Thais de Lima Resende

Análise de fatores extrínsecos e intrínsecos que predispõem a quedas em idosos

OBJECTIVE: In a sample of elderly individuals from Porto Alegre - RS, Brazil, to analyze the intrinsic and extrinsic factors that predispose them to the risk of falls and fractures. METHODS: The study included a random sample of 267 elderly individuals, to whom two balance tests were applied: the Functional Reach Test (FRT) and the Timed Up and Go Test (TUG). The elderly also answered a questionnaire (13 questions divided into four categories) on sociodemographic and health factors. RESULTS: Elderly individuals from both genders (76.8% women), aged between 60 and 90 years (mean = 70.22 years, SD = ± 7.30 years) participated in the study. A statistically significant association (p < 0.05) was found between age, self-perception of eyesight, type of dwelling, last monthly income, and the FRT; the same was found between age range, self-rated health (p < 0.001) and the TUG. CONCLUSION: It was identified that, in the sample of elderly individuals living in Porto Alegre - RS, Brazil, the intrinsic factors that predispose to the risk of falls and fractures are older age, poor self-perception of eyesight, and poor selfrated health; the extrinsic factors are type of dwelling (living in a house) and a monthly income < one minimum wage.

Clinical profile, quality of life and depressive symptoms of women with urinary incontince attending a university hospital

OBJECTIVES To describe the characteristics of urinary incontinence (UI) and to evaluate its impact on health-related quality of life (QOL) and depressive symptoms in women referred for physical therapy at a university hospital. METHODS A descriptive cross-sectional study with demographic data collection related to UI. All women were evaluated through examination and also through depression and QOL questionnaires. RESULTS Forty-eight women were evaluated (53.8±10.9 years), 47.9% with mixed UI (MUI), 39.6% with stress UI (SUI) and 12.5% with urge UI (UUI). In 50% of the cases the urinary loss lasted between 3.3 and 10 years. There was no significant difference in the pelvic floor muscle strength among the different types of UI (P>0.05). Depressive symptoms were detected in 37% of the women. Changes in the QOL were observed in all three groups of women with UI. According to the Kings Health Questionnaire (KHQ), women with MUI presented more compromised health perception and greater physical, social, daily activity and personal relationship limitations (P<0.05). The women with MUI presented a worse health perception (P<0.05) according to the WHOQOL-Bref. CONCLUSION Depressive symptoms were detected in more than a third of the women whose quality of life was adversely affected and the greatest impact was observed in the patients with MUI.

Analysis of extrinsic and intrinsic factors that predispose elderly individuals to fall

OBJECTIVE In a sample of elderly individuals from Porto Alegre - RS, Brazil, to analyze the intrinsic and extrinsic factors that predispose them to the risk of falls and fractures. METHODS The study included a random sample of 267 elderly individuals, to whom two balance tests were applied: the Functional Reach Test (FRT) and the Timed Up and Go Test (TUG). The elderly also answered a questionnaire (13 questions divided into four categories) on sociodemographic and health factors. RESULTS Elderly individuals from both genders (76.8% women), aged between 60 and 90 years (mean = 70.22 years, SD = ± 7.30 years) participated in the study. A statistically significant association (p < 0.05) was found between age, self-perception of eyesight, type of dwelling, last monthly income, and the FRT; the same was found between age range, self-rated health (p < 0.001) and the TUG. CONCLUSION It was identified that, in the sample of elderly individuals living in Porto Alegre - RS, Brazil, the intrinsic factors that predispose to the risk of falls and fractures are older age, poor self-perception of eyesight, and poor selfrated health; the extrinsic factors are type of dwelling (living in a house) and a monthly income < one minimum wage.

Qualidade de vida de idosos com incontinência urinária

Objective: To assess the prevalence of urinary incontinence (UI) in an elderly citizen sample in Porto Alegre, RS, as well as to determine whether there is a difference in the quality of life between incontinent and continent people. Materials and Methods: A crosscut survey with 509 elderly citizens. Barthel’s Index and a closed question were used to evaluate the UI and WHOQOL-Bref. Data were analyzed by SPSS 11.5. The study was carried out according to Resolution 196/96-CNS/MS. Results: Analyzing the Barthel’s Index, 24% presented UI; among women, 29.4% and 10.3% among men. In the single question, 50% have mentioned UI. There was an association between sex and incontinence, prevailing the women (p<0.001), and between UI and the quality of life global assessment and health (p<0.05). The results confirm the findings of other surveys. Conclusion: The quality of life and health are better among the continent subjects. Planning and investment in therapeutic interventions, with interdisciplinary approaches, are essential to improve the quality of life in such population group.

Physical therapy intervention in women with urinary incontinence associated with pelvic organ prolapse

BACKGROUND Urinary incontinence (UI) is a prevalent condition that affects women of all ages. Pelvic organ prolapse in conjunction with UI is a common occurrence. OBJECTIVE To assess the effect of pelvic prolapse on the outcome of physical therapy treatment for women with UI. METHODS The study included 48 women aged between 35 and 78 years who underwent anamnesis and measurement of pelvic floor strength (bi-digital test and perineometry). The physical therapy intervention consisted of transvaginal electrical stimulation and pelvic floor exercise for up to 15 weekly sessions. RESULTS The majority of the women had normal delivery and 2.6±1.5 children (range=0-7). Pelvic prolapse was observed in 72.4% of the women who had normal delivery, in 100% of those who had cesarean section, and in 77.8% of those who had both normal and cesarean deliveries. 48% of the women had mixed UI, 39.5% had stress UI, and 12.5% had urge UI. The duration of symptoms varied from 2 to 28 years (7.9±5.3). In the participants with and without prolapse, a significant difference was observed in the pre- and post-treatment comparisons for the pelvic floor muscles. The pre- and post-treatment perineometry showed a significant increase only in the women with prolapse (p=0.048). 87.5% of the participants became continent. CONCLUSIONS The physical therapy treatment was effective in treating and/or curing the symptoms of UI, whether or not associated with pelvic prolapse, regardless of the clinical type of incontinence. Clinical Trial Registration (Brazilian Clinical Trial Registry): RBR-3p5s66.

Mobilidade funcional em idosos institucionalizados e não institucionalizados

INTRODUCTION: Falls are a major cause of morbidity and mortality in old age, with consequences ranging from minor injuries to death. The measure of functional mobility can be used to predict the risk of falls and to measure the result of interventions that seek to reduce it. OBJECTIVES: To assess and compare a functional mobility measure in elderly people living in the community and in a long stay institution (LSI), and determine its relation to age and sex in the different places of residence. MATERIALS AND METHOD: This observational, analytical and cross-sectional study used data from two other observational studies carried out in the city of Porto Alegre, Brazil. A total of 413 elderly people took part in this study; out of those 72 were institutionalized (average age = 80.9 ± 8.1years) and 341 lived in the community (69.8 ± 7.5 years). The Timed Up and Go Test (TUG) was used to evaluate the degree of functional mobility. RESULTS: No statistical difference was found in the TUG mean values presented by the genders, both in the community (p>0.05) and in the LSI (p>0.05). Institutionalized men and women showed significantly higher TUG mean than those living in the community (p<0.01). A significant difference was detected between the TUG means, when compared in terms of age group (p = 0.003). CONCLUSION: Functional mobility decreases with age in men and women, but does not differ between the sexes. Elderly people living in the community were faster than the institutionalized ones and therefore had a lower risk of falls. It is clear that there is a need for interventions that help both groups improve their mobility and reduce the risk of falls.

The effect of outpatient physical therapy intervention on pelvic floor muscles in women with urinary incontinence

OBJECTIVE To assess the effect of a weekly, short-term physical therapy intervention on the pelvic floor muscles and urinary incontinence (UI) among patients of the public health system. METHOD Quasi-experimental before-and-after study. Clinical history and function evaluation were performed using perineal bidigital maneuvers and perineometry. The intervention consisted of transvaginal electrical stimulation and pelvic floor kinesiotherapy. Data were analyzed using the paired t test or Wilcoxon signed-rank test, Pearson product-moment correlation coefficient or Spearmans rank correlation coefficient. A value of P<0.05 was considered significant. RESULTS Eight-two women 55.1±10.9 years-old were evaluated. Mixed urinary incontinence (MUI), stress urinary incontinence (SUI) and urge urinary incontinence (UUI) were observed in 52.4%, 36.6% and 11%, respectively. The length of UI was 6.0 years (3.0-10). Approximately 13.64 physical therapy sessions were held on average. There was no difference in perineometry measurements following the intervention (40.6±24.1 versus 41.7±25.4, P=0.098). Muscle function significantly increased (P<0.01) in the bidigital maneuver. The patients reported being continent or satisfied with the treatment in 88.9% of cases. CONCLUSIONS The results demonstrated an increase in muscle function and the attainment of urinary continence or treatment satisfaction in most cases.

Adaptação transcultural do Selection, Optimization and Compensation questionnaire (SOC) para aplicação a idosos

This paper describes the transcultural adaptation to Portuguese of the Selection, Optimization and Compensation questionnaire (SOC), to be applied to aged people. The instrument aims to check the level of adaptation by aged people facing daily challenges, and then explains their successful aging. From the understanding of what makes aged people successful, it will be possible to direct caring and attention to the health of this age group. We will assess the use of four planning strategies for life, which constitute the model of selective optimization plus compensation proposed by Baltes. This model is structured in Aging Psychology´s perspective known as life-span. The process of transcultural adaptation involved the following steps: initial translation; translation´s summary; back-translation into English; review by a committee of experts whose task is to assess semantic, idiomatic, experimental and conceptual equivalence and the pretest for final version, which included 34 aged people. From transcultural adaptation of SOC questionnaire it was possible to propose a preliminary version in Portuguese. However, for acceptance of transcultural equivalence between the original and the translation, it is necessary the later comparison between psychometric properties of Portuguese version and the original, a necessary task which is already been performed and will be presented in forthcoming articles.

Avaliação da qualidade de vida antes e depois de tratamento fisioterapêutico para incontinência urinária

This quasi experimental study analyzed the influence of a physical therapy intervention on the quality of life (QoL) of women with urinary incontinence (UI) and its effectiveness for urinary loss. Took part in this study 55 women (35 to 87 years) with a clinical diagnosis of UI who underwent an anamnesis and had the function of their pelvic floor muscles (PFMF; bidigital test) and their QoL measured (Kings Health Questionnaire - KHQ). Up to 15 weekly sessions were carried out with endovaginal electrical stimulation and perineal exercises. Once the participants reported not losing urine or expressed the desire to stop the treatment, it was terminated, regardless of the number of sessions undertaken. After treatment, the bidigital test and the KHQ were repeated and the participants were asked if they considered themselves to be continent, satisfied with the treatment or not improved. Most participants were aged between 51 and 60 years, underwent vaginal delivery with episiotomy and had prolapse. Most had mixed UI, followed by stress UI. The situations when the urinary loss most commonly occurred were coughing and sneezing, which happened mostly in jets. There was a significant improvement in all of the KHQ domains, except the general health perception. After the intervention, 90.9% of the women said that they were continent or satisfied with the treatment. The physical therapy intervention resulted in improved QoL and it was effective for containing the urinary loss.Correspondence to: Mara Regina Knorst – Avenida Ipiranga, 6.681, Predio 12, sala 803 – CEP: 90619-900 – Porto Alegre (RS), Brasil – E-mail: mknorst@pucrs.br Presentation: jul. 2012 – Accepted for publication: jul. 2013 – Financing source: none – Conflict of interests: nothing to declare – Approval at the Ethics Committee n. 06/03194. AbstrAct | This quasi experimental study analyzed the influence of a physical therapy intervention on the quality of life (QoL) of women with urinary incontinence (UI) and its effectiveness for urinary loss. Took part in this study 55 women (35 to 87 years) with a clinical diagnosis of UI who underwent an anamnesis and had the function of their pelvic floor muscles (PFMF; bidigital test) and their QoL measured (King’s Health Questionnaire — KHQ). Up to 15 weekly sessions were carried out with endovaginal electrical stimulation and perineal exercises. Once the participants reported not losing urine or expressed the desire to stop the treatment, it was terminated, regardless of the number of sessions undertaken. After treatment, the bidigital test and the KHQ were repeated and the participants were asked if they considered themselves to be continent, satisfied with the treatment or not improved. Most participants were aged between 51 and 60 years, underwent vaginal delivery with episiotomy and had prolapse. Most had mixed UI, followed by stress UI. The situations when the urinary loss most commonly occurred were coughing and sneezing, which happened mostly in jets. There was a significant improvement in all of the KHQ domains, except the general health perception. After the intervention, 90.9% of the women said that they were continent or satisfied with the treatment. The physical therapy intervention resulted in improved QoL and it was effective for containing the urinary loss.

The profile of spinal injuries in the elderly population

Correspondence to: Thais de Lima Resende − Avenida Ipiranga, 6.681, Prédio 12A, 8o Andar – FAENFI − CEP: 90619-900 − Porto Alegre (RS), Brazil − E-mail: athaislr@gmail.com Presentation: Jun. 2013 – Accepted for publication: Feb. 2014 – Financing source: none – Conflict of interests: nothing to declare – Approval of the Ethics Committee of PUCRS (No. 10/04968), of the Grupo Hospitalar Conceição (No. 10-010) and the Secretaria Municipal da Saúde de Porto Alegre (Process No. 001.004651.10.3; Registry 458). ABSTRACT | This retrospective cross-sectional study sought to: describe the profile of the elderly population who suffered spinal injury (SI) between 2005 and 2010 in Porto Alegre (RS), Brazil; compare the trauma mechanism and type of SI prevalence in both sexes; and compare the trauma mechanism in the sample’s age groups. To this end, medical records were reviewed for the following data: age, sex, main mechanisms of injury and spinal levels affected. Out of 1.320 records analyzed, 370 belonged to elderly subjects, 58.6% women (73.07±8.52 years) and 41.4% men (69.4±7.5 years). The most prevalent SI mechanisms were falls from own height (37.7%), height (24.3%) and unspecified (20.1%). The most affected vertebral levels were L1 (30.0%), T12 (16.2%) and L2 (11.9%). Only 26 (7%) individuals who had SI suffered a spinal cord lesion, with a higher prevalence of incomplete lesion (82.6%). No significant association was detected between the occurrence of SI and its type or sex. In the time and region investigated, the SI profile in the elderly can be described as: women over 70, who suffered a fall from their own height, injuring mainly the lumbar region. Elderly men and women were equally affected by SI without spinal cord lesion. Falls from height predominated in those aged 60-69, whereas falls from own height were commonest among those aged 70 and over.Este estudo transversal retrospectivo teve como objetivos: tracar o perfil da populacao idosa que sofreu trauma raquimedular (TRM) entre 2005 e 2010 em Porto Alegre (RS), Brasil; comparar a prevalencia nos sexos dos diferentes mecanismos de trauma e do tipo de lesao medular; e comparar o mecanismo de trauma de acordo com a faixa etaria da amostra. A coleta em prontuarios de dois Servicos de Arquivo Medico (SAME) envolveu os seguintes dados: idade, sexo, principais mecanismos de lesao e niveis medulares mais acometidos. Foram analisados 1.320 prontuarios, dos quais 370 eram de idosos; destes, 58,6% eram de mulheres (73,07±8,52 anos) e 41,4% de homens (69,4±7,5 anos). Prevaleceram quedas da propria altura (37,7%), quedas de altura (24,3%) e quedas sem especificacao (20,1%). Os niveis vertebrais mais acometidos foram L1 (30,0%), T12 (16,2%) e L2 (11,9%). Apenas 26 (7%) dos individuos que sofreram TRM apresentaram lesao medular, com maior prevalencia da incompleta (82,6%). Nao foi detectada associacao significativa entre a ocorrencia de TRM ou o seu tipo e sexo. O perfil do TRM em idosos da regiao pode ser descrito como: mulheres acima de 70 anos que sofreram queda da propria altura, lesionando principalmente a regiao lombar. Idosos e idosas foram igualmente acometidos por TRM sem lesao medular, com predominio de quedas de altura na faixa dos 60 anos e quedas da propria altura acima dos 70 anos.