Detalhes bibliográficos
| Ano de defesa: |
2022 |
| Autor(a) principal: |
Zmuda, Gabriela Guimarães Oliveira
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| Orientador(a): |
Bós, Angelo Jose Gonçalves
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| Banca de defesa: |
Não Informado pela instituição |
| Tipo de documento: |
Tese
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| Tipo de acesso: |
Acesso aberto |
| Idioma: |
por |
| Instituição de defesa: |
Pontifícia Universidade Católica do Rio Grande do Sul
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| Programa de Pós-Graduação: |
Programa de Pós-Graduação em Gerontologia Biomédica
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| Departamento: |
Escola de Medicina
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| País: |
Brasil
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| Palavras-chave em Português: |
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| Área do conhecimento CNPq: |
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| Link de acesso: |
https://tede2.pucrs.br/tede2/handle/tede/10158
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Resumo: |
Aging brings sensory-perceptual-motor alterations that directly affect postural control, which depend on the integration of information coming from the sensory system (vestibular, visual and somatosensory or proprioceptive) and the action of the musculoskeletal system. Cohort analytical observational study that aims to evaluate the participation of systems for maintaining body balance and parameters of the Mobility Suite® smartphone application in predicting falls in the elderly. The population consisted of elderly people (≥ 60 years) who were invited to participate in the study for convenience. Those who walked independently, without the use of auxiliary gait devices, as well as those who understood verbal commands were included. The elderly had their balance assessed by Foam-Laser Posturography (FLP) and their risk of falling by the functional tests of the Mobility Suite® smartphone application. The future occurrence of falls was monitored for one year, through telephone contact. Participants were divided into two groups (fallers and non-fallers). The distribution of variables was tested using the chi-square. Parameter means were tested by Student's t. The number of days between assessment and first fall or last contact was calculated for the survival analysis assessed by simple and adjusted Cox Damage Regression models. The efficiency of the test phases was tested using sensitivity and specificity parameters (curve ROC). Degrees less than 5% were considered statistically significant and between 5 and 10% indicative of significance (Epi InfoTM 7.2). Of the 42 evaluated, 52.38% elderly had a fall. Women had proportionally more falls than men (58.82%; p=0.091). In FES-I, fallers had the highest mean (22.90±5.19; p=0.088). In the GDS-15 and in the MMSE, fallers showed greater impairment, 3.95±3.18 (p=0.002) and 26.68±2.98 (p=0.038), respectively. We did not find significant differences in SOT scores and sensory analysis between groups, however fallers had lower means in all FLP components. In the sTUG Doctor, fallers needed more time (10.09±1.57; p=0.010) and more steps to complete the test (12.36±1.09; p=0.039). We did not have elderly people classified at high risk of falling, however, 76.92% of the sample with medium risk fell during follow-up (p=0.047). In the 4STB test, in the Semi-Tandem and Tandem phase, higher values of trunk displacement were observed in fallers, 2.17±0.55; p=0.067 and 3.04±0.96; p=0.004, respectively. In the 30SCS test, we observed in all phases the highest mean in the fallers, S2ST (1.05±0.12; p=0.023), ST (1.10±0.17; p<0.001), ST2S (1.01±0 .07; p=0.055), SIT (1.03±0.06; p=0.011) and number of repetitions (9.45±1.33; p<0.001). Elderly classified below average in the 30SCS test had proportionally more falls (39.13%; p=0.056). The components and phases that showed the best accuracy to define the fall outcome with their respective cut-off points in relation to FLP were the SOT V (73.15) and the Visual Analysis (92%). Regarding the tests of the Mobility Suite® application, the total TUG (10.09 seconds), the Tandem phase (2.51 cm) and the 30SCS Total phase (10.05 repetitions) were used. Through this study, it was possible to establish fall prediction parameters for the FLP components and application tests. Still, propose normality values for the Mobility Suite® tests. This was the first longitudinal study that used the FLP and the Mobility Suite® to assess the prediction of falls in the elderly. The tests proved to be satisfactory even in elderly people with a low risk of falls. In the case of the application, it proved to be useful for use in different environments and health contexts and can be used in future investigations. Through this study, we obtained initial parameters on the quantification of tests in the elderly, providing subsidies for the establishment of normal values for the elderly population. |
