Search

Problematic use of opioids by older adults is associated with adverse effects and has become a public health crisis worldwide. Ageing-related disabilities in activities of daily living (ADL) could promote unnecessary use of opioids in this population. This study evaluates the association between ADL disability and opioid consumption in Brazilian older adults. Study design- cross-sectional secondary data analysis of the second wave of the Brazil Longitudinal Study of Ageing (ELSI-Brazil). Data from the second wave of the Brazil Longitudinal Study of Ageing (ELSI-Brazil) were used. Older adults with chronic pain were included. ADL disability was measured using the Katz Index. The primary outcome was opioid consumption for chronic pain. The primary association was explored using logistic regression models adjusting for predetermined confounders. Sensitivity analyses evaluating model performance were done by calibrating and validating the model using randomly split equal sets. In those who reported presence of chronic pain (n = 2865), the prevalence of opioid use was 29% (95% CI:23.1%–35.6%). In adjusted models, participants with moderate and severe ADL disability had 1.6 (95% CI:1.13–2.32; P = 0.009) and 3.8 (95% CI: 1.80–7.90; P < 0.001) times higher odds of opioid consumption compared to no disability, respectively. Being female, alcohol consumption, higher pain intensity, history of dementia, fractures, and presence of ≥2 comorbidities were significantly associated with increased opioid use (P < 0.05). Nearly one-third of the Brazilian elderly population experiencing chronic pain reported using opioids. The functional decline during the process of ageing appears to be a risk factor for pain intolerance and opioid use. Multidisciplinary approaches to detect early ADL disabilities and improve mobility and access to assistive technologies need to be established to prevent opioid overuse and addiction in elderly populations. [ABSTRACT FROM AUTHOR]

To investigate the validity of six age-predicted maximum heart rate (HRmax) equations after stroke. Sixty individuals (54 (12) years; 64 (69) months after stroke) were included. A Cardiopulmonary Exercise Test (CPET) performed on a treadmill obtained the HRmax. The most used age-predicted equations were investigated: (1) 220-age, proposed by Fox; (2) 206.9– (0.67 × age), proposed by Gellish; (3) 208– (0.7 × age), proposed by Tanaka; (4) 216.6– (0.84 × age), proposed by Astrand; (5) 164– (0.72 × age) and (6) 200– (0.92 × age) proposed by Brawner. No statistically significant agreement was found between the HRmax obtained by the CPET and the one predicted by the equations 1–5 (–0.18 ≤ 95% confidence interval ≤0.79). A significant and moderate agreement was found between the HRmax obtained by the CPET and the one predicted by equation (6) (95% CI= 0.05–0.75; Intraclass Correlation Coefficient= 0.51). Bland-Altman plots showed that equations (1–4) and (6) overestimated the HRmax. Equation (6) presented the lower mean difference. The equations developed for non-disabled individuals (1–4) are not adequate to be used in individuals after a stroke. Equation (6) (Brawner) showed the best results to be used in individuals after stroke; however, it should be used cautiously. Prediction equations for maximum heart rate (HRmax) are commonly used to prescribe aerobic exercise for individuals following a stroke. The equations developed for non-disabled individuals are not valid for use with individuals after stroke, leading to an overestimation of the HRmax. An age-predicted HRmax equation developed for individuals with coronary heart disease may provide outcomes that are more accurate for stroke survivors, but care should still be taken when using it. [ABSTRACT FROM AUTHOR]

different populations have different averages of life-space assessment scores and defining cutoff values of clinical significance by each population should take into consideration. Different cutoffs to define restricted life space have been reported. The most common is a score of 60 points. There are other cutoffs derived from receiver operating characteristic (ROC) analysis and used to classify older adults according to their ability in activities of daily living (ADLs) (52.3 points) or instrumental activities of daily living (IADLs) (56 points); other cutoffs are specialized for people with cognitive impairment (26.75 points) or people with spinal cord injury who need mobility aids (78.5 points). The aims were to identify cutoff points of Life Space Assessment (LSA) in older adults in different sites and to determine the relationship of the cutoff scores with mobility disability and depression. The study population was composed of community-dwelling adults aged 65–74 years who were not institutionalized. An ROC analysis was constructed, and the area under the curve (AUC) was calculated to identify the optimal cutoff that discriminates life-space restriction for each city. Logistic regressions were executed by site to comprehend the association among restricted LSA and mobility disability and depression. In total, 1890 participants were included in the analyses (52.38% women, 37.19% mobility disability and 21.32% had depression). Canada cities had the highest cutoff, while Tirana and Natal had the lowest cutoff (< 50). Kingston was the site with the highest association between life-space restriction and mobility disability (OR 5.4, 95% CI 2.9–10). Saint-Hyacinthe, Tirana, and Manizales had significant associations between depression and restricted life space (OR 3.25, 95% CI 1.53–6.89, OR 3.14, 95% CI 1.88–5.24, and OR 3.99, 95% CI 2.28–6.98, respectively). Different cutoffs to define restricted life-space have been identified in elderly people at different sites. The analysis of the relationship between the restricted life space and personal characteristics like depression and mobility disability supported these findings. The groupings produced by the cutoff points for each site showed notable variations. These findings emphasize the importance of population-based cutoffs to improve the general applicability of LSM criteria and take into consideration the importance of site-specific approaches. [ABSTRACT FROM AUTHOR]

BACKGROUND: In recent years, with ever-improving technology, considerable progress has been made in the approaches available to develop mobility assistive technology systems. OBJECTIVE: This paper aims to anticipate the future of assistive technologies of navigation and mobility for people with severe visual disabilities in the next twenty years (2021–2041). METHODS: We conducted a technology foresight exercise by identifying promising technologies and invited over 20,000 researchers worldwide to share their views on the future of assistive technologies for people with visual impairment. The technologies and respondents were identified from specialized journals indexed on Web of Science. RESULTS: Most respondents believe computer vision will be the most important assistive technology group for mobility and navigation for visually impaired people, especially with haptic feedback. They also believe that voice and vibrotactile are the most relevant feedback and that glasses and smartphones will be the most important tools for visual impairment support. CONCLUSIONS: While costs and lack of user training may hamper the development and use of these new technologies, they represent the future of assistive technology for people with visual impairments. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper develops an approach that articulates methods characterized as soft and hard Operational Research. This approach is known in the literature as Multimethodology, Hybrid Modeling, or Mixing Methods. As a Multi‐Paradigm Hybrid Study, the present research provides an interface between the qualitative and quantitative modeling of the problem addressed. In this way, it facilitates the engagement of managers with analysts in the search for solutions to problems. The applied objective is to improve the performance of production processes at a prosthetics and orthotics factory located in Rio de Janeiro, Brazil. It applies a multimethodology to support evaluation and intervention using knowledge mapping and a discrete‐event simulation model. Lessons learned from integrated workshops enabled the devising of an alternative improvement scenario for orthotics manufacturing. Theoretical results are validated through effective intervention, providing an increase in production capacity and reduction of the manufacturing lead time. This was made possible through the understanding and engagement of stakeholders during the modeling process. [ABSTRACT FROM AUTHOR]

Copyright of Avances en Enfermería is the property of Editorial Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to characterize the ostomized users treated in a Department of Orthoses and Prostheses in the region of Campos Gerais, Paraná, regarding socio-demographic, clinical and related to ostomy care. Methodology: Retrospective, descriptive and quantitative study, conducted between February and April 2019 by collecting data from 246 medical records. Results: Most of the sample was male (133; 54.07%), with a mean age of 62.44 years (min=04; max=97), married (138; 56, 10%), with one to four years of schooling (103; 41.87%), who lived with their spouse and children (72; 29.27%) and retired (106; 43.09%). There was a predominance of colostomies (164; 66.66%), permanent (59; 23.98%), whose main cause was cancer (155; 63.01%). Conclusion: The results support the management of the Enterostomal Therapist responsible for the users in search of improvements in care, knowing the needs and individual characteristics of each patient. [ABSTRACT FROM AUTHOR]

Introduction. The Functional Mobility Assessment (FMA) measures satisfaction with mobility devices in daily life. However, in Brazil, there is a lack of instruments which measure functional mobility. Objective. We aim to report the cross-cultural adaptation process and face validity of the FMA for use in Brazil. Methods. Two international guidelines were used in the cross-cultural adaptation process. Two independent translators translated the instrument from English to Brazilian Portuguese, and the two versions were reconciled. Two different translators back translated this reconciled version, and an expert committee analysed the resulting synthesis. For face validity, the FMA was applied with 24 participants, divided into two groups, users with disabilities (n = 12) and occupational therapy students (n = 12), to verify their understanding of each item of the instrument. Results. The cross-cultural adaptation of the FMA was concluded, and its face validity presented that both groups understood most or completely all instrument items. Conclusion. The Brazilian version of FMA is now available in Brazilian Portuguese and has face validation. Further studies should test its psychometric properties. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PURPOSE: The purpose this study was perform a biomechanical evaluation to compare the influence of commercial models of different non-articular proximal forearm orthoses widths (2.5 cm, 5.5 cm, 7.5 cm and 12.0 cm) in the extensor muscle activation, range of motion and grip strength in healthy subjects. METHODS: Was analyzed data from extensor carpi radialis, extensor carpi ulnares and extensor digitorum comunis using surface electromyography, simultaneous with a wrist electrogoniometer MiotecTM and a hydraulic dynamometer JamarTM. The sequence of tests with all the commercial orthoses models was randomized. Statistics analyses were performed by linear model with mixed effects. RESULTS: According to our findings the non-articular proximal forearm orthoses (2.5 cm -- narrowest) positioned close to lateral epicondyle provided lesser muscle activation on extensor carpi radialis brevis/longus and extensor digitorum comunis, decreased wrist extension and grip strength during submaximal grip task (p< 0.01). CONCLUSIONS: A narrow non-articular proximal forearm orthosis positioned close to the lateral epicondyle might decrease the extensor muscle activation and therefore could reduce mechanical stress on its insertion, based on this sample. Clinical studies must be conducted to conform these findings. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Compare the efficacy of orthoses and patient education with and without the addition to Low-Level Laser Therapy (LLLT - 660 nm, 30 mW, a continuous regime and bean area of 0.06 cm2). The laser irradiation was delivered with the fluency of 10J/cm2 in patients with mild and moderate Carpal Tunnel Syndrome (CTS). METHODS: 48 patients were randomized and 30 finished the protocol (a sample loss of 37.5%), 90% female and 10% males. Randomization was applied to allocate the patients in each one of the groups, with association or not to LLLT (group orthoses or LLLT and orthoses). All of them were submitted to ergonomic home orientations. The short-term symptoms and function outcome were assessed through: Boston Carpal Tunnel Questionnaire (BCTQ) - Severity of Symptoms (SS) Functional Score (FS). Pain (VAS), Semmes-Weinstein monofilaments, 2PD and pinch strength was used for characterization of the sample. Most of the participants were women, over 4th decade enrolled on heavy hand duties occupations, right-handed, 66.7% affected on dominant hand, without alterations in sensory median nerve thresholds or pinch strength. RESULTS: Both groups showed a reduction of total BCTQ score and its subdomains after six weeks, with significant difference (p <0.05), comparing to baseline. No significant difference was found between groups. A Minimal clinical change was observed after the intervention in 92.3% of participants for BCTQ subdomain severity of symptoms at individual comparison for LLLT and orthoses group and 76.5% for the orthoses group, demonstrating clinical relevance. Effect size Cohen's index was moderate for the severity of symptoms. CONCLUSION: LLLT in association to orthoses and ergonomic orientation seems to be effective in short-term symptoms relieve for patients with mild and moderate CTS. [ABSTRACT FROM AUTHOR]

Background: Improved gait efficiency is one of the goals of therapy for children with cerebral palsy (CP). Postural insoles can allow more efficient gait by improving biomechanical alignment. Objective: The aim of the present study was to determine the effect of the combination of postural insoles and ankle-foot orthoses on static and functional balance in children with CP. Method: A randomized, controlled, double-blind, clinical trial. After meeting legal requirements and the eligibility criteria, 20 children between four and 12 years of age were randomly allocated either to the control group (CG) (n=10) or the experimental group (EG) (n=10). The CG used placebo insoles and the EG used postural insoles. The Berg Balance Scale, Timed Up-and-Go Test, Six-Minute Walk Test, and Gross Motor Function Measure-88 were used to assess balance as well as the determination of oscillations from the center of pressure in the anteroposterior and mediolateral directions with eyes open and closed. Three evaluations were carried out: 1) immediately following placement of the insoles; 2) after three months of insole use; and 3) one month after suspending insole use. Results: The EG achieved significantly better results in comparison to the CG on the Timed Up-and-Go Test as well as body sway in the anteroposterior and mediolateral directions. Conclusion: Postural insoles led to an improvement in static balance among children with cerebral palsy, as demonstrated by the reduction in body sway in the anteroposterior and mediolateral directions. Postural insole use also led to a better performance on the Timed Up‑and-Go Test. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Terapia Ocupacional da UFSCar is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To present a new walking aid with axillary support (WAAS) for children with cerebral palsy (CP) and to investigate its impact on the lower limb muscles activation in the gait of children with CP. Method: Six children with spastic diparesis due to CP performed a straight line walking course in two situations: with and without using the WAAS. Each course was repeated three times for both situations, and electromyography (EMG) activity of quadriceps, hamstrings, tibialis anterior and gastrocnemius were recorded during all trials. Results: The use of WAAS significantly increased the EMG activity of the quadriceps and hamstrings during stance phase and tibialis anterior during swing phase, with no significant increase in gastrocnemius activation. Conclusion: The use of WAAS improved the synergism of lower limbs muscles of children with CP by reducing the coactivation of antagonistic muscles, especially during the swing phase of gait. Providing a walking aid with improved trunk stability may enable children with CP to improve muscular synergism and walking ability, thus favoring independent mobility, with possible gains in social participation and quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Cerebral palsy (CP) may involve muscle imbalance between the spastic muscles and their antagonists leading to weak postural changes, decreased mobility and chest deformities. Objective: To improve postural condition in children with CP using physiotherapy and assistive technology (AT). Materials and methods: Five children with CP and multiple disabilities and postural changes like scoliosis were included in this study. AT involved the use of low-cost custom made cushion seat and backrest for the wheelchairs to achieve 90° of trunk flexion. This was performed in 10 sessions after the beginning of physiotherapy. As evaluation-intervention tool, photographs were taken at the beginning and end of each session, and then analyzed using software for postural assessment (SAPO). Results: Twenty-five per cent of the participants had an improvement of trunk angulations at the end of the treatment program. Conclusion: The use of AT with physiotherapy treatment proved efficient in the postural alignment of children with CP children in a wheelchair. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this case study, designers proactively proposed new product ideas to a client by using an ergonomic approach. This approach differs from a more traditional approach where one works within a specific, clientdefined project. The methodology used included basic ergonomic techniques such as task analysis and information gathering sessions conducted with users. It was adapted so that these enriched user sessions could be conducted within a short time period. After meeting with five users in seven days, designers identified 20 problems that could be tackled and eight design ideas that could be implemented over the short, medium and long term. The ideas encompassed a wide range of potential projects, including physical product improvements, new product lines, Web-site and software improvements and longer term research. Problems identified and ideas generated involved many disciplines including occupational therapy, mechanical engineering, graphical design, software engineering, sales and manufacturing know-how. This wide range was possible because designers were not constrained to specific project scopes and timelines. The client was involved in the idea evaluation process. As a result of this study two new projects were initiated so far. [ABSTRACT FROM AUTHOR]

Objectives: To understand the opinion of the parents about the baby walker and compare the age of gait acquisition between infants that used a walker and those that did not. Methods: In this quali-quantitative study, an interview involving a semi-structured questionnaire was carried out with 26 parents, 14 of whose infants used the equipment (BWG) and 12 of whose infants did not (NBWG) prior to gait acquisition. After extensive content analysis, categories for interpreting the results emerged. For data triangulation, the age of gait acquisition was documented by weekly telephone contact. Student's t-test was used for comparison between groups with a significance level of α=0.05. Results: The following categories were identified in the parents' reports: a) information about the baby walker; b) doubt/ decision to use it vs. certainty about not using it; c) beliefs about the use of a baby-walker; and d) benefits and harm from use. The age of independent gait acquisition did not differ between groups (p=0.837): BWG initiated gait at 376.17 (SD=32.62) days and NBWG did so at 378.75 (SD=27.99) days. Conclusions: The beliefs and feelings that permeate the decision to use a baby walker illustrate the different rationales adopted by parents about the role of this equipment in the child's development of gait and autonomy. The use of a baby walker did not influence the age of gait acquisition. The results broaden the understanding of choices that influence child-rearing practices prior to gait acquisition. [ABSTRACT FROM AUTHOR]

Objective(s): The aim of this study was to evaluate the orofacial manifestations in patients with Mobius syndrome (MS), establish an early adequate dental treatment and discuss the possible etiology of all cases examined based on information about the gestational intercurrences. Design: Prospective study. Setting: Special Care Dentistry Center, School of Dentistry, University of Sao Paulo, Brazil. Subject(s) and methods: Twenty-nine patients with MS aged 0 to 4 underwent prospective dental examination as well as early orthodontic treatment. Results: All patients presented micrognathia, lack of lip seal, high arched palate and weak soft palate. The use of orthopedic appliances was recommended to all 29 patients, but only 13 adhered to treatment and were monitored for at least 24 months. We observed that, after 24 months of treatment, the palate was expanded and micrognathia became less severe in the majority of the cases. Pregnancy-related complications were reported by 27 (97%) of the 29 mothers. Conclusion(s): The early use of orthopedic appliances was important to prevent malocclusion and glossoptosis. Attempted abortion with misoprostol is associated with an increased risk of MS in infants. [ABSTRACT FROM AUTHOR]