Yes / Objectives: The objectives of the study are to investigate how different levels of functional ability relate to quality of life, well‐being, and satisfaction with life, conceptualised as reflecting capability to “live well” in people with dementia. Methods/design: Participants were 1496 people with mild‐to‐moderate dementia and 1188 informants who completed baseline assessments in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study. Total selfrated and informant‐rated scores on the Functional Activities Questionnaire were split into six ability levels to monitor how poorer functioning impacts the ability to live well. We also investigated the potential influence of sociodemographic and diagnostic variables, depression, cognition, and carer stress. Results: Multivariate multiple regression models found that people with dementia who had the greatest functional impairment according to self‐ratings and informant ratings had poorer living well scores than those with the least functional impairment. Sociodemographic and diagnostic factors and cognition had little impact on effect sizes. For self‐ratings, depression attenuated the relationship between functional ability and living well, whereas carer stress attenuated informant ratings. Conclusions: People with dementia with the least functional impairments had greater capability to live well than those with the most functional impairment. Even subtle perceived difficulties in functional ability had a detrimental effect on the ability of people with dementia to live well. Depression in people with dementia and carer stress in informants influenced these associations, and therefore, these factors should be routinely included in future research studies and clinical assessments.

This thesis is based on four studies that explore accessibility for older adults during whole trips by public transport. The overall goal was to gain knowledge of the interrelationships among key variables and to develop a conceptual model of the overall accessibility of public transport. More specifically, the research goals were: (a) to explore links among the key variables postulated to be involved in overall accessibility and to explore the links between these variables and railway accessibility; (b) to gain a deeper understanding of links between critical incidents in traveling and travel behavior decisions; and (c) to develop a conceptual model of overall accessibility. The key variables contributing to overall accessibility are functional ability (depending partly on the person’s functional limitation or disease), travel behavior, and barriers encountered during whole-trip traveling involving train. Respondents with more than one functional limitation or disease reported lower functional ability than did those with only one such limitation and respondents with low functional ability were less frequent travelers than were those with high functional ability. Frequent travelers reported railway accessibility to be better than did those who traveled less frequently. The main barriers were ticket cost and poor punctuality, but respondents with the lowest functional ability attributed the barriers encountered to their own health. The critical incidents most frequently reported were found in the categories “physical environment onboard vehicles” and “physical environment at stations or stops”, as well as in the “pricing and planning during ticketing” phase of the trip. Five themes of reactions to critical incidents were identified that had resulted in behavior change: firm restrictions, unpredictability, unfair treatment, complicated trips, and earlier adverse experiences. A conceptual model of overall accessibility was developed, grounded in the empirical research results. This model is summarized in the following propositions: Overall accessibility is a reciprocal relationship among the barriers/facilitators encountered, functional ability, and travel behavior. Accessibility emerges in the person–environment interaction. To understand accessibility, past experiences and future expectations should both be considered, because both will guide travel decisions. / Measurements enable future train travelling for everybody

Orientador: Anita Liberalesso Neri / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação / Made available in DSpace on 2018-08-06T23:44:15Z (GMT). No. of bitstreams: 1 Rabelo_DorisFirmino_M.pdf: 518803 bytes, checksum: 124441c54baa8054625094924d0fbf74 (MD5) Previous issue date: 2006 / Resumo: Objetivos: Investigar em pessoas acometidas por acidente vascular cerebral (AVC), as relações entre as incapacidades geradas pelo AVC, o senso de ajustamento pessoal e o bem-estar subjetivo. Método: Participaram 52 afetados por AVC acima de 50 anos freqüentadores de grupos de reabilitação. Os dados foram coletados por meio de entrevista individual, apoiados em: a) questionário sócio-demográfico e itens concernentes ao AVC; b) Brazilian OARS Multidimensional Functional Assessment Questionaire - BOMFAQ para avaliar a capacidade funcional; c) para avaliar o bem-estar subjetivo, uma escala de satisfação com a vida global e uma de satisfação com a vida referenciada a domínios (capacidade física, mental e envolvimento social), e outra escala que avalia ânimo positivo e negativo; d) ajustamento pessoal pela Escala de Desenvolvimento Pessoal ¿ EDEP em versão reduzida. Resultados: Verificou-se que os principais preditores de baixo bem-estar subjetivo entre pessoas acometidas por AVC são: ter restrições em atividades importantes ligadas à identidade pessoal; ter sofrido AVC há menos de 3 anos; não contar com suporte para realizar atividades básicas e instrumentais de vida diária; maior necessidade de ajuda em atividades de vida diária; baixo escore de ajustamento psicológico; alto escore de afetos negativos; baixo escore de afetos positivos; comparação social desfavorável quanto à satisfação com a vida em relação a outros de mesma idade não afetados por AVC; comparação desfavorável da vida atual em comparação com a vida há cinco anos; e avaliação negativa da própria vida no momento. São influências favoráveis após um AVC: programas sociais de apoio e de reabilitação, suporte social, continuidade de uma ocupação produtiva, integração social e manutenção da competência em atividades instrumentais de vida diária / Abstract: Objectives: Investigating relationships between functional disability, perceived personal adjustment and subjective well-being among people who had suffered stroke. Method: There were 52 individuals aged 50 and more, participants of rehabilitation groups. Data were collected through an individual interview including: a) a sociodemographic questionnaire and items about the stroke; b) the Brazilian version of the OARS Multidimensional Functional Assessment Questionaire - BOMFAQ -, assessing functional ability; c) to assess the subjective well-being: scales of general life satisfaction, satisfaction concerning physical and mental ability, and social involvement, and positive/negative affect; d) a reduced version of the Escala de Desenvolvimento Pessoal (EDEP), assessing aspects of the psychological adjustment referenced to the Ryff's model and to the concept of generativity. Results: The main predictors of low subjective well-being were: restrictions related to important activities concerning personal identity; having had stroke less than three years ago; low instrumental support to perform basic and instrumental activities of daily living; high necessity for instrumental support in activities of daily living; low score of perceived psychological adjustment; high score of negative affect; low score of positive affect; low scores in global life satisfaction in comparison with others who did not suffer stroke, in satisfaction with current life in comparison with life five years ago, and in satisfaction with current life. The following variables showed positive effects on well being: social support, involvement in rehabilitation programs, continuity of a productive occupation, social integration and maintenance of competence in instrumental activities of daily living / Mestrado / Mestre em Gerontologia

Orientador: Maria Jose D'Elboux Diogo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação / Made available in DSpace on 2018-08-08T05:57:22Z (GMT). No. of bitstreams: 1 Paula_JoaoAntonioMartini_D.pdf: 1106781 bytes, checksum: 8d6d7cf6d2c4798ef3aa30ddeba613d8 (MD5) Previous issue date: 2007 / Resumo: O objetivo desta pesquisa foi identificar associações entre dados sóciodemográficos, de saúde física, antropométricos e de bem-estar subjetivo de 122 idosos atendidos em ambulatório de hospital universitário, e a sua capacidade funcional motora e cognitiva, que foi avaliada por meio da Short Physical Performance Battery (SPPB), do Mini-Exame do Estado Mental (MEEM) e da Medida de Independência Funcional (MIF), de acordo com gênero e faixa etária, verificando também associações entre estes. Foram observadas correlações significativas entre os escores dos três últimos e também entre estes e os outros indicadores. Os homens tiveram maiores rendimento mensal e escores antropométricos. As mulheres tiveram desempenho inferior nos testes SPPB, MEEM e MIF, e pior saúde percebida comparada. Entre grupos etários de 60 a 69, 70 a 79, e 80 anos ou mais, o último apresentou escores ou medidas menores em relação aos outros dois nas medidas antropométricas, na SPPB e no MEEM, mas teve maior bem-estar subjetivo. O número de doenças em prontuário associou-se positivamente ao índice de massa corpórea (IMC) e às circunferências de braço e quadril, e negativamente à pontuação de equilíbrio da SPPB. O número de medicamentos em uso associou-se positivamente ao de doenças, ao peso, ao IMC, e às circunferências de braço, cintura e quadril. Concluiu-se que os testes funcionais se associaram significativamente a outros indicadores de saúde, e que a SPPB e o MEEM, testes de observação direta do desempenho motor e cognitivo, respectivamente, complementaram os dados da MIF, um instrumento que avalia independência funcional em seus aspectos motores e cognitivo-sociais por meio do relato do próprio examinando ou de terceiro / Abstract: The purpose of this study was to identify associations among sociodemographic, physical health, anthropometric and subjective well-being data in 122 ambulatory elders of university hospital, and their motor and cognitive functional capacity, evaluated by means of the Short Physical Performance Battery (SPPB), the Functional Independence Measure (FIM) and the Mini-Mental State Examination (MMSE), in accordance with gender and age group, also verifying associations between these instruments. Significant correlations were found among the scores of the three functional tests, and also between their scores and those of other indicators. Men had greater monthly income and anthropometric scores. Women had lower performance in SPPB, MMSE and FIM tests, and worse compared perceived health. Among the age groups 60 to 69, 70 to 79 and 80 or more years old, the last one had lower scores than the others in anthropometric measures, SPPB and MMSE. On the other hand, this group had higher scores of subjective well-being. The number of registered diseases was positively associated with body mass index (BMI), upper arm, waist and hip circumference, and had negative correlation with the balance component of SPPB. The number of medicines in use was positively correlated with number of diseases, body weight, BMI, upper arm, waist and hip circumference. It was concluded that the functional tests were significantly associated with other health indicators, and also that SPPB and MMSE, motor and cognitive performance measures, respectively, complemented FIM, an instrument of reported functional independence in motor, cognitive and social activities / Doutorado / Educação, Sociedade, Politica e Cultura / Doutor em Educação

Orientador: Anita Liberalesso Neri / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T11:51:01Z (GMT). No. of bitstreams: 1 Rodrigues_NataliaOliveira_M.pdf: 968654 bytes, checksum: 9565c69d29cedbf239608c47ef8a2a4e (MD5) Previous issue date: 2011 / Resumo: Fundamentos: As condições socioculturais e econômicas interagem com os processos biológicos, ao longo de toda a vida, podendo propiciar proteção ou vulnerabilidade na velhice. Objetivos: Descrever e analisar a vulnerabilidade em idosos, residentes na comunidade, conforme condições sociais (gênero, idade e renda), individuais (número de doenças, incapacidade funcional, suporte social percebido e saúde percebida) e programáticas (índice de SUS-dependência, Índice de Vulnerabilidade Social e acesso aos serviços médicos e odontológicos) e analisar a influência dessas condições sobre a saúde percebida dos mesmos idosos. Métodos: No contexto de um estudo sobre fragilidade, participaram 688 idosos recrutados em domicílio, sem déficit cognitivo sugestivo de demência, residentes em 88 setores censitários urbanos sorteados entre os 832 existentes em Campinas, SP. Eles foram entrevistados em sessão única de coleta de dados realizada em centros comunitários, mediante questionários e escalas de autorrelato. Resultados: Dos participantes, 68% eram mulheres; a idade variou entre 65 e 90 anos, com média de 72,28 ± 5,41 anos; a renda familiar mensal variou de zero e 57,83 salários e a média foi de 4,72 ± 5,28 salários mínimos. Cerca de 60% dos idosos viviam em regiões de menor vulnerabilidade social e com menor dependência dos serviços públicos de saúde. Apenas 11% não apresentaram doenças. O suporte social percebido e a saúde percebida foram predominantemente positivos. A análise multivariada apontou como preditores de melhor saúde percebida menor número de doenças, sinais e sintomas, melhor suporte social percebido e uso de serviços dentários privados. Conclusão: Em uma amostra predominantemente feminina, com boa capacidade funcional, vivendo principalmente em regiões de menor IVS e com menor dependência dos serviços públicos de saúde; as variáveis mais fortemente relacionadas a boa saúde percebida foram a ausência de doenças, sinais e sintomas, o melhor suporte social percebido e o uso de serviço dentário particular / Abstract: Foundation: The social cultural and economical conditions interact with the biological processes, throughout the whole life, being able to result in protection or vulnerability at elderly age. Objectives: Describe and analyze the vulnerability in community elders, as far as social conditions (gender, age, and income), individuals (number of diseases, functional incapability, perceived social support and self-reported health) and programmatic (SUS-dependency index, social vulnerability index and access to health and dental care) and analyze the relative influence on these conditions on self-reported health of the least aged. Methods: In the context of the study about fragility, 668 elders participated recruited at home without cognitive impairment suggestive of mental illness, residents of 88 urban sectors randomly chosen among the existing 832 in Campinas, SP. They were interviewed only once for data collection done at community centers, along with questionnaire and self-reported scales. Results: Of all participants, 68% were women, with ages between 65 and 90, with an average between 72.28 +- 5.41 years of age, the family income ranged from 0 to 57.83 minimum wages and the average were between 4.72 +- 5.28 minimum wages. Just about 60% of all elderly lived in regions of lesser social vulnerability and with lesser dependency on public health care. Only 11 % showed no disease. The perceived social support and self-reported health were strongly positive. The multi-various analyzes showed that self-reported health a smaller number of diseases, signs and symptoms, better social support and the use of private dental care. Conclusion: The physical decline in social support can magnify the search for health care, especially for elderly at lower economic class that suffered the effect of deficiency in the access of medical and dental care. These factors affect the self perception of elderly health, when positive, can act as protectors of self reported health / Mestrado / Saúde e Qualidade de Vida na Velhice / Mestre em Gerontologia

Abstract Reduced physical function and persistent pain are serious consequences of rheumatoid arthritis (RA). Clinical trials have shown that patients with RA suffer from a poor health-related quality of life (HR-QoL). However, limited information is available on the HR-QoL of patients treated in normal clinical practice. The purpose of the present study was to obtain information of how RA can influence on the patients´ HR-QoL and functional ability in a clinical setting and to investigate the impact of disease-related and demographic factors on the HR-QoL. The theoretical framework of the study was the biopsychosocial concept of health, i.e. the ICF model (International Classification of Functioning, Disability and Health) endorsed by WHO. HR-QoL was measured by the Nottingham Health Profile (NHP) questionnaire and functional ability by the Health Assessment Questionnaire (HAQ). The contents of these instruments and the NHP results were evaluated also within the ICF categories. The study consisted of a cross-sectional series and a longitudinal cohort carried out in two central hospitals in Finland in the late 1990s. The cross-sectional group of 122 consecutive out-patients had a mean disease duration of 11 years. The HR-QoL values of the patients were compared with those of an age and gender matched ”healthy” control group living in the same area. The HR-QoL values of the patients were examined also at different functional ability levels. The longitudinal group of 62 consecutive patients had symptom duration ≤ 24 months and no prior use of antirheumatic drugs or glucocorticosteroids at inclusion. First, the impact of the treatment response assessed by the EULAR (DAS28) criteria on HR-QoL was examined at six months from disease onset. Secondly, the HR-QoL changes and their associations with age and gender and with the changes in disease activity, radiographic assessments of hands and feet and functional ability were examined for ten years after the onset of RA. RA patients had poorer scores than the controls in the NHP in the dimensions measuring mobility, pain and energy. These dimensions, along with sleep, displayed also a significant linear association with poorer HAQ levels (p < 0.001). A better treatment response during the first six months was linearly associated with better HR-QoL with respect to the pain, energy and mobility dimensions (p < 0.001). Those patients exhibiting no response to treatment had already at baseline the poorest HR-QoL in the dimension for pain and emotional reaction compared with those in the moderate and good responders. During the ten years´ follow-up, all NHP dimensions except social isolation displayed significant improvements, these being most marked during the first six months. Changes in disease activity correlated with changes in pain, energy and emotional reaction (p < 0.001). The mean level of the HAQ was well preserved over the ten years of this study and its changes were correlated with changes in pain, mobility and energy (p < 0.001). Women had somewhat poorer NHP improvements in the dimensions assessing energy, emotional reaction and social isolation than males. Disease duration associated strongly with poorer mobility and pain dimensions (p < 0.01). Within the ICF framework, pain, mobility, energy and sleep were identified as being the most important categories from the patient's perspective. The results of the present study demonstrate that RA has a major influence on the patients´ HR-QoL but early and active treatment can improve the situation. In the ICF framework, the NHP covers a broader spectrum of the ICF categories than can be assessed by the HAQ. / Tiivistelmä Alentunut fyysinen toimintakyky ja jatkuva kipu ovat nivelreumaan liittyviä vakavia seurannaisvaikutuksia. Kliiniset tutkimukset ovat osoittaneet, että nivelreumaa sairastavat potilaat kärsivät huonontuneesta terveyteen liittyvästä elämänlaadusta. Normaalista kliinisestä käytännöstä saatava tieto potilaiden terveyteen liittyvästä elämänlaadusta on kuitenkin niukkaa. Tämän tutkimuksen tarkoituksena oli saada tietoa nivelreuman vaikutuksista potilaiden terveyteen liittyvään elämänlaatuun ja toimintakykyyn kliinisessä asetelmassa ja tutkia sekä tautiin liittyvien että demografisten tekijöiden vaikutusta terveyteen liittyvään elämänlaatuun. Tutkimuksen teoreettisena viitekehyksenä käytettiin WHO:n hyväksymää toimintakyvyn, toimintarajoitteiden ja terveyden kansainvälistä luokitusta (ICF-malli). Terveyteen liittyvää elämänlaatua arvioitiin mittarilla Nottingham Health Profile (NHP) ja toimintakykyä mittarilla Health Assessment Questionnaire (HAQ). Kyseisten mittareiden sisältö samoin kuin NHP- tuloksia arvioitiin käyttämällä myös ICF- luokitusta. Tutkimus käsitti poikkileikkaus- ja pitkittäistutkimuksen, jotka toteutettiin 1990-luvun lopulla kahdessa suomalaisessa keskussairaalassa. Poikkileikkaustutkimukseen osallistui 122 perättäistä polikliinistä potilasta, joilla taudin kesto oli ollut keskimäärin 11 vuotta. Potilaiden terveyteen liittyvää elämänlaatua verrattiin samalla seudulla elävään iän ja sukupuolen suhteen kaltaistettuun verrokkiryhmään. Potilaiden terveyteen liittyvää elämänlaatua arvioitiin myös eri toimintakykytasoilla. Pitkittäistutkimus käsitti 62 perättäistä potilasta, joilla oireet olivat kestäneet ≤ 24 kuukautta ja jotka tutkimuksen alkaessa eivät olleet käyttäneet edeltävästi antireumaatteja tai kortikosteroideja. Näillä potilailla hoitovasteen vaikutusta terveyteen liittyvään elämänlaatuun arvioitiin EULAR DAS28- kriteerein kuuden kuukauden kohdalla taudin alusta. Lisäksi tutkittiin terveyteen liittyvän elämänlaadun muutoksia kymmenen vuoden ajalta nivelreuman alusta ja näiden muutosten yhteyttä ikään ja sukupuoleen, taudin aktiviteetissa ja käsissä ja jalkaterissä todettuihin röntgenmuutoksiin samoin kuin toimintakyvyn muutoksiin. Hoitovasteetta jääneillä potilailla oli jo lähtötilanteessa huonoin terveyteen liittyvä elämänlaatu kipu- ja tunnereaktiot- ulottuvuuksissa verrattuna kohtalaisen ja hyvän hoitovasteen saaneisiin. Kymmenen vuoden seurannassa kaikki NHP- ulottuvuudet sosiaalista eristyneisyyttä lukuun ottamatta osoittivat merkittävää paranemista. Selvintä se oli ensimmäisen kuuden kuukauden aikana. Taudin aktiviteetin muutokset korreloivat kipu-, tarmokkuus- ja tunnereaktiot- ulottuvuuksien muutoksiin (p <  0.001). Keskimääräinen HAQ- taso säilyi hyvänä kymmenen vuoden seurannassa ja HAQ- muutokset korreloivat kipu-, liikkuminen- ja tarmokkuus- ulottuvuuksien muutosten kanssa (p <  0.001). Naisilla oli miehiä jonkin verran huonompi NHP-paraneminen tarmokkuus-, tunnereaktiot- ja sosiaalinen eristyneisyys- ulottuvuuksissa. Taudin kesto oli selvästi yhteydessä huonompiin liikkuminen- ja kipu- ulottuvuuksiin (p <  0.01). ICF- luokitusta käytettäessä potilaiden näkökulmasta kipu, liikkuminen, tarmokkuus ja uni nousivat tärkeimmiksi kategorioiksi. Tämän tutkimuksen tulokset osoittavat, että nivelreumalla on huomattava vaikutus potilaiden terveyteen liittyvään elämänlaatuun, jota varhainen ja aktiivinen hoito voi kuitenkin parantaa. ICF- viitekehyksessä NHP kattaa laajemman spektrin ICF- luokista kuin HAQ.

Orientador: Anita Liberalesso Neri / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T16:40:50Z (GMT). No. of bitstreams: 1 Bez_JoelitaPessoadeOliveira_M.pdf: 1421448 bytes, checksum: d5441d718add36c7485f9282ff87e83c (MD5) Previous issue date: 2011 / Resumo: A importância da autopercepção de saúde para o autocuidado e o bem-estar e a escassez de dados brasileiros sobre relações entre perda de força e função muscular e autoavaliação de saúde em idosos, justificam a realização de uma investigação sobre relações entre essas variáveis. Objetivos: descrever condições de força de preensão, velocidade da marcha e autoavaliação de saúde e investigar relações entre elas, considerando-se as variáveis gênero, idade e renda familiar, em amostra probabilística de idosos comunitários com 65 anos e mais, integrantes de um estudo populacional sobre fragilidade. Métodos: 689 idosos sem déficit cognitivo sugestivo de demência foram submetidos a testes de velocidade da marcha (média do tempo gasto para percorrer três vezes 4,6 m, ajustada por gênero e IMC) e de força de preensão manual (média em kg força de 3 medidas com dinamômetro Jamar na mão dominante, ajustada por altura e gênero). Os idosos foram classificados como de baixa, média e alta força e velocidade. Auto-avaliação de saúde foi avaliada por um item escalar com 5 pontos. Resultados: Os homens e os idosos mais novos pontuaram mais alto em força de preensão e velocidade da marcha; os de 80 anos e mais e as mulheres tiveram menor força de preensão e menor velocidade da marcha; lentidão da marcha e baixa renda foram fatores de risco para pior avaliação de saúde. Conclusões: Baixa força muscular afeta a autoavaliação de saúde porque acarreta diminuição da capacidade funcional, especialmente na presença de pobreza e escassez de recursos compensatórios / Abstract: The scarcity of Brazilian data on the effects of loss of muscle strength and function and self-rated heath in old age, as well as the evidence according with self-rated health is an important antecedent of self-care and well-being are good reasons to investigate relationships between these variables. Objective: Investigating patterns of performance and relationships between grip strength, gait speed and self-rated health in community-dwelling elderly stratified by gender, age and family income. Methods: 689 elderly people without cognitive deficit suggestive of dementia were submitted to 3 measures of grip strength with dynamometer Jamar and to 3 measures of time spent to walk 4,6 m. The means were respectively adjusted by gender and BMI and by gender and height. Comparisons between groups were based on their quartiles of strength and speed. Self-related health was assessed with a five point scale. Results: The male and the youngest scored significantly higher on grip strength and gait speed than the female and oldest did; the richest scored higher than the poorest on grip strength and gait speed; those aged greater than 80 and female showed lower grip strength and gait speed than the youngest and male did. The poorest scored lower and the richest higher than the other groups in self-rated health. Multivariate regression analysis showed low gait speed and low income as risk factors to worse health evaluation. Conclusion: The association between low muscular strength and worse self-evaluations of health is mediated by functional incapacities in interaction with insufficient environmental resources / Mestrado / Gerontologia / Mestre em Gerontologia

Text in Afrikaans / In this quantitative study emphasis is placed on the role of the nurse as a member of the rehabilitation team. Furthermore, the role of the nurse in patient education as well as the importance of effective patient education during the rehabilitation process after hip replacement surgery is emphasised. Various factors that impacted on the rehabilitation process are highlighted. A structured interview schedule was used to interview a group of 20 respondents. All of the respondents participated voluntarily. Orem's Selfcare Theory was used as a theoretical basis for the study. The researcher determined which information respondents regarded as important to attain functional independence during the rehabilitation process. The data gathered would serve as recommendation for a planned information brochure that could in future be given to patients at their first visit to the surgeon before surgery. The brochure could then be used as a basis for patient education in the course of the rehabilitation process. / Advanced Nursing Sciences / M.A. (Verpleegkunde)

O processo de envelhecimento acarreta um declínio no equilíbrio postural, na força muscular e no condicionamento cardiorrespiratório, influenciando diretamente a capacidade funcional do idoso. No entanto, a prática sistemática de atividade física pode reduzir esses efeitos deletérios. Os exercícios realizados em meio aquático, como a hidroginástica, são adequados e seguros para essa população, devido ao reduzido impacto sobre os membros inferiores e à diminuição da sobrecarga cardiovascular. Assim, o objetivo do presente estudo foi analisar e comparar os efeitos de três métodos de treinamento de hidroginástica no equilíbrio corporal e na aptidão física de idosos. A amostra foi composta por 44 mulheres saudáveis, com idades entre 60 e 75 anos, sedentárias há no mínimo seis meses, as quais foram divididas aleatoriamente em três grupos: Equilíbrio (GE; n=17; 66 ± 3,68 anos), Força (GF; n=13; 65,3 ± 3,68 anos) e Aeróbico (GA; n=14; 63,7 ± 4,09 anos). Os grupos realizaram o treinamento durante 12 semanas, com duas sessões semanais de 45min, e um período controle de quatro semanas. Foram mensuradas variáveis de equilíbrio corporal, neuromusculares, cardiorrespiratórias e funcionais antes e após esses períodos. Para análise estatística utilizou-se o teste T pareado para a comparação dos dados no período controle e a Generalized Estimating Equations (GEE) para a comparação entre os momentos e entre os grupos Adotou-se um nível de significância de α=0,05 e os dados foram rodados no SPSS 20.0. Após o treinamento, todos os grupos apresentaram melhora no equilíbrio estático (p<0,05), constatada pela redução da amplitude máxima de deslocamento do centro de pressão plantar nas direções ântero-posterior (COPap) e médio-lateral (COPml), durante os apoios bilateral (olhos abertos e olhos fechados) e unilateral, e da velocidade média do COPap na situação bilateral com olhos fechados. Além disso, houve incremento no equilíbrio dinâmico, avaliado através do teste de Marcha Tandem, após as três intervenções (p<0,001). Em todas as variáveis supracitadas, não se verificou diferença significativa entre os grupos, sendo esse um dos principais achados do presente estudo. Em relação às variáveis neuromusculares, houve aumento significativo na força dinâmica máxima, mensurada através do teste de uma repetição máxima dos extensores do joelho (1RM), sem diferença entre os grupos (p>0,05). Porém, ao analisar estatisticamente os percentuais de incremento do 1RM (Δ%), observaram-se valores significativamente maiores no GF comparado ao GE (31,51 ± 3,44 vs 14,85 ± 2,26%). Nas avaliações cardiorrespiratórias, observou-se incremento significativo no consumo de oxigênio no segundo limiar ventilatório (VO2LV2) e de pico (VO2pico) somente em GA e GE, sem diferença entre os grupos, enquanto a frequência cardíaca no segundo limiar ventilatório (FCLV2) reduziu significativamente apenas no GF No entanto, o desempenho no teste “caminhada de seis minutos” melhorou significativamente nos três grupos, sem diferença entre os mesmos. Todas as variáveis funcionais avaliadas melhoraram significativamente após o treinamento, com diferença estatística somente entre GE e GA nos testes “flexão de cotovelo” e “levantar e sentar”, com maiores valores no GA no pós-treinamento. Todavia, constataram-se valores significativamente maiores no Δ% do teste “flexão de cotovelo” do GA e do GF comparados ao do GE (GA: 52,35 ± 9,63%; GF: 53,39 ± 6,82%; GE: 22,65 ± 5,09%) e diferença significativa no Δ% do teste “levantar e sentar” entre GA e GE (42,04 ± 4,58% vs 23,68 ± 4,75%), sendo ambos similares ao GF (37,41 ± 4,23%). Concluiu-se que o treinamento na hidroginástica foi efetivo para melhora de diversos parâmetros do equilíbrio corporal e da aptidão física de mulheres idosas, independente do método empregado. Porém, alguns resultados sugerem que as maiores adaptações na força muscular (1RM e resistência) tenham sido provocadas pelos treinamentos de força e aeróbico, enquanto as alterações cardiorrespiratórias mais relevantes ocasionadas pelos treinamentos de equilíbrio e aeróbico. / The aging process leads to a decline in postural balance, muscle strength and cardiorespiratory system, affecting directly the functional capacity of the elderly. However, the systematic practice of physical activity may reduce these deleterious effects. The exercises performed in water environment, such as water-based, are appropriate and safe for this population, especially by offering a reduced impact on the lower limbs and a decrease in cardiovascular overload. Thus, the aim of this study was to analyze and compare the effects of three different water-based exercises programs on body balance and physical fitness in the elderly. The sample was composed of 44 healthy women, aged between 60 and 75 years, sedentary for at least six months, randomly into three groups: Balance (GE; n = 17; 66 ± 3.68 years), Strength (GF; n = 13; 65.3 ± 3.68 years) and Endurance (GA; n = 14; 63.7 ± 4.09 years). The groups had trained for 12 weeks, with two 45 minutes weekly sessions, and maintained a control period during four weeks. Balance, neuromuscular, cardiorespiratory and functional responses were measured before and after these periods. The statistical analysis was performed using paired T test for comparisons in the control period, and Generalized Estimating Equations (GEE) to comparisons between moments and between groups. The significance level was α = 0.05 (SPSS 20.0) After the training period, all groups showed improvement in the static balance (p<0.05), verified by the reduction of the maximum displacement amplitude of center of pressure (COP) in the anteroposterior (COPap) and mid-lateral (COPml) directions, during the bilateral (eyes open and closed) and unilateral support bases, and the average COPap velocity in the bilateral situation with eyes closed. In addition, there was an increase in the dynamic balance, evaluated by the Tandem test, after the three interventions (p<0.001). In all variables previously mentioned, there was no significant difference between groups, being one of the main findings of the present study. In adition, there was a significant increase in maximal dynamic strength, measured by one maximal repetition test of knee extensors (1RM), with no difference between groups (p>0.05). However, the statistical analysis with percentages of 1RM incrementes (Δ%) showed higher values in the GF compared to the GE (31.51 ± 3.44 vs. 14.85 ± 2.26%; p<0.05). The cardiorespiratory measurements analysis showed a significant increase in the peak oxygen uptake (VO2pico) and in the oxygen uptake corresponding to the second ventilatory threshold (VO2LV2) only in GA and GE, with no difference between groups, while heart rate corresponding to the second ventilatory threshold (FCLV2) decreased significantly only in GF However, the “six-minute walk test” performance improved significantly in all groups, with no difference between them. All functional variables improved significantly after training, with statistical difference between GA and GE only in the "arm curl test" and "chair stand test", with higher values in GA at posttraining moment. On the other hand, significantly higher values were found in the Δ% of "arm curl test" in GA and GF compared to GE (GA: 52.35 ± 9.63%; GF: 53.39 ± 6.82%; GE: 22.65 ± 5.09%) and significant difference in the Δ% of "chair stand test" between GA and GE (42.04 ± 4.58% vs 23.68 ± 4.75%), being both similar to GF (37.41 ± 4.23%). It was concluded that the water-based exercise training was effective to improve several body balance and physical fitness parameters of elderly women, regardless of the method used. However, some results suggest that the greatest adaptations in muscular strength (1RM and resistance) were provoked by strength training and aerobic training, while the most relevant cardiorespiratory changes were caused by aerobic training and balance training.

Nors Lietuvos plento ir treko dviratininkų rengimo klausimais mokslinių publikacijų yra paskelbta nemažai, tačiau Lietuvos kalnų dviratininkų rengimo, fizinių ir funkcinių galių kaitos mokslinių tyrimų duomenų literatūros šaltiniuose mes neaptikome. Todėl yra aktualu išryškinti Lietuvos kalnų dviratininkų esminius parengtumo ir treniruočių bruožus, kurie vėliau leistų tobulinti šios rungties dviratininkų rengimą. Tikslas. Ištirti Lietuvos kalnų dviratininkų rengimą ir jų fizinių ir funkcinių galių dinamiką metiniu treniruočių ciklu. Uždaviniai: ištirti Lietuvos kalnų dviratininkų rengimąsi kalnų dviračių kroso ir maratono varžyboms ir išryškinti rengimo ypatumus; nustatyti Lietuvos kalnų dviratininkų fizinio išsivystymo rodiklių kaitą metiniu rengimosi ciklu; nustatyti Lietuvos kalnų dviratininkų fizinių ir funkcinių galių rodiklių kaitą metiniu rengimosi ciklu; išanalizuoti ir apibendrinti Lietuvos kalnų dviratininkų varžybinę veiklą. Buvo analizuotas kalnų dviratininkų atliktas fizinis krūvis parengiamuoju ir varžybiniu laikotarpiais. Atlikta sportininkų dienoraščių analizė. Tyrimuose dalyvavo Lietuvos kalnų dviratininkai (n = 19). Išmatuoti antropometriniai ir fiziometriniai fizinio išsivystymo rodikliai. Specialiam anaerobiniam alaktatiniam galingumui nustatyti buvo taikomas 10s trukmės maksimalių pastangų testas, o mišriam anaerobiniam alaktatiniam glikolitiniam galingumui nustatyti naudotas Wingate 30 s trukmės maksimalių pastangų testas. Aerobinis pajėgumas... [toliau žr. visą tekstą] / We found many studies investigating Lithuanian track and road cyclists, however there are no studies on the training characteristics, physical strength and functional ability of Lithuanian mountain bikers. Therefore it is highly relevant to highlight the essential features of the preparation and training of Lithuanian mountain bikers, which would allow us to improve the training process. The aim of this study was to investigate the dynamics of training, physical strength and functional ability of Lithuanian mountain bikers during the annual training cycle. The tasks of this study: to investigate the training for cross country and cross country marathon events of Lithuanian mountain bikers and highlight the training features; to establish the changes in indices of the physical development, physical strength and functional ability during the annual training cycle; to analyze and summarize the competitive activity of Lithuanian mountain bikers. Nineteen Lithuanian mountain bikers (19 – 29 years old) who participated in cross country and cross country marathon events were tested during the preparatory and competitive phase of their season. Anthropometric and physiometric indices of physical development were measured. Muscle power in the different zones of energy production was studied. The 10-second test was performed to estimate the special alactic anaerobic power output, whereas the 30-second Wingate test was performed to estimate composite alactic anaerobic glycolytic power... [to full text]