paulo (UNIFESP), 2014-06-25) Peixoto, Thatiana Cristina Alves [UNIFESP]; Gomes, Walter Jose Gomes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objetivo: O propósito deste estudo foi avaliar a influência de um programa de reabilitação cardíaca precoce na qualidade de vida relacionada a saúde e capacidade funcional em pacientes que sofreram infarto agudo do miocárdio recentemente. Este programa foi iniciado na fase intra-hospitalar com seguimento de maneira não supervisionada após a alta hospitalar. Métodos: Dando seguimento ao tratamento realizado na fase intra-hospitalar. Pacientes de baixo risco cardiovascular que sofreram IAM foram radomizados em dois grupos: 1) grupo controle (GC) (n=43), que recebeu orientações para continuar a realizar exercícios, e grupo intervenção (GI) (n=45), que recebeu um protocolo de exercícios não supervisionados. Inicialmente todos os pacientes receberam o mesmo programa de exercícios precoces, realizados na fase intra-hospitalar, inciando 12 horas após a reperfusão. Na alta hospitalar, todos os pacientes foram classificados quanto ao risco cardiovascular. A qualidade de vida (QV) foi avaliada por meio do questionário específico Mac New, questionário específico realizado 30 dias após a alta hospitalar. A capacidade funcional foi avaliada por meio da distância percorrida no teste de caminhada de seis minutos (TC6), no dia da alta e 30 dias após o protocolo. Resultados: o Score global do questionário de qualidade de vida relacionada à saúde foi maior no GI após 30 dias do protocolo de estudo quando comparado com o GC; os domínios dos scores físico e emocional, foram significantemente maiores no GI (p<0,05). Além disso, o GI apresentou melhor distância percorrida no TC6 (p<0,0001), quando comparado ao grupo GC. Conclusão: Programa de reabilitação cardiovascular baseado em exercícios progressivos, iniciados na fase hospitalar (fase I) precocemente, com seguimento não supervisionado na fase II, melhorou a capacidade funcional e a tolerância ao exercício com impacto positivo na qualidade de vida relacionada à saúde em pacientes com IAM recente e baixo risco cardiovascular.
- ItemAcesso aberto (Open Access)Estratégia de troca entre agentes anti-TNF-alfa não melhora a capacidade funcional em pacientes com artrite reumatoide de longa evolução(Sociedade Brasileira de Reumatologia, 2012-02-01) Soares, Maria Roberta Melo Pereira [UNIFESP]; Reis Neto, Edgard Torres dos [UNIFESP]; Luz, Karine Rodrigues [UNIFESP]; Ciconelli, Rozana Mesquita [UNIFESP]; Pinheiro, Marcelo de Medeiros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVES: To assess clinical response after switching between anti-tumor necrosis factor-alpha (anti-TNF-alpha) agents in patients with rheumatoid arthritis (RA). PATIENTS AND METHODS: This study included 99 patients diagnosed with RA American College of Rheumatology, 1987), on anti-TNF-alpha therapy, to assess the therapeutic response after 24 weeks. Switching was performed if, after 12 to 24 weeks, a severe adverse event was reported (toxicity: T) or if no reduction greater than 0.6 in the initial Disease Activity Score 28 (DAS28) occurred (inadequate response: IR). In case of IR, the patient was considered as primary failure (PF). Secondary failure (SF) was defined as loss of response after initial improvement. Remission (DAS28 < 2.6), low disease activity (between 2.61 and 3.2), and functional improvement [increase in the initial Health Assessment Questionnaire (HAQ) > 0.2] were assessed by use of linear regression analysis. The significance level adopted was P < 0.05. RESULTS: Switching was performed in 39 (39.4%) patients, especially due to PF (24.3%), SF (35.1%) and T (40.5%). The retention rate of the first agent was 60.1%, and the mean time for switching was 14.2 ± 10.9 months. After switching, a tendency towards a decrease in DAS28 was observed (4.7 ± 1.4; P = 0.08), but not in the HAQ (1.2 ± 0.77; P = 0.11). Around 43% of the patients achieved good/moderate EULAR response. The major determinant of switching was a higher initial DAS28, independent of age, duration of disease, and functional capacity. CONCLUSION: Switching between anti-TNF-alpha agents is a valid strategy to control disease activity, despite the low likelihood of remission and no significant improvement in functional capacity
- ItemAcesso aberto (Open Access)Fatores associados à sintomatologia depressiva numa coorte urbana de idosos(Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, 2009-01-01) Lima, Márcio Tomita Da Rocha [UNIFESP]; Silva, Rebeca de Souza e [UNIFESP]; Ramos, Luiz Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: The process of population aging in Brazil has been fast and intense, increasing the prevalence of chronic diseases and psychological and mental problems, mainly depression, which is associated with functional losses of the aged one. OBJECTIVE: To analyse the association between depressive symptomatology and other indicators of functional capacity, and with mortality after 15 years of follow-up, in an urban cohort of elderly. METHODS: 1667 aged (> 65 years-old) residents in Clementino Village in São Paulo city were studied through a multidimensional evaluation of the functional capacity, as well as the death certificate of the deaths occurred between 1991 (beginning of the study) and April of 2006. In univaried analysis we calculated odds ratio and its significance statistics was evaluated by the reliable interval (95%). The logistic regression was used in the multiple analysis. RESULTS: 21,1% of the elderly were depressed in 1991. In univaried analysis the highest ratios of depressed people were found in the feminine sex, aged older than 80 years-old, illiterates, widowers or bachelors, high level of physical dependence, cognitive deficit, users of more medicines and among those who died in the period of 15 years. In multivaried analysis, controlling by sex and age, physical dependence and the users of more medicines are associated to depression. CONCLUSIONS: The worse levels of disability answer, by an expressive way, to the occurrence of depressive symptomatology between the aged ones.
- ItemAcesso aberto (Open Access)Patients with autosomal dominant spinocerebellar ataxia have more risk of falls, important balance impairment, and decreased ability to function(Academia Brasileira de Neurologia - ABNEURO, 2013-08-01) Aizawa, Carolina Yuri P. [UNIFESP]; Pedroso, Jose Luiz [UNIFESP]; Braga-neto, Pedro [UNIFESP]; Callegari, Marilia Rezende [UNIFESP]; Barsottini, Orlando Graziani Povoas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVES: To assess balance and ability to function in patients with spinocerebellar ataxia. METHODS: A total of 44 patients with different spinocerebellar ataxia types 1, 2, 3, and 6 were evaluated using the Tinetti balance and gait assessment and the functional independence measure. The scale for the assessment and rating of ataxia and the international cooperative ataxia rating scale were used to evaluate disease severity. RESULTS: Most patients showed significant risk of falls. The balance scores were significantly different in spinocerebellar ataxia types. A significant positive correlation between balance and disease severity was found. CONCLUSION: Patients with spinocerebellar ataxia have important balance impairment and risk of falls that influence the ability to function such as self-care, transfers, and locomotion. Furthermore, the more severe ataxia is, the more compromised are postural balance, risk of falls, and ability to function.