Viviane de Souza Pinho Costa

Zumbido: possível associação com alterações cervicais em idosos

INTRODUCAO: O zumbido e um sintoma prevalente e de alto impacto na qualidade de vida do paciente idoso. A presenca de cervicalgia e alteracoes na coluna cervical sao comuns em pacientes com queixa de zumbido. OBJETIVO: Avaliar a prevalencia do zumbido e cervicalgia em um grupo de idosos e verificar a possivel associacao entre zumbido, cervicalgia e restricao de amplitude de movimento cervical. METODO: Estudo transversal retrospectivo com avaliacao da amplitude de movimento cervical atraves de goniometria e do zumbido e da cervicalgia atraves da aplicacao de questionario padronizado. RESULTADOS: A amostra foi constituida por 147 individuos, com idade media de 69,22 anos sendo 61,90% mulheres. Desses individuos, 42,85% apresentaram queixa de zumbido 51% dos individuos relataram queixa de dor cervical. Nao houve associacao entre zumbido e dor cervical e nem associacao entre zumbido e restricao de amplitude de movimento cervical. CONCLUSAO: Embora nao tenha sido constatada associacao entre zumbido e dor cervical e entre zumbido e restricao de amplitude de movimento, observou-se grande prevalencia de queixa de zumbido, de cervicalgia e de diminuicao na amplitude de movimento cervical na populacao de idosos. Os resultados da presente pesquisa, por meio da constatacao desta grande prevalencia do zumbido em toda a populacao de estudo, servirao de base a uma integracao entre profissionais da area de saude envolvidos com tais alteracoes.

Effectiveness of a vestibular rehabilitation protocol to improve the health-related quality of life and postural balance in patients with vertigo

Introduction Dizziness can be characterized as a balance disorder that causes discomfort, leading to several functional limitations. Currently, vestibular rehabilitation has been highlighted as a possible treatment. Objective Analyze the effects of completing a vestibular rehabilitation treatment protocol on quality of life and postural balance in patients with vestibular complaints, as well as to compare these effects between the patients taking or not taking antivertigo drugs. Methods A nonrandomized controlled trial was performed with 20 patients previously diagnosed with vestibular diseases. Information regarding vertigo symptoms, quality of life as assessed through the Dizziness Handicap Inventory, visual analog scale of dizziness, and stabilometry using force platform was collected. Patients were treated for 12 weeks by a custom protocol. The sample was divided into two groups according to the use (medicated group, n = 9) or not (control group, n = 11) of antivertigo drugs. Results There was improvement in quality of life (p < 0.001) and intensity of dizziness (p = 0.003) with the intervention. An improvement of postural balance was observed through functional tests. However, no statistically significant difference was noted in stabilometry. When both groups were compared, no statistically significant differences between the variations of the variables analyzed were found in the re-evaluation session. Conclusion Quality of life and postural balance are improved with intervention. However, this improvement is not associated with pharmacologic treatment.

Avaliação da manobra de reposicionamento de Epley em indivíduos com vertigem posicional paroxística benigna

PURPOSE: to evaluate the stabilometry parameters after Epleys maneuver in individuals with BPPV previously confirmed through Dix-Hallpike maneuver. METHODS: an experimental study which included patients with BPPV with positional nystagmus taking Dix-Hallpikes test and assessed in 2008, at the Multidisciplinary Vertigo Ambulatory, and who were also submitted to Epleys maneuver and assessed as for their postural balance through a stabilometry exam, both before and after such maneuver. RESULTS: the 13 female subjects with ages ranging from 15 to 78 years with previously confirmed BPPV, who were selected for the research, showed a significant statistically improvement regarding their postural balance after Epleys maneuver in all analyzed parameters as for both exams. CONCLUSION: in this research the Epleys maneuver was shown as a procedure of important intervention for improving the answers of postural balance in individuals with BPPV evaluated by the stabilometry.

Análise da influência da farmacoterapia sobre a qualidade de vida em idosos com osteoartrite

AIMS This study aimed to assess the influence of pharmacotherapy on health-related quality of life of elderly with ostheoartritis. METHODS Longitudinal study involving 91 older adults from both genders (Age: 70.36±5.57 years) from EELO project with self-reported knee or hip ostheoartritis, confirmed by radiographic analysis. Data regarding pharmacotherapy was assessed by a structured questionnaire and the quality of life was analyzed by SF-36 questionnaire at the initial moment and two years thereafter. All domains from quality of life were grouped in physical and mental components for further data analysis. RESULTS A statistically significant decline in health-related quality of life was observed (Wilcoxon test, p<0.05). However, it was observed a slighted decline in physical components in group treated with chondroitin/glucosamine when compared to other groups, according to Kruskal-Wallis test (p=0.007). On the other hand, it was not observed any influence of pharmacological treatment on mental components of health-related quality of life (p>0.05). CONCLUSIONS Treatment with condroitin/glucosamin contributes to a lower decline in physical component while it had no influence on mental component of health-related quality of life in older adults with ostheoartritis.

Physical Activity in the Prevention of Benign Paroxysmal Positional Vertigo: Probable Association

Introduction Physical inactivity is an important risk factor for many age-related diseases and symptoms such as dizziness and vertigo. Objective The aim of the study was to investigate the possible association between benign paroxysmal positional vertigo (BPPV) and regular physical activity in elderly subjects. Methods This cross-sectional study included 491 elderly individuals who lived independently. Physical exercise was assessed through a questionnaire and BPPV by history and the Dix-Hallpike maneuver. Results The present study indicates no significant association between BPPV with lack of physical activity in men and in the total population. We have confirmed associations between BPPV with lack of physical activity in women (p = 0.01). Women with a sedentary lifestyle who do not practice physical activity are 2.62 more likely to have BPPV than those with regular physical activity. Conclusion These results highlight the importance of identifying risk factors for BPPV that can be modified through specific interventions. Regular physical activity is a lifestyle with potential to decrease the risk of vertigo in women.

Is There a Possible Association between Dietary Habits and Benign Paroxysmal Positional Vertigo in the Elderly? The Importance of Diet and Counseling

Introduction Poor diet habits and inadequate intake of nutrients are a concern in the elderly. Nutritional education with guidance may improve the results of the treatment of vertigo. Objective Evaluate the presence of benign paroxysmal positional vertigo (BPPV) associated with feeding habits. Methods Cross-sectional study with elderly people living independently. We evaluated nutritional habits through the method of dietary 24-hour recall and manipulation of Dix-Hallpike. Results Based on a sample of 487 individuals, 117 had BPPV. Among the 117 elderly patients with BPPV, 37 (31.62%) had inadequate feeding. From those 370 individuals without BPPV, 97 (26.21%) had inappropriate feeding. No significant association between nutritional habits and BPPV in the total population was observed (p = 0.3064). However, there was significant relation between BPPV and inadequate carbohydrate intake (p = 0.0419) and insufficient fiber intake (p = 0.03), and the diet of these subjects was rich in polyunsaturated fatty acids (p = 0.0084). Conclusion These data correlate with the dyslipidemia and hypertriglyceridemia status, making it extremely important to reduce the intake of fats and carbohydrates and increase the fiber intake to stabilize triglycerides and thus minimize harmful effects on the inner ear. Food readjustment is suggested in patients with BPPV, along with the work of a multidisciplinary team to improve the quality of the elderly.

Prevalência e associações da vertigem posicional paroxística benigna em idosos

PURPOSE:to determine the prevalence of benign paroxysmal positional vertigo and identify their associations in an elderly population.METHODS:a cross-sectional study in elderly patients evaluated by audiological evaluation, comorbidity questionnaireand Dix-Hallpike maneuver Were applied nonparametric tests: Chi-square and multivariate regression with a confidence interval of 95%.RESULTS:the final sample consisted of 494 individuals, with a median age of 69 (64.75 to 74.00) years. Observed prevalence of 23.9% of benign paroxysmal positional vertigo and 51.6% of neck pain and headache 37.9%. There was a statistically significant association between benign paroxysmal positional vertigo and neck pain, headache and gender in this population.CONCLUSION:it is concluded that this elderly population the prevalence of benign paroxysmal positional vertigo was 23.9% and the neck pain was 51.6% and there was a significant association between benign paroxysmal positional vertigo with neck pain and female gender.

A cadeira de rodas e seus componentes essenciais para a locomoção de pessoas com tetraplegia por lesão da medula espinhal

Objetivo: Compreender quais itens sao essenciais a cadeira de rodas (CR) na perspectiva da pessoa tetraplegica por lesao da medula espinhal (LME). Metodo: O estudo qualitativo foi com entrevista semi-estruturada e analise de discurso, bem como, checklist da CR em uso e do Sistema Unico de Saude (SUS). Resultados: No total foram dez entrevistados: nove homens e uma mulher, media de idade de 42,3 anos (± 9,23), dois advogados, um economista e demais aposentados. As causas da LME foram acidente automobilistico (60%), mergulho em aguas rasas (30%) e atropelamento (10%), respectivamente. O tempo de lesao foi em media 16,3 anos (± 7,14) e todos realizavam fisioterapia. Os numeros de CR, ate a adequada, foram duas a cinco e todos praticavam esporte adaptado ou lazer com CR. O checklist apontou itens insuficientes na CR do SUS e da analise dos discursos resultaram em quatro categorias: Itens, materiais e condicoes necessarias; A conquista da funcionalidade; Vantagens e desvantagens da CR; e Sentimentos vivenciados. A CR e essencial para a locomocao das pessoas com tetraplegia e conhecer modelos, experimentar e ter orientacoes sobre os itens adequados sao importantes para a aquisicao. Os itens adequados facilitam a aceitacao, melhor adaptacao, locomocao e autonomia. Conclusao: A cadeira do SUS mostrou-se insuficiente, o que leva ao abandono. A adquirida por funcionalidade, com itens essenciais, o que responde a individualidade e ao gosto do usuario, mostrou-se util e adequada apesar de seu elevado custo.