Renato Nickel

Quality of life issues and occupational performance of persons with epilepsy

Epilepsy causes restrictions in the performance of various daily activities. The aiming of this study was to investigate whether these restrictions affect the perceived quality of life. The assessments Quality of Life in Epilepsy-31 (QOLIE-31) and Canadian Occupational Performance Measure (COPM) were applied in a sample that consisted of a single group of 34 subjects with at least two years of uncontrolled seizures. The results indicated that the most affected domains of QOLIE-31 were seizure worry, 29.77 (±21.72), and effects of drugs, 49.75 (±28.58), and for the COPM, the average of performance and satisfaction were respectively 3.10 (±3.07) and 4.45 (±3.29), and performance limitations most frequently cited were maintain employment (18), left home alone (15) and courses (15). The application of the Spearman correlation coefficient showed that the three main performance limitations posed by the COPM, especially regarding the level of satisfaction, influence the perception of quality of life. Thus, occupational performance proves to be an important area of intervention with subjects with epilepsy.

Evaluation of functionality and disability of older elderly outpatients using the WHODAS 2.0

Objectives: To analyze the level of functionality and disability of older elderly persons receiving care at a university hospital in Curitiba, Parana, and identify functional differences between men and women. Method: A descriptive, cross-sectional study with a quantitative approach, based on a convenience sample of elderly persons receiving outpatient care, was undertaken. The Brazilian version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Results: A total of 28 people with a mean age of 86.21 (±4.17) were evaluated. Of these 50.0 % were male, 46.4 % were widowed, and 57.1 % performed the evaluated activities independently. There were no significant differences between genders in terms of age (p≤0.635) or years of study (p≤0.329), although women showed a higher level of disability than men in general (p≤0.16). Conclusion: The WHODAS 2.0 proved to be a sensitive tool for the analysis and comparison of the level of functionality of the older elderly. However, it is important to develop prospective studies, with non-convenience samples, for a better reflection on the disability and functionality of older elderly persons.

Botulinum toxin for hereditary spastic paraplegia: effects on motor and non-motor manifestations

Motor and non-motor manifestations are common and disabling features of hereditary spastic paraplegia (HSP). Botulinum toxin type A (Btx-A) is considered effective for spasticity and may improve gait in these patients. Little is known about the effects of Btx-A on non-motor symptoms in HSP patients. Objective To assess the efficacy of Btx-A on motor and non-motor manifestations in HSP patients. Methods Thirty-three adult patients with a clinical and molecular diagnosis of HSP were evaluated before and after Btx-A injections. Results Mean age was 41.7 ± 13.6 years and there were 18 women. Most patients had a pure phenotype and SPG4 was the most frequent genotype. The Btx-A injections resulted in a decrease in spasticity at the adductor muscles, and no other motor measure was significantly modified. In contrast, fatigue scores were significantly reduced after Btx-A injections. Conclusion Btx-A injections resulted in no significant functional motor improvement for HSP, but fatigue improved after treatment.

Características profissionais, de formação e distribuição geográfica dos fisioterapeutas do Paraná - Brasil

Este estudio tuvo como objetivo conocer el perfil de los fisioterapeutas paranaenses en el ano de 2015, sus caracteristicas sociodemograficas, tendencias en la formacion y el mercado de trabajo, en una investigacion cuantitativa de caracter transversal. La muestra fue compuesta por 377 fisioterapeutas, de los 11272 inscritos en el Consejo Profesional en el ano de 2015, que respondieron a un cuestionario estructurado disponible en linea. Los resultados mostraron que los fisioterapeutas de Parana se constituyen predominantemente por jovenes de 21 a 40 anos (el 81,7%), del sexo femenino (el 77,7%), y se concentran en la macrorregion de Curitiba (el 53,6%). La gran parte se graduo en los ultimos diez anos (el 59,9%) y posee postgrado lato sensu (el 73,7%), sin embargo, pocos poseen maestria o doctorado. La gran parte (el 82,8%) trabaja exclusivamente con la profesion, en un unico empleo (el 53,3%), en institucion privada (el 59,2%), como autonomos (el 55,7%), con carga horaria de mas de ocho horas diarias (el 35,5%). Con relacion el area de actuacion, el 68,7% trabajan en mas de un area, siendo la Traumatologia y la Ortopedia las que presentan el numero de profesionales actuantes mas grande (el 59,9%), despues de la Neurofuncional (el 41,1%) y de la Respiratoria (el 38,7%). La gran parte de los profesionales tienen ingreso mensual entre el piso salarial y cuatro mil reales (el 42,9%). Asi, fue posible plantear el perfil del fisioterapeuta de Parana en 2015, vislumbrando la identidad de la profesion en el estado y la proyeccion de tendencias futuras, lo que posibilitara las instituciones de ensenanza superior y las entidades representativas de la categoria la creacion de estrategias futuras para la formacion y la regulacion del mercado de trabajo.