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Previous issue date: 2018-01-24 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Performance of oldest-old fallers and do non fallers in the evaluation of Timed Up and Go (TUG) using a smartphone application
The falling is a serious event in the elderly population. Oldest-old (80 years or more) are more susceptible to their occurrence. Mobile technologies are shown as a facilitative and preventive alternative in actions in the field of public health. It is a cross-sectional observational and analytical study, with the objective to observe the performance of oldest-old fallers and non-fallers during the Timed Up and Go (TUG) test using a smartphone application. Participants were oldest-old (?90 years old), from Porto Alegre (RS), accompanied by the Care for the Oldest-Old Multiprofessional Project. We included in the study oldest-old that walked independently (without caregiver, family member or health professional) and safely, with or without the aid of gait devices (walking stick, crutch and walker) were included in the study; as well as those who understood verbal commands. Oldest-old patients who reported significant lower limb or spine pain on the day of the test were excluded from the study. In the analysis we use the sociodemographic variables (sex, age, schooling and monthly income), clinical variables (Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), presence of multimorbities( ) and polypharmacy 5? medications) and variables related to falls (history of falling in the last six months and fear of falling). As well as, parameters tracked by the application, which are temporal (Total TUG Duration, Transition Length from Seating to Standing (s) and Duration of Transition from Standing to Seating) and Angular (Maximum Trunk Angle Variation (g) and Maximum angular velocity during the forward lean phase (g / s) of the application). Significance levels of less than 5% were considered to be statistically significant and those between 5 and 10% were indicative of significance. The data were analyzed in the Epi InfoTM 7.2 program. From the 98 volunteers that participated at the study, 26.5% reported fall in the last six months. Women (25.76%) reported more frequent falls than men (p=0.492). Oldest-old fallers had mean age (92?3.14 years) higher than non-fallers (p=0.636), as well as more depressive symptoms (p<0.001). In the complete TUG, 97% of the non-fallers presented a medium or high risk of falling, compared to 92% of the fallers, showing an inadequacy of this classification for oldest-old. Fallers presented worse performance in each of the phases of the TUG, demonstrating to be more able to find differences between the groups than the complete test. Cut-off points for risk of falls were >1.68 seconds, in the sitting to standing phase, <1.91 seconds, in the standing to sitting phase, >42.2 degrees in the angle variation, and >84 degrees/second at the speed angle. The UAH Mobility Suite? smartphone application was able to evaluate the performance of oldest-old fallers and do non fallers through TUG time and its parameters, although any parameters were significant when compared to groups. Depression proved to be the only statistically significant variable, indicating that oldest-old depressive symptoms are more likely to fall. This was the first report of the use of UAHMobilitySuite? in oldest-old ones. The application has proved to be useful for being used in the home environment, and can be used in future researches. / Desempenho de longevos caidores e n?o caidores na avalia??o do Timed Up and Go (TUG) utilizando um aplicativo de smartphone
A queda ? um evento grave na popula??o idosa. Longevos (80 anos ou mais) est?o mais suscept?veis ? sua ocorr?ncia. Tecnologias m?veis mostram-se como uma alternativa facilitadora e preventiva em a??es no ?mbito da sa?de p?blica. Este estudo consiste em uma investiga??o transversal observacional e anal?tica, tendo por objetivo observar o desempenho de longevos caidores e n?o caidores atrav?s do teste Timed Up and Go (TUG) utilizando um aplicativo de smartphone. Participaram longevos (?90 anos), de Porto Alegre (RS), acompanhados domiciliarmente pelo projeto de Aten??o Multiprofissional ao Longevo. Foram inclu?dos no estudo longevos que deambulavam de forma independente (sem aux?lio de cuidador, familiar ou profissional da sa?de) e segura, com ou sem o aux?lio de dispositivos de marcha (bengala, muleta e andador); assim como aqueles que compreendiam comandos verbais. Utilizou-se para an?lise as vari?veis sociodemogr?ficas (sexo, idade, escolaridade e renda mensal), vari?veis cl?nicas (Mini Exame do Estado Mental (MEEM), Escala de Depress?o Geri?trica (Geriatric Depression Scale - GDS), presen?a de multimorbidades (2? doen?as) e polifarm?cia 5? medicamentos) e vari?veis relacionadas as quedas (hist?rico de queda nos ?ltimos seis meses e medo de cair). Assim como, par?metros rastreados pelo aplicativo, sendo eles temporais (Dura??o total do TUG (s); Dura??o da transi??o de sentado para em p? (s) e Dura??o da transi??o de em p? para sentado) e angulares (Varia??o m?xima do ?ngulo do tronco na fase de inclina??o para frente (g) e Velocidade angular m?xima durante a fase de inclina??o para frente (g/s) do aplicativo). Os graus de signific?ncia menores que 5% foram considerados estatisticamente significativos e os entre 5 e 10% como indicativos de signific?ncia. Os dados foram analisados no programa Epi InfoTM 7.2. Dos 98 avaliados, 26,5% referiram quedas nos ?ltimos seis meses. As mulheres (25,76%) referiam quedas mais frequentemente que os homens (p=0,492). Longevos caidores apresentaram m?dia de idade (92?3,14 anos) superior aos n?o caidores (p=0,636), assim como mais sintomas depressivos (p<0,001). No TUG completo, 97% dos longevos n?o caidores apresentaram a classifica??o de risco m?dio ou alto de queda, contra 92% dos caidores, demonstrando a inadequa??o dessa classifica??o para longevos. Caidores apresentaram pior desempenho em cada uma das fases do TUG, atrav?s do aplicativo, demonstrando ser mais capaz de observar diferen?as entre os grupos do que o teste completo. Pontos de corte para o risco de queda foram >1,68 segundos, na fase de sentado para em p?, <1,91 segundos, na fase de p? para sentado, >42,2 graus na varia??o do ?ngulo e >84 graus?segundos na velocidade do ?ngulo. O aplicativo de smartphone UAH Mobility Suite? foi capaz de avaliar o desempenho de longevos caidores e n?o caidores atrav?s do tempo do TUG e seus par?metros, embora nenhum par?metro tenha sido significativo quando comparado os grupos. A depress?o mostrou-se a ?nica vari?vel estatisticamente significativa, indicando que, longevos com sintomas depressivos apresentam mais chances de cair. Este foi o primeiro relato da utiliza??o do UAHMobilitySuite? em longevos. O aplicativo mostrou-se ?til para utiliza??o no ambiente domiciliar, podendo ser utilizado em investiga??es futuras.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/8192 |
| Date | 24 January 2018 |
| Creators | Oliveira, Gabriela Guimar?es |
| Contributors | B?s, ?ngelo Jos? Gon?alves, Pinho, M?rcio Sarroglia |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, Brasil, Escola de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 500, 600, 500, 600, -224747486637135387, -969369452308786627, 2075167498588264571 |
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