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Rela????o entre cifose dorsal, densidade mineral ??ssea e risco de quedas em idosasRegolin, Fabiana 19 June 2009 (has links)
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Previous issue date: 2009-06-19 / Introduction: The increase of dorsal kyphosis is frequent for elderly people. This posture
deformity can be caused both by osteoporotic and non-osteoporotic conditions. Regardless its
origins, the increase of dorsal kyphosis has been considered an intrinsic factor for the elderly
to fall. A variety of instruments is available to evaluate posture control, including the
posturography and the Time Up and Go clinical test. Objectives: Verify and analyze the
influence of the angular measure of dorsal kyphosis and of the osseous mineral density on the
risk of elderly women to fall. Materials and Methods: The research was a cross-sectional
study, had evaluated 95 elderly women in two steps. First, the measurement of the dorsal
kyphosis??? angle, using the flexicurve method. Then, the Time Up and Go test, and the
collection of data using a stabilometer. Each patient was submitted to Folstein Mini Mental
Status Examination. On the second phase of the research, each elderly woman had her
osseous densitometry examined. Considering the measured curves of dorsal kyphosis and the
interpretation of osseous densitometry, the participants were divided into four groups: first,
those who lost osseous mass and whose dorsal kyphosis increased; second, those who lost
osseous mass but whose dorsal kyphosis did not increase; third, those who did not lose
osseous mass and whose dorsal kyphosis did not increase; and fourth, those whose dorsal
kyphosis increased, but did not lose of osseous mass. The performances of each group, at the
static force platform and at the Time Up and Go test, were then statistically analyzed and
compared. Results: At the static force platform, there was significant statistical difference
only between the first and the third group, in the antero-posterior direction (p=0,0124), as
well as the third group was the only one that exhibited homogeneous performances with eyes
opened and eyes closed, in the medial-lateral direction (p=0,4263). Meanwhile, in the anteroposterior
direction, no group exhibited any difference between both tries (p 0,6298).
Concerning the Time Up and Go test, the group 4 (with loss of osseous mass and without
increase of dorsal kyphosis) has achieved the best performance (12,6s). Conclusions: The
angular measure of dorsal kyphosis and the osseous mineral density were co-related to the
risk of falling, statically, in the antero-posterior direction. During the dynamic posture, the
risk of falling was co-related to age. / Contextualiza????o: O aumento da cifose dorsal ?? um achado comum na pessoa idosa. Esta altera????o postural pode ser explicada por condi????es ostepor??ticas e por condi????es n??o osteopor??ticas. Independentemente de sua origem, o aumento da cifose dorsal tem sido considerado um fator intr??nseco de quedas em idosos. Est?? dispon??vel uma variedade de
instrumentos para avalia????o do controle postural, como a posturografia e o teste cl??nico Time Up and Go. Objetivos: Verificar e analisar a rela????o entre a medida angular da cifose dorsal e a densidade mineral ??ssea sobre o risco de quedas em mulheres idosas. Materiais e M??todos: Por meio de um estudo transversal, foram avaliadas 95 idosas em 2 etapas distintas. Na
primeira, foi obtida a medida angular da cifose dorsal pelo m??todo flexicurva, foi realizado o teste Time Up and Go, assim como foram obtidos os dados estabilom??tricos na plataforma de for??a est??tica de cada volunt??ria. Ainda nesta etapa, a participante foi submetida ao Mini Exame do Estado Mental de Folstein. Na segunda etapa foi realizado o exame de densitometria ??ssea. A partir da medida angular da cifose dorsal e da interpreta????o da
densitometria ??ssea, as participantes foram divididas em 4 grupos: grupo 1 (com perda de massa ??ssea e com aumento da cifose dorsal), grupo 2 (com perda de massa ??ssea e sem aumento da cifose dorsal), grupo 3 (sem perda de massa ??ssea e sem aumento da cifose dorsal) e grupo 4 (sem perda de massa ??ssea e com aumento da cifose dorsal). O desempenho, na plataforma de for??a est??tica e no teste Time Up and Go, de cada grupo, foi analisado, estatisticamente, entre si. Resultados: Na plataforma de for??a est??tica, houve diferen??a estatisticamente significativa apenas entre os desempenhos dos grupos 1 e 3 na dire????o ??ntero-posterior (p=0,0124). Ainda em rela????o ?? plataforma de for??a, apenas o grupo 3 n??o apresentou diferen??a no desempenho entre as tentativas de olhos abertos e de olhos fechados na dire????o m??dio-lateral (p=0,4263), enquanto que na dire????o ??ntero-posterior nenhum grupo apresentou diferen??a entre ambas as tentativas (p 0,6298). J?? no teste Time Up and Go o grupo 4 (sem perda de massa ??ssea e com aumento da cifose dorsal) obtive o melhor desempenho (12,6s). Conclus??o: A medida angular da cifose dorsal e a densidade mineral
??ssea foram relacionadas ao risco de quedas, estaticamente, na dire????o ??ntero-posterior. Durante a postura din??mica o risco de quedas foi associado ?? vari??vel idade.
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