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Alencar MA, Soares BL, Rangel MFDA, Abdo JS, Almeida RAPD, Araújo CMD, Souza LCD, Gomes GDC. Fatigue in amyotrophic lateral sclerosis and correlated factors. Arq Neuropsiquiatr 2022; 80:1045-1051. [PMID: 36535289 PMCID: PMC9770075 DOI: 10.1055/s-0042-1758563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that leads to muscle weakness and paralysis. Fatigue is a disabling symptom, frequently reported in ALS, but remains under-investigated in this population. Thus, an accurate investigation of this symptom and possible associated factors in this clinical condition is needed to assist in the establishment of an adequate treatment approach. OBJECTIVE To investigate the presence of fatigue in individuals with ALS and possible factors correlated with this symptom. METHODS Sixty-five individuals with sporadic ALS participated in the present study. Demographic, clinical, and functional aspects were investigated. Evaluations involved the Fatigue Severity Scale (FSS), ALS Functional Scale (ALSRFS-R), and Quality of Life (QoL) questionnaire (ALSAQ-40). Descriptive and correlation analyses were performed with SPSS statistical program for Windows version 19.0 (IBM Corp., Armonk, NY, USA). RESULTS Among the 65 individuals evaluated, 44.6% (n = 29) presented fatigue based on the FSS. The mean fatigue intensity was 5.4 ± 1.2 and only 10.4% used a specific medication for fatigue. Differences between the groups with and without fatigue were found regarding sex (p = 0.049), pain intensity (p = 0.026), functioning (p = 0.004), disease severity (p = 0.029), and QoL (p = 0.000). Fatigue was correlated with pain intensity (r = 0.425; p = 0.001), muscle strength (r = - 0.356; p = 0.004), functioning (r = - 0.363; p = 0.003), and QoL (r = 0.481; p = 0.000). No correlations were found with age, time since diagnosis, cramps, or other mobility parameters. CONCLUSIONS Fatigue is a common symptom among individuals with ALS and may be present in all stages of the disease. This symptom was correlated with worse functioning, poorer QoL, greater pain intensity, disease severity, muscle weakness, and the female sex in individuals with ALS.
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Affiliation(s)
- Mariana Asmar Alencar
- Universidade Federal de Minas Gerais, Departamento de Fisioterapia, Belo Horizonte MG, Brazil.,Address for correspondence Mariana Asmar Alencar
| | - Bruna Laura Soares
- Universidade Federal de Minas Gerais, Departamento de Fisioterapia, Belo Horizonte MG, Brazil.
| | | | - Juliana Silva Abdo
- Universidade Federal de Minas Gerais, Departamento de Fisioterapia, Belo Horizonte MG, Brazil.
| | | | - Caroline Martins de Araújo
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Neurociência, Belo Horizonte MG, Brazil.
| | - Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Neurociência, Belo Horizonte MG, Brazil.,Universidade Federal de Minas Gerais, Departamento de Medicina Interna, Belo Horizonte MG, Brazil.
| | - Gisele de Cássia Gomes
- Universidade Federal de Minas Gerais, Departamento de Fisioterapia, Belo Horizonte MG, Brazil.
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Brito SAFD, Santana MDM, Benfica PDA, Aguiar LT, Gomes GDC, Faria CDCDM. The modified sphygmomanometer test for assessment of muscle strength of community-dwelling older adults in clinical practice: reliability and validity. Disabil Rehabil 2020; 44:131-138. [PMID: 32393131 DOI: 10.1080/09638288.2020.1758804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: (a) to investigate the test-retest and inter-rater reliabilities and the criterion-related validity of the modified sphygmomanometer test (MST) for the assessment of muscle strength in community-dwelling older adults, (b) to calculate the standard error of measurement (SEM) and the smallest real difference (SRD); (c) to verify whether the number of trials affect the results.Methods: Bilateral strength of lower limbs (LL) and grip muscles were evaluated with the MST and with portable dynamometers in 50 older adults (69.92 ± 5.52 years). Intra-class Correlation Coefficients (ICC) was used to evaluate the inter-rater and test-retest reliabilities and Pearson Correlations was used to investigate the criterion-related validity of the MST. SEM and SRD were also calculated. Analysis of variance was used to investigate whether the number of trials affects the results.Results: Significant correlations with high to very high magnitude were found for all muscle groups evaluated for test-retest and inter-rater reliabilities (0.80 ≤ ICC ≤ 0.99; p < 0.001) and validity (0.80 ≤ r ≤ 0.91; p < 0.001). Moreover, the values provided by different numbers of trials were similar. The SEM (3.66 ≤ SEM ≤ 20.46) and the SRD (10.15 ≤ SRD95% ≤ 56.70) were considered low for all outcome measures.Conclusion: The MST showed adequate results for all the measurement properties evaluated for the assessment of the muscle strength of older adults.Implications for rehabilitationOlder adults often develop sarcopenia and dynapenia that are associated with an increased number of falls and fractures and loss of independence.Portable dynamometer is the standard instrument to evaluate isometric muscle strength, however this instrument is expensive and it is not readily available in the underdeveloped or in developed countries.The Modified Sphygmomanometer Test is an alternative method for the clinical measurement of muscle strength, is portable, has a low-cost and provides an objective measurement.In this study the Modified Sphygmomanometer Test showed adequate results for all the measurement properties evaluated for the assessment of the muscle strength in community-dwelling older adults and a single trial after test familiarization can be used to measure the muscle strength in this population.
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Affiliation(s)
| | - Marina de Melo Santana
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Poliana do Amaral Benfica
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Tavares Aguiar
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Gisele de Cássia Gomes
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Abdo JS, Mendes ARM, Alencar MA, Gomes GDC. Influência da escolaridade de idosas nos ganhos de função executiva após treino de dupla tarefa. Rev bras geriatr gerontol 2020. [DOI: 10.1590/1981-22562020023.200088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Investigar a influência da escolaridade nos ganhos de função executiva após o treinamento com dupla tarefa (DT). Método Estudo exploratório realizado com 31 idosas, com escolaridade ≥3 anos e sem alterações das funções cognitivas rastreadas pelo Miniexame do Estado Mental (MEEM). As participantes foram distribuídas em dois grupos a partir do critério escolaridade, sendo o Grupo 1 com escolaridade de três a sete anos (n=17) e o Grupo 2 com escolaridade igual e superior a oito anos (n=14). Foram avaliadas as funções executivas antes e após o treinamento através dos testes Stroop, Exame Cognitivo de Addenbrooke - Revisado (ACE-R) e Trilhas B. O protocolo de intervenção consistiu em três sessões semanais, duração de 50 minutos cada, com a realização de atividades de DT cognitiva e motora, associadas à caminhada, por 12 semanas. Resultados A ANOVA indicou que o treinamento de DT melhorou significativamente o desempenho nos testes Stroop (F=5,95; p=0,02) e ACE-R (F=18,33; p<0,0001), independentemente da escolaridade. Foi verificado efeito do grupo nos testes ACE-R (F=14,65; p<0,001) e Trilhas B (F=18,74; p<0,001). Em nenhum dos testes analisados, foi observado efeito da interação grupo x tempo (0,04<F<2,14; 0,15<p<0,95). Conclusão O treinamento de DT pode melhorar significativamente a função executiva de idosas, independente do nível de escolaridade, podendo ser utilizado na prática clínica como uma proposta de intervenção, visando o ganho de função executiva.
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Macedo BGD, Oliveira HSCD, Paula MVD, Gomes GDC, Antunes CMDF. Association between inflammatory mediators, grip strength and mobility in community-dwelling elderly. Fisioter mov 2018. [DOI: 10.1590/1980-5918.031.ao32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Aging is associated with loss of muscle mass, immunosenescence and increased production of inflammatory mediators, high levels being predictors of a decline in functional capacity in the elderly. Objective: To assess the association between inflammatory mediators, interleukin 6 (IL-6) and C-reactive protein (CRP) and functional capacity in the elderly. Methods: Cross-sectional study with 308 community-dwelling elderly. The study was approved by the Research Ethics Committee, under protocol number 067/2010. Grip strength (GS) was measured using a JAMAR® dynamometer and functional capacity by the Timed Up and Go (TUG) test. Blood tests were performed and serum levels of C-reactive protein and interleukin 6 assessed. Spearman’s coefficient was applied to analyze the correlation between variables and the Mann-Whitney for intergroup comparison. Significance was set at 0.05. Results: There was no significant correlation between GS, the TUG and inflammatory mediators (CRP and IL-6). However, by adjusting for variables such as age, sex and muscle mass, a significant and inverse correlation (p = 0.023) was observed between GS and CPR. Conclusion: Elderly subjects with low C-reactive protein levels performed better in the grip strength test. It is important to investigate the adverse effects on functional capacity that can be influenced by inflammatory cytokines in the elderly during aging.
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Gomes GDC, Teixeira-Salmela LF, Freitas FASD, Fonseca MLM, Pinheiro MDB, Morais VADC, Caramelli P. Gait performance of the elderly under dual-task conditions: Review of instruments employed and kinematic parameters. Rev bras geriatr gerontol 2016. [DOI: 10.1590/1809-9823.2016.14159] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction The physiological deterioration associated with ageing exposes elderly persons to greater risks of falls, especially during the performance of simultaneous tasks during gait. Objectives To evaluate the effects of dual tasks (DT) on spatiotemporal gait parameters and to identify the tools and tasks most commonly used to assess the performance of DT among the elderly. Method Searches of the MEDLINE, PsycINFO, CINAHL, and SciELO databases were conducted. Observational studies, which evaluated gait changes during the performance of DT, published up to April 2014, were selected. Results A total of 385 articles were found, of which 28 were selected. Decreases in speed and increases in stride variability, stride time, step width, and double support time were observed under DT conditions. Motion analysis systems, such as the GAITRite walkway(r) system were the mostly commonly used instruments for the analyses of kinematic parameters (16 studies). DT was most commonly assessed by arithmetic calculations in 20 studies, followed by verbal fluency, in nine studies. The gait parameters most commonly assessed were speed (19 studies), followed by stride variability (14 studies). Conclusion The elderly showed changes in spatiotemporal gait parameters under DT conditions. Gait speed and stride variability were often assessed and, together, were considered good indicators of risks of falls.
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Affiliation(s)
- Gisele de Cássia Gomes
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
| | | | | | | | | | | | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
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Gomes GDC, Teixeira-Salmela LF, Fonseca BE, Freitas FASD, Fonseca MLM, Pacheco BD, Gonçalves MR, Caramelli P. Age and education influence the performance of elderly women on the dual-task Timed Up and Go test. Arq Neuropsiquiatr 2015; 73:187-93. [PMID: 25807122 DOI: 10.1590/0004-282x20140233] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 11/21/2014] [Indexed: 11/22/2022]
Abstract
Gait variability is related to functional decline in the elderly. The dual-task Timed Up and Go Test (TUG-DT) reflects the performance in daily activities. Objective To evaluate the differences in time to perform the TUG with and without DT in elderly women with different ages and levels of education and physical activity. Method Ninety-two elderly women perfomed the TUG at usual and fast speeds, with and without motor and cognitive DT. Results Increases in the time to perform the TUG-DT were observed at older ages and lower educational levels, but not at different levels of physical activity. More educated women performed the test faster with and without DT at both speeds. When age was considered, significant differences were found only for the TUG-DT at both speeds. Conclusion Younger women with higher education levels demonstrated better performances on the TUG-DT.
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Affiliation(s)
- Gisele de Cássia Gomes
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Bruna Espeschit Fonseca
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Bruna Débora Pacheco
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marisa Rocha Gonçalves
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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