Thesis (M.S.)--University of South Florida, 2007. / Title from PDF of title page. Document formatted into pages; contains 20 pages. Includes bibliographical references.

Fibromialgia é uma síndrome reumática caracterizada por dores musculosqueléticas generalizadas e crônicas, associadas à presença de tender points, fadiga, distúrbios do sono e rigidez matinal com freqüente impacto na capacidade funcional e qualidade de vida. Estudos apontam prevalência em torno de 2% e 3% na população adulta. Este trabalho teve como objetivo avaliar a prevalência de Fibromialgia, sintomas associados e impacto na capacidade funcional e qualidade de vida, na população do município de Embu, SP. A amostra foi selecionada entre os indivíduos cadastrados nas Unidades Básicas de Saúde de Embu no ano de 2003, com idade entre 35 e 60 anos. Dos 2269 sujeitos com telefone, 768 foram entrevistados sobre a presença, localização e tempo de dor. Destes, 304 compareceram para a avaliação pessoalmente que consistia na dolorimetria dos tender points; avaliação da dor pela Escala Analógica Visual (VAS), dos distúrbio do sono pelo Post Sleep Inventory (PSI), da fadiga pela Chalder Fatigue Scale, da capacidade funcional pelo Stanford Health Questionnaire (HAQ) e da qualidade de vida pelo Fibromialgia Impact Questionnaire (FIQ). Para a análise dos dados utilizou-se Análise Descritiva, Estimação Baeysiana, Análise Inferencial (Kruskal- Wallis, Friedmam e ANOVA, com nível de significância de 5%), Tabelas de Contingência e Probabilidade Condicional. Os 768 sujeitos foram classificados em quatro os grupos: Sem Dor (SD) - 185 indivíduos; Dor Regional ou localizada (DR) - 388 indivíduos; Dor Generalizada (DG) segundo o Colégio Américo de Reumatologia (ACR) - 195 indivíduos. Esta classificação nos 304 sujeitos avaliados com exceção dos 106 com DG e crônica dos quais 19 foram classificados como Fibromialgia (FM). A média de idade foi 47,9 (7,2) na amostra total e 49,1 (6,8) na sub-amostra. A prevalência de dor generalizada e crônica foi de 24% com IC95% [21%; 27%] e a de Fibromialgia de 4,4% com IC 95% [2,6%; 6,3%]. Todos os sintomas avaliados são mais intensos no grupo FM, seguido pelo de DG. As maiores probabilidades de coincidências entre a classificação dos grupos e a dos questionários são dadas pelos índices da VAS, HAQ, FIQ e, principalmente, pelo índice geral (média dos demais índices). Esta forma de avaliação tem probabilidade alta (94%) de identificar os sujeitos sem fibromialgia e revelante (67%) para os possíveis fibromiálgicos / Fibromyalgia is a rheumatic syndrome characterized by chronic widespread pain, tender points, fatigue, sleep disorders and morning stiffness. Functional Disability and negative impact in the quality of life are frequent. Studies show a fibromyalgia prevalence around 2% and 3%. The aim of this study was to assess the prevalence of fibromyalgia, associated symptoms, functional disability and quality of life in residents of Embu, SP, Brazil. The sample was selected in individuals of the primary health care, aged by 35 and 60 years old. Of all 2269 subjects with phone number, we interviewed 768 with questions about presence of pain, pain location and time of pain. Of these subjects, 304 were personally evaluated, including tender points examination and assessment of pain by the Visual Analogue Scale (VAS), sleep disorders by the Post Sleep Inventory (PSI), fatigue by the Chalder Fatigue Scale, functional disability by Stanford Health Assessment Questionnaire (HAQ) and quality life by the Fibromyalgia Impact Questionnaire (FIQ). The data were analysed using Descriptive, Baeysian and Interferential Analyses (Kruskal-Wallis, Friedmam, ANOVA, with significance level of 5%), Contingence Tables and Conditional Probabilities. The 768 subjects were distributed in three groups: Without Pain (WP) - 185 individuals, Regional Pain (RP) - 388 individuals and Widespread pain (WpP). In the sub-sample of 304 subjects, the groups of chronic widespread pain were classified in Fibromyalgia (FM), with 19 subjects, and Non-Fibromyalgia, with 87 subjects. The mean age was 47,9 (7,2) years old for 768 sample and 49,1 (6,8) for the 304 sub-sample. The prevalence of chronic widespread pain was 24%, with 95% credibility interval [21%; 27%] and fibromyalgia prevalence was 4,4%, with 95% credibility interval [2,6%; 6,3%]. Pain, sleep disorders, fatigue, functional disability and quality of life were worse in the FM Group, followed by WpP, RP and WP. The major probability coincidence were obtained by VAS, HAQ FIQ and Global indices (mean of all questionnaires). This kind of assessment has high probability (94%) to identify non-fibromyalgia individuals and considerable (67%) to possible fibromyalgia patients

Introdução: A imobilização prolongada no leito pode desencadear alterações em diferentes sistemas do corpo e na capacidade funcional. Durante a internação hospitalar, o repouso acontece com frequência e alterações na funcionalidade instaladas neste período podem perdurar mesmo após a alta. Este ambiente pode induzir o paciente à inatividade física o que pode afetar principalmente a força muscular. Objetivos: Avaliar o impacto da internação hospitalar na capacidade funcional e força muscular de pacientes hospitalizados e identificar possíveis preditores de ocorrência de eventos pós alta. Métodos: Trata-se de um estudo coorte prospectivo que inclui 250 pacientes internados em enfermarias do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Foram incluídos pacientes de ambos os gêneros, com idade >=50 anos. Foram excluídos pacientes com déficits cognitivos, dellírium, aqueles que não conseguiram realizar os testes propostos e/ou apresentarem > 48 horas de admissão na enfermaria. Dados clínicos e sociodemográficos foram avaliados a partir da análise dos prontuários. A força de preensão palmar (FPP) foi avaliada pelo dinamomêtro palmar e a capacidade funcional (CF) avaliada pelo índice de Barthel. Para verificar a ocorrência de quedas e re-internações, foi realizado um acompanhamento por telefone de 1, 3 e 6 meses pós-alta. Análise estatística: As variáveis numéricas foram representadas em mediana e intervalo interquartil (5% a 95%) e média e desvio padrão (DP). As variáveis categóricas foram descritas em valores absolutos e porcentagem. A comparação entre os sujeitos adultos e idosos no momento da admissão, foi realizada através do teste de Mann-Whitney Rank Sum Test e teste de Qui-Quadrado. A comparação entre as pontuações da admissão e alta hospitalar da FPP e CF foi realizada através do teste t de Student e Wilcoxon Signed Rank Test. Um modelo de Regressão Logística Múltipla foi utilizado para identificar possíveis preditores de perda de FPP durante a hospitalização e a ocorrência de quedas e re-internação no acompanhamento pós-alta. Resultados: A CF avaliada pelo Índice de Barthel não sofreu alterações (p=0,83), no entanto, foi verificada uma redução significativa de FPP durante o período de hospitalização (p=0,03), sendo a FPP no momento admissão o principal preditor de perda de força. A ocorrência de quedas e re-internações aumentam progressivamente com o acompanhamento pós-alta, sendo os principais preditores de ocorrência de quedas o auto-relato de queda prévia e a idade e, para re-internação o tempo de hospitalização. Conclusão: A hospitalização pode gerar perda de força de preensão palmar, no entanto, a capacidade funcional avaliada pelo Indice de Barthel não se altera. A ocorrência de queda e re-internação aumentam com o período de acompanhamento pós-alta e foi possível identificar preditores para a ocorrência destes eventos / Introduction: Prolonged bed rest can trigger changes in different body systems and functional capacity. During hospitalization, the rest happens frequently and changes in functionality installed in this period can last even after hospital discharge. This environment can induce the patient to physical inactivity which can affect the musculoskeletal system, especially the muscular strength. Objectives: Evaluated the impact of hospitalization on functional capacity and muscle strength of hospitalized patients. Methods: This was a prospective cohort study including 250 patients in wards of the Hospital Central Institute of the Faculty of Medicine, University of São Paulo. They included patients of both genders, aged >= 50 years. Patients with cognitive deficits, dellírium, those who cannot perform the tests proposed and / or submit > 48 hours of admission to the ward. Clinical and sociodemographic data were evaluated from the analysis of medical records. The hand grip strength (HGS) was evaluated by the hand dynamometer and the functional capacity (FC) evaluated by the Barthel Index. To verify the occurrence of falls and re-hospitalizations, a telephone follow-up of 1, 3 and 6 months post-discharge was performed. Statistical analysis: Numerical variables were represented in median and interquartile range (5% to 95%) and mean and standard deviation (SD). Categorical variables were described in absolute values and percentage. The comparison between adult and elderly subjects at admission was performed using the Mann-Whitney Rank Sum Test and Chi-Square test. The comparison between admission and discharge scores of FPP and CF was performed using Student\'s t-test and Wilcoxon Signed Rank Test. A Multiple Logistic Regression model was used to identify possible predictors of FPP loss during hospitalization and the occurrence of falls and re-admission at post-discharge follow-up. Results: The FC assessed by the Barthel Index did not change (p = 0.83); however, there was a significant reduction in FPP during the hospitalization period (p = 0.03). The occurrence of falls and re-hospitalizations increase progressively with post-discharge follow-up, the main predictors of occurrence of falls being the self-reported prior fall and the age, and for re-hospitalization, hospitalization time (p < 0,001). Conclusion: Hospitalization may lead to loss of hand grip strength, however, the functional capacity assessed by the Barthel Index does not change. The occurrence of fall and re-hospitalization increased with the post-discharge period and it was possible to identify predictors for the occurrence of these events

The purpose of this study is to explore the question of whether or not graduate schools in social work have adequately prepared social workers to deal with the changing needs of individuals with disabilities.

Thesis (MOccTher)-- University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Malingering, the intentional simulation or exaggeration of symptoms for secondary gain, has a significant financial impact on disability insurance given its prevalence. Multidisciplinary professionals involved in disability determination therefore require a tool which would assist in the screening of suspected malingerers. AIM: The Credibility Assessment Tool (CAT), a tool which was developed as part of the Performance APGAR, was reviewed in terms of its validity and application to the screening of malingering. Research objectives included the review of face and content validity through a literature review and concept analysis, as well as the review of construct and concurrent validity by comparing the results with the operationalised malingering construct and available malingering protocols. The adapted Slick criteria as proposed by Aronoff, applicable to chronic pain, neurocognitive, neurological and psychiatric symptoms, was identified as the most suitable criterion standard for use of comparison. DESIGN: The research design was a descriptive analytical design, which was performed retrospectively with a report review from insurance referrals to the researcher. Informed consent was obtained from insurers who legally own the reports. A saturated sample of convenience of 184 cases with depression and pain as predominant symptoms were analysed. Recall bias were minimised through omission of personal identifiers and the use of a peer check of 20 random cases. Results in the peer check were suggestive of poor inter-rater reliability, rather than recall bias. METHOD: Cases were analysed according to the guidelines from the respective authors of the CAT and adapted Slick criteria, however this was further defined to ensure that the study could be replicated. RESULTS: Face validity was adequate in terms of purpose, item selection and association between consistency criteria, however require improvement in terms of standardised instruction and weighting of the scale. Content validity was rated as adequate to excellent, given that it supports criteria linked to the malingering construct. Construct validity was adequate as demonstrated by association between concepts obtained through concept analysis. Correlation between the CAT and adapted Slick was strong (r>0.5) however caution is expressed that this requires further research. CONCLUSION: Recommendations for further research included the review of content validity with subject experts, criterion and predictive valid through a case-control study of known-groups, as well as the reliability of the CAT, and the use of specialised ADL indices for malingering detection. Adaptation to the CAT was depicted in the proposed Consistency Assessment Tool. / AFRIKAANSE OPSOMMING: Malingering, die opsetlike nabootsing of oordrywing van simptome vir sekondêre gewin, het ‘n beduidende finansiële impak op ongeskiktheidsversekering as gevolg van die prevalensie daarvan. Multidissiplinêre professionele persone betrokke by ongeskiktheidsevaluasies het daarom ‘n meetinstrument nodig om moontlike malingeerders te identifiseer. DOEL: Die Credibility Assessment Tool (CAT), wat ontwikkel was as deel van die Performance APGAR, was ondersoek in terme van geldigheid en toepassing op malingering. Navorsingsdoelwitte het die ondersoek van voorkoms- en inhoudsgeldigheid deur ‘n literatuurstudie en konsep analise behels, sowel as konstruk- en korrelasie geldigheid deur die vergelyking van die resultate met beskikbare malingering protokolle en operasionele konstrukte. Die aangepaste Slick kriteria soos voorgestel deur Aronoff, wat toepaslik is op kroniese pyn, neurokognitiewe, neurologiese en psigiatriese simptome, was ge-identifiseer as die meeste gepaste kriterium standaard vir vergelyking. ONTWERP: Die studieontwerp was ‘n beskrywende analitiese studie wat retrospektief uitgevoer was deur ‘n ondersoek van verslae van versekeraars. Ingeligte toestemming was verkry van versekeraars wat die wetlike eienaars van die verslae is. ‘n Gerieflikheidsteekproef van 184 gevalle met depressie en pyn as hoof simptome was geanaliseer. Sydighede was verminder deur persoonlike inligting te verwyder en die gebruik van ‘n eweknie evaluasie van 20 ewekansige getrekte gevalle. Voorlopige resultate dui onbevredigende betroubaarheid aan, eerder as sydighede. METODE: Gevalle was ge-evalueer volgends die riglyne van die verskeie outeure van die CAT en aangepaste Slick kriteria, en was sodanig verder gedefinieer om te verseker dat die studie herhaal kan word. RESULTATE: Voorkomsgeldigheid was voldoende, maar verbetering is aanbeveel in terme van gestandardiseerde instruksie en skaal verdeling. Inhoudsgeldigheid was beduidend in vergelyking met die wetenskaplike literatuur en die geoperasionaliseerde konstrukte. Konstrukgeldigheid was bevestig deur die positiewe verhoudings tussen die aangepaste Slick en CAT kriteria. ‘n Sterk korrelasie was gevind tussen die aangepaste Slick en CAT, maar hierdie moet versigtig geinterpreteer word aangesien verdere navorsing verlang word. GEVOLGTREKKING: Aanbevelings vir verdere navorsing sluit in die ondersoek van die inhoudsgeldigheid met eksperte, kriterium- en voorspellingsgeldigheid, sowel as die betroubaarheid van die CAT en die gebruik van gespesialiseerde ADL indekse vir uitkenning van malingering. Aanpassing vir die CAT word ook voorgestel.

Thesis (MPhil (Rehabilitation))--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: The South African National Census (1996) reports a disability prevalence of 6,6% in South Africa. In November 1999 the government paid out 635 881 temporary or permanent disability grants. Legislation is in place to allow the Department of Social Services to administer the grants. For this study demographic information of disability grant recipients in a semi-rural area was sought in order to improve understanding of disability and to assist in service delivery. The study was executed in Kleinmond, a coastal town in the Western Cape with a population of 3 918, where 189 people reported a disability during the 1996 census. Objective The objective of this study was to determine the disability profile, caregiver utilization and needs of disability grant recipients in Kleinmond, Western Cape, South Africa. METHODS A descriptive survey was the study design of choice. The study population consisted of recipients of a permanent disability grant who collected their grants at the Kleinmond Post Office in June 1999. In order to capture the necessary information, a questionnaire was developed based on the disability catalogue of the International Classification of Impairment, Disability and Handicap (ICIDH) of the World Health Organisation. Pilot studies were conducted and the researcher interviewed 29 grantees during the main study in Kleinmond in June/July 1999. Repeatability of the questionnaire was tested. Ninety six percent of the responses were the same on the second visit to four randomly selected grantees. Data was analysed with the statistical software package STATISTICA. RESULTS The response rate was 90% (29/32). The mean age of the mainly male grantees was 42 years (range: 18 - 64). Most grantees were single, but the majority stayed with someone else. Ninety three percent (27/29) were unemployed while 69% (20/29) felt they were able to work. Most grantees took regular medication and the majority accessed health services at the primary level local clinic. Twenty five grantees (86%or 25/29) reported multiple disabilities, while one person did not fit into any of the categories. The most common disability category was situational disability (82% or 24/29). Nineteen persons with disabilities (66% or 19/29) relied on help which was mainly given by the parents. Assistance was needed with activities such as collecting the disability grant, shopping and managing money. With regard to needs of grantees, most found it important to have the clinic closer to their homes (52% or 15/29), to increase the amount of the disability grant (76% or 22/29) and to raise awareness of disability in the community (69% or 20/29). CONCLUSION Most disability grant recipients in this study reported problems in many of the seven disability categories of the ICIDH, i.e. multiple disabilities. This is consistent with the assumption that only severely disabled people qualify for a permanent disability grant in South Africa. This might explain why the majority of the grantees utilized a caregiver for some tasks. Needs with regard to health and social services of this defined group of persons with disabilities in Kleinmond will be brought to the attention of the authorities, who are planning a new community centre and clinic. / AFRIKAANSE OPSOMMING: Volgens die Nasionale Sensus opname van 1996 is die prevalensie van ongeskiktheid in Suid- Afrika 6.6%. Bevindinge dui aan dat 635881 individue 'n ongskiktheidstoelaag ontvang. Hierdie toelae word volgens wetgewing deur die Departement van Maatskaplike Dienste ge-administreer. In hierdie studie is demografiese inligting van individue wat 'n ongeskiktheidstoelaag ontvang ingesamel in 'n poging om insig in gestremdheid en dienslewering aan gestremdes te verbeter. Die studiepopulasie het bestaan uit individue wat 'n ongeskiktheidstoelaag in die Wes-Kaapse kusdorp Kleinmond ontvang. Kleinmond het 'n populasie van 3 918 waarvan 189 individue ongeskik is volgens die 1996 sensus. DOEL Die doel van die studie was om 'n ongesiktheidsprofiel van individue in Kleinmond te bepaal, asook te evalueer of hulle versorgers benodig het en om hulle behoeftes te bepaal. METODOLOGIE Daar is gebruik gemaak van 'n beskrywende studie. Die studiepopulasie het bestaan uit aile individue woonagtig in Kleinmond wat 'n permanente ongeskiktheidstoelaag ontvang het en dit by die poskantoor afgehaal het. Data is deur middel van 'n vraelys ingesamel. Die vraelys is gebaseer op die ongeskiktheids katalogus van die Internasionale Klassifikasie van Gebrek, Ongeskiktheid en Gestremdheid (ICIDH) van die Wereld Gesondheidsorganisasie. Die vraelys is getoets deur middel van loodsstudies. Die betroubaarheid van die vraelys is ook getoets deur tydens die navorsing dieselfde vrae tydens 'n tweede besoek aan vier kandidate te stel. Hierdie vier individue is ewekansig geselekteer en 96% van die response het ooreen gestem met die van die eerste besoek. Data is verkry van 29 individue gedurende Junie/Julie 1999. Data analise is met behulp van STATISTICA, 'n statistiese sagteware pakket, gedoen.RESULTATE Die responskoers was 90% (29/32). Die meerderheid van die studiepopulasie was manlik met 'n gemiddelde ouderdom van 42 jaar (rykwydte: 18 - 64). Individue was meerendeels ongetroud en het wonings met ander persone gedeel. Uit die studiepopulasie was 93% (27/29) individue werkloos. Van hierdie groep het 69% (20/29) egter gevoel dat hulle wei een of ander vorm van arbeid kan verrig. Bykans aile individue uit die studiepopulasie het gereeld medikasie gebruik. Die plaaslike prirnere gesondheids kliniek is deur die meeste individue benut vir gesondheidssorg. Meeste individue (86% of 25/29) het meer as een ongeskiktheid gehad en een persoon het nie in enige van die kateqoriee ingepas nie. Die ongeskiktheid wat die mees algemeenste voorgekom het was situasie-gebonde ongeskiktheid (82% of 24/29). Hulp is hoofsaaklik deur ouers verskaf en 66% individue (19/29) het van hulp gebruik gemaak. Hierdie hulp was meestal nodig met aktiwiteite soos die afhaal van die ongeskiktheidtoelaag, die doen van inkopies en die bestuur van persoonlike finansies. Die studiepopulasie het 3 groot behoeftes uitgespreek naamlik 'n kliniek nader aan hulle wonings (52% of 15/29), 'n verhoging in die ongeskiktheidstoelaag (76% of 22/29) en .n groter bewustheid van ongeskiktheid in die gemeenskap (69% of 20/29). Samevatting Baie van die individue uit die studiepopulasie het ongeskikthede in meer as een van die ongeskiktheidskategoriee aangedui. Hierdie bevinding is in ooreenstemming met die aanname dat in Suid-Afrika slegs individue met erge ongeskiktheid n ongeskiktheidstoelaag ontvang. Dit kan moontlik ook verklaar waarom die meerderheid van die populasie versorgers benodig het vir die uitvoer van sekere take. Die behoeftes van hierdie studiepopulasie sal onder die aandag van die plaaslike owerheid, wat tans besig is met die beplanning van 'n nuwe gemeensskapssentrum en kliniek, gebring word.

PURPOSE: To evaluate whether the Amblyopia and Strabismus Questionnaire (A&SQ) is a suitable instrument for the assessment of vision-related quality-of life (VR-QoL) in individuals with strabismus and/or amblyopia. METHODS: The A&SQ was completed by 102 individuals, all of whom had amblyopia, strabismus, or both. Rasch analysis was used to evaluate the usefulness of individual questionnaire items (i.e., questions); the response-scale performance; how well the items targeted VR-QoL; whether individual items showed response bias, depending on factors such as whether strabismus was present; and dimensionality. RESULTS: Items relating to concerns about the appearance of the eyes were applicable only to those with strabismus, and many items showed large ceiling effects. The response scale showed disordered responses and underused response options, which improved after the number of response options was reduced from five to three. This change improved the discriminative ability of the questionnaire (person separation index increased from 1.98 to 2.11). Significant bias was found between strabismic and nonstrabismic respondents. Separate Rasch analyses conducted for subjects with and without strabismus indicated that all A&SQ items seemed appropriate for individuals with strabismus (Rasch infit values between 0.60 and 1.40), but several items fitted the model poorly in amblyopes without strabismus. The AS&Q was not found to be unidimensional. CONCLUSIONS: The findings highlight the limitations of the A&SQ instrument in the assessment of VR-QoL in subjects with strabismus and especially in those with amblyopia alone. The results suggest that separate instruments are needed to quantify VR-QoL in amblyopes with and without strabismus.

<p>Multipla skleroza (MS) je hronična, inflamatorna, demijelinizaciona i degenerativna bolest centralnog nervnog sistema koja rezultuje &scaron;irokim spektrom invaliditeta. U sklopu bolesti mogu da se pojave brojni simptomi koji se ispoljavaju kroz poremećaje kognitivnih i motoričkih sposobnosti. Efekti kognitivne i motoričke disfunkcije su veliki i ne utiču samo na obolelog već i na člano e porodice i udruženi su sa socijalnom participacijom osoba sa MS. Ciljevi istraživanja su: utvrditi stepen socijalne participaci je, prisutnost poremećaja kognitivnih sposobnosti (pamćenja, verbalne fluentnosti, vizuo prostorne funkcije, govora i pažnje) i poremećaja motoričkih sposobnosti (manuelnih sposobnosti i hoda) kod obolelih od MS. Istraživanje je sprovedeno tokom 2013. i 2014. godine na Klinici za neurologi ju, Kliničkog centra Vojvodi ne. Uzorak je činilo 108 ispitanika obolelih od MS (relapsno-remitentna forma) starosti od 20 do 53 godine (AS 39,86 godina; SD 8,20 godina). Metode primenjene u istraživanju su: Op&scaron;ti upitnik, Kognitivni skrining audio zapisom (Audio Recorded Cognitive Screen &ndash; ARCS), Tempom uslovljen auditivni test serijskog sabiranja (Paced Auditory Serial Additional Test &ndash; PASAT), Test 9 rupa (9 Hole Peg Test), Test 25 koraka (25 Foot Walk Test), Skala za procenu neurolo&scaron;kog deficita (Expanded Disability Status Scale &ndash; EDSS), Upitnik za procenu socijalne participacije i Skala za procenu invaliditeta 2.0 Svetske zdravstvene organizacije (World Health Organization Disability Assessment Schedule &ndash; WHO DAS 2.0). Prema na&scaron;im rezultatima, niži stepen neurolo&scaron;kog deficita praćen je vi&scaron;om participacijom i vi&scaron;im nivoom aktuelnog funkcionisanja i obrnuto (r=0,43, p=0,00). Ispitanici sa blagim neurolo&scaron;kim deficitom imaju bolju participaciju (niži skor na WHO DAS 2.0 skali) od osoba sa izraženim neurolo&scaron;kim deficitom. Pozitivna korelacija postoji između stepena poremećaja kognitivnih sposobnosti i stepena neurolo&scaron;kog deficita kod obolelih od MS, odnosno veći neurolo&scaron;ki deficit je praćen pri sutno&scaron;ću kognitivnih deficita (r=-0,27, p=0,00). Osobe bez neurolo&scaron;kog deficita i osobe sa blagim neurolo&scaron;kim deficitom imaju značajno niže skorove odnosno bo lje motoričke sposobnosti i gornjih i donjih ekstremiteta od osoba sa izraženim neurolo&scaron;kim deficitom (p=0,00). Korelacije izme đu kognitivnog funkcionisanja merenog ARCS i aktuelnog nivoa funkcionisanja (invaliditeta) su negativne. Vi&scaron;i stepen invalidnosti praćen je i lo&scaron;ijim kognitivnim statusom. Hijerarhijskom regresionom analizom se proveravao zajednički doprinos svih prediktorskih varijabli u obja&scaron;njavanju ukupne participacije osoba sa MS. Najveći doprinos imaju starost ispitanika, kognitivne sposobnosti i motoričke sposobnosti gornjih ekstremiteta. Rezultati omogućavaju uvid u motoričke i kognitivne sposobnosti obolelih od MS kao i saznanja o faktorima koji utiču na stepen socijalne participacije. Na osnovu ovih rezultata moguće je planiranje programa rehabilitacije i psiho socijalne podr&scaron;ke obolelima od MS. ARCS može da se primenju je kao nova, jednostavna, efikasna i jeftina metoda u skriningu kognitivnih sposobnosti kod obolelih od MS.</p> / <p>Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating degenerative disease of the central nervous system that results in a vast spectrum of disabilities. As part of the disease, many symptoms can occur that manifest as impairments of cognitive and motor abilities. The effects of cognitive and motor dysfunctions are significant and affect not only the patient but also his/her family, and are associated with the social participation of people with MS. The research objectives were to determine the degree of social participation, the presence of cognitive abilities (memory, verbal fluency, visuo spatial functions, speech and attention) and disorders of motor skills (manual skills and gait) in patients with MS. The study was conducted in 2013 and 2014 at the Neurology Clinic, Clinical Center of Vojvodina. The sample consisted of 108 patients suffering from the relapsing-remitting form of MS, aged 20-53 years (AS 39,86 years; SD 20,8 years). The methods applied in the study were the General Questionnaire, the Audio Recorded Cognitive Screen (ARCS), the Paced Auditory Serial Additional Test (PASAT), the 9 Hole Peg Test, the 25 Foot Walk Test, the Expanded Disability Status Scale (EDSS), and the World Health Organization Disability Assessment Schedule (WHO DAS 2.0). According to our results, a lower degree of neurological deficit was associated with a higher degree of participation and a higher level of current functioning, and vice versa (r= 0,43, p= 0,00). Subjects with mild neurological deficits had better social participation (a lower score on the WHO DAS 2.0 scale) compared with subjects with severe neurological deficits. A positive correlation was found between the degree of cognitive ability and the degree of neurological deficit in patients with MS, i.e. a greater neurological deficit was accompanied by the presence of cognitive deficits (r = -0,27, p= 0,00). Subjects with no neurological deficits and those with mild neurological deficits had significantly lower scores and better motor skills of both upper and lower extremities, compared with those with severe neurological deficits (p = 0,00). Correlations between cognitive functioning as measured by the ARCS and the current level of functioning (disability) were negative. A higher degree of disability was associated by a worse cognitive status. The hierarchical regression analysis was used to test the joint contribution of all predictor variables to the overall participation of people with MS. The highest contribution was found forage and cognitive and motor skills of upper extremities. The results provide insights in to the motor and cognitive abilities of patients with MS, as well as in formation about the factors influencing the level of their social participation. Based on these results it is possible to plan a program of rehabilitation and psychosocial support to patients with MS. The ARCS may be utilized as a new, simple, efficient and inexpensive method in the screening of cognitive abilities of people with MS.</p>

No abstract provided / GR 2016

Introdução: A Distrofia Muscular de Duchenne (DMD) é caracterizada como uma fraqueza muscular progressiva que leva à incapacidade. Devido às dificuldades funcionais enfrentadas pelos indivíduos com DMD, o uso da tecnologia assistiva é essencial para proporcionar ou promover habilidades funcionais. Na DMD, além do comprometimento musculoesquelético, uma disfunção autonômica cardíaca também tem sido relatada. Assim, visamos investigar as respostas autonômicas agudas de indivíduos com DMD durante a realização de uma tarefa no computador. Método: A variabilidade da frequência cardíaca foi avaliada através de métodos lineares e não lineares, utilizando uma cinta torácica com equipamento de monitoramento de eletrocardiograma (ECG). Assim, 45 indivíduos foram incluídos no grupo com DMD e 45 no grupo de desenvolvimento típico (controle), avaliados for 20 minutos em repouso sentado e 5 minutos com a realização de uma tarefa no computador. Resultados: Os indivíduos com DMD apresentaram menor modulação cardíaca parassimpática durante o repouso, que diminuiu ainda mais durante a tarefa no computador. Conclusão: Indivíduos com DMD exibiram respostas autonômicas cardíacas mais intensas durante a tarefa no computador / Introduction: Duchenne muscular dystrophy (DMD) is characterized by progressive muscle weakness that leads to disability. Due to functional difficulties faced by individuals with DMD, the use of assistive technology is essential to provide or expand functional abilities. In DMD, as well as musculoskeletal impairment, cardiac autonomic dysfunction has also been reported. Thus, we aimed to investigate acute cardiac autonomic responses in a computer task of DMD subjects. Method: Heart rate variability was evaluated through linear and nonlinear methods, using a breast strap electrocardiogram (ECG) measuring device. Thus, 45 subjects were included in the group with DMD and 45 in the typical development (control) group, assessed for 20 minutes sitting at rest and five minutes with a task on the computer. Results: Individuals with DMD had lower parasympathetic cardiac modulation at rest, which decreased further during the task on the computer. Conclusion: Individuals with DMD exhibited more intense cardiac autonomic responses during computer tasks