Ana Carolina Basso Schmitt

Queixas musculoesqueléticas em uma Unidade Básica de Saúde: implicações para o planejamento das ações em saúde e fisioterapia

Correspondence to: Raquel Aparecida Casarotto – Universidade de São Paulo – Faculdade de Medicina – Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional – Rua Cipotânea, 51 – CEP: 05360-000 – São Paulo (SP), Brasil – E-mail: racasaro@usp.br Presentation: Dec. 2012 – Accepted for publication: Aug. 2013 – Financing source: none – Conflict of interests: nothing to declare – Approval at the Ethics Committee n. 1242/09. AbstrAct | Objective: The aim of this study was to analyze the prevalence musculoskeletal complaints in adults in a Health Center. Methods: There were evaluated users seen in spontaneous reception in the period of 2010 March to 2011 May. Altogether there were studied 1.023 individuals. The characterization of the complaints was conducted through a questionnaire with socio demographic data and the reason for the demand for care. Results: Data from this study showed that most users were women (71.2%), aged 31 to 60 years (50.0%), single (31.6%), retired (14.2%) and had complaints in various systems (77.1%). The musculoskeletal system was the most affected (14.4%), representing the second reason for seeking treatment (31.0%). Analyzing the odds ratios of occurrence of musculoskeletal complaints in relation to the variables studied, we found that people aged 40 to 59 years were 3.49 (95%CI 2.17–5.57) times more likely to occur in association with these pains than older and younger persons. There was no association between other systems and the variables studied. Conclusion: The high prevalence of musculoskeletal complaints requires a new look from health managers to meet these demands, thinking about the possibility of including the physiotherapist in primary health care unit to treat less complex pains.OBJECTIVE: The aim of this study was to analyze the prevalence musculoskeletal complaints in adults in a Health Center. METHODS: There were evaluated users seen in spontaneous reception in the period of 2010 March to 2011 May. Altogether there were studied 1.023 individuals. The characterization of the complaints was conducted through a questionnaire with socio demographic data and the reason for the demand for care. RESULTS: Data from this study showed that most users were women (71.2%), aged 31 to 60 years (50.0%), single (31.6%), retired (14.2%) and had complaints in various systems (77.1%). The musculoskeletal system was the most affected (14.4%), representing the second reason for seeking treatment (31.0%). Analyzing the odds ratios of occurrence of musculoskeletal complaints in relation to the variables studied, we found that people aged 40 to 59 years were 3.49 (95%CI 2.17-5.57) times more likely to occur in association with these pains than older and younger persons. There was no association between other systems and the variables studied. CONCLUSION: The high prevalence of musculoskeletal complaints requires a new look from health managers to meet these demands, thinking about the possibility of including the physiotherapist in primary health care unit to treat less complex pains.

Posture Alignment of Adolescent Idiopathic Scoliosis: Photogrammetry in Scoliosis School Screening

Objective: The objective of this study was to describe the posture patterns of adolescents diagnosed with adolescent idiopathic scoliosis (AIS) in a scoliosis school screening (SSS). Methods: Two‐dimensional photogrammetry was used to assess the posture of 37 adolescents diagnosed with scoliosis (scoliosis group, SG) (Cobb angle ≥10°) and 76 adolescents with a false positive diagnosis (false positive group, FPG) (Cobb angle <10°, angle of trunk rotation ≥7°). In total, 2562 10‐ to 14‐year‐old adolescents were enrolled in the SSS, which was performed in public schools in the cities of Amparo, Pedreira, and Mogi Mirim in the state of São Paulo, Brazil. Their posture was analyzed using Postural Analysis Software. Continuous variables were tested using Student t test, and categorical variables were tested using a χ2 test. The SG, FPG, simple curve group, and double curve group were all compared. Bivariate analysis was used to identify associations between postural deviations and scoliosis. The adopted significance level was &agr; = .05. Results: The SG (2.7 ± 1.9°) had greater shoulder obliquity than the FPG (1.9 ± 1.4°) (P = .010), and this deviation was associated with scoliosis (odds ratio [95% CI] P = 1.4 [1.1‐1.8] 0.011). The SG had asymmetry between the right‐ and left‐side lower limb frontal angle, shoulder sagittal alignment, and knee angle. The double curve group (3 ± 1.7°) presented a greater value of the vertical alignment of the torso than the simple curve group did (1.9 ± 1°; P = .032). Conclusions: Adolescents diagnosed with AIS in an SSS had greater shoulder obliquity and asymmetry between the right and left sides. Shoulder obliquity was the only postural deviation associated with AIS.

O acesso e o fazer da reabilitação na Atenção Primária à Saúde

Para a adequada oferta de servicos de reabilitacao no Brasil e preciso conhecer a disponibilidade de acesso existente na Rede Assistencial de Saude (RAS) e desenvolver praticas que atendam as necessidades de saude. Buscou-se estimar a tendencia da distribuicao de recursos humanos de reabilitacao na RAS 2007-2015, especificamente na Atencao Primaria a Saude (APS) e conhecer a pratica de Clinica Ampliada (CA), Projeto Terapeutico Singular (PTS) e Apoio Matricial (AM) para fonoaudiologos, fisioterapeutas e terapeutas ocupacionais. Buscou-se profissionais na Rede Assistencial pelo Cadastro Nacional de Estabelecimentos de Saude (CNES). A tendencia mensal foi construida por modelos de regressao linear Prais-Winsten. Para conhecer as praticas de CA, PTS e AM, construiu-se discursos do sujeito coletivo a partir de entrevistas de 12 profissionais. Media complexidade teve a maior concentracao de profissionais, exceto em hospitais na cidade de Sao Paulo. A APS, por sua vez, teve a menor possibilidade de acesso. Mesmo timido, houve crescimento dos tres profissionais na assistencia, com enfase para os fisioterapeutas em hospital de Sao Paulo, em relacao ao estado (0,73%) e cidade (0,95%). Na APS, o crescimento maior foi do terapeuta ocupacional em Sao Paulo-cidade e do fisioterapeuta no Brasil. Para AM, CA e PTS, alem da dificuldade do fazer, destacaram-se, respectivamente, ideias de “pluralidade de concepcoes”, “visao biopsicossocial” e “possibilidade de adaptacao” do cuidado. Embora crescente, a disponibilidade de profissionais e baixa e desigual, concentrada na especialidade e enfatizando ampliacao de fisioterapeutas no hospital e terapeutas ocupacionais na APS.

O fisioterapeuta do estado de São Paulo

To identify the profile of the physical therapist is important for a profession overview, which can help organs and institutions of higher education to train more qualified, fulfilled, valued, and recognized professionals for health care. The profile of the physical therapist has already been studied in other states, specific specialties or workplace; however we are not aware of the current profile of the physical therapist in the state of Sao Paulo (SP). The aim of this study was to describe the profile of the physical therapist of SP according to demographic, training, and professional performance aspects. All physical therapists registered in Crefito-3 with at least one year since graduation were invited to participate in the study, by means of answering an online questionnaire. In total, 2,323 physical therapists participated in the research. The sample was composed by: 80% women, 62% graduated between 2001 and 2010, 83% graduated from a private university, and 66.7% had attended a post-graduation specialization course. Most of them worked as physical therapists and had physiotherapy as their only source of income. The predominant workplace was home care and the monthly gross income was up to R

El acceso y la práctica a la rehabilitación en la Atención Primaria de Salud

3,000.00 in 45% of cases. Professionals who were graduated for a longer time, those who work in universities and in their own clinics were better remunerated. Most professionals are satisfied with their profession, often attend update courses, present low adherence to unions and associations and are unaware of the current legislation in force. There is a predominance of female physical therapists in the state of Sao Paulo, young, who attended a post-graduation specialization course and who seek to be updated, but with low participation in the professions institutions. Many are self-employed, professionals working in universities and in their own clinics are the best paid and the time of training and experience are relevant factors to achieve a better monthly income.

The access and rehabilitation working process in Primary Health Care

Para a adequada oferta de servicos de reabilitacao no Brasil e preciso conhecer a disponibilidade de acesso existente na Rede Assistencial de Saude (RAS) e desenvolver praticas que atendam as necessidades de saude. Buscou-se estimar a tendencia da distribuicao de recursos humanos de reabilitacao na RAS 2007-2015, especificamente na Atencao Primaria a Saude (APS) e conhecer a pratica de Clinica Ampliada (CA), Projeto Terapeutico Singular (PTS) e Apoio Matricial (AM) para fonoaudiologos, fisioterapeutas e terapeutas ocupacionais. Buscou-se profissionais na Rede Assistencial pelo Cadastro Nacional de Estabelecimentos de Saude (CNES). A tendencia mensal foi construida por modelos de regressao linear Prais-Winsten. Para conhecer as praticas de CA, PTS e AM, construiu-se discursos do sujeito coletivo a partir de entrevistas de 12 profissionais. Media complexidade teve a maior concentracao de profissionais, exceto em hospitais na cidade de Sao Paulo. A APS, por sua vez, teve a menor possibilidade de acesso. Mesmo timido, houve crescimento dos tres profissionais na assistencia, com enfase para os fisioterapeutas em hospital de Sao Paulo, em relacao ao estado (0,73%) e cidade (0,95%). Na APS, o crescimento maior foi do terapeuta ocupacional em Sao Paulo-cidade e do fisioterapeuta no Brasil. Para AM, CA e PTS, alem da dificuldade do fazer, destacaram-se, respectivamente, ideias de “pluralidade de concepcoes”, “visao biopsicossocial” e “possibilidade de adaptacao” do cuidado. Embora crescente, a disponibilidade de profissionais e baixa e desigual, concentrada na especialidade e enfatizando ampliacao de fisioterapeutas no hospital e terapeutas ocupacionais na APS.

Prevalence and factors associated with urinary incontinence in climacteric

Para a adequada oferta de servicos de reabilitacao no Brasil e preciso conhecer a disponibilidade de acesso existente na Rede Assistencial de Saude (RAS) e desenvolver praticas que atendam as necessidades de saude. Buscou-se estimar a tendencia da distribuicao de recursos humanos de reabilitacao na RAS 2007-2015, especificamente na Atencao Primaria a Saude (APS) e conhecer a pratica de Clinica Ampliada (CA), Projeto Terapeutico Singular (PTS) e Apoio Matricial (AM) para fonoaudiologos, fisioterapeutas e terapeutas ocupacionais. Buscou-se profissionais na Rede Assistencial pelo Cadastro Nacional de Estabelecimentos de Saude (CNES). A tendencia mensal foi construida por modelos de regressao linear Prais-Winsten. Para conhecer as praticas de CA, PTS e AM, construiu-se discursos do sujeito coletivo a partir de entrevistas de 12 profissionais. Media complexidade teve a maior concentracao de profissionais, exceto em hospitais na cidade de Sao Paulo. A APS, por sua vez, teve a menor possibilidade de acesso. Mesmo timido, houve crescimento dos tres profissionais na assistencia, com enfase para os fisioterapeutas em hospital de Sao Paulo, em relacao ao estado (0,73%) e cidade (0,95%). Na APS, o crescimento maior foi do terapeuta ocupacional em Sao Paulo-cidade e do fisioterapeuta no Brasil. Para AM, CA e PTS, alem da dificuldade do fazer, destacaram-se, respectivamente, ideias de “pluralidade de concepcoes”, “visao biopsicossocial” e “possibilidade de adaptacao” do cuidado. Embora crescente, a disponibilidade de profissionais e baixa e desigual, concentrada na especialidade e enfatizando ampliacao de fisioterapeutas no hospital e terapeutas ocupacionais na APS.

Prevalence of musculoskeletal pain and impact on physical function and health care services in Belterra/PA

OBJECTIVE To estimate the prevalence and identify associated factors to urinary incontinence (UI) in climacteric women. METHOD In a cross-sectional study with a stratified random sample, 1,200 women aged between 35 and 72 years were studied, enrolled in the Family Health Strategy in the city of Pindamonhangaba, São Paulo. Urinary incontinence was investigated using the International Consultation of Incontinence Questionnaire - Short Form, while associated factors were assessed based on a self-reported questionnaire with socio-demographic, obstetric and gynecological history, morbidities and drug use. The prevalence of urinary incontinence was estimated with a 95% confidence interval (95CI) and the associated factors were identified through multiple logistic regression model performed using Stata software, version 11.0. RESULTS Women had a mean age of 51.9 years, most were in menopause (59.4%), married (87.5%), Catholic (48.9%), and declared themselves black or brown (47.2%). The mean age of menopause of women with UI was 47.3 years. The prevalence of UI was 20.4% (95CI: 17.8-23.1%). The factors associated with UI were urinary loss during pregnancy (p=0.000) and after delivery (p=0.000), genital prolapse (p=0.000), stress (p=0.001), depression (p=0.002), and obesity (p=0.006). CONCLUSION The prevalence of UI was lower but similar to that found in most similar studies. Factors associated with the genesis of UI were urinary loss during pregnancy and after delivery, genital prolapse and obesity.

El fisioterapeuta del estado de São Paulo

Introduction: Musculoskeletal pain worth being investigated for being a multidimensional prevalent phenomenon, difficult to be understood which may have as main factors: tissue injury as well as emotional, social and environmental aspects. It is essential to know the specificity of the pain to define strategies for disease prevention and health promotion of the population. Objective: To estimate the prevalence of musculoskeletal pain, describing its features and functional implications in population from Belterra/Para. Method: In a descriptive study, there were evaluated subjects who participated in activities of the project Bandeira Cientifica. Prevalence of pain was estimated with a confidence interval of 95%. Descriptive measures were used to characterize pain and consequences for functionality. Results: 453 subjects were interviewed, the mean age was 44.3 years old (SD = 18.0) and 69.6% were women. Prevalence of chronic pain was 62.5% and of back pain was 55.0%. Almost daily pain was felt by 67.9% and by 69.6% the intensity was strong or unbearable during crisis. Individuals with unbearable intensity and daily frequency of symptoms reported difficulty to perform heavy activities (91.5%) and to remain in the same position (82.9%). Conclusion: The prevalence of pain was high, of chronic feature, with high intensity and high frequency, long duration, most frequently in the vertebral column. The pain had interference in the performance of heavy activities and maintaining the same posture in people with greater intensity and frequency of pain.

The physical therapist in the state of São Paulo

To identify the profile of the physical therapist is important for a profession overview, which can help organs and institutions of higher education to train more qualified, fulfilled, valued, and recognized professionals for health care. The profile of the physical therapist has already been studied in other states, specific specialties or workplace; however we are not aware of the current profile of the physical therapist in the state of Sao Paulo (SP). The aim of this study was to describe the profile of the physical therapist of SP according to demographic, training, and professional performance aspects. All physical therapists registered in Crefito-3 with at least one year since graduation were invited to participate in the study, by means of answering an online questionnaire. In total, 2,323 physical therapists participated in the research. The sample was composed by: 80% women, 62% graduated between 2001 and 2010, 83% graduated from a private university, and 66.7% had attended a post-graduation specialization course. Most of them worked as physical therapists and had physiotherapy as their only source of income. The predominant workplace was home care and the monthly gross income was up to R