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Previous issue date: 2016-12-15 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Artigo 1 - Analisar a descri??o epidemiol?gica de indiv?duos com doen?a de Parkinson (DP), de acordo com medidas agrupadas conforme a estrutura conceitual da Classifica??o Internacional de Funcionalidade, Incapacidade e Sa?de (CIF); Artigo 2 ? Avaliar a preval?ncia de quedas e os fatores associados em indiv?duos com DP caidores recorrentes e n?o caidores. M?todo: Estudo do tipo anal?tico e transversal com amostra de 78 indiv?duos com DP residentes em Natal, Rio Grande do Norte. Foram coletadas informa??es de natureza sociodemogr?ficas e relacionadas ao desempenho f?sico funcional, sa?de mental e qualidade de vida por meio de 14 instrumentos categorizados entre os dom?nios ?Estrutura e fun??o corporal?, ?Atividade? e ?Participa??o?. No dom?nio ?Estrutura e fun??o corporal? foram utilizados a Escala de Incapacidade de Hoehn & Yahr (HY), Montreal Cognitive Assessment (MoCA), Unified Parkinson Disease Rating Scale - UPDRS (dom?nio III, exame motor), For?a de preens?o manual, Geriatric Depression Scale (GDS - 15) e Falls Efficay Scale ? International (FES - I). No dom?nio ?Atividade?, Nine Hole Peg Test (9HPT), UPDRS (dom?nio II, atividades de vida di?ria), Freezing of Gait Questionnaire (FOGQ), MiniBESTest, Timed Up & Go (TUG), Perfil de Atividade Humana (PAH), Velocidade da marcha de 10 metros (10MWT) e Five Times Sit to Stand (STDP - 5X). E no dom?nio ?Participa??o?, o Parkinson Disease Quality of Life Questionnaire (PDQ ? 39). Todos os participantes foram avaliados no tempo ON da medica??o antiparkinsoniana. A an?lise estat?stica foi realizada no programa Statistical Package for Social Sciences (SPSS Inc., Chicago, USA), vers?o 21.0. A normalidade dos dados foi verificada pelo teste Shapiro Wilks, tendo sido adotado p < 0.05. Artigo 1 ? Testes T de Student para amostras independentes e U de Mann-Whitney foram utilizados para a compara??o das vari?veis relacionadas ao desempenho f?sico funcional, sa?de mental e qualidade de vida, entre os sexos. Artigo 2 ? Regress?o log?stica bin?ria foi utilizada para determinar os preditores de quedas, onde as vari?veis com p < 0.10 foram inclu?das no modelo final multivari?vel. Resultados: Artigo 1 - Mais da metade da amostra (64.1%) foi composta por homens, com maior preval?ncia na faixa et?ria entre 70 e 79 anos (35.9%). Quanto ao n?mero de comorbidades, 52 (66.7%) afirmaram possuir ? 4 e dentre estas a mais citada foi disfun??o visual (87.2%). Diferen?as significativas entre homens e mulheres foram observadas para: preens?o manual (p= 0.001), MiniBESTest (p=0.034), FES ? I (p=0.004) e PDQ ? 39 (p=0.006), onde as mulheres apresentaram pior desempenho. Quadro de dem?ncia estava presente em 64.1% da amostra total. Artigo 2 ? Quanto ao hist?rico de quedas, 47 (60.3%) da amostra foi classificada como ?n?o caidor? e 31 (39.7%) como ?caidor recorrente?. Os fatores de risco associados ?s quedas recorrentes foram: tempo longo de dura??o da DP [OR=1.24, (95% IC=1.05?1.47), p=0.010], presen?a de hipertens?o arterial sist?mica [OR=5.81, (95% IC=1.46?23.09), p=0.012), dificuldade de evacua??o [OR=3.71, (95% IC=1.01?13.66), p=0.048] e presen?a de freezing [OR=3.78, (95% IC=1.02?13.97), p=0.046]. Conclus?o: A amostra revelou-se, predominantemente, masculina, muito idosa, fisicamente debilitada ou inativa, com quadro de dem?ncia e classificada, em sua maioria, como ?n?o caidor?. Tempo de dura??o da DP, presen?a de hipertens?o arterial sist?mica, dificuldade de evacua??o e freezing s?o fatores de risco para quedas recorrentes na amostra estudada. O conhecimento acerca das caracter?sticas sociodemogr?ficas e cl?nicas da popula??o com DP pode permitir ao fisioterapeuta e a equipe de sa?de uma melhor compreens?o do progn?stico da doen?a e partir disso, planejar condutas terap?uticas mais adequadas as reais demandas apresentadas por essa popula??o. / Article 1 ? Analyze the epidemiological description of individuals with Parkinson?s disease (PD), according to clustered measures, in line with the conceptual structure of the International Classification of Functionality, Disability and Health (ICF); Article 2 ? Assess the prevalence of falls and associated factors in recurrent fallers and non-fallers with PD. Method: Analytical cross-sectional study with a sample of 78 individuals with PD, residing in Natal, Rio Grande do Norte state, Brazil. Sociodemographic information and that related to physical functioning, mental health and quality of life was collected using 14 instruments categorized in the domains ?Structure and Body function?, ?Activity? and ?Participation?. For the ?Structure and Body function? domain the following instruments were used: Hoehn & Yahr (HY) Disability Scale, Montreal Cognitive Assessment (MoCA), Unified Parkinson Disease Rating Scale - UPDRS (part III, motor subscale), Grip strength, Geriatric Depression Scale (GDS - 15) and Falls Efficacy Scale ? International (FES - I). The following were applied for the ?Activity? domain: Nine Hole Peg Test (9HPT), UPDRS (part II, activities of daily life), Freezing of Gait Questionnaire (FOGQ), MiniBESTest, Timed Up & Go (TUG), Human Activity Profile (HAP), 10 Meter Walking Test (10MWT) and Five Times Sit to Stand (STDP - 5X). In the ?Participation? domain, the Parkinson Disease Quality of Life Questionnaire (PDQ ? 39) test was used. All participants were assessed during the ?ON? time of antiparkinsonian medication. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS Inc., Chicago, USA) 21.0 software. Data normality was verified by the Shapiro-Wilks test, adopting p < 0.05. Article 1 ? The variables related to physical functioning, mental health and quality of life were compared between sexes using the Student?s t-test for independent samples and the Mann-Whitney U test. Article 2 ? Binary logistic regression was applied to determine the predictors of falls, where variables with p < 0.10 were included in the final multivariate model. Results: Article 1 ? More than half the sample (64.1%) was composed of men, with higher prevalence in the 70-79 year age group (35.9%). With respect to the number of comorbidities, 52 (66.7%) had 4 or more and the most reported were visual dysfunction (87.2%). Significant differences were observed between men and women for grip strength (p= 0.001), MiniBESTest (p=0.034), FES ? I (p=0.004) and PDQ ? 39 (p=0.006), where women exhibited worse performance. Dementia (64.1%) was present in the entire sample. Article 2 ? In regard to history of falls, 47 (60.3%) individuals in the sample were classified as ?non-fallers? and 31 (39.7%) as ?recurring fallers?. The following risk factors were associated with recurring falls: prolonged PD [OR=1.24, (95% CI=1.05?1.47), p=0.010], presence of systemic hypertension [OR=5.81, (95% CI=1.46?23.09), p=0.012), evacuation difficulties [OR=3.71, (95% CI=1.01?13.66), p=0.048] and presence of freezing [OR=3.78, (95% CI=1.02?13.97), p=0.046]. Conclusion: The sample was predominantly male, elderly, physically disabled or inactive, with the presence of dementia, depressive symptoms and a majority classified as ?non-fallers?. PD duration, systemic hypertension, evacuation difficulties, and freezing are risk factors for recurring falls in the study sample. Knowledge of the sociodemographic and clinical characteristics in the population with PD would provide physiotherapists and the health team with better understanding of its prognosis, thereby contributing to planning therapies that meet the real demands of this population.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/23661 |
| Date | 15 December 2016 |
| Creators | Trigueiro, Larissa Coutinho de Lucena |
| Contributors | 84091193404, http://lattes.cnpq.br/6535678775361874, Paula, F?tima Val?ria Rodrigues de, 45637121672, http://lattes.cnpq.br/3172824242930935, Lima, Lidiane Andrea Oliveira, 02530883645, http://lattes.cnpq.br/4317936872165101, Lima, N?bia Maria Freire Vieira, 80418597553, http://lattes.cnpq.br/6229072599237735, Guerra, Ricardo Oliveira, 39643069400, http://lattes.cnpq.br/4265185619165890, Lindquist, Ana Raquel Rodrigues |
| Publisher | PROGRAMA DE P?S-GRADUA??O EM FISIOTERAPIA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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