Made available in DSpace on 2016-06-24T04:16:38Z (GMT). No. of bitstreams: 1 Luiz Sinesio Silva Neto.pdf: 13875 bytes, checksum: 26bf9fe8c8522c7aa35da21286663621 (MD5) Previous issue date: 2011-09-30 / Objective: To investigate the association between sarcopenia, sarcopenic obesity and muscle strength and variables related to quality of life in elderly women. Method: The sample consisted of 56 female volunteers who underwent body composition analysis (BMI and x-ray absorptiometry dual-energy DXA). Handgrip strength was measured using a Jamar dynamometer. We used the SF-36 health questionnaire to analyze quality of life. The data were analyzed with descriptive statistics and the Pearson correlation coefficient; SPSS 15.0 was used to perform the statistical analysis. Results: The mean age of the subjects was 64.92±5.74 years; of the 56 volunteers evaluated, 19.64% (n=11) were classified as sarcopenic obese and 45 (80.36%) were not. Thirteen volunteers (23.21%) were classified as sarcopenic while 43 (76.78%) were not. Although there were no statistically significant differences between the studied parameters and quality of life among those with sarcopenia or sarcopenic obesity, the values were lower in affected individuals. Interestingly, handgrip strength correlated positively and significantly with all of the SF-36 dimensions except VIT (p=0.08) and SM (p=0.25). Conclusions: Seeing that handgrip strength is a determining factor in quality of life aspects in this population, the screening and identification of small functional changes using simple clinical measures may facilitate early intervention and help prevent disability. In contrast, neither sarcopenia nor sarcopenic obesity were found to be associated with quality of life. / Objetivo: Verificar a associação entre sarcopenia, obesidade sarcopênica e força muscular com variáveis relacionadas à qualidade de vida em idosas. Método: A amostra foi composta por 56 voluntárias do sexo feminino que se submeteram à análise de composição corporal (IMC e absortometria de raios-x de dupla energia DXA). A força de preensão palmar (FPP) foi mensurada pelo dinamômetro Jamar. Para análise de qualidade de vida, usou-se o questionário SF-36; para análise estatística, os dados foram apresentados por meio da estatística descritiva e Coeficiente de Correlação de Pearson. O software SPSS, versão 15,0, foi utilizado para realização de todas as análises. Resultados: As idosas apresentaram média de idade de 64,92±5,74anos. Das 56 voluntárias avaliadas, 19,64% (n=11) foram classificadas com obesidade sarcopênica. Treze voluntárias (23,21%) foram classificadas como sarcopênicas. Os principais achados do presente estudo demonstraram que, embora não fosse encontrada significância estatística entre os parâmetros estudados em idosas classificadas com sarcopenia e obesidade sarcopênica e as dimensões de qualidade de vida, os valores médios foram inferiores nas acometidas. De forma interessante, a variável FPP correlacionou-se positiva e significativamente com todos os domínios do SF-36, com exceção de VIT (p=0,08) e SM (p=0,25). Conclusões: A FPP é um fator determinante nos aspectos relacionados à qualidade de vida na população estudada. O rastreamento e a identificação de pequenas alterações funcionais por meio de medidas clínicas simples, como a FPP, podem favorecer a intervenção precoce e prevenir incapacidades. Em contraste, sarcopenia e obesidade sarcopênica não foram associadas à qualidade de vida.

Background: The relationship between interpersonal trauma (IPT) and substance misuse is complex and multi-factorial, but has not been examined fully in the existing few studies involving pregnant women who misuse substances. UK based midwifery education and practice is unique, but there is limited evidence regarding midwives experiences and perceptions of supporting this client group. Aims: The aim of this study was to chronologically map out pregnant women's past experiences of abuse and substance use, explore their experiences and perceptions of their journey to motherhood and explore midwives' experiences and perceptions of supporting this client group. Methods: A qualitative study was conducted. Five eligible pregnant women supported by specialist midwifery services in Central Scotland were recruited. Data were collected using a life history calendar (LHC), followed by an in-depth, semi-structured interview. Six eligible midwives were recruited from one NHS board in Central Scotland. In depth, semi-structured interviews were carried out. Findings: Individual LHCs were converted into chronological timelines. Transcribed interviews were analysed using Interpretative Phenomenological Analysis. The life history calendars revealed the pregnant participants' experiences of IPT and substance misuse as complex, interconnected and ongoing, including during pregnancy and motherhood. Three major overarching themes emerged from the pregnant participants' interview transcripts: “psychological trauma”, “dabbling to addiction” and “addiction and the identity of pregnancy and motherhood”. Three major overarching themes emerged from the midwifery participants' interview transcripts: “psychological trauma”, “stigma” and “managing unmanageable situations”. Conclusions: This study sheds new light on the lived experiences and perceptions of a previously under-researched and largely misunderstood group of vulnerable women. It highlights some of the challenges faced by midwives in clinical practice. Important areas for future research are highlighted, along with implications for multi-disciplinary education, policy and practice.

Very severe maternal obesity (BMI > 40kg/m2) increases significantly the risks of poor pregnancy outcomes for both mothers and babies. In light of the limited success of behavioural interventions to date in improving outcomes in very severely obese women, this study sought to gain an understanding of women's beliefs and experiences regarding weight, health and pregnancy, within the context of their everyday lives. Qualitative serial interviews were conducted with eleven very severely obese women during pregnancy and the postnatal period. Seven partners of the women took part in one semi-structured interview during the woman's pregnancy. Analysis took place in several stages using a thematic approach. Themes were identified within and between individual women's accounts, as well as within and between the accounts of members of couples. Participants' narratives demonstrated the ways in which they navigated the experience of high-risk pregnancy, and stigma emerged as a key theme. This research contributes new knowledge about the complex ways in which women experience ‘very severe obese' pregnant embodiment, relating to both formal and informal discourses around weight and health in pregnancy. Most undertook ‘moral accounting' in response to stigma, and several accounts resonated with Monaghan's (2006) categorisations of excuses, justifications, contrition and repudiation, in both accounting for their weight and in demonstrating their ‘fitness' for pregnancy and motherhood. Following birth, high levels of motivation to enact behaviour change were expressed, in some cases alongside repudiatory accounting regarding the associated risks and the medicalisation of very severe obesity. Participants experienced a lack of formal healthcare support in the postnatal period. Future approaches to policy and practice should consider ways in which to engage women and partners during pregnancy, exploring ways which in which stigma can be acknowledged and neutralised, in order to provide support and advice during and after pregnancy and birth, and into parenthood.

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Background: Fall risk increases with age and visual impairment, yet the oldest-old adults (>85 years) are rarely studied. Partnered dance improves mobility, balance, and quality of life in older individuals with movement impairment. Objective: The aim of the study was to determine the feasibility and participant satisfaction of an adapted tango program amongst these oldest-old adults with visual impairment. Exploratory analyses were conducted to determine efficacy of the program in improving balance and gait. Methods: In a repeated-measures, one-group experimental design, 13 older adults (7 women; age: M = 86.9 years, SD = 5.9 years, range = 77–95 years) with visual impairment (best eye acuity: M = 0.63, SD = 0.6 logMAR) participated in an adapted tango program of twenty 1.5-hour lessons, within 11 weeks. Feasibility included evaluation of facility access, safety, volunteer assistant retention, and participant retention and satisfaction. Participants were evaluated for balance, lower body strength, and quality of life in two baseline observations, immediately after the program and 1 month later. Results: Twelve participants completed the program. The facility was adequate, no injuries were sustained, and participants and volunteers were retained throughout. Participants reported enjoyment and improvements in physical well-being. Exploratory measures of dynamic postural control (p < .001), lower body strength (p = .056), and general vision-related quality of life (p = .032) scores showed improvements following training. Discussion: These older individuals with visual impairment benefitted from 30 hours of tango instruction adapted for their capabilities.

Evidence-based recommendations for interventions to reduce fall risk in older adults with visual impairment are lacking. Adapted tango dance (Tango) and a balance and mobility program (FallProof) have improved mobility, balance, and quality of life (QOL) in individuals with movement impairment. This study compared the efficacy of Tango and FallProof for 32 individuals with visual impairment (age: M = 79.3, SD =11 [51–95 years]). Participants were assigned to Tango or FallProof to complete twenty, 90-min lessons within 12 weeks. Participants underwent assessment of balance, dual-tasking, endurance, gait, and vision-related QOL. The balance reactions of participants in both groups improved (p < .001). Endurance, cognitive dual-tasking, and vision-related QOL may have improved more for Tango than FallProof. Group differences and gains were maintained across time. Both programs could be effective options for motor rehabilitation for older adults with visual impairment because they may improve mobility and QOL while reducing fall risk.

Book Summary: Recognized as two of the world's leading authorities on the subject, Susan Herdman and Richard Clendaniel, joined by a team of expert contributors, deliver the 4th Edition of the field's definitive text on the management of vestibular diseases and disorders. From assessment through therapy, they present the scientific and clinical knowledge you need to distinguish between vestibular and non-vestibular dizziness and to plan and implement the appropriate treatments.

The use of low-cost interactive game technology for balance rehabilitation has become more popular recently, with generally good outcomes. Very little research has been undertaken to determine whether this technology is appropriate for balance assessment. The Wii balance board has good reliability and is comparable to a research-grade force plate; however, recent studies examining the relationship between Wii Fit games and measures of balance and mobility demonstrate conflicting findings. This study found that the Wii Fit was feasible for community-dwelling older women to safely use the balance board and quickly learn the Wii Fit games. The Ski Slalom game scores were strongly correlated with several balance and mobility measures, whereas Table Tilt game scores were not. Based on these findings, the Ski Slalom game may have utility in the evaluation of balance problems in community-dwelling older adults.

Book Summary: Balance Function Assessment and Management, now in its second edition, continues to comprehensively address the assessment and treatment of balance system impairments through contributions from top experts in the areas of dizziness and vertigo. Designed for use in graduate audiology programs and by practicing audiologists, this is also a valuable text for those in the fields of physical therapy, otolaryngology, and neurology. Assessment chapters focus on ocular motility testing, positional/positioning testing, caloric testing, rotational testing, computerized dynamic posturography, and vestibular evoked potentials. Treatment chapters examine nonmedical, medical, and surgical treatments of dizziness and vertigo, vestibular rehabilitation, and assessment of and intervention for risk of falls. Additionally, this text provides background information on the vestibular and ocular motor systems with corresponding sample cases. New topics addressed in this edition include: Development of the vestibular system Central compensation following peripheral vestibular system impairment Video head impulse test (vHIT) Biomechanics and physiology of balance Electrocochleography (ECochG) Pediatric vestibular system and balance assessment Effects of age on the vestibular and balance systems An added bonus to the second edition is the companion website that offers additional reference materials, such as video clips, associated with the text.

Book Summary: In two freestanding but linked volumes, Textbook of Neural Repair and Rehabilitation provides comprehensive coverage of the science and practice of neurological rehabilitation. This volume, Medical Neurorehabilitation, can stand alone as a clinical handbook for neurorehabilitation. It covers the practical applications of the basic science principles presented in volume 1, provides authoritative guidelines on the management of disabling symptoms, and describes comprehensive rehabilitation approaches for the major categories of disabling neurological disorders. Emphasizing the integration of basic and clinical knowledge, this book and its companion are edited and written by leading international authorities. Together they are an essential resource for neuroscientists and provide a foundation for the work of clinical neurorehabilitation professionals.