Fatores que influenciam a prática de atividade física e risco de quedas em idosos com Doença Pulmonar Obstrutiva Crônica
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2018-05-30
Autores
Pontes, Natália de Souza [UNESP]
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Universidade Estadual Paulista (Unesp)
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Introdução: A DPOC é uma doença respiratória crônica, com repercussões sistêmicas, atribuídas a combinação de fatores de risco relacionados às manifestações pulmonares e extrapulmonares da doença, como a dispneia e atrofia muscular periférica, acarretando fraqueza muscular em extremidades inferiores, influenciando nos níveis de atividade física da população e aumentando o risco de quedas. Objetivo: identificar os fatores que facilitam e dificultam a adesão à prática de atividade física e o risco de quedas de idosos com DPOC atendidos em unidades de saúde da família. Métodos: Para a avaliação qualitativa, foi incluída uma sub-amostra, de um estudo de prevalência em andamento, realizado com idosos com DPOC, de ambos os sexos. Os idosos com DPOC foram convidados a participar de grupos de discussão, os quais foram conduzidos por um moderador com experiência em pesquisa qualitativa, que posteriormente foram transcritos verbatim. A análise dos dados qualitativos se dá por meio da análise de conteúdo, que é desenvolvida como meio de categorização de dados para efeitos de classificação, organização e compactação. Para a avaliação foram avaliados o equilíbrio estático com o teste de Romberg, o equilíbrio funcional com a Escala de Equilíbrio de Berg (EEB) e a mobilidade funcional por meio do teste Time Up & Go (TUG). Resultados: Os idosos consideram a DPOC uma doença, e como barreiras citaram as físicas, psicológicas, sociais, os sintomas apresentados pela doença, as percepções ou experiências negativas com a prática de atividade física, além da infraestrutura inadequada e prática não supervisionadas. Os fatores facilitadores identificados foram os efeitos positivos físicos, psicológicos e sociais percebidos, as razões para o início da prática (doenças pré-existentes associadas). A amostra foi composta, de 20 idosos, 55% homens e 45% mulheres. Os idosos foram divididos em dois grupos: G-DPOC (n=10; 73,6±7,71 anos), idosos com diagnóstico clínico de DPOC de acordo com a Classificação Internacional de Doenças (CID10) e grupo controle (GC; n=10; 69,7±6,17 anos), idosos saudáveis. Em relação ao equilíbrio estático e funcional, apenas os idosos com DPOC apresentaram risco de quedas (Romberg=20%; EEB=30%, respectivamente). O TUG dos idosos com DPOC foi maior comparado ao dos idosos sem DPOC (13,3±4 vs 10,3±3 segundos; p=0,095). Além disso, nos idosos com DPOC houve correlação negativa entre o EEB e TUG (r=0,826; p=0,005), indicando que quanto menor a pontuação na EEB maior o tempo na execução do TUG. Conclusão: Foi possível identificar os fatores considerados facilitadores e as barreiras para a prática de atividade física e que os idosos com DPOC apresentam maior risco de quedas em comparação aos idosos saudáveis.
Introduction: COPD is a chronic respiratory disease with systemic repercussions, attributed to the combination of risk factors related to pulmonary and extrapulmonary manifestations of the disease, such as dyspnea and peripheral muscular atrophy, leading to muscle weakness in the lower extremities, influencing activity levels and increase the risk of falls. Objective: to identify factors that facilitate and hamper adherence to physical activity practice and the risk of falls of elderly people with COPD attended at family health units. Methods: For the qualitative evaluation of factors influencing the practice of physical activity, a sub-sample of in progress prevalence study was carried out with elderly patients with COPD of both sexes. The elderly with COPD were invited to participate in discussion groups, which were conducted by a moderator with experience in qualitative research, who were later transcribed verbatim. The analysis of qualitative data is done through content analysis, which is developed as a means of categorizing data for purposes of classification, organization and compaction. For the evaluation, the static balance with the Romberg test, the functional balance with the Berg Balance Scale (BBS) and functional mobility were evaluated using the Time Up & Go (TUG) test. Results: The elderly consider COPD a disease, and as barriers they cited the factors physical, psychological and social, the symptoms presented by the disease, negative perceptions or experiences with the practice of physical activity, as well as inadequate infrastructure and unsupervised practical. The facilitating factors identified were positive physical, psychological and social effects perceived, the reasons for the beginning of the practice (associated pre-existing diseases). The sample consisted of 20 elderly, 55% male and 45% female. The elderly were divided into two groups: G-COPD (n = 10; 73.6 ± 7.71 years), elderly with clinical diagnosis of COPD according to the International Classification of Diseases (ICD10) and control group (CG; = 10, 69.7 ± 6.17 years), healthy elderly. In relation to the static and functional balance, only the elderly with COPD presented a risk of falls (Romberg = 20%, BBS = 30%, respectively). The TUG of the elderly with COPD was higher compared to the elderly without COPD (13.3 ± 4 vs 10.3 ± 3 seconds, p = 0.095). In addition, in the elderly with COPD, there was a negative correlation between BBS and TUG (r = 0.826; p = 0.005), indicating that the lower the BBS score the longer the TUG execution time. Conclusion: It was possible to identify the factors considered as facilitators and barriers to physical activity practice and that the elderly with COPD are a higher risk of falls compared to the healthy elderly.
Introduction: COPD is a chronic respiratory disease with systemic repercussions, attributed to the combination of risk factors related to pulmonary and extrapulmonary manifestations of the disease, such as dyspnea and peripheral muscular atrophy, leading to muscle weakness in the lower extremities, influencing activity levels and increase the risk of falls. Objective: to identify factors that facilitate and hamper adherence to physical activity practice and the risk of falls of elderly people with COPD attended at family health units. Methods: For the qualitative evaluation of factors influencing the practice of physical activity, a sub-sample of in progress prevalence study was carried out with elderly patients with COPD of both sexes. The elderly with COPD were invited to participate in discussion groups, which were conducted by a moderator with experience in qualitative research, who were later transcribed verbatim. The analysis of qualitative data is done through content analysis, which is developed as a means of categorizing data for purposes of classification, organization and compaction. For the evaluation, the static balance with the Romberg test, the functional balance with the Berg Balance Scale (BBS) and functional mobility were evaluated using the Time Up & Go (TUG) test. Results: The elderly consider COPD a disease, and as barriers they cited the factors physical, psychological and social, the symptoms presented by the disease, negative perceptions or experiences with the practice of physical activity, as well as inadequate infrastructure and unsupervised practical. The facilitating factors identified were positive physical, psychological and social effects perceived, the reasons for the beginning of the practice (associated pre-existing diseases). The sample consisted of 20 elderly, 55% male and 45% female. The elderly were divided into two groups: G-COPD (n = 10; 73.6 ± 7.71 years), elderly with clinical diagnosis of COPD according to the International Classification of Diseases (ICD10) and control group (CG; = 10, 69.7 ± 6.17 years), healthy elderly. In relation to the static and functional balance, only the elderly with COPD presented a risk of falls (Romberg = 20%, BBS = 30%, respectively). The TUG of the elderly with COPD was higher compared to the elderly without COPD (13.3 ± 4 vs 10.3 ± 3 seconds, p = 0.095). In addition, in the elderly with COPD, there was a negative correlation between BBS and TUG (r = 0.826; p = 0.005), indicating that the lower the BBS score the longer the TUG execution time. Conclusion: It was possible to identify the factors considered as facilitators and barriers to physical activity practice and that the elderly with COPD are a higher risk of falls compared to the healthy elderly.
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Palavras-chave
Doença Pulmonar Obstrutiva Crônica, Idoso, Atividade Física, Acidentes por Quedas, Atenção Básica, Chronic Obstructive Pulmonary Disease, Elderly, Physical Activity, Accidents by Falls, Primary Health Care