OBJETIVOS: Investigar a funcionalidade de idosos cadastrados na Estratégia Saúde da Família ESF e classificar pelas categorias de Atividade e Participação da Classificação Internacional de Funcionalidade, Incapacidade e Saúde CIF. MÉTODO: Pesquisa transversal, descritiva, realizada em 124 idosos cadastrados na ESF Águas Lindas I, município de Ananindeua, Pará, Brasil. A coleta de dados ocorreu no ambiente domiciliar dos idosos. Investigaram-se as características sociodemográficas, a funcionalidade, pelo Índice de Katz e escala de Lawton, e o nível de Atividade e Participação, segundo a CIF. A análise estatística foi realizada no programa SPSS 18.0, utilizando a média, desvio-padrão e o teste Qui-quadrado de Pearson x2, com descrição da frequência relativa simples de cada domínio avaliado. RESULTADOS: 66,9 % dos idosos eram do sexo feminino, com média de idade 68,5 dp±8,19 anos, casados n=61 e recebiam aposentadoria n=69. Cerca de 65% dos idosos eram independentes para todas as atividades avaliadas pelo Índice de Katz e escala de Lawton. Quanto à classificação da funcionalidade pela CIF, a maioria foi classificada com códigos que indicam nenhuma dificuldade. CONCLUSÃO: A maior parcela dos idosos estudados apresenta-se ativa e participativa, ou seja, é capaz de desempenhar uma tarefa diária, o que talvez represente um envelhecimento com poucas perdas.

BackgroundLeprosy has a global presence; more than 180 thousand new cases were registered in 2013, 15% of which were found in the Americas. The elderly are a very susceptible demographic in terms of developing illnesses, mainly because of characteristics natural to the senescence of the human organism. This study’s goals were to analyze leprosy in an elderly population from a hyperendemic region of the Brazilian Amazon in a historical series from 2004 to 2013 and to determine the clinical and epidemiological profile of a series of leprosy cases of elderly people in the period spanning from 2009 to 2013.MethodsTo achieve these goals, an observational, longitudinal, retrospective and descriptive study was put together to analyze leprosy in elderly people from data acquired from the Notification Aggravations Information System. Furthermore, a profile of the disease from a retrospective cohort based on data collected from medical records was developed.ResultsThe number of new cases and the leprosy detection rate decreased across the observed period but remained stable among the elderly. The trend for the next ten years indicates decreases in the number of cases and in the detection rate in the general population and an increase in only the elderly. The overall profile was characterized by a predominance of males (64.32%), the multibacillary clinical form (87.57%), Type 1 reaction episodes (37.50%) and some physical incapacity at diagnosis (49.19%). The risk of reaction was greater in the first six months of multidrug therapy, and the positive result from the skin smear was associated with the greater chance of reactional condition development.ConclusionsThe resulting data demonstrate that leprosy amongst the elderly deserves attention because of the increased susceptibility to disability in this age group, with their higher risk of reaction and their greater level of co-morbidity.

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Introduction: Neuropathic pain is a common and disabling late complication of leprosy. We investigated the clinical and electrophysiological characteristics of neuropathic pain in leprosy patients by evaluating nerve conduction, sympathetic skin response (SSR) and A-waves. Methods: Twenty one leprosy patients with neuropathic pain validated by the Douleur Neuropathique en 4 (DN4)Questionnaire were selected for study. Pain intensity was measured by the visual analog scale. Demographic and clinical data were collected for all patients. Clinical data included appraisal of the median, ulnar, radial, tibial and common peroneal nerves, assessment of the sympathetic skin response and conventional electrophysiological recordings. Results: Among all electroneuromyographic presentations, multifocal mononeuropathy was still the most prevalent. Sensory loss was observed more frequently than motor deficits. As most patients presented advanced clinical forms of leprosy and were under treatment, this high mean was found and the ulnar nerve was most frequently affected. The sympathetic skin response was absent in 16 patients. Higher DN4 Questionnaire scores were observed in women and in those receiving corticosteroid therapy. These inferences are possible to be made, but our study's limitations don't allow us to be certain about it. The statistical significance found only permits us to evidence what we related on the textual part of the study. Limitations: The small number of patients studied, the lack of sophisticated diagnostic methods for leprosy, as well as the difficulties in assessing nerve conduction were the main limitations of this study. Conclusion: The neurophysiological and clinical findings in leprous neuropathy were modest despite the conspicuous neuropathic pain. Although electrophysiological studies are a vital tool to verify nerve damage, variations in the clinical presentation of leprosy neuropathic pain render the diagnosis challenging. Further studies are needed to describe the neurophysiological evolution of this disease.

Stroke is the leading cause of neurological disability and hemiparesis is its most common sequelae. The physical and functional limitations combined with the influence of environmental factors directly affect an individual's functionally. For an effective neurological rehabilitation, it is essential that physiotherapists know the patient's functional profile in order to plan the treatment to meet his/her real needs. Objective: To analyze the functional activities and influence of environmental factors in poststroke hemiparetic patients before and after physical therapy. Method: Twelve post-stroke hemiparetic patients were evaluated before and after 20 physical therapy sessions with the Barthel Index (BI) and an evaluation model based on an abbreviated core set of the International Classification of Functioning, Disability and Health (ICF) for stroke, based in the generic qualifiers system of the ICF. Results: There was significant improvement for the activities walk (d450) (p = 0.0033), dress (d540) (p = 0.018) and eat (d550) (p = 0.018) for the evaluation model based on the ICF. According to the BI, significant improvement was detected for the activities of feed (p = 0.0341), dress (p = 0.0277), toilet (p = 0.0117), and up/ down stairs (p = 0.0077). The environment factors immediate family and health professionals were the most positive influence on the health status of patients. Conclusion: Physical therapy was effective for improving the condition of patients since, according to the patients, some daily activities can be performed with more ease at the end of the physical therapy treatment. To meet their needs, it is important to develop an individual treatment plan, emphasizing the context in which he/she is inserted, in order to address the real limitations on activities and restrictions to participation.