Avaliação dos efeitos da hospitalização sobre a capacidade funcional de idosos
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Data
2020-10-06
Autores
Mota, Helena Silva [UNIFESP]
Orientadores
Volpe, Márcia Souza [UNIFESP]
Tipo
Trabalho de conclusão de curso de graduação
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Resumo
O processo senil corresponde ao envelhecimento fisiológico do organismo e também pode ser definido como um declínio funcional dependente do tempo que causa perda progressiva da integridade fisiológica, função prejudicada dos órgãos e subsequente aumento da vulnerabilidade à morte. Com a perda da integridade fisiológica, a internação hospitalar decorrente de doença aguda se torna mais frequente e a internação, por sua vez, pode acelerar a perda de capacidade funcional. É importante ressaltar que o conceito de funcionalidade transcende a saúde física e reflete a interação entre as várias dimensões da saúde: biológica, individual e social. Portanto, a limitação física compromete atividades desenvolvidas pelo idoso e sua participação na sociedade, impactando negativamente na sua qualidade de vida. Fatores como, a imobilidade no leito e a pior alimentação/ingestão de nutrientes parecem estar relacionados com a perda de capacidade funcional durante o processo de internação hospitalar. O objetivo principal desse estudo foi avaliar os efeitos da hospitalização sobre a capacidade funcional de pacientes idosos. Foram incluídos pacientes internados nas enfermarias da Santa Casa de Santos, com idade igual ou superior a 65 anos, sem doença neuromuscular ou ortopédica que impeça a realização dos testes, com capacidade de caminhar independentemente previamente à internação, índice de massa corpórea < 30 kg/m2, estáveis hemodinamicamente, sem desconforto respiratório e sem expectativa de abordagem cirúrgica. Os pacientes foram avaliados entre o segundo e terceiro dia de internação e no momento da alta hospitalar. Os métodos avaliativos foram: força da musculatura respiratória, força de preensão palmar, Timed Up and Go (TUG) e índice de Barthel, utilizamos de análise descritiva através do cálculo das médias e desvio padrão. Foram avaliados 18 idosos, com idade média de 69 anos, sendo 11 do sexo masculino e 7 do sexo feminino e os resultados mostram que a força da musculatura respiratória sofreu redução ao longo da internação, na média inicial de PIMáx= 89 ± 24 cmH 2 O e final PIMáx= 82,5 ± 30 cmH 2 O e aumento na média inicial de PEMáx= 88 ± 23 cmH 2 O e final PEMáx = 94 ± 27 cmH 2 O. A média de força de preensão palmar também sofreu redução: de 20,5 ± 8 Kgf para 19,5 ± 8 Kgf. Enquanto o tempo para completar o TUG reduziu de 15,3 ± 5,6 s para 14,4 ± 5,5 s. Já o índice de Barthel não apresentou alteração significativa (médias inicial e final iguais a 91 e 90 pontos, respectivamente). Esses resultados indicam um declínio da função respiratória e da força muscular global, após um período relativamente curto de internação hospitalar. Assim, intervenções fisioterapêuticas, entre outras medidas, poderão ser adotadas para minimizar a perda de capacidade funcional de idosos internados.
The senile process corresponds to the physiological aging of the organism and can also be defined as a time-dependent functional decline that causes progressive loss of physiological integrity, impaired organ function and subsequent increased vulnerability to death. With the loss of physiological integrity, hospitalization due to acute illness becomes more frequent and hospitalization, in turn, can accelerate the loss of functional capacity. It is important to note that the concept of functionality transcends physical health and reflects an interaction between the various dimensions of health: biological, individual and social. Therefore, physical limitations compromise activities developed by the elderly and their participation in society, negatively impacting their quality of life. Factors such as bed immobility and worse nutrient feeding / intake seem to be related to the loss of functional capacity during the hospitalization process. The main objective of this study was to evaluate the effects of hospitalization on the functional capacity of elderly patients. Patients admitted to the wards of Santa Casa de Santos, aged 65 years or over, without neuromuscular or orthopedic disease that prevented the tests from being included, with the ability to walk before admission, body mass index <30 kg / m2 , hemodynamically stable, without respiratory distress and without expectation of a surgical approach. Patients were taken between the second and third day of hospitalization and at the time of hospital discharge. The evaluated methods were: respiratory muscle strength, handgrip strength, Timed Up and Go (TUG) and Barthel index, we used descriptive analysis through the calculation of means and standard deviation. Eighteen elderly people were obtained, with an average age of 69 years, 11 of whom were male and 7 female, and the results show that the strength of the respiratory musculature was reduced during hospitalization, in the initial mean of MIP = 89 ± 24 cmH2O and Final MEP = 82.5 ± 30 cmH2O and increase in the initial mean MEP = 88 ± 23 cmH2O and final MEP = 94 ± 27 cmH2O. The average handgrip strength also decreased: from 20.5 ± 8 Kgf to 19.5 ± 8 Kgf. While the time to complete the TUG reduced from 15.3 ± 5.6 s to 14.4 ± 5.5 s. The Barthel index does not present any significant change (initial and final averages equal to 91 and 90 points, respectively). These results indicate a decline in respiratory function and overall muscle strength, after a relatively short period of hospitalization. Thus, physical therapy interventions, among other measures, eliminated should be adopted to minimize the loss of functional capacity of hospitalized elderly
The senile process corresponds to the physiological aging of the organism and can also be defined as a time-dependent functional decline that causes progressive loss of physiological integrity, impaired organ function and subsequent increased vulnerability to death. With the loss of physiological integrity, hospitalization due to acute illness becomes more frequent and hospitalization, in turn, can accelerate the loss of functional capacity. It is important to note that the concept of functionality transcends physical health and reflects an interaction between the various dimensions of health: biological, individual and social. Therefore, physical limitations compromise activities developed by the elderly and their participation in society, negatively impacting their quality of life. Factors such as bed immobility and worse nutrient feeding / intake seem to be related to the loss of functional capacity during the hospitalization process. The main objective of this study was to evaluate the effects of hospitalization on the functional capacity of elderly patients. Patients admitted to the wards of Santa Casa de Santos, aged 65 years or over, without neuromuscular or orthopedic disease that prevented the tests from being included, with the ability to walk before admission, body mass index <30 kg / m2 , hemodynamically stable, without respiratory distress and without expectation of a surgical approach. Patients were taken between the second and third day of hospitalization and at the time of hospital discharge. The evaluated methods were: respiratory muscle strength, handgrip strength, Timed Up and Go (TUG) and Barthel index, we used descriptive analysis through the calculation of means and standard deviation. Eighteen elderly people were obtained, with an average age of 69 years, 11 of whom were male and 7 female, and the results show that the strength of the respiratory musculature was reduced during hospitalization, in the initial mean of MIP = 89 ± 24 cmH2O and Final MEP = 82.5 ± 30 cmH2O and increase in the initial mean MEP = 88 ± 23 cmH2O and final MEP = 94 ± 27 cmH2O. The average handgrip strength also decreased: from 20.5 ± 8 Kgf to 19.5 ± 8 Kgf. While the time to complete the TUG reduced from 15.3 ± 5.6 s to 14.4 ± 5.5 s. The Barthel index does not present any significant change (initial and final averages equal to 91 and 90 points, respectively). These results indicate a decline in respiratory function and overall muscle strength, after a relatively short period of hospitalization. Thus, physical therapy interventions, among other measures, eliminated should be adopted to minimize the loss of functional capacity of hospitalized elderly
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MOTA, Helena Silva.Avaliação dos efeitos da hospitalização sobre a capacidade funcional de idosos. 2020. 26 f. Trabalho de conclusão de curso de graduação (Fisioterapia) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2020..