STATIC BALNCE IN OLDER ADULTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE UNDERGOING PULMONARY REHABILITATION

Geriatrics, Gerontology and Aging

Cristino Carneiro Oliveira¹  Laura Maria Tomazi Neves²  Bianca Callegari³  Kaio Primo Manso⁴  Clara Narcisa Silva Almeida⁵  Juliana Figueiredo Ferreira⁵  Rayane Alves da Costa⁵ 

[1] Department of Physical Therapy, Universidade Federal de Juiz de Fora – Governador Valadares Campus (MG), Brazil.;Graduate Program in Movement Science, Universidade Federal do Pará – Belém (PA), Brazil. João de Barros Barreto University Hospital, Universidade Federal do Pará – Belém (PA), Brazil.;Human Motricity Laboratory, Institute of Health Sciences, Universidade Federal do Pará – Belém (PA), Brazil. Graduate Program in Movement Science, Universidade Federal do Pará – Belém (PA), Brazil.;School of Physical Therapy and Occupational Therapy, Institute of Health Sciences, Universidade Federal do Pará – Belém (PA), Brazil. Human Motricity Laboratory, Institute of Health Sciences, Universidade Federal do Pará – Belém (PA), Brazil.;School of Physical Therapy and Occupational Therapy, Institute of Health Sciences, Universidade Federal do Pará – Belém (PA), Brazil.;

关键词: chronic obstructive pulmonary disease;    aged;    postural balance;    proprioception;    respiratory muscles;   

DOI  :  10.5327/Z2447-212320201900091

来源: DOAJ

【 摘 要 】

OBJECTIVES: To examine older people’s preferences for self-involvement in end-of-life care decision-making in scenarios of mental capacity (competency) and incapacity, and to identify associated factors. METHODS: A cross-sectional survey was conducted including 400 individuals aged 60+ years living in the city of Belo Horizonte, Brazil. RESULTS: Among 400 respondents, 95.3% preferred self-involvement when capable (due to the high percentage, associated factors were not calculated) and 64.5% preferred self-involvement when incapable through, for example, a living will. Considering that participants could choose multiple answers, the most frequent combinations in the capacity scenario were “yourself” and “other relatives” (76.8%) and “yourself” and “the doctor” (67.8%). In the incapacity scenario, the most frequent combinations were “yourself” and “other relatives” (usually their children and, less often, their grandchildren) (59.3%) and “yourself” and “the doctor” (48.5%). Three factors were associated with a preference for self-involvement in an incapacity scenario. Those who were married or had a partner (widowed; adjusted odds ratio [AOR] = 0.37; 95% confidence interval [CI] 0.19–0.68) and those who were male (female; AOR = 0.62; 95%CI 0.38–1.00) were less likely to prefer self-involvement. Those who were younger, as in age bands 60-69 years (80+; AOR = 2.35; 95%CI 1.20–4.58) and 70–79 years (80+; AOR = 2.45; 95%CI 1.21–4.94), were more likely to prefer self-involvement. CONCLUSIONS: Most participants preferred self-involvement in both scenarios of capacity and incapacity. Preference for self-involvement was higher in the scenario of capacity, while preference for the involvement of other relatives (usually their children) was greater in the scenario of incapacity.OBJECTIVE: To compare balance between older adults with and without chronic obstructive pulmonary disease (COPD) in tasks involving proprioceptive changes and respiratory muscle load, and to investigate the association between balance, functional capacity, and peripheral and respiratory muscle strength. METHODS: Fourteen older adults with COPD undergoing pulmonary rehabilitation and nine older adults without pulmonary disease were evaluated for static balance on a force platform under four conditions: eyes open, eyes closed, eyes closed on foam, and eyes open with respiratory overload. Differences between groups, among conditions and group/condition interactions, were tested using two-way ANOVA. Associations were explored using Pearson’s correlation coefficient. RESULTS: No differences in the posturographic variables were found in the group/condition interactions (p ≥ 0.23). The COPD group exhibited greater total displacement (F = 8.79, p = 0.003), mediolateral sway (F = 4.01, p = 0.04) and anteroposterior velocity (F = 4.28, p = 0.04) in the group effect analysis. Significant differences were found between eyes closed on foam and other conditions for all posturographic variables: anteroposterior sway (F = 13.39), mediolateral sway (F = 28.58), total displacement (F = 59.4), area (F = 37.68), anteroposterior velocity (F = 26.42), and mediolateral velocity (F = 33.29), in the condition effect analysis (p < 0.001, post-hoc). In the COPD group, significant correlations were found between the Glittre-ADL test, anteroposterior sway (r = 0.68, p = 0.01), and anteroposterior velocity (r = 0.67, p = 0.009); the 6MWT was also correlated with anteroposterior velocity (r = 0.59, p = 0.03). CONCLUSION: Older adults with COPD present balance deficits compared to healthy individuals. The unstable surface caused greater postural instability compared to other conditions in both groups. Impaired balance was associated with reduced physical function and exercise capacity.

【 授权许可】

Unknown