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.
Introduction: Children with neuromotor changes are challenged daily, and such challenges may be faced with the help of a caregiver. Thus, the functional dependence of these children lead to the daily demands, causing physical and emotional distress, which affect the quality of life of their caregiver. Objective: Analyze the sociodemographic indicators that interfere with the level of life quality of the caregivers of children with neuromotor changes. Method: 50 caregivers of children with neuromotor changes were interviewed at the Association of Parents and Friends of the Exceptional (APAE) of Paraiba, on the city of João Pessoa. To evaluate the quality of life, the questionnaire SF-36 was used, in addition to collecting demographic data (sex, age, degree of kinship, marital status, number of children, school level and religion). For the data analysis, a descriptive study was developed, the normality test of Shapiro-Wilk was realized, followed by the inferential analysis with non-parametric correlation of Spearman, considering the significant value α = 0,05. Results: There was a predominance of the female sex (96%) with medium age of ≥ 39 years old. Correlating the sociodemographic indicators with the level of life quality of the SF-36 of the caregivers, only the vitality domain presented significance with the variables: number of children (p=0,012), benefits (p=0,044), and how the transfer of the child is done (p=0,044). There was no significant difference relating the sociodemographic indicators on the other domains. Conclusion: The knowledge of sociodemographic indicators that interfere with the quality of life shows the importance of preventive measures, such as guidance and, if needed, treatment for improvement of possible grievances.
RESUMO A mobilização precoce vem se destacando na última década por ser uma estratégia alternativa para minimizar os efeitos deletérios do imobilismo no leito no paciente crítico. Consiste de atividades terapêuticas progressivas que se iniciam logo após a estabilização das alterações fisiológicas do paciente e oferece benefícios a curto, médio e longo prazo. Vários trabalhos evidenciam seus efeitos na população adulta, entretanto, pesquisas feitas com crianças são escassas. Objetivo: Verificar e reunir as evidências científicas disponíveis na literatura sobre mobilização precoce em crianças criticamente doentes. Metodologia: Trata-se de uma revisão sistemática de literatura do tipo integrativa, por meio da busca de artigos científicos nas bases de dados SciELO, BVS e PubMed, utilizando os descritores “children”, “critical ill”, “early mobilization”, “pediatrics” e “rehabilitation”, nos idiomas português e inglês, com textos completos publicados entre os anos de 2013 e 2018. Resultados: Foram encontrados 183 artigos elegíveis, dos quais 9 foram selecionados para serem revisados. Os trabalhos abordaram, principalmente, as barreiras, os benefícios, a segurança e a viabilidade da mobilização precoce nas Unidades de Terapia Intensiva Pediátricas (UTIPs), bem como o envolvimento do fisioterapeuta na reabilitação precoce da criança criticamente doente. Conclusões: A mobilização precoce é segura, viável, oferece poucos riscos ao paciente, favorece o aumento da mobilidade das crianças e pressupõe um menor tempo de internação. O fortalecimento da equipe multidisciplinar pode contribuir para a implementação da mobilização precoce em UTIPs. PALAVRAS-CHAVE: Criança; Doença Crítica; Mobilização Precoce; Reabilitação.EARLY MOBILIZATION IN CRITICALLY ILL CHILDREN: A INTEGRATIVE REVIEWABSTRACTEarly mobilization has been highlighted in the last decade as an alternative strategy to minimize the deleterious effects of bed rest in critical patients. It consists of progressive therapeutic activities that begin soon after stabilizing the physiological changes of the patient and offers benefits in the short, medium and long term. Several studies show its effects on the adult population, however, research on children is scarce. Objective: To verify and gather the scientific evidence available in the literature on early mobilization in critically ill children. Methodology: This is a systematic review of literature of the integrative type, through the search of scientific articles in the SciELO, BVS and PubMed, using the descriptors "children", "critical ill", "early mobilization", "pediatrics" and "rehabilitation", in Portuguese and English, with full texts published between 2013 and 2018. Results: 183 eligible articles, of which 9 were selected for review. The work focused on the barriers, benefits, safety and feasibility of early mobilization in Pediatric Intensive Care Units (PICUs), as well as the involvement of the physiotherapist in the early rehabilitation of critically ill children. Conclusions: Early mobilization is safe, viable, offers few risks to the patient, favors the increase of children’s mobility and presupposes a shorter hospitalization time. The strengthening of the multidisciplinary team can contribute to the implementation of early mobilization in PICUs.KEYWORDS: Child; Critical Illness; Early Mobilization; Rehabilitation.
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