Introduction: Respiratory function changes in patients with Parkinson’s disease (PD) contribute to aspiration pneumonia, the main cause of mortality in PD population. Objective: To compare the effects of functional training and cycle exercise in respiratory function of elderly with PD. Methods: Twenty participants were randomised into two groups. Experimental group (EG) (n = 10) performed cycle exercise and control group (CG) (n = 10) was trained with functional training. A blinded researcher evaluated maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), thoracoabdominal amplitude, forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) before and after interventions. Results: Both groups did not improve significantly respiratory function. Only CG improved significantly FVC (p = 0.01). No differences were found between groups. Conclusion: 8-week exercise programs are not able to improve the respiratory function of elderly in 2 to 3 PD Hoehn & Yahr stage. Both functional training and cycle exercise do not to improve respiratory function in elderly with PD.
Introduction: Postural instability affects balance control in Parkinson disease (PD) patients and increases the particular risk of falling compared with healthy older adults. Video games with not immersive virtual reality have been used in neurological disorders rehabilitation process. Objective: To evaluate the effectiveness of the video game console Nintendo Wii (NW) on postural balance and mobility treatment of adults with PD in Hoehn and Yahr stages I to III. Methods: The following databases were searched electronically on MEDLINE, Cochrane Library, PEDro, CAPES Periodic, BIREME, and LILACS databases. The search period for this review was January 2010 to June 2016. The assessment of methodological quality was performed using the PEDro Scale as reference. Results: 12 original studies were selected, but only 3 were randomized controlled trials (RCTs). Conclusion: Some of the studies analysed suggest that NW can provide improvement in balance and mobility of adults with PD. These benefits should be interpreted with caution because of the low methodological quality of the included trials, and the lack of common assessment of treatment effects. There is little evidence to ensure the effectiveness and support the inclusion of the treatment with NW of patients with PD.
Introduction: Respiratory dysfunction is the main cause of death in Parkinson's disease (PD) patients and bronchoaspiration pneumonia is the most common clinical respiratory complication. Objective: To assess respiratory function of elderly with PD in mild to moderate phase of the disease. Methods: A cross-sectional study was carried. Elderly in 2 to 3 PD Hoehn & Yahr stage have participated. A single researcher has evaluated maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), thoracoabdominal amplitude, forced vital capacity (FVC) and expiratory volume in the first second (FEV1). Results: Sixty elderly have participated and their all spirometry and manovacuometry parameters presented significant differences (p < 0.05) comparing with predicted values, except for FVC (p = 0.25). Only umbilical level did not reach normal values on cirtometry parameters. Patients classified as a restrictive disorder presented significant decrease in thoracic expandability. However the participants classified as an obstructive disorder showed significant decrease in expiratory muscle strength and peak expiratory flows. Conclusion: Elderly in mild or moderate phase of PD presented reduction in respiratory parameters. Spirometry showed to be an important tool to evaluate respiratory function and to indicate the modality of respiratory exercise. Our results suggest the indication of thoracic flexibility exercises for patient with PD classified as restrictive disorder and strength exercise of respiratory muscles for those classified as obstructive disorder.
Introdução: A Política Nacional de Práticas Integrativas e Complementares (PNPIC) objetiva garantir a integralidade à saúde através de práticas com abordagem holística. Objetivo: Avaliar a concepção e o conhecimento dos acadêmicos de saúde acerca da Política Nacional de Práticas Integrativas e Complementares (PIC) e sua aplicabilidade no Sistema Único de Saúde (SUS). Material e Métodos: Estudo transversal, descritivo, realizado com 56 acadêmicos de saúde, participantes de uma palestra aberta intitulada “POLÍTICA NACIONAL DE PRÁTICAS INTEGRATIVAS E COMPLEMENTARES NO SUS: Você Conhece?”. Foi aplicado um questionário semiestruturado, auto administrado, antes e imediatamente após a palestra. Os dados foram descritos por valores absolutos e frequência relativa. Para comparar as frequências oriundas das amostras pareadas foi utilizado o teste de McNemar (p<0,05). Resultados: Antes da palestra, 67,9% desconheciam a PNPIC e quais eram as PIC e 66,1% nunca foram esclarecidos sobre a existência e aplicabilidade destas práticas por profissionais de saúde e em sua formação acadêmica, bem como 69,6% não sabiam dizer se poderiam ser oferecidas no SUS. Após a palestra houve mudanças positivas nesse perfil: 91,1% (p<0,001) declararam conhecer a PNPIC, 73,2% (p<0,001) responderam que receberam esclarecimentos sobre a existência e aplicabilidade da PNPIC e 89,3% (p<0,001) afirmaram que as PIC poderiam ser oferecidas pelo SUS. Conclusão: Os resultados sugerem que os participantes, após a palestra, ampliaram seus conhecimentos relacionados à PNPIC. Estudos de seguimento são recomendados, bem como estender a pesquisa para profissionais da área de saúde, a título de comparação.
It is recommended that patients with Parkinsons disease (PD) perform physical exercise throughout their lives. Exercise should slow disease progression and motivate the patient. Objective: Verify and compare the motivation of elderly with PD submitted to functional training, stationary bicycle exercise and exergame. Method: A randomized clinical trial was developed at a referral center. Group 1 (G1) performed functional training, group 2 (G2) trained with stationary bicycle and group 3 (G3) played on Xbox 360 with Kinect sensor. At the end of training, an interview was conducted by a single non-blind investigator to evaluate patient motivation about therapeutic exercise programs they were submitted to. For each question there were four answers options: I was not motivated, I was not very motivated, I was motivated and I was very motivated. The variables were summarized in median and interquartile range and in absolute and relative frequencies. The Pearson Chi-square test was used for statistical inference. The level of significance was 5% (p <0.05). Fifty-three older people with PD have participated. Results: Many participants have reported that exercise (G1: 72%, G2: 53%, G3: 44%) and the physiotherapist (G1: 83%, G2: 76%, G3: 94%) were very motivating. Only two participants of G2 rated exercise as not very motivating. However, no significant difference was found between the three groups. Conclusion: Older individuals with PD considered functional training, bicycle exercise and exergame as motivating modalities of physical exercise.
A auditoria no Sistema Único de Saúde (SUS) surgiu com a proposta demonitorar e verificar o cumprimento dos princípios básicos do SUS. O objetivo deste estudo é compreender o funcionamento do processo de auditoria nos três níveis de gestão, além de entender o papel do enfermeiro auditor. Trata-se de uma revisão de literatura constituída por artigos científicos nacionais, relatórios, portarias, decretos e leis disponíveis em sites governamentais publicados a partir de 1993, ano de criação do Sistema Nacional de Auditoria (SNA). Conclui-se que, conhecidos os mecanismos de avaliação do Sistema, pode-sed trabalhar para aperfeiçoar o SUS e melhorar o atendimento aos usuários.
INTRODUÇÃO: A incontinência urinária (IU) é um dos mais constrangedores e estressantes sintomas urinários e a principal disfunção do assoalho pélvico. O tratamento através da realidade virtual tem o objetivo de aumentar a adesão das pacientes ao tratamento de forma lúdica e não invasiva, promovendo a capacidade de contração dos MAP durante as atividades físicas, com potenciais reflexos na melhora da incontinência. OBJETIVOS: Avaliar a função muscular do assoalho pélvico e perda de urina de mulheres incontinentes tratadas por meio de um protocolo específico de terapia por exposição à realidade virtual. MÉTODOS: Relato de casos, composto 02 casos de mulheres com diagnóstico médico de IU. Tratadas com realidade virtual através dos jogos do Nintendo Wii Fit PlusTM por 12 sessões de 50 minutos cada, três vezes por semana. Cada sessão compreendeu de 20 minutos de momento educativo, com orientações das ações durante os jogos e treinamento prévio para a contração dos músculos transverso do abdome e assoalho pélvico, seguido de 30 minutos de intervenção com o jogo. O protocolo foi dividido em duas fases de seis sessões cada de acordo com a dificuldade dos jogos, priorizando inicialmente aqueles que exploravam movimentos da pelve no plano frontal (Lotus FocusTM, Penguin SlideTM e Soccer HeadingTM) e, com a evolução, os que permitiam movimentos pélvicos mais globalizados (Penguin SlideTM, Table TiltTM e Balance BubbleTM). A função muscular do assoalho pélvico e a perda urinária foram avaliadas, respectivamente, através do Esquema PERFECT e do pad test de 1 hora, sendo os resultados sumarizados de forma descritiva em tabelas do Excel. RESULTADOS: Melhora da perda urinária através do pad test de 1 hora e da função muscular através da palpação digital associada ao Esquema PERFECT das participantes com incontinência urinária após intervenção. CONCLUSÃO: O tratamento dos MAP através da realidade virtual demonstrou-se efetivo na melhora da perda urinária e da função muscular do assoalho pélvico nas participantes deste estudo, porém fazem-se necessárias ensaios clínicos para comprovar sua eficácia.
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