1
|
Rodrigues NO, Vidal Bravalhieri AA, de Moraes TP, Barros JA, Ansai JH, Christofoletti G. Efficacy of Transcranial Direct Current Stimulation (tDCS) on Cognition, Anxiety, and Mobility in Community-Dwelling Older Individuals: A Controlled Clinical Trial. Brain Sci 2023; 13:1614. [PMID: 38137062 PMCID: PMC10741841 DOI: 10.3390/brainsci13121614] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) has gained popularity as a method of modulating cortical excitability in people with physical and mental disabilities. However, there is a lack of consensus on its effectiveness in older individuals. This study aimed to assess the efficacy of a 2-month tDCS program for improving physical and mental performance in community-dwelling older individuals. In this single-blinded, controlled clinical trial, forty-two participants were allocated to one of three groups: (1) the tDCS group, which received, twice a week, 20 min sessions of 2 mA electric current through electrodes placed on the dorsolateral prefrontal cortex; (2) the tDCS-placebo group, which underwent the same electrode placement as the tDCS group but without actual electric stimulation; and (3) the cognitive-control group, which completed crossword puzzles. Main outcome measures were cognition, mobility, and anxiety. Multivariate analyses of variance were employed. Significance was set at 5% (p < 0.05). Regarding the results, no significant benefits were observed in the tDCS group compared with the tDCS-placebo or cognitive-control groups for cognition (p = 0.557), mobility (p = 0.871), or anxiety (p = 0.356). Cognition exhibited positive oscillations during the assessments (main effect of time: p = 0.001). However, given that all groups showed similar variations in cognitive scores (main effect of group: p = 0.101; group × time effect: p = 0.557), it is more likely that the improvement reflects the learning response of the participants to the cognitive tests rather than the effect of tDCS. In conclusion, a 2-month tDCS program with two sessions per week appears to be ineffective in improving physical and mental performance in community-dwelling older individuals. Further studies are necessary to establish whether or not tDCS is effective in healthy older individuals.
Collapse
Affiliation(s)
- Nathalia Oliveira Rodrigues
- Institute of Health, Faculty of Medicine, Federal University of Mato Grosso do Sul (UFMS), Campo Grande 79060-900, Brazil; (N.O.R.); (A.A.V.B.); (T.P.d.M.)
| | - Anna Alice Vidal Bravalhieri
- Institute of Health, Faculty of Medicine, Federal University of Mato Grosso do Sul (UFMS), Campo Grande 79060-900, Brazil; (N.O.R.); (A.A.V.B.); (T.P.d.M.)
| | - Tatiane Pereira de Moraes
- Institute of Health, Faculty of Medicine, Federal University of Mato Grosso do Sul (UFMS), Campo Grande 79060-900, Brazil; (N.O.R.); (A.A.V.B.); (T.P.d.M.)
| | - Jorge Aparecido Barros
- Department of Physical Therapy, Dom Bosco Catholic University (UCDB), Campo Grande 79117-900, Brazil;
| | - Juliana Hotta Ansai
- Department of Gerontology, Federal University of São Carlos (UFSCAR), São Carlos 13565-905, Brazil;
| | - Gustavo Christofoletti
- Institute of Health, Faculty of Medicine, Federal University of Mato Grosso do Sul (UFMS), Campo Grande 79060-900, Brazil; (N.O.R.); (A.A.V.B.); (T.P.d.M.)
| |
Collapse
|
2
|
Novaes ADC, Bianco OAFM, Silva DBD, Silva LCD, Dotta EA, Ansai JH, Tavares LRC, Gramani-Say K. Fall accidents in older people: a time trend analysis of the period 2000-2020 and the estimated economic burden on the Brazilian health system in 2025. Cien Saude Colet 2023; 28:3101-3110. [PMID: 37970995 DOI: 10.1590/1413-812320232811.15722022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/06/2023] [Indexed: 11/19/2023] Open
Abstract
Longitudinal monitoring of indicators of accidental falls can facilitate the planning of effective care and prevention actions. This article aims to analyze temporal trends in variables related to falls among older persons in Brazil and in the state of São Paulo during the period 2000-2020 and estimate the projected economic burden on the health system in 2025. We conducted a quantitative retrospective observational study using data from the Health Information System. The Joinpoint Regression Program version 4.7.0 and SPSS version 20.0 were used to perform linear regression and calculate the Average Annual Percent Change (AAPC), adopting a 95% confidence interval. There was an increase in mean and total admissions costs due to falls at national level in both intervals of the study period. There was an increase in total admissions costs and the total number of admissions due to falls in the state of São Paulo (AAPC of 8.5% and 4.3%, respectively). Projections for the year 2025 suggest that the total number of admissions due to falls in Brazil will be around 150,000, resulting in costs of approximately R$ 260 million. There was an increase in the variables analyzed by this study, revealing the importance of fall prevention programs associated with national public policies.
Collapse
Affiliation(s)
| | | | | | - Livea Cristina da Silva
- Universidade Federal de São Carlos. Rod. Washington Luís s/n, Monjolinho. 13565-905 São Carlos SP Brasil.
| | - Eduarda Adami Dotta
- Universidade Federal de São Carlos. Rod. Washington Luís s/n, Monjolinho. 13565-905 São Carlos SP Brasil.
| | - Juliana Hotta Ansai
- Universidade Federal de São Carlos. Rod. Washington Luís s/n, Monjolinho. 13565-905 São Carlos SP Brasil.
| | | | - Karina Gramani-Say
- Universidade Federal de São Carlos. Rod. Washington Luís s/n, Monjolinho. 13565-905 São Carlos SP Brasil.
| |
Collapse
|
3
|
Gerassi RC, de Andrade LP, Tsen C, Pereira ABS, Pereira GN, Aily JB, Gomes GADO, Ansai JH. Family caregivers' satisfaction with telerehabilitation and follow-up intervention for older people with dementia: Randomized clinical trial. Geriatr Nurs 2023; 54:66-75. [PMID: 37703692 DOI: 10.1016/j.gerinurse.2023.08.011] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 09/15/2023]
Abstract
The present study aimed to assess caregiver satisfaction with a telerehabilitation program and remote monitoring for older adults with dementia and their caregivers during the COVID-19 pandemic, as well as to identify the factors influencing caregiver satisfaction. This study adopted a mixed-methods approach and was part of a randomized clinical trial, with blinded assessors, comprising two groups: the Intervention Group (IG) receiving a telerehabilitation program involving standardized physical exercises for older adults with dementia, along with caregiver guidelines for the caregiver; and the Control Group (CG) receiving remote monitoring. At baseline, factors related to older adults with dementia and their caregivers were measured. After 12 weeks, caregiver satisfaction with the interventions was assessed. The final sample consisted of 64 pairs of family caregivers and older people with dementia. Caregivers in the IG showed higher satisfaction levels with the intervention, Internet-based treatment, and healthcare received compared to caregivers in the CG. Both groups expressed positive views towards the treatment, with excellent ratings for audio and video quality, and a preference for Internet-based treatment over face-to-face. In the IG, only the amount of time dedicated to caregiving influenced satisfaction with the intervention, whereas in the CG, cognitive and functional performance of the older people influenced satisfaction with remote monitoring. Our findings suggest the potential of the program in providing effective care for older people with dementia and their caregivers.
Collapse
Affiliation(s)
- Renata Carolina Gerassi
- Gerontology Graduate Program, Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, km 235, São Carlos, SP 13565-905, Brazil
| | | | - Carolina Tsen
- Department of Physical Therapy, Federal University of São Carlos São Carlos, SP, Brazil
| | | | | | - Jéssica Bianca Aily
- Department of Physical Therapy, Federal University of São Carlos São Carlos, SP, Brazil
| | - Grace Angélica de Oliveira Gomes
- Gerontology Graduate Program, Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, km 235, São Carlos, SP 13565-905, Brazil
| | - Juliana Hotta Ansai
- Gerontology Graduate Program, Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, km 235, São Carlos, SP 13565-905, Brazil.
| |
Collapse
|
4
|
Candanedo MJBL, Gramani-Say K, Gerassi RC, Janducci AL, Florido JVB, Alberto SN, Rossi PG, Ansai JH. Effects of case management based on preventing falls in older people: A systematic review. Worldviews Evid Based Nurs 2023; 20:401-414. [PMID: 36999687 DOI: 10.1111/wvn.12643] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/23/2023] [Accepted: 03/04/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Falls among older adults can lead to negative consequences with physical, functional, social, and psychological functioning, and a high prevalence of mortality. However, it is still unclear whether case management can reduce the number of falls in this population. AIMS The aims of this review were to analyze the effects of case management on preventing falls and reducing risk factors for falls in older people. METHODS A systematic review was conducted, searching for and synthesizing clinical trials involving case management in older people who had falls or risk for fall outcomes. Two authors extracted data using predefined data fields, and risk of bias was assessed by the Physiotherapy Evidence Database (PEDro) scale. RESULTS Twelve studies were included in the final review. Case management in older people did not significantly reduce the number of falls, falls per person, or severity of falls compared to control groups. Adherence to recommendations in case management ranged from 25% to 88%. LINKING EVIDENCE TO ACTION There is limited evidence of reduced rates of falls and specific risk factors for falls among people who received case management interventions. Randomized trials with good quality are needed.
Collapse
Affiliation(s)
| | - Karina Gramani-Say
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | - Renata Carolina Gerassi
- Department of Gerontology, Gerontology Graduate Program, Federal University of São Carlos, São Carlos, Brazil
| | - Ana Luisa Janducci
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | | | - Silsam Napolitano Alberto
- Department of Gerontology, Gerontology Graduate Program, Federal University of São Carlos, São Carlos, Brazil
| | - Paulo Giusti Rossi
- Department of Clinical Medicine, Faculty of Medicine of Ribeirão, Preto, University of São Paulo, São Paulo, Brazil
| | - Juliana Hotta Ansai
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
| |
Collapse
|
5
|
Janducci AL, Gramani-Say K, da Silva LC, Florido JVB, Novaes ADC, Porcatti LR, Ansai JH. Treatment fidelity and satisfaction with an intervention based on case management for older people with falls history: Randomized clinical trial. Geriatr Nurs 2023; 52:48-55. [PMID: 37243992 DOI: 10.1016/j.gerinurse.2023.05.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE To verify the treatment fidelity and satisfaction with a multifactorial intervention based on case management in community-dwelling older people with falls history and related sociodemographic and clinical factors. METHODS This is a single-center, randomized, parallel-group controlled clinical trial. 62 community-dwelling older people with falls history were distributed into two groups. The Intervention Group (IG) underwent a case management involving multidimensional evaluation, explanation of the risk factors for falls identified, implementation of an intervention proposal based on the identified risks, elaboration of an individualized falls intervention plan, implementation, monitoring and review of the intervention plan. The Control Group (CG) was accompanied by a monthly phone call. After 16 weeks, the volunteers answered two closed questionnaires about treatment fidelity or non-fidelity to intervention (IG) and satisfaction with intervention (both groups). In addition, the frequency of intervention, adherence to each recommendation of the case management and satisfaction with general care were evaluated. RESULTS There was good treatment fidelity based on case management, as well as good adherence to recommendations. In addition, the satisfaction of both groups was positive, although the IG had a better score (p<0.05). There was a significant influence of monthly income and general health on treatment fidelity (IG). Also, age, years of schooling, general health and physical mobility significantly influenced satisfaction with the IG. There was a significant influence of number of falls on satisfaction with monitoring conducted in the CG. CONCLUSIONS Clinical and sociodemographic factors can influence treatment fidelity and satisfaction of older people with falls history to a falls prevention program.
Collapse
Affiliation(s)
- Ana Luísa Janducci
- Department of Gerontology, Federal University of São Carlos, São Carlos - SP, Brazil
| | - Karina Gramani-Say
- Department of Gerontology, Federal University of São Carlos, São Carlos - SP, Brazil
| | | | | | | | | | - Juliana Hotta Ansai
- Department of Gerontology, Federal University of São Carlos, São Carlos - SP, Brazil.
| |
Collapse
|
6
|
Alves JE, Pelegrini LNDC, Porcatti LR, Ansai JH, Candanedo MJBL, Gramani-Say K. Effects of a cognitive stimulation program on physical and cognitive dimensions in community-dwelling faller older adults with cognitive impairment: study protocol. BMC Neurol 2023; 23:107. [PMID: 36932354 PMCID: PMC10020753 DOI: 10.1186/s12883-023-03154-1] [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] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/08/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Cognitive functioning is an important dimension among the elderly. Cognitive maintenance is vital for aging due to its association with autonomy and independence. Considering the importance of preventive programs in older adults' health, this study aims to share an intervention protocol of a falls prevention program for community-dwelling faller older adults with cognitive impairment. METHODS This is the protocol of an experimental and longitudinal study, consisting of cognitive stimulation associated with physical exercise in a 16-week fall prevention program. For cognitive intervention, the APG Cognitive Training Protocol will be used. Participants will be assessed pre-and post-intervention and will be randomly allocated to experimental or control groups. The screening protocol is composed of the TUG, FES-I, LAWTON & BRODY, ACE-R, GAI and fall survey instruments, focusing on the assessment of balance and mobility, fear of falling, performance on IADL, cognitive and anxiety tracking, respectively. DISCUSSION This study can determine the long-term effects of multimodal cognitive training, providing evidence for its replication in the provision of care for the elderly. The objective is to promote improvements in the cognitive performance, mobility and balance of the elderly, with a focus on reducing the number of falls, fractures, hospitalizations and institutionalization, serving as an alternative to interrupt the cycle of falls. TRIAL REGISTRATION The research was approved by the Research Ethics Committee with Human Beings at the Federal University of São Carlos, CAAE: 3654240.9.0000.5504 and Brazilian Registry of Clinical Trials (REBEC) RBR-3t85fd, registered on the 25th of September, 2020.
Collapse
Affiliation(s)
- José Emanuel Alves
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| | - Lucas N. de Carvalho Pelegrini
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| | - Luana Rafaela Porcatti
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| | - Juliana Hotta Ansai
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| | - Maria Juana Beatriz Lima Candanedo
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| | - Karina Gramani-Say
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, Rodovia Washington Luiz, Km 235, São Carlos, São Paulo, 13565-905 Brazil
| |
Collapse
|
7
|
Farche ACS, Cassemiliano G, Rossi PG, Carnavale BF, Lee S, Message LB, da Silva Santos VR, Ansai JH, Ferriolli E, Pereira ND, Oviedo GR, Guerra-Balic M, Giné-Garriga M, Lopes MA, de Medeiros Takahashi AC. Self-management strategies and multicomponent training to mitigate the effects of the interruption of physical exercise programmes in the pandemic context on functionality, sedentary behaviour, physical capacity, mental health, body composition and quality of life in older adults: a blinded randomized controlled study protocol. Trials 2022; 23:923. [PMCID: PMC9636685 DOI: 10.1186/s13063-022-06844-2] [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] [Received: 08/04/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Background Considering the confinement recommended by the World Health Organization due to the pandemic caused by COVID-19, many community physical exercise programmes for older adults have had their activities cancelled. In this context, proposing strategies to recover the possible adverse effects of the confinement period is pertinent. The use of self-management strategies associated with regular physical activity reduces sedentary behaviour and improves physical capacity in older adults. Thus, the purpose of this study was to describe a multicomponent training programme combined with a self-management strategy protocol to mitigate the effects of interruptions in physical exercise programmes on functionality, physical capacity, mental health, body composition and quality of life in older adults. Methods This will be a blinded, randomized and controlled clinical trial performed in São Carlos, SP, Brazil. Eighty older adults will be divided into two groups: multicomponent training (Multi) and multicomponent training + self-management strategies (Multi+SM). The intervention will be performed over 16 weeks on three alternate days of every week, with 50-min sessions. The assessment of physical capacity will be performed before the interruption of physical exercise programmes (T0: initial assessment, March 2020), preintervention (T1: immediately after the return of the exercise programme) and postintervention (T2). The assessments of physical activity level, quality of life, mental health, functionality and body composition will be performed at T1 and T2. Discussion The results from this MC+SM protocol will allow us to contribute clinical support to evaluate the variables analysed and to guide future public health policies with the aim of minimizing the possible deleterious effects arising from the physical exercise interruption periods caused by epidemics and pandemics. Trial registration RBR-10zs97gk. Prospectively registered in Brazilian Registry of Clinical Trials (ReBEC) on 17 June 2021. Registry name: Use of self-management strategies combined with multicomponent training to mitigate the effects of social distancing due to COVID-19 on capacity, physical capacity, mental health and quality of life in older adults - A blind, randomized and controlled clinical trial.
Collapse
Affiliation(s)
- Ana Claudia Silva Farche
- grid.411247.50000 0001 2163 588XDepartment of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Gabriela Cassemiliano
- grid.411247.50000 0001 2163 588XDepartment of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Paulo Giusti Rossi
- grid.411247.50000 0001 2163 588XDepartment of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Bianca Ferdin Carnavale
- grid.411247.50000 0001 2163 588XDepartment of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Stefany Lee
- grid.411247.50000 0001 2163 588XDepartment of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Laura Bonome Message
- grid.411247.50000 0001 2163 588XDepartment of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Juliana Hotta Ansai
- grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | - Eduardo Ferriolli
- grid.11899.380000 0004 1937 0722Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Carlos, Brazil
| | - Natália Duarte Pereira
- grid.411247.50000 0001 2163 588XDepartment of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Guillermo Rúben Oviedo
- grid.6162.30000 0001 2174 6723School of Psychology, Education and Sport Sciences, Ramon Llull University, Barcelona, Spain
| | - Myriam Guerra-Balic
- grid.6162.30000 0001 2174 6723School of Psychology, Education and Sport Sciences, Ramon Llull University, Barcelona, Spain
| | - Maria Giné-Garriga
- grid.6162.30000 0001 2174 6723School of Psychology, Education and Sport Sciences, Ramon Llull University, Barcelona, Spain
| | - Marina Araújo Lopes
- grid.5841.80000 0004 1937 0247Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | | |
Collapse
|
8
|
Souza MM, Ansai JH, Silva DCPD, Rossi PG, Takahashi ACDM, Andrade LPD. Can timed up and go subtasks predict functional decline in older adults with cognitive impairment? Dement Neuropsychol 2022; 16:466-474. [DOI: 10.1590/1980-5764-dn-2021-0111] [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] [Received: 11/11/2021] [Revised: 06/16/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT. Even in the early stages of cognitive impairment, older people can present important motor alterations. However, there are no studies that have investigated Timed Up and Go (TUG) and its subtasks in predicting impairment of functional capacity over time in this population. Objectives: The aim of this study was to verify if the TUG test and its subtasks can predict functional decline over 32 months in older adults with mild cognitive impairment (MCI) and mild Alzheimer’s disease (AD). Methods: This is a prospective 32-month follow-up study, including at baseline 78 older adults (MCI: n=40; AD: n=38). The TUG and its subtasks (e.g., sit-to-stand, walking forward, turn, walking back, and turn-to-sit) were performed at baseline using the Qualisys Motion system. Functional capacity was assessed at baseline and after 32 months. Results: After follow-up, the sample had 45 older adults (MCI: n=25; AD: n=20). Of these, 28 declined functional capacity (MCI: n=13; AD: n=15). No TUG variable significantly predicted (p>0.05) functional decline in both groups, by univariate logistic regression analysis with the covariate gender. Conclusions: Although older adults with MCI and mild AD declined functional capacity, the TUG test and its subtasks could not predict this decline over 32 months.
Collapse
|
9
|
Oliveira JCD, Gonçalves GH, Campos DM, Ferreira DL, Silva NCD, Ansai JH. Telefonemas mensais e calendários como registro para a taxa de quedas de idosos da comunidade inseridos em um ensaio clínico randomizado. Fisioter Pesqui 2022. [DOI: 10.1590/1809-2950/20032229022022pt] [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: 12/23/2022] Open
Abstract
RESUMO Os objetivos deste estudo de caráter longitudinal prospectivo foram analisar telefonemas mensais e calendários como registro da taxa de quedas de idosos da comunidade ao longo de 22 semanas e verificar os fatores relacionados à adesão ao calendário de quedas. Os participantes passaram por avaliações de anamnese, nível de atividade física, medidas neuropsicológicas e mobilidade. Receberam também um calendário de quedas que deveria ser preenchido, ao longo das 22 semanas, no(s) dia(s) em que o evento ocorresse. Ademais, os idosos foram contatados mensalmente por telefone para o questionamento da ocorrência de quedas naquele período. Para análise dos dados, foi adotado nível de significância de α=0,05, e para execução dos testes estatísticos foi utilizado o software SPSS 20.0. Os dois instrumentos foram comparados quanto à “sensibilidade” e à “especificidade”. Foram incluídos 52 idosos no estudo, com média de idade de 70,5 anos. A adesão ao método do calendário foi de 63,4% em comparação à estratégia dos telefonemas. Dos nove participantes que relataram quedas pelos telefonemas, três as notificaram no calendário, resultando em uma sensibilidade de 33%. Dos 43 idosos que não relataram quedas por telefonemas, 31 entregaram o calendário sem registro, o que resultou em uma especificidade do calendário de 72%. Anos de escolaridade, pontuação no Miniexame de Estado Mental e desempenho no exame cognitivo de Addenbrooke (versão revisada) influenciaram significativamente na adesão ao calendário de quedas. Concluiu-se que houve maior notificação de quedas pelo método do telefonema mensal em comparação ao do calendário em idosos da comunidade.
Collapse
|
10
|
Oliveira JCD, Gonçalves GH, Campos DM, Ferreira DL, Silva NCD, Ansai JH. Monthly phone calls and calendars to record falls rate in community-dwelling older adults included in a randomized clinical trial. Fisioter Pesqui 2022. [DOI: 10.1590/1809-2950/20032229022022en] [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: 12/23/2022] Open
Abstract
ABSTRACT This longitudinal study aimed to analyze monthly phone calls and calendars as a mean to record falls rate in community-dwelling older adults over 22 weeks, and to verify factors related to adherence to the falls calendar. Participants underwent an assessment composed by anamnesis, level of physical activity, neuropsychological measures, and mobility. They also received a schedule of falls that should be completed over 22 weeks, on the day(s) a fall occurred. Moreover, the volunteers received monthly phone calls to inquire about occurrence of falls over time. For data analysis, a α=0.05 significance level was adopted and the SPSS software (20.0) was used to perform statistical tests. The two tools were compared regarding “sensitivity” and “specificity.” In total, 52 older adults composed the final sample, with a mean age of 70.5 years old. The adherence to the calendar was 63.4% compared to phone calls. Of nine participants who reported falls by phone calls, three notified them in the calendar, resulting in a 33% sensitivity. Out of the 43 people who did not report falls by phone calls, 31 delivered the calendar without registration. Thus, the specificity of the calendar was 72%. Schooling level, Mini Mental State Exam score and the Addenbrooke’s Cognitive Examination (revised version) score significantly influenced adherence to the calendar. In conclusion, there was a greater registration of falls by the monthly phone call compared to the calendar tool in community-dwelling older adults.
Collapse
|
11
|
Alberto SN, Ansai JH, Janducci AL, Florido JVB, Novaes ADC, Caetano MJD, Rossi PG, Tavares LRC, Lord SR, Gramani-Say K. A Case Management Program at Home to Reduce Fall Risk in Older Adults (the MAGIC Study): Protocol for a Single-Blind Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e34796. [PMID: 35700005 PMCID: PMC9237774 DOI: 10.2196/34796] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/04/2022] [Accepted: 04/01/2022] [Indexed: 11/29/2022] Open
Abstract
Background Individual case management programs may be particularly effective in reducing fall risk as they can better identify barriers and facilitators to health recommendations. Objective This paper describes the protocol for a single-blind, parallel-group randomized controlled trial that aims to investigate the effectiveness and cost-effectiveness of a home-based multifactorial program targeting fall risk factors among people aged 60 years and over who have fallen at least twice in the past 12 months (the MAGIC trial). Methods Older people with a history of at least 2 falls in the last year will be divided into 2 groups. The intervention group will receive case management at home for reducing the risk of falls, including a multidimensional assessment, explanation of fall risk factors, and elaboration and monitoring of an individualized intervention plan based on the identified fall risk factors, personal preferences, and available resources. The control group will be monitored once a month. Assessments (clinical data, fall risk awareness, physical and mental factors, safety at home, feet and shoes, and risk and rate of falls) will be carried out at baseline, after 16 weeks of the intervention, and at the posttrial 6-week and 1-year follow-up. After 16 weeks of the intervention, satisfaction and adherence to the intervention will also be assessed. Economic health will be evaluated for the period up to the posttrial 1-year follow-up. Results Data collection started in April 2021, and we expected to end recruitment in December 2021. This case management program will address multifactorial assessments using validated tools and the implementation of individualized intervention plans focused on reducing fall risk factors. Conclusions This trial may provide reliable and valuable information about the effectiveness of case management for increasing fall risk awareness and reducing fall risk in older people. Trial Registration Brazilian Clinical Trials Registry (ReBec) RBR-3t85fd; https://ensaiosclinicos.gov.br/rg/RBR-3t85fd International Registered Report Identifier (IRRID) DERR1-10.2196/34796
Collapse
Affiliation(s)
| | - Juliana Hotta Ansai
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | - Ana Luísa Janducci
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | | | | | | | - Paulo Giusti Rossi
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | - Stephen Ronald Lord
- Australia and School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia
| | - Karina Gramani-Say
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
| |
Collapse
|
12
|
Ferreira DL, Christofoletti G, Campos DM, Janducci AL, Candanedo MJBL, Ansai JH. Effects of Aquatic Physical Exercise on Motor Risk Factors for Falls in Older People During the COVID-19 Pandemic: A Randomized Controlled Trial. J Manipulative Physiol Ther 2022; 45:378-388. [PMID: 36175314 PMCID: PMC9372189 DOI: 10.1016/j.jmpt.2022.08.002] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/15/2022] [Accepted: 08/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to assess the effects of aquatic training on motor risk factors for falls in older people during the COVID-19 pandemic. METHODS A randomized controlled trial was carried out with older people, divided into an aquatic training group (ATG) (n = 24) and a control group (CG) (n = 25). Muscle strength was assessed by the 5-Times Sit-to-Stand Test, mobility by the simple and dual-task Timed Up and Go Test, and postural stability through stabilometric data (force platform). The CG received monthly calls to monitor general health. The ATG carried out training lasting 16 weeks, with two 1-hour sessions per week. RESULTS Both groups improved muscular strength and cognitive-motor tasks, and they performed a dual task with fewer errors in the secondary task after 16 weeks regardless of the pandemic and COVID-19 diagnosis. There was a significant decrease in the area of center of pressure displacement in the tandem posture with eyes closed in the CG. When analyzing participants who adhered at least 50% to the intervention, the ATG significantly reduced the number of steps on the Timed Up and Go Test performance. Both groups improved muscular strength and cognitive-motor tasks and increased the cognitive task cost. In the CG, there was a significant decrease in the mean amplitude of the anteroposterior center of pressure displacement in the feet together with eyes open. CONCLUSION We found that aquatic physical exercise presented positive effects on some potentially modifiable motor risk factors for falls (mobility and muscle strength) regardless of the COVID-19 pandemic and COVID-19 diagnosis, especially among people who adhered to the intervention.
Collapse
Affiliation(s)
- Daniela Lemes Ferreira
- Movement Science Graduate Program, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso Do Sul, Brazil
| | - Gustavo Christofoletti
- Movement Science Graduate Program, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso Do Sul, Brazil; Physical Therapy Course, University Of Mato Grosso Do Sul, Campo Grande, Mato Grosso Do Sul, Brazil
| | - Dayane Melo Campos
- Movement Science Graduate Program, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso Do Sul, Brazil
| | - Ana Luísa Janducci
- Department of Gerontology, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | | | - Juliana Hotta Ansai
- Department of Gerontology, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
| |
Collapse
|
13
|
Cezar NODC, Ansai JH, Oliveira MPBD, da Silva DCP, Gomes WDL, Barreiros BA, Langelli TDCO, de Andrade LP. Feasibility of improving strength and functioning and decreasing the risk of falls in older adults with Alzheimer's dementia: a randomized controlled home-based exercise trial. Arch Gerontol Geriatr 2021; 96:104476. [PMID: 34260986 DOI: 10.1016/j.archger.2021.104476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the effects of a Home-based multimodal exercise program for older people with Alzheimer's disease (AD-HOMEX) on muscle strength, mobility, the risk of falls and functioning. MATERIALS AND METHODS A trial with a blinded assessor was conducted involving 40 older people with mild to moderate AD randomized to an intervention group (IG) or control group (CG). The IG participated in a 16-week protocol with three 60-minute sessions per week. The sessions were performed at the participant's home by a physiotherapist and involved progressive individualized physical exercises. Muscle strength (5X Sit-to-Stand Test [5XSTS], 30-Second Chair Stand test, isokinetic and hand-grip dynamometer), functioning (DAFS-R and ADL-Q), mobility and the risk of falls (TUG) were assessed at baseline and after training. Intention-to-treat analysis was adopted. RESULTS There was a significant group-evaluation time interaction for the 5XSTS (p = 0.011). The IG demonstrated an improved performance on the 5XSTS (p = 0.020) and a reduced risk of falls (p = 0.000), whereas the CG exhibited a worse functional limitation (p = 0.008) after 16 weeks. The CG had an increased risk of falls (p = 0.006) and worse performance on the ADL-Q (p = 0.047) at the follow-up evaluation. An improvement in the IG and worsening in the CG were found regarding transition patterns between severity levels of functional limitation based on the ADL-Q. CONCLUSIONS Home-based physical exercise for older people with mild to moderate AD is an effective strategy that decreases the risk of falls and improves strength and functioning.
Collapse
Affiliation(s)
- Natália Oiring de Castro Cezar
- Department of Physical Therapy, Federal University of São Carlos; Department of Gerontology, Federal University of São Carlos.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Campos DM, Ferreira DL, Gonçalves GH, Farche ACS, de Oliveira JC, Ansai JH. Effects of aquatic physical exercise on neuropsychological factors in older people: A systematic review. Arch Gerontol Geriatr 2021; 96:104435. [PMID: 34030045 DOI: 10.1016/j.archger.2021.104435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/05/2021] [Accepted: 05/08/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND . There is a lack of standardized protocols and clinical trials for older adults involving neuropsychological factors in the literature. Furthermore, no systematic review has been published investigating this theme. PURPOSE . The purpose of this systematic review was to analyze the effects of aquatic physical exercise on neuropsychological factors in older adults. METHODS . A systematic review (CRD42020176899) was conducted, using articles from Pubmed, Web of Science, Scopus, Cochrane Library, Science Direct and Medline published until March 2020 (without limit of previous year). Eligibility criteria for selecting studies were: clinical trials; samples with a mean age of 65 years old and over; articles involving aquatic physical exercise; and presenting neuropsychological outcomes (behavior, cognition, psychological, mental health). RESULTS AND DISCUSSION . The search yielded 801 records and 16 studies were included, totaling: 1707 older adults, with a mean age of 71.3 years old (range of mean ages in the studies: 65.3 to 88.4 years old) and a predominance of women. Aquatic physical exercise showed positive results in the mental component of quality of life, fear of falling, mood, anxiety and internal health locus of control in healthy sedentary older adults. Only one study out of 5 carried out with older adults with osteoarthritis showed improvements in psychological well-being after aquatic intervention. Older women with osteopenia or osteoporosis showed improvements in the mental component of quality of life. Studies on dementia showed a significant improvement in behavioral and psychological symptoms after aquatic intervention and no effect on depressive symptoms. CONCLUSION . Based on the results of this systematic review, aquatic physical exercise has positive effects on quality of life, fear of falling, cognitive functions, mood, anxiety and internal health locus of control in sedentary community-dwelling older people. It can be a great resource for carrying out physical activities in this population.
Collapse
Affiliation(s)
- Dayane Melo Campos
- Movement Science Graduate Program, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Brazil
| | - Daniela Lemes Ferreira
- Movement Science Graduate Program, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Brazil
| | - Glaucia Helena Gonçalves
- Movement Science Graduate Program, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Brazil; Department of Physical Therapy, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Brazil
| | | | - Jéssica Cerutti de Oliveira
- Department of Physical Therapy, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Brazil
| | - Juliana Hotta Ansai
- Movement Science Graduate Program, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Brazil; Department of Gerontology, Federal University of São Carlos, Brazil.
| |
Collapse
|
15
|
Masse FAA, Ansai JH, Fiogbe E, Rossi PG, Vilarinho ACG, Takahashi ACDM, Pires de Andrade L. Progression of Gait Changes in Older Adults With Mild Cognitive Impairment: A Systematic Review. J Geriatr Phys Ther 2021; 44:119-124. [PMID: 33534339 DOI: 10.1519/jpt.0000000000000281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The identification of altered gait and its progression over time is important to gaining a better understanding of the clinical aspects of mild cognitive impairment (MCI) in older adults. The aim of the present systematic review was to determine changes in gait variables over time among older adults with MCI. METHODS The PubMed, Web of Science, Scopus, and Science Direct databases were searched for relevant articles using the following keywords and Medical Subject Headings: Aged AND "Mild cognitive impairment" AND (gait OR locomotion). A hand search was also performed of the reference lists of the selected articles in an attempt to find additional records. The following were the inclusion criteria: longitudinal studies and clinical trials involving a control group without intervention; samples of individuals 65 years or older; and characterization of gait using a single or dual task. RESULTS AND DISCUSSION The initial search led to the retrieval of 6979 studies, 9 of which met the inclusion criteria. The duration of follow-up among the studies ranged from 6 months to 2 years. Most trials investigated gait speed. Other gait variables were step length, time required to walk a given distance, and mean weekly gait speed. Altered gait progressed in older adults with MCI. The main alterations were gait speed and variability in daily number of steps in follow-up periods lasting more than 1 year. No significant changes in gait variables were found in shorter follow-up periods (up to 6 months). CONCLUSIONS The progression of gait changes in older adults with MCI has been underinvestigated. MCI leads to reduced gait speed in longer follow-up periods. Such information can contribute to the determination of motor interventions for older adults with MCI, especially in the early stages.
Collapse
Affiliation(s)
| | - Juliana Hotta Ansai
- Course of Physical Therapy, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Elie Fiogbe
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Paulo Giusti Rossi
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | | | | | | |
Collapse
|
16
|
Cezar NODC, Ansai JH, de Oliveira MPB, da Silva DCP, Vale FAC, Takahashi ACDM, de Andrade LP. Changes in executive function and gait in people with mild cognitive impairment and Alzheimer disease. Dement Neuropsychol 2021; 15:60-68. [PMID: 33907598 PMCID: PMC8049569 DOI: 10.1590/1980-57642021dn15-010006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Changes in executive function and motor aspects can compromise the prognosis of older adults with mild cognitive impairment (MCI) and favor the evolution to dementia. Objectives The aim of this study was to investigate the changes in executive function and gait and to determine the association between changes in these variables. Methods A 32-month longitudinal study was conducted with 40 volunteers: 19 with preserved cognition (PrC), 15 with MCI and 6 with Alzheimer disease (AD). Executive function and gait speed were assessed using the Frontal Assessment Battery, the Clock-Drawing test and the 10-meter walk test. For data analysis, the Pearson product-moment correlation, two-way repeated-measures ANOVA, and chi-square were conducted. Results After 32 months, an improvement in the executive function was found in all groups (p=0.003). At baseline, gait speed was slower in individuals with MCI and AD compared to those with PrC (p=0.044), that was maintained after the follow-up (p=0.001). There was significant increase in number of steps in all groups (p=0.001). No significant association was found between changes in gait speed and executive function. Conclusions It should be taken into account that gait deteriorates prior to executive function to plan interventions and health strategies for this population.
Collapse
Affiliation(s)
| | - Juliana Hotta Ansai
- Graduate Program in Movement Sciences, Universidade Federal de Mato Grosso do Sul - Campo Grande, MS, Brazil
| | | | | | | | | | | |
Collapse
|
17
|
Vassimon-Barroso V, Pantoni CBF, Zazzetta MS, Ferreira DL, Vasilceac FA, Ansai JH. User and family satisfaction with nursing homes: a systematic review. Int J Qual Health Care 2021; 33:6039070. [PMID: 33325518 DOI: 10.1093/intqhc/mzaa160] [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] [Received: 11/23/2020] [Revised: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Implementation of person-directed care planning is a challenge for nursing home services. User satisfaction is indispensable to implement it. OBJECTIVE The aim of this study was to address user and family satisfaction with nursing homes and the scales used and to identify the determinants of satisfaction with this service. METHODS A systematic review was conducted, and the Cochrane Library, PubMed, Scopus, Web of Science and CINAHL databases were searched between December 2019 and April 2020. Studies involving assessment of user or family satisfaction with nursing homes and users ≥65 years old or their families were included in this review. The methodological quality of the included studies was assessed by the Joanna Briggs Institute reviewer's manual. RESULTS Eight articles were included based on the eligibility criteria, from a total of 2378 records found in the electronic search. All studies presented a cross-sectional design, and the total sample of this review was 57 214 older people. Most of the studies included showed positive overall satisfaction with nursing homes. There was no consensus about the best scale to assess satisfaction because of the huge variety of tools among studies. The most common determinants of satisfaction among studies were quality of life (mental and physical components), anxiety and social and health factors. CONCLUSION The findings of our review may contribute to a better view of satisfaction with nursing homes experienced by users and families and to an improvement of care in these institutions.
Collapse
Affiliation(s)
- Verena Vassimon-Barroso
- Department of Gerontology, Federal University of São Carlos, Washington Luis highway, 235 km, São Paulo 13565-905, Brazil
| | - Camila Bianca Falasco Pantoni
- Department of Gerontology, Federal University of São Carlos, Washington Luis highway, 235 km, São Paulo 13565-905, Brazil
| | - Marisa Silvana Zazzetta
- Department of Gerontology, Federal University of São Carlos, Washington Luis highway, 235 km, São Paulo 13565-905, Brazil
| | - Daniela Lemes Ferreira
- Graduate Program in Movement Sciences, Federal University of Mato Grosso do Sul, Costa e Silva Avenue, Mato Grosso do Sul 79070-900, Brazil
| | - Fernando Augusto Vasilceac
- Department of Gerontology, Federal University of São Carlos, Washington Luis highway, 235 km, São Paulo 13565-905, Brazil
| | - Juliana Hotta Ansai
- Department of Gerontology, Federal University of São Carlos, Washington Luis highway, 235 km, São Paulo 13565-905, Brazil.,Graduate Program in Movement Sciences, Federal University of Mato Grosso do Sul, Costa e Silva Avenue, Mato Grosso do Sul 79070-900, Brazil
| |
Collapse
|
18
|
Cezar NODC, Ansai JH, de Andrade LP. Home‐based multimodal exercise program in older people with Alzheimer disease: Randomized controlled trial protocol. Physiother Res Int 2021; 26:e1899. [DOI: 10.1002/pri.1899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/30/2020] [Accepted: 12/25/2020] [Indexed: 12/17/2022]
Affiliation(s)
| | - Juliana Hotta Ansai
- Graduate Program in Movement Sciences Federal University of Mato Grosso do Sul (UFMS) Campo Grande Mato Grosso do Sul Brazil
| | - Larissa Pires de Andrade
- Department of Physical Therapy Federal University of São Carlos (UFSCar) São Carlos São Paulo Brazil
| |
Collapse
|
19
|
Izzo TF, Candanedo MJBL, Higuti AY, Corrêa LM, Campos DM, Ansai JH. Immediate physiological effects of listening to music before physical exercise in institutionalized older people with dementia. Fisioter Pesqui 2021. [DOI: 10.1590/1809-2950/20028628032021] [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: 11/22/2022] Open
Abstract
ABSTRACT The evolution of dementia is strongly related to cognitive, motor, and functional changes and to the presence of cardiovascular diseases. Disturbances vary according to phase of dementia and can limit instrumental and basic activities of daily living. The aim of this study was to analyze the immediate physiological effects of listening to music before physical exercise in institutionalized older people with moderate to advanced dementia. A randomized trial was conducted with 18 institutionalized older people with dementia (mean age was 79 years old, 52.6% were female), who were divided into a Training with Music Group (TWMG) and a Training without Music Group (TWtMG). The evaluation included heart rate (HR), blood pressure (BP) and HR variability (HRV). The assessment was conducted in a closed environment or in places with minimal visual and auditory stimulation. The TWMG was submitted to stimuli with music for 15 minutes and physical exercises for 30 minutes to improve/maintain their global mobility. The TWtMG performed the same physical exercises, however without music before physical exercise. The interventions lasted 12 weeks, and were performed individually once a week. In the TWMG, we observe a decrease in diastolic BP in the third session. In the sixth week, the HR increased after the session in both groups. TWMG improved HRV in the third session, with a difference between groups only after the session. After the sixth session, HRV values improved in both groups. In conclusion, listening to music before physical exercise is associated with positive effects in people with dementia, as it tends to maintain and improve physiological factors.
Collapse
|
20
|
Rossi PG, Carnavale BF, Farche ACS, Ansai JH, de Andrade LP, Takahashi ACDM. Effects of physical exercise on the cognition of older adults with frailty syndrome: A systematic review and meta-analysis of randomized trials. Arch Gerontol Geriatr 2020; 93:104322. [PMID: 33360014 DOI: 10.1016/j.archger.2020.104322] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/23/2020] [Accepted: 12/08/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To analyze the effects of physical exercise on the cognition of community-dwelling older adults with frailty syndrome, through randomized clinical trials. DATA SOURCES Articles published until March 2020 were searched in the databases Science Direct, Scopus, Web of Science, PubMed, Lilacs, Cochrane, IEEE, EMBASE, and SciELO. Search terms included frailty, aged, exercise, rehabilitation, and cognition. For the Portuguese language, equivalent terms were used. STUDY SELECTION Only randomized clinical trials that used physical exercise as an intervention method in community-dwelling older adults (≥ 60y.) with frailty syndrome, and which performed cognitive assessments before and after the intervention were included. DATA EXTRACTION Two authors performed data extraction using predefined data fields. The risk of bias of the six included studies was assessed using the PEDro scale. DATA SYNTHESIS In total, 4501 studies were found. After the selection process, 6 studies were included in the systematic review and 4 studies in the meta-analysis, all with a low risk of bias. The studies included 655 community-dwelling older adults with frailty syndrome. The types of intervention varied, with multicomponent physical exercise being the most frequent. The cognitive assessments were diverse, and the Mini-mental State Examination, Trail Making Test forms A and B, and Digit Span test were the most frequently applied. A meta-analysis was performed with Global Cognition and Trail Making Test forms A and B. The data from the meta-analysis showed that physical exercise improves Global Cognition (Mean Difference = 2.26; 95% CI, 0.42 - 4.09; P = 0.02) and mental flexibility (Trail Making Test B) (Mean Difference = -30.45; 95% CI; - 47.72 - -13.19; P = 0.0005). CONCLUSION Interventions with physical exercise promote benefits in global cognition and mental flexibility of older adults with frailty syndrome.
Collapse
Affiliation(s)
- Paulo Giusti Rossi
- Research Laboratory of Older Adults Health (LaPeSI), Department of Physical Therapy (DFisio), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Bianca Ferdin Carnavale
- Research Laboratory of Older Adults Health (LaPeSI), Department of Physical Therapy (DFisio), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ana Claudia Silva Farche
- Research Laboratory of Older Adults Health (LaPeSI), Department of Physical Therapy (DFisio), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Juliana Hotta Ansai
- Department of Gerontology (DGero), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil; Movement Science Graduate Program, Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
| | - Larissa Pires de Andrade
- Research Laboratory of Older Adults Health (LaPeSI), Department of Physical Therapy (DFisio), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Anielle Cristhine de Medeiros Takahashi
- Research Laboratory of Older Adults Health (LaPeSI), Department of Physical Therapy (DFisio), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| |
Collapse
|
21
|
da Silva ACS, Ansai JH, Cezar NODC, Carvalho Vale FA, dos Santos JG, de Andrade LP. Outcomes and interventions in the elderly with and without cognitive impairment: a longitudinal study. Dement Neuropsychol 2020; 14:394-402. [PMID: 33354293 PMCID: PMC7735049 DOI: 10.1590/1980-57642020dn14-040010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 06/25/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Clinical follow-up studies are necessary for a better understanding of the evolution of cognitive impairment as well as the development of better assessment and intervention tools. OBJECTIVE To investigate whether older people with preserved cognition (PC), mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) show differences in clinical outcomes and interventions after a 32-month period. METHODS One hundred twenty-four community-dwelling older people were included and classified in one of three groups (PC, MCI and mild AD). Information on clinical outcomes (deaths, new diagnoses, falls, need for assistance or changes in routine and hospitalizations) and interventions (increased use of medication, physiotherapeutic intervention, practice of physical exercise, etc.) in the 32-month period were collected by telephone or during a home visit on a single day. RESULTS Ninety-five participants (35 with PC, 33 with MCI and 27 with AD) were reevaluated after 32 months. The need for assistance/changes in routine was significantly higher in the AD group, especially with regard to basic activities of daily living. Unlike the other groups, the PC group did not show "other diagnoses" (urinary incontinence, prolapse, change in vision or autoimmune disease). No significant differences were found regarding other variables. CONCLUSIONS Older people with and without cognitive impairment exhibited differences in some clinical outcomes after 32 months, such as need for assistance or changes in their routine and new diagnoses of specific diseases. Therefore, the multidimensionality of geriatric patients should be considered when planning assessments and interventions.
Collapse
Affiliation(s)
| | - Juliana Hotta Ansai
- Gerontology Department, Universidade Federal de São Carlos – São Carlos, SP, Brazil
| | | | | | | | | |
Collapse
|
22
|
Higuti AY, Barbosa SRM, Corrêa LM, Izzo TF, Ansai JH. Effects of listening to music and practicing physical exercise on functional and cognitive aspects in institutionalized older adults with dementia: Pilot study. Explore (NY) 2020; 17:292-296. [PMID: 32771267 DOI: 10.1016/j.explore.2020.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 06/22/2020] [Accepted: 07/26/2020] [Indexed: 11/28/2022]
Abstract
AIM Determine the effects of listening to music and practicing physical exercise on functional and cognitive aspects in institutionalized older adults with dementia. METHODS A randomized clinical pilot trial was conducted involving 17 institutionalized older adults with moderate to advanced dementia. The participants were allocated to two groups: training with music (TWM) and training without music (TWtM). The TWtM group performed light exercises with a focus on mobility. The TWM group was initially submitted to a cognitive stimulus with music, followed by the same exercises as those performed in the TWtM Group. Sessions were held once a week for 12 weeks. Functional and cognitive assessments were performed at baseline and after the 12-week intervention. RESULTS No significant differences in functional or cognitive performance were found between groups or evaluation times. Both groups maintained their performances after 12 weeks. CONCLUSIONS Listening to music combined with physical exercise training did not exert an effect on functional or cognitive performance in institutionalized older adults with moderate to advanced dementia.
Collapse
Affiliation(s)
- Aline Yumi Higuti
- Department of Physical Therapy, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Suzi Rosa Miziara Barbosa
- Department of Physical Therapy, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Lucas Magalhães Corrêa
- Department of Physical Therapy, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Tamires Ferri Izzo
- Department of Physical Therapy, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Juliana Hotta Ansai
- Movement Science Graduate Program, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Brazil; Department of Gerontology, Federal University of São Carlos, São Carlos, SP, Brazil.
| |
Collapse
|
23
|
Ansai JH, Farche ACS, Rossi PG, de Andrade LP, Nakagawa TH, Takahashi ACDM. Performance of Different Timed Up and Go Subtasks in Frailty Syndrome. J Geriatr Phys Ther 2020; 42:287-293. [PMID: 29210935 DOI: 10.1519/jpt.0000000000000162] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Gait speed, mobility, and postural transitions should be taken into account in older adults with frailty syndrome and can be assessed by the Timed Up and Go (TUG) Test. However, it is unclear which TUG subtasks have greater influence in identifying frail people and whether prefrail individuals present with any reduced subtask performance. The objective of this study was to investigate the differences in performance of TUG subtasks between frail, prefrail, and nonfrail older adults. METHODS A cross-sectional study was performed with community-dwelling older adults, including 43 nonfrail, 30 prefrail, and 7 frail individuals. The TUG subtasks (sit-to-stand, walking forward, turning, walking back, and turn-to-sit) were assessed using a Qualisys motion system. Data were captured by Qualisys Track Manager software and processed by Visual 3D software. The Matlab program was used to detect, separate, and analyze the TUG subtasks. Statistical significance was set at α= .05 and SigmaPlot software (11.0) was used. RESULTS AND DISCUSSION The total time to complete the TUG was significantly longer among frail participants than among those who were prefrail and nonfrail. Statistically significant differences in temporal parameters in the turning, walking forward, and walking back subtasks between nonfrail/prefrail and frail older people were found. In addition, the transition TUG subtasks (average and peak velocities of the trunk) distinguished the frail group from the other groups, demonstrating altered quality of movement. CONCLUSIONS The findings support the value of analyzing the TUG subtasks to improve understanding of mobility deficits in frailty syndrome.
Collapse
Affiliation(s)
- Juliana Hotta Ansai
- Department of Physiotherapy, Federal University of Mato Grosso do Sul, Brazil
| | | | - Paulo Giusti Rossi
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | | | | | | |
Collapse
|
24
|
Ansai JH, Vassimon-Barroso V, Farche ACS, Buto MSDS, Andrade LPD, Rebelatto JR. Accuracy of mobility tests for screening the risk of falls in patients with mild cognitive impairment and alzheimer’s disease. Fisioter Pesqui 2019. [DOI: 10.1590/1809-2950/18006726032019] [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
ABSTRACT Identifying gait and balance disorders in the earlier stages of Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI) could reduce or prevent falls in older adults. This cross-sectional study aimed to determine which mobility tests best discriminate the risk of falls in MCI and mild AD. Functional mobility was assessed by the timed up and go test (TUG) and 10-meter walk test (10MWT). A calendar of falls was produced, with follow-up via telephone calls during 6 months. For the MCI Group (n=38), time spent on the 10MWT was the best variable for discriminating fallers, with a cut-off point of 10.69 seconds associated with the highest accuracy (76.3%). In the AD Group (n=37), 10MWT cadence was the best variable for discriminating fallers, with a cut-off point of 101.39 steps per minute associated with an accuracy of 81.1%. As a conclusion, 10MWT time and cadence were the most accurate variables for screening the risk of falls in MCI and mild AD, respectively. The 10MWT is a functional, simple and easy test and it should be widely used in clinical practice.
Collapse
|
25
|
de Almeida ML, Dalpubel D, Ribeiro EB, de Oliveira ESB, Ansai JH, Vale FAC. Subjective cognitive impairment, cognitive disorders and self-perceived health: The importance of the informant. Dement Neuropsychol 2019; 13:335-342. [PMID: 31555407 PMCID: PMC6753912 DOI: 10.1590/1980-57642018dn13-030011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
There is great divergence of results in the literature regarding the clinical relevance and etiology of subjective cognitive impairment (SCI). Currently, SCI is studied as a pre-clinical symptom of Alzheimer's disease, before establishing a possible diagnosis of mild cognitive impairment (MCI). The hypothesis was that SCI is associated with low cognitive performance and poor self-perceived health.
Collapse
Affiliation(s)
- Mariana Luciano de Almeida
- Universidade de São Paulo College of Nursing of Ribeirão Preto Ribeirão PretoSP Brazil MSc, College of Nursing of Ribeirão Preto - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Daniela Dalpubel
- Universidade de São Paulo Medicine School of Ribeirão Preto Ribeirão PretoSP Brazil MSc, Medicine School of Ribeirão Preto - Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Estela Barbosa Ribeiro
- Federal University of São Carlos Nursing Department São CarlosSP Brazil MSc, Nursing Department - Federal University of São Carlos, São Carlos, SP, Brazil
| | - Eduardo Schneider Bueno de Oliveira
- Universidade de São Paulo Federal University of São Carlos Statistic Department São CarlosSP Brazil MSc, Statistic Department - Federal University of São Carlos/Universidade de São Paulo, São Carlos, SP, Brazil
| | - Juliana Hotta Ansai
- Federal University of Mato Grosso do Sul Campo GrandeMS Brazil PhD, Federal University of Mato Grosso do Sul. Campo Grande, MS, Brazil
| | - Francisco Assis Carvalho Vale
- Federal University of São Carlos Medicine Department São CarlosSP Brazil PhD, Medicine Department - Federal University of São Carlos, São Carlos, SP, Brazil
| |
Collapse
|
26
|
Ansai JH, Andrade LPD, Masse FAA, Gonçalves J, Takahashi ACDM, Vale FAC, Rebelatto JR. Risk Factors for Falls in Older Adults With Mild Cognitive Impairment and Mild Alzheimer Disease. J Geriatr Phys Ther 2019; 42:E116-E121. [DOI: 10.1519/jpt.0000000000000135] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
27
|
Giusti Rossi P, Pires de Andrade L, Hotta Ansai J, Silva Farche AC, Carnaz L, Dalpubel D, Ferriolli E, Assis Carvalho Vale F, de Medeiros Takahashi AC. Dual-Task Performance: Influence of Frailty, Level of Physical Activity, and Cognition. J Geriatr Phys Ther 2019. [DOI: 10.1519/jpt.0000000000000182] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
28
|
Mumic de Melo L, Hotta Ansai J, Giusti Rossi P, Carvalho Vale FA, Cristhine de Medeiros Takahashi A, Pires de Andrade L. Performance of an Adapted Version of the Timed Up-and-Go Test in People with Cognitive Impairments. J Mot Behav 2019; 51:647-654. [DOI: 10.1080/00222895.2018.1552917] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Laura Mumic de Melo
- Postgraduate Program of Physiotherapy, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Juliana Hotta Ansai
- Physiotherapy Department, Instituto Integrado de Saúde, Cidade Universitária, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Paulo Giusti Rossi
- Postgraduate Program of Physiotherapy, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | | | | | - Larissa Pires de Andrade
- Postgraduate Program of Physiotherapy, Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| |
Collapse
|
29
|
Ansai JH, Andrade LPD, Nakagawa TH, Rebelatto JR. Performances on the Timed Up and Go Test and subtasks between fallers and non-fallers in older adults with cognitive impairment. Arq Neuro-Psiquiatr 2018; 76:381-386. [DOI: 10.1590/0004-282x20180055] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 03/05/2018] [Indexed: 11/22/2022]
Abstract
ABSTRACT This work aimed to compare performances on the Timed Up and Go (TUG) test and its subtasks between faller and non-faller older adults with mild cognitive impairment (MCI) and mild Alzheimer’s disease (AD). A prospective study was conducted, with 38 older adults with MCI and 37 with mild AD. Participants underwent an assessment at baseline (the TUG and its subtasks using the Qualisys ProReflex system) and the monitoring of falls at the six-month follow up. After six months, 52.6% participants with MCI and 51.3% with AD fell. In accordance with specific subtasks, total performance on the TUG distinguished fallers from non-fallers with AD, fallers from non-fallers with MCI and non-fallers with MCI from non-fallers with AD. Although no other difference was found in total performances, non-fallers with MCI and fallers with AD differed on the walking forward, turn and turn-to-sit subtasks; and fallers with MCI and non-fallers with AD differed on the turn-to-sit subtask.
Collapse
|
30
|
Gonçalves J, Ansai JH, Masse FAA, Vale FAC, Takahashi ACDM, Andrade LPD. Dual-task as a predictor of falls in older people with mild cognitive impairment and mild Alzheimer's disease: a prospective cohort study. Braz J Phys Ther 2018; 22:417-423. [PMID: 29636306 DOI: 10.1016/j.bjpt.2018.03.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/07/2018] [Accepted: 03/22/2018] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND A dual-task tool with a challenging and daily secondary task, which involves executive functions, could facilitate the screening for risk of falls in older people with mild cognitive impairment or mild Alzheimer's disease. OBJECTIVE To verify if a motor-cognitive dual-task test could predict falls in older people with mild cognitive impairment or mild Alzheimer's disease, and to establish cutoff scores for the tool for both groups. METHODS A prospective study was conducted with community-dwelling older adults, including 40 with mild cognitive impairment and 38 with mild Alzheimer's disease. The dual-task test consisted of the Timed up and Go Test associated with a motor-cognitive task using a phone to call. Falls were recorded during six months by calendar and monthly telephone calls and the participants were categorized as fallers or non-fallers. RESULTS In the Mild cognitive impairment Group, fallers presented higher values in time (35.2s), number of steps (33.7 steps) and motor task cost (116%) on dual-task compared to non-fallers. Time, number of steps and motor task cost were significantly associated with falls in people with mild cognitive impairment. Multivariate analysis identified higher number of steps spent on the test to be independently associated with falls. A time greater than 23.88s (sensitivity=80%; specificity=61%) and a number of steps over 29.50 (sensitivity=65%; specificity=83%) indicated prediction of risk of falls in the Mild cognitive impairment Group. Among people with Alzheimer's disease, no differences in dual-task between fallers and non-fallers were found and no variable of the tool was able to predict falls. CONCLUSION The dual-task predicts falls only in older people with mild cognitive impairment.
Collapse
Affiliation(s)
- Jessica Gonçalves
- Departamento de Fisioterapia, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Juliana Hotta Ansai
- Curso de Fisioterapia, Instituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
| | | | | | | | - Larissa Pires de Andrade
- Departamento de Fisioterapia, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| |
Collapse
|
31
|
Medeiros LB, Ansai JH, Buto MSDS, Barroso VDV, Farche ACS, Rossi PG, Andrade LPD, Takahashi ACDM. Impact of a dual task intervention on physical performance of older adults who practice physical exercise. ACTA ACUST UNITED AC 2018. [DOI: 10.5007/1980-0037.2018v20n1p10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Physical exercises, especially multicomponent training, can improve cognitive functions and physical impairments in older adults. The aim this study was to purpose of this two-arm clinical trial was to investigate the effects of the addition of a dual task to multicomponent training on physical performances of community-dwelling older adults who practice physical exercise. Seventy-one older adults were divided into a control group (CG) and intervention group (IG). Participants of the CG performed isolated multicomponent training, participants of the IG performed multicomponent training associated with cognitive tasks and both protocols lasted 12 weeks. The assessment consisted of flexibility, handgrip strength, lower limb strength, balance, functional mobility and aerobic capacity. The CG presented greater flexibility than the IG, regardless of time. There was a worse performance in lower limb strength, regardless of group. The addition of a dual task to the multicomponent training was not able to improve physical performances of older adults. Further studies are needed to confirm whether the dual task training contributes to both cognitive and physical benefits in older adults who practice physical exercise.
Collapse
|
32
|
Bragatto VSR, Andrade LPD, Rossi PG, Ansai JH. Dual-task during gait between elderly with mild cognitive impairment and Alzheimer: systematic review. Fisioter mov 2017. [DOI: 10.1590/1980-5918.030.004.ar03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Studies report that mobility changes could be present in early stages of Alzheimer’s disease (AD) or even in previous stages, such as mild cognitive impairment (MCI). The use of motor tests, involving dual task, could facilitate screening and differentiation between elderly with AD and MCI. Objective: to verify if gait tests associated with secondary tasks could differentiate elderly with AD and MCI. Methods: We conducted a systematic review in Pubmed, Web of Science, Medline and Scielo databases. Of the articles included, we collected information about year of the study, characteristics of the sample and the dual task test studied. Results: The databases were accessed during November 2014 and August 2015 and a total of 198 scientific papers was obtained. After reading first the summaries and then the full texts, five studies were inserted in the review. Elderly with AD presented a reduction of gait speed and stride length, using executive functions and countdown as secondary cognitive tasks. The type of MCI appears to influence the differentiation with AD. Conclusion: The review showed that some gait tests associated with a secondary task differentiate elderly with AD and MCI. It emphasizes the need of new studies involving this issue in order to obtain cut-off points and facilitate prevention, early diagnosis and observation of cognitive impairment’s evolution in clinical practice of elderly.
Collapse
|
33
|
Ansai JH, Andrade LPD, Rossi PG, Almeida ML, Carvalho Vale FA, Rebelatto JR. Association Between Gait and Dual Task With Cognitive Domains in Older People With Cognitive Impairment. J Mot Behav 2017; 50:409-415. [PMID: 28901834 DOI: 10.1080/00222895.2017.1363702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/18/2022]
Abstract
The authors investigated whether impaired gait and dual-task performances are associated with specific cognitive domains among older people with preserved cognition (PC), mild cognitive impairment (MCI), and mild Alzheimer's disease (AD). The sample comprised 40 older adults with PC, 40 with MCI, and 38 with mild AD. The assessment consisted of gait (measured by 10-m walk test and Timed Up and Go Test [TUGT]), dual task (measured by TUGT associated with a cognitive-motor task of calling a phone number), and cognition (domains of the Addenbrooke Cognitive Examination-Revised and Frontal Assessment Battery [FAB]). For data analysis, the Pearson product-moment correlation and the backward stepwise linear regression were conducted. Language, fluency, and visuospatial domains predicted the 10-m walk test measure specifically in PC, MCI, and AD groups. Only the visuospatial domain was independently associated with the TUGT measure in the MCI and AD groups. FAB score, language domain, and FAB score and fluency domain were the strongest predictors for the isolated cognitive-motor task measure in the PC, MCI, and AD groups, respectively. The visuospatial domain was independently associated with the dual-task test measure in all 3 groups. The study findings demonstrate the influence of specific cognitive domains in daily mobility tasks in people with different cognitive profiles.
Collapse
Affiliation(s)
| | | | - Paulo Giusti Rossi
- a Department of Physiotherapy , Federal University of São Carlos , Brazil
| | | | | | | |
Collapse
|
34
|
Ansai JH, Aurichio TR, Gonçalves R, Rebelatto JR. Effects of two physical exercise protocols on physical performance related to falls in the oldest old: A randomized controlled trial. Geriatr Gerontol Int 2015; 16:492-9. [PMID: 25868484 DOI: 10.1111/ggi.12497] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2015] [Indexed: 11/29/2022]
Abstract
AIM To compare the effects of 16-week multicomponent and resistance training, and 6-week detraining on physical variables related to a higher risk of falls in very old people. METHODS A randomized, three-arm, controlled trial was carried out. A total of 69 community-dwelling older adults aged 80 years and older were allocated to three groups: control, multicomponent training and resistance training. They were assessed at baseline, after 16-week training and 6-week detraining. The control group did not perform any intervention. The multicomponent group performed protocol consisting of warm-up, aerobic, strength, balance and cool-down exercises. The resistance group underwent strength exercises using six adapted machines. The training sessions had progressive intensity, lasted 16 weeks and 12 included three 1-h sessions per week. The assessment consisted of anamneses, five-repetition sit-to-stand, one-leg standing, tandem and dual task tests. For statistical analysis, α = 0.05 was used. RESULTS There were no significant differences between groups and assessments in any variable when analyzed by intention to treat. However, when analyzed, the older adults who adhered to the training, the multicomponent group, had a significant improvement in the sit-to-stand and the one-leg standing (right support) tests. There was a significant main effect between times on the one-leg standing (left support) test. CONCLUSION In very old people, multicomponent training seems to be more beneficial and presents fewer adverse events when the adherence to protocol is higher.
Collapse
Affiliation(s)
- Juliana Hotta Ansai
- Postgraduate Program of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - Thais Rabiatt Aurichio
- Postgraduate Program of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - Raquel Gonçalves
- Postgraduate Program of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - José Rubens Rebelatto
- Postgraduate Program of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| |
Collapse
|
35
|
Ansai JH, Aurichio TR, Rebelatto JR. Relationship between balance and dual task walking in the very elderly. Geriatr Gerontol Int 2015; 16:89-94. [PMID: 25597594 DOI: 10.1111/ggi.12438] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Juliana Hotta Ansai
- Postgraduate Program in Physiotherapy; National Health Council; Federal University of São Carlos; São Carlos Brazil
| | - Thais Rabiatti Aurichio
- Postgraduate Program in Physiotherapy; National Health Council; Federal University of São Carlos; São Carlos Brazil
| | - José Rubens Rebelatto
- Postgraduate Program in Physiotherapy; National Health Council; Federal University of São Carlos; São Carlos Brazil
| |
Collapse
|
36
|
Ansai JH, Rebelatto JR. Effect of two physical exercise protocols on cognition and depressive symptoms in oldest-old people: A randomized controlled trial. Geriatr Gerontol Int 2014; 15:1127-34. [DOI: 10.1111/ggi.12411] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2014] [Indexed: 12/23/2022]
Affiliation(s)
- Juliana Hotta Ansai
- Postgraduate Program in Physiotherapy; Federal University of São Carlos; São Carlos Brazil
| | - José Rubens Rebelatto
- Postgraduate Program in Physiotherapy; Federal University of São Carlos; São Carlos Brazil
- National Health Council; Brasilia Brazil
| |
Collapse
|
37
|
Ansai JH, Glisoi SFDN, Oliveira TD, Soares AT, Cabral KDN, Sera CTN, Paschoal SMP. Revisão de dois instrumentos clínicos de avaliação para predizer risco de quedas em idosos. Rev bras geriatr gerontol 2014. [DOI: 10.1590/s1809-98232014000100017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introdução: Quedas são um problema clínico comum nos idosos, que pode reduzir sua mobilidade e independência. O uso de instrumentos simples para detecção do risco de quedas é fundamental para prevenção e tratamento de tais eventos. Não há, porém, consenso quanto aos testes mais adequados para cada situação. Objetivo: Revisar estudos sobre eficácia, sensibilidade e especificidade dos testes Timed Up and Go Test e Berg Balance Scale, a fim de verificar qual é o mais apropriado para predizer quedas em idosos. Métodos: Realizou-se revisão bibliográfica nas bases de dados MEDLINE, PubMed, ISI, LILACS e Portal de Periódicos CAPES, entre os anos de 2001 e 2011. Resultados: Foram selecionados 37 artigos, sendo 17 sobre a Berg Balance Scale e 20 sobre o Timed Up and Go Test. A revisão mostrou que os dois testes podem ser bons preditores de quedas, mas os artigos diferiram quanto à definição de queda e caidor, tipo de estudo, quantidade e característica da amostra e avaliação de quedas, levando a diferentes resultados quanto a nota de corte, sensibilidade, especificidade e predição de quedas. Há controvérsias quanto à capacidade de predição em perfis específicos, como os idosos ativos. Conclusão: Os testes avaliados são eficazes para predição de quedas, desde que adaptados para cada perfil. Novos estudos devem ser realizados com metodologia homogênea, a fim de favorecer a comparação de resultados sobre a eficácia desses testes.
Collapse
|
38
|
Ansai JH, Glisoi SFDN, Silva TOD, Ferreira FPC, Lunardi AC, Sera CTN. Evolução de desempenho físico e força de preensão palmar em idosos assistidos por um programa de assistência domiciliar interdisciplinar em um ano. Fisioter Pesqui 2013. [DOI: 10.1590/s1809-29502013000200016] [Citation(s) in RCA: 2] [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
Com o aumento de morbidades no envelhecimento, há necessidade de serviços de saúde que prestem assistência aos idosos, como o atendimento domiciliar. Com o objetivo de analisar o desempenho físico e a força de preensão palmar (FPP) em idosos atendidos pelo Núcleo de Assistência Domiciliar Interdisciplinar, 19 idosos com capacidade de compreensão, independentes para marcha e sem descompensação de doença foram avaliados e reavaliados após um ano. A avaliação consistiu na coleta de dados clínicos e antropométricos nos registros de prontuários e desempenho físico (Short Physical Performance Battery-SPPB) e força de preensão palmar no domicílio do paciente. Compararam-se as avaliações (teste t pareado) e verificou-se associação entre índice de massa corporal (IMC), idade, SPPB e FPP (correlação de Pearson). Em um ano, houve piora significativa na FPP nos dois membros, velocidade de marcha e desempenho físico geral. O IMC, equilíbrio e força de membros inferiores (FMI) foram mantidos. Correlação inversa foi observada entre idade e variação de equilíbrio (r=-0,55) e direta entre FPP e marcha (r=0,48). As outras variáveis não apresentaram correlação significativa. Uma assistência mais específica e frequente traria benefícios para a independência e qualidade de vida dessa população, uma vez que os idosos têm elevada perda funcional e comorbidades.
Collapse
|