Background: Elderly people with dementia may exhibit behavioral and psychological symptoms throughout the course of disease. Non-pharmacological therapies, such as regular physical activity, are considered strategies for managing these symptoms. Objective: The aim of this study was to investigate whether participation in physical exercise programs is effective in reducing behavioral and neuropsychiatric symptoms in elderly people with Mild Cognitive Impairment (MCI) and dementia. Methods: A literature review was carried out in MEDLINE (PubMed), SciELO, Web of Science, Scopus and SPORTDiscus databases from 2010 to 2020. The eligible studies were randomized clinical trials involving elderly people with mild cognitive impairment or dementia and assessing changes in neuropsychiatric and psychological symptoms as primary or secondary outcomes. The studies had a group with only physical exercise as an intervention compared to a control group. Results: Of 175 publications identified in the initial survey, only 7 studies met the eligibility criteria. Four out of 7 studies demonstrated positive effects in reducing behavioral symptoms, while the others did not report differences between gains according to the type of protocol. Conclusions: Moderate to intense aerobic and muscle strengthening exercises may have a potential benefit in the management of behavioral and psychological symptoms in dementia, but studies varied in their conclusions. This review indicates the need for further intervention studies to investigate, as a primary outcome, the absolute effect of physical exercise and its impact on behavioral and psychological symptoms in elderly people with MCI dementia, especially in the early stages of the disease.
Introdução: A escrita manual corresponde a uma forma de comunicação com o objetivo de reproduzir informações para outras pessoas. Quando bem adquirida, a escrita é considerada um ato automático em que a pessoa a executa sem que haja o planejamento dos movimentos necessários. Traumas, lesões e outras disfunções podem alterar o desempenho da escrita, como ocorre na Doença de Parkinson (DP). Objetivo: Diante disso, teve-se como objetivo estudar a escrita manual de pessoas com Doença de Parkinson antes e após o treino da escrita e de habilidades manuais. Métodos: Este trabalho corresponde à análise dos dados de um estudo piloto, no qual participaram cinco pessoas com DP, todos com o membro direito dominante para a escrita. Os participantes foram submetidos a cinco intervenções, incluindo a avaliação e reavaliação. Resultados/Discussão: Os resultados mostram que houve melhora na legibilidade da escrita e que os sintomas clínicos apresentados pelos pacientes interferem negativamente no desempenho da escrita manual. Indica-se que esta proposta de tratamento seja implementada num tempo maior e que sejam incorporadas outras medidas de resultado para aprimorar as análises. Conclusão: Foi possível perceber que houve melhora no uso das habilidades motoras finas necessárias para o desempenho da escrita dos participantes, como melhora na precisão dos traços e na coordenação motora fina. Em relação ao treino da escrita, o estudo aponta que a utilização de pistas visuais, como por exemplo, tracejados, favorece a escrita manual.AbstractIntroduction: Manual writing corresponds to a form of communication for the purpose of reproducing information for other people. When well-received, writing is considered an automatic act in which the person performs it without planning the necessary movements. Trauma, injury, and other dysfunctions can alter writing performance, as occurs in Parkinson's Disease (PD). Objective: This study aimed to study the handwriting of people with Parkinson's disease before and after writing and manual skills training. Methods: This work corresponds to the analysis of the data of a pilot study, in which five people with PD participated, all with the dominant right member for writing. Participants underwent five interventions, including assessment and reevaluation. Results/Discussion:The results show that there was an improvement in the legibility of writing and that the clinical symptoms presented by the patients interfered negatively in the performance of manual writing. It is suggested that this treatment proposal be implemented in a longer time and that other outcome measures be incorporated to improve the analyzes. Conclusion: It was possible to notice that there was an improvement in the use of the fine motor skills necessary for the writing performance of the participants, such as improvement in the precision of the traces and fine motor coordination. In relation to writing training, the study points out that the use of visual cues, such as dashes, favors manual writing.Keywords: Handwriting; Motor Skills; Occupational Therapy; Parkinson Disease ResumenIntroducción: La escritura manual corresponde a una forma de comunicación con el objetivo de reproducir información a otras personas. Cuando es bien adquirida, la escritura es considerada un acto automático en que la persona la ejecuta sin que haya la planificación de los movimientos necesarios. Traumas, lesiones y otras disfunciones pueden alterar el desempeño de la escritura, como ocurre en la enfermedad de Parkinson. Objetivo: Estudiar la escritura manual de personas con enfermedad de Parkinson antes y después del entrenamiento de la escritura y de habilidades manuales. Métodos: Este trabajo corresponde al análisis de los datos de un estudio piloto, en el que participaron cinco personas con Parkinson, todos con el miembro derecho dominante para la escritura. Los participantes se sometieron a cinco intervenciones, incluida la evaluación y la reevaluación. Resultados/Discusión: Los resultados muestran que hubo mejoría en la legibilidad de la escritura y que los síntomas clínicos presentados por los pacientes interfieren negativamente en el desempeño de la escritura manual. Se indica que esta propuesta de tratamiento se aplique en un tiempo mayor y que se incorporen otras medidas de resultado para mejorar los análisis. Conclusión: Fue posible percibir que hubo mejoría en el uso de las habilidades motoras finas necesarias para el desempeño de la escritura de los participantes, como mejora en la precisión de los trazos y en la coordinación motora fina. En cuanto al entrenamiento de la escritura, el estudio apunta que la utilización de pistas visuales, como por ejemplo, discontinuas, favorece la escritura manual.Palabrasclave: Destreza Motora; Escritura Manual; Enfermedad de Parkinson; Terapia ocupacional.
Objective: To analyze the influence of treatment with non-immersive virtual reality games (VR) on the quality of life (QOL) of people with Parkinson’s disease (PD). Methods: Uncontrolled clinical trial using 14 people with PD between stages I and IV of PD. Treatment with NIVR occurred for 6 months, 1 initial assessment and 2 quarterly re-evaluations. The instruments to measure the results were the Parkinson’s Disease Questionnaire (PDQ-39) and a Self-Perception of Performance Questionnaire. The treatment protocol used was Kinect® for Xbox 360, and the following games: Kinect Advenctures®, Your Shape: Fitness Evolved®, and Kinect Sports®. Statistical analysis of the PDQ-39 used the Wilcoxon test (p ≤ 0.05) while the Self-Perception of Performance Questionnaire was analyzed qualitatively for thematic content, identifying six categories. Results: There was a statistically significant difference after 3 months of treatment with the NIVR games in terms of mobility, emotional well-being, stigma, cognition, and total score of the PDQ-39. After 6 months of treatment the results were maintained, but no further gains. However, for a neurodegenerative disease this maintenance of gains is favorable for the functional prognosis of the patients. In the thematic categories, what stood out was an improvement of reports on mobility, activities of daily living, emotional well-being, stigma, and bodily discomfort. Conclusion: Treatment with NIVR benefits QOL of people with PD, especially including mobility, emotional well-being, stigma, and cognition
Contextualização: O estudo analisa as estratégias adotadas por terapeutas ocupacionais de um Centro Especializado em Reabilitação IV do Recife-PE, via teleconsulta e telemonitoramento, em meio à pandemia de COVID-19. Processo de intervenção: As ações aqui contempladas corroboram com evidências científicas relevantes para a prática profissional, ajustadas à modalidade remota de assistência. Análise crítica da prática: Reflete-se sobre o potencial da utilização da tecnologia a favor do acesso e continuidade à reabilitação, lançando mão desde o acolhimento ao paciente até o fornecimento de orientações adequadas quanto ao cuidado pessoal e familiar, educação em saúde, desenvolvimento de habilidades, estruturação da rotina, adaptações e treino de atividades significativas.Palavras-chave: Infecções por coronavírus. Pandemias. Terapia Ocupacional. Telemonitoramento. AbstractContextualization: The study analyzes the strategies adopted by occupational therapists at a Specialized Center for Rehabilitation IV in Recife-PE, via teleconsult and telemonitoring, amid the COVID-19 pandemic. Intervention process: The actions contemplated here go according to official health recommendations, as well as following scientific evidence relevant to professional practice. Practice analysis: It reflects on the potential of using technology in favor of access and continuity to rehabilitation, using everything from welcoming the patient to providing adequate guidance on personal and family care, health education, skills development, routine structuring, adaptations and training of significant activities.Keywords: Coronavirus Infections. Pandemics. Telemonitoring. Occupational Therapy. ResumenContextualización: El estudio analiza las estrategias adoptadas por los terapeutas ocupacionales en un Centro Especializado para la Rehabilitación IV en Recife-PE, a través de la teleconsulta y la telemonitorización, en medio de la pandemia COVID-19. Proceso de intervención: Las acciones contempladas aquí están de acuerdo con las recomendaciones oficiales de salud, así como siguiendo la evidencia científica relevante para la práctica profesional. Análisis crítico de la práctica: Reflexiona sobre el potencial del uso de la tecnología a favor del acceso y la continuidad de la rehabilitación, utilizando todo, desde dar la bienvenida al paciente hasta proporcionar una orientación adecuada sobre el cuidado personal y familiar, educación para la salud, desarrollo de habilidades, estructuración rutinaria, adaptaciones y entrenamiento de actividades significativas.Palabras clave: Infecciones por Coronavirus. Pandemias. Telemonitorización. Terapia Ocupacional.
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