Isabel Aparecida Porcatti de Walsh

Capacidade para o trabalho em indivíduos com lesões músculo-esqueléticas crônicas

OBJETIVO: Avaliar o impacto de fatores pessoais, do trabalho e da lesao na capacidade funcional dos trabalhadores com e sem historia de acometimento de lesoes musculo-esqueleticas relacionadas ao trabalho, atraves da aplicacao do indice de capacidade para o trabalho. METODOS: Participaram do estudo 127 trabalhadores da linha de producao de uma empresa multinacional de porte medio. Foi aplicada uma traducao autorizada do indice de capacidade para o trabalho, um questionario elaborado pelo Instituto de Saude Ocupacional da Finlândia, assim como uma escala de dor. Os resultados foram analisados descritivamente, por meio do teste qui-quadrado e pela analise de regressao logistica. RESULTADOS: Todos os fatores pessoais, ocupacionais e clinicos analisados apresentaram relacao significativa com a capacidade para o trabalho. A analise de regressao mostrou que as variaveis de dor e afastamentos, quando associadas, explicam 59% das ocorrencias de baixa capacidade para o trabalho. CONCLUSOES: Diferentes niveis de dor refletiram niveis tambem distintos e equivalentes de perda da capacidade para o trabalho, o que pode sugerir que os relatos de dor sao consistentes. Ou, por outro lado, que ambos - dor e incapacidade - sao baseados em auto-relatos e, portanto, estao permeados pelos mesmos mecanismos de percepcao. Estudos futuros podem contribuir para melhor avaliar essas tendencias.

Clinical and functional aspects of work-related musculoskeletal disorders among active workers

OBJECTIVE To evaluate musculoskeletal disorders among active industrial workers. METHODS The study was carried out in São Carlos, Southeastern Brazil, in 2005. One hundred and thirty-four female workers were physically evaluated and answered questions about their physical symptoms, filled out a pain scale and gave responses in the Oswestry Disability Questionnaire, and the Work Ability Index questionnaire. The data were analyzed descriptively, and in correlation tests and through applying logistic regression. The outcome was evaluated in relation to the perceptions of pain, symptoms, physical assessment, ability to work and disability. RESULTS Clinical evaluations and sick leave presented positive correlations with the subjective variables. The Work Ability Index presented a negative correlation with the physical disability index (r=-0.69). Symptoms reported at the time of the assessment presented a good correlation with the results from the pain scale and the clinical findings. Previous sick leave showed an association with disability (OR=1.13; 95% CI:1.08;1.18). CONCLUSION Symptom reports and pain scales may be useful for assessing current conditions at the time of evaluating individuals with work-related musculoskeletal disorders, as they are easier to apply. In more severe cases of such injuries, clinical and functional evaluations and questionnaires such as those relating to ability to work and disability are preferable. Precise and specific evaluations of these disorders may contribute towards fairer legal and administrative decisions.

Musculoskeletal pain, profile and quality of life of individuals with sickle cell disease

BACKGROUND Sickle cell disease is a prevalent condition in Brazil. Its clinical presentation includes vascular occlusion that result in ischemia, inflammation, dysfunctions, pain and chronic hemolysis, causing irreversible damage and compromising quality of life. OBJECTIVE The objectives of this study were to verify the relationship between musculoskeletal pain, from different body parts, with social economic characteristics and quality of life among individuals with sickle cell disease. METHODS 27 individuals with sickle cell disease were interviewed with the use of a structured questionnaire with questions about personal, social, economic and cultural variables, the Nordic musculoskeletal symptoms questionnaire and the SF-36 Health Survey. Data were analyzed descriptively using frequencies and percentages. The inferential Chi-Square test was used for dichotomous variables and the Student t- test for continuous variables, with a significance of 5%. A logistic regression was performed using all variables that correlated with pain as dependent variables. RESULTS The mean age was 31.77 years, predominantly male, black, registered active employment, with average education and income up to three minimum wages. The regions most affected by pain were hip/limbs, chest, lower back and arms. Physical Functioning from the SF-36 had the highest score and mental health the lowest score. Musculoskeletal pain was present in the arms, chest and lower back. Social Functioning was not associated with pain, indicating the influence of other factors. Arm pain was more frequent in black individuals and those with low education. CONCLUSION Body pain was associated with race and education and all pain areas were associated with the physical components of the SF-36. Pain was significantly associated with vitality and mental health components of the SF-36.

Lung function and six-minute walk test performance in individuals with sickle cell disease

Background Sickle Cell Disease (SCD), which is characterized by a mutation in the gene encoding beta hemoglobin, causes bodily dysfunctions such as impaired pulmonary function and reduced functional capacity. Objective To assess changes in pulmonary function and functional capacity in patients with SCD and to identify the relationships between these variables. Method We evaluated sociodemographic, anthropometric, lung function (spirometry), respiratory (manovacuometer), peripheral muscle strength (Handgrip strength - HS) and functional capacity (i.e., the six-minute walk test) parameters in 21 individuals with SCD (average age of 29±6 years). Shapiro-Wilk, paired Students, Wilcoxon, Pearson and Spearman correlation tests were used for statistical analyses, and the significance threshold was set at p<0.05. Results A total of 47.6% of the study subjects exhibited an altered ventilation pattern, 42.8% had a restrictive ventilatory pattern (RVP) and 4.8% exhibited a mixed ventilatory pattern (MVP). The observed maximal inspiratory pressure (MIP) values were below the predicted values for women (64 cmH2O), and the maximum expiratory pressure (MEP) values, HS values and distance walked during the 6MWT were below the predicted values for both men (103 cmH2O, 39 Kgf and 447 m, respectively) and women (64 cmH2O; 27 Kgf; 405 m, respectively). Positive correlations were observed between maximum voluntary ventilation (MVV) and MEP (r=0.4; p=0.046); MVV and BMI (r=0.6; p=0.003); and between HS and MIP (r=0.7; p=0.001), MEP (r=0.6; p=0.002), MVV (r=0.5; p=0.015), distance walked in the 6MWT (r=0.4; p=0.038) and BMI (r=0.6; p=0.004). Conclusions SCD promoted changes in lung function and functional capacity, including RVPs and a reduction in the distance walked in the 6MWT when compared to the predictions. In addition, significant correlations between the variables were observed.

Relationship of musculoskeletal pain with physical and functional variables and with postural changes in school children from 6 to 12 years of age.

BACKGROUND Painful disorders can affect children and adolescents, causing distress and significant demand for health services. OBJECTIVE To identify the prevalence of musculoskeletal pain and its relation to age, sex, body mass index (BMI), how to carry school supplies, postures used in ADLs, outside school physical exercises and postural changes in students. METHOD Cross-sectional exploratory study with a convenience sample consisted of 262 schoolchildren aged 6 to 12 years (137 female). Data collection was conducted by questionnaire containing personal data, presence and location of pain, means of transportation and illustrative figures for choosing the way of carrying school supplies and postures ADLs. Postural evaluation was performed by observational analysis and body mass index calculated from information on height, weight, age and sex. Descriptive analysis was carried out with numbers and percentages. For inferential statistics, comparison of average age according to the presence of pain was performed by Kruskal-Wallis with Dunns post-test. Categorical variables were compared with chi-square test. RESULTS The presence of musculoskeletal pain was reported by 51.1% of the students and 38.93% had pain in only one region. The most affected regions were legs, spine, arms and shoulders. The pain increased with age and with physical activity. CONCLUSIONS In the our sample, 51.1% of students reported pain and 38.93% reported pain in only one region. There was no association between the presence of pain and sex, BMI, how to carry school supplies, postures used in ADLs and postural changes. The increasing age and physical exercise influenced significantly the presence of pain.

Work ability, musculoskeletal symptoms and quality of life among community health workers in Uberaba, Minas Gerais, Brazil

O objetivo deste estudo foi avaliar a capacidade para o trabalho (CT), aspectos socioeconomicos, qualidade de vida (QV) e sintomas osteomusculares, bem como as associacoes entre estes em agentes comunitarios de saude (ACS) da cidade de Uberaba, Minas Gerais. Participaram da pesquisa 47 ACS (42 mulheres e 5 homens), com idade media de 37,26 12,74 anos, que responderam um questionario sociodemografico, o Questionario Nordico de Sintomas Osteomusculares, o Questionario de Qualidade de Vida SF-36 e o Indice de Capacidade para o Trabalho. A analise inferencial foi realizada com a utilizacao do teste de Mann-Whitney, teste de Kruskall Wallis e teste de correlacao de Spearmann, com significância de 5%. Dos ACS entrevistados, 82,98% apresentaram sintomas osteomusculares nos ultimos 7 dias e 93,62% nos ultimos 12 meses. O dominio da QV mais comprometido foi a dor, seguido pela vitalidade, aspectos sociais, saude mental, estado geral de saude, aspectos emocionais, aspecto fisico e capacidade funcional. A media da CT foi de 36,51±7,95. A comparacao entre sexo e CT indicou que maior numero de mulheres apresentou capacidade inadequada. Maior incidencia de sintomas implicou capacidade inadequada. Quanto mais baixos os escores da QV, menor a CT.

Fatores que influenciam a capacidade física de pacientes com doença pulmonar obstrutiva crônica

The purpose of this study was to verify to what extent certain factors may influence physical capacity (as assessed by the six-minute walk test, 6MWT) of patients with chronic obstructive pulmonary disease (COPD); factors considered were age, forced expiratory volume in one second (FEV1), maximum voluntary ventilation (MVV), and distance covered in the symptom-limited cardiopulmonary exercise test (CET). Subjects were 18 male elderly (mean age 69.6±8.4 years) with II- and III-degree COPD diagnosis, submitted to spirometry and the 6MW and CE tests. Moderate significant correlations were found between distance walked at the 6MWT and FEV1 (r=0.62), MVV (r=0.50), and distance walked in CET (r=0.67); no correlation was found with age. Therefore, it may be said that the degree of airway obstruction, endurance of respiratory muscles, and maximum exertion capacity may influence physical capacity of subjects with II- and III-degree COPD when performing a daily activity such as walking.

Postural biomechanical risks for nursing workers

Introduction In the hospital environment, several types of professionals must be involved in continuous working shifts, under working conditions that are often unsatisfactory. Objective The objective of the present study was to analyze the biomechanical risk factors for work-related musculoskeletal disorders (WRMD). Material and methods This was a cross-sectional, exploratory, descriptive and quantitative study and its analysis considered 15 workers, in three shifts. A questionnaire containing personal information and general data regarding the work environment was applied. The REBA protocol was used for posture assessment, once the workers were recorded while performing their activities. The results were presented descriptively. Results In light of the results obtained, the working day was found excessive, particularly considering the weekly frequency and period of time of the working shifts. The REBA protocol showed that the positions adopted presented high risk for the development of WRMD in all nine activities evaluated. Conclusion The nursing activities were characterized as stressful for the workers involved.

Postural biomechanical risks for nursing workersRiscos biomecânicos posturais em trabalhadores de enfermagem

Introduction In the hospital environment, several types of professionals must be involved in continuous working shifts, under working conditions that are often unsatisfactory. Objective The objective of the present study was to analyze the biomechanical risk factors for work-related musculoskeletal disorders (WRMD). Material and methods This was a cross-sectional, exploratory, descriptive and quantitative study and its analysis considered 15 workers, in three shifts. A questionnaire containing personal information and general data regarding the work environment was applied. The REBA protocol was used for posture assessment, once the workers were recorded while performing their activities. The results were presented descriptively. Results In light of the results obtained, the working day was found excessive, particularly considering the weekly frequency and period of time of the working shifts. The REBA protocol showed that the positions adopted presented high risk for the development of WRMD in all nine activities evaluated. Conclusion The nursing activities were characterized as stressful for the workers involved.

Prática de exames de rastreio para câncer de mama e fatores associados : inquérito de saúde da mulher em Uberaba MG, Brasil, 2014

This study aimed to characterize womens socioeconomic and epidemiological profile in Uberaba according to the breast cancer screening practice and identify associated factors with this practice. This is a cross-sectional research part of the Womens Health Survey in Uberaba (MG). Data was collected by home interview, referring to socioeconomic and epidemiological issues and breast cancer screening practice, from a sample of 1,520 women above 20 years of age. After processing the data, we performed statistical analysis with measures of association by the Chi-square test, bivariate and multivariate Poisson regression, with a significance level of 5%. The results showed a profile of breast cancer screening practice with white women (66%), high schooling and per capita income, in common-law marriage (67,5%), non-heads of households (64,4%) and non-smokers (64,6%). Factors associated with higher practice were the age groups 40-49 and 50-69 years (PR = 0.7 and 0.64), per capita income higher than one minimum wage (PR = 1.17) and public or health plan mammography coverage (PR = 1.98 and 1.94). We can conclude that factors associated with breast cancer screening practice have been identified in the studied sample.