Showing papers by "Marcia A. Ciol published in 2015"

A randomized controlled trial of an educational programme to improve self-care in Brazilian patients following percutaneous coronary intervention.

Abstract: Aims To test an educational programme with telephone follow-up to improve self-care in Brazilian patients who underwent percutaneous coronary intervention. Background Percutaneous coronary intervention has been established as a treatment for coronary disease. However, additional intervention is needed to improve self-care for individuals who undergo this procedure to reduce further disease. Telephone follow-up is one strategy that has been used to improve chronic disease self-care. Design Randomized controlled trial. Trial registration: ClinicalTrials.gov, NCT01341093. Methods Sixty patients who were preparing for their first percutaneous coronary intervention between 2011–2012 were randomly allocated to an educational programme with telephone follow-up (N = 30) or a control group (N = 30). Perceived health status was assessed with the Medical Outcomes Study 36-Item Short Form. Self-efficacy, symptoms of anxiety and depression and medication adherence were also assessed. Measures were collected before intervention (baseline) and 6 months later. Results Both groups improved from baseline to 6 months in the ‘Physical Component Summary’ and in the domains of ‘Physical Functioning’, ‘Role–Emotional’ and ‘Role–Physical’. The educational programme group showed a reduction in anxiety from baseline to 6-month follow-up, while the control group showed a slight increase. No differences in symptoms in depression and self-efficacy were found and both groups reported high levels of medication adherence. Conclusion The educational programme with telephone follow-up is a promising intervention as it led to reduction in anxiety for those receiving the educational programme. Further improvements in timing and focus of the educational programme, such as targeting emotional and social lifestyle changes, might be warranted.

Young Adults Largely Depend on Vision for Postural Control When Standing on a BOSU Ball but Not on Foam

Abstract: What happens at the sensory level when a person is balancing on compliant surfaces? Compliant surfaces such as both-sides-up (BOSU) balls are often used as a form of "proprioceptive exercises." Clinical theories in neurorehabilitation suggest that compliant surfaces disrupt the somatosensory contribution to balance and increase reliance on vision and vestibular input. Understanding the sensory aspects of compliant surfaces' exercises would have important implications for balance training of athletes and of people with somatosensory deficits such as people with recurrent ankle sprains. We tested this clinical theory in a sample of 30 healthy young adults and 10 adults with a history of repeated ankle sprains while they were standing on a BOSU ball, memory foam, or floor. We measured participants' center of pressure response to dots projected on a screen, moving mediolaterally at one of the 3 frequencies (0.4, 0.48, and 0.56 Hz). We calculated magnitude of the postural response (gains) and participants' primary frequency (PF) of sway and compared it between surfaces per frequency. In both groups, gains were significantly higher on the BOSU compared with floor or foam (p < 0.001) with no significant difference between floor and foam. The PF difference was significant (p < 0.001) with a clear peak matching of the visual stimulation frequency only on the BOSU. During a single session of stance on compliant surfaces, visual dependence was a dominant factor on a challenging condition. When prescribing BOSU exercises to young adults as specific balance training, trainers should consider its effect on increased visual dependence with respect to that session's goals.

Virtual Sensorimotor Balance Training for Children With Fetal Alcohol Spectrum Disorders: Feasibility Study

Abstract: Background Diminished sensory adaptation has been associated with poor balance control for children with fetal alcohol spectrum disorders (FASD). A virtual reality system, Sensorimotor Training to Affect Balance, Engagement and Learning (STABEL), was developed to train sensory control for balance. Objectives The purpose of this study was to examine the STABEL system in children with FASD and children with typical development (TD) to (1) determine the feasibility of the STABEL system and (2) explore the immediate effects of the STABEL system on sensory attention and postural control. Design This is a technical report with observational study data. Methods Eleven children with FASD and 11 children with TD, aged 8 to 16 years, completed 30 minutes of STABEL training. The children answered questions about their experience using STABEL. Sensory attention and postural control were measured pre- and post-STABEL training with the Multimodal Balance Entrainment Response system and compared using repeated-measures analysis of variance. Results All children engaged in game play and tolerated controlled sensory input during the STABEL protocol. Immediate effects post-STABEL training in both groups were increased postural sway velocity and some changes in entrainment gain. Children with FASD showed higher entrainment gain to vestibular stimuli. There were no significant changes in sensory attention fractions. Limitations The small sample size, dose of STABEL training, and exploratory statistical analyses are study limitations, but findings warrant larger systematic study to examine therapeutic effects. Conclusions Children completed the training protocol, demonstrating the feasibility of the STABEL system. Differences in postural sway velocity post-STABEL training may have been affected by fatigue, warranting further investigation. Limited immediate effects suggest more practice is needed to affect sensory attention; however, entrainment gain changes suggest the STABEL system provoked vestibular responses during balance practice.

Somatic and cognitive-affective depressive symptoms among patients with heart disease: differences by sex and age

Abstract: OBJETIVO: este estudio investigo la asociacion de sintomas somaticos y cognitivo-afectivos con el sexo y la edad en pacientes hospitalizados con enfermedad cardiaca. METODO: este estudio fue un analisis secundario de dos estudios observacionales anteriores, totalizando 531 pacientes con enfermedad cardiaca, internados de 2005 a 2011, en dos hospitales publicos en Ribeirao Preto, estado de Sao Paulo, Brasil. Los sintomas somaticos y cognitivo-afectivos fueron evaluados utilizandose las subescalas del Inventario Beck de Depresion - I (IBD-I). RESULTADOS: de los 531 participantes, 62,7% era del sexo masculino, con promedio de edad de 57,3 anos (DE= 13,0) para los hombres y 56,2 anos (DE = 12,1) para el sexo femenino. El analisis de variancia mostro un efecto del sexo (p<0,001 para sintomas somaticos y p=0,005 para los sintomas cognitivo-afectivos), pero ningun efecto de la edad. Las mujeres presentaron valores medios mas altos que los hombres en ambas subescalas IBD-I: 7,1 (4,5) vs. 5.4 (4.3) para los sintomas somaticos, y 8,3 (7,9) vs. 6,7 (7,2) para los sintomas cognitivo-afectivos. No fueron encontradas diferencias por edad para sintomas somaticos (p=0,84) o sintomas cognitivo-afectivos (p=0,84). CONCLUSION: las mujeres internadas con enfermedad cardiaca tenian mas sintomas somaticos y cognitivo-afectivos que los hombres. No fue encontrada asociacion de los sintomas somaticos y cognitivo-afectivos con la edad. Investigaciones futuras de esos pacientes podrian revelar si esas diferencias por sexo continuan durante todo el proceso de rehabilitacion.

Relationship of multiscale entropy to task difficulty and sway velocity in healthy young adults.

Abstract: Purpose/background: Multiscale entropy (MSE) is a nonlinear measure of postural control that quantifies how complex the postural sway is by assigning a complexity index to the center of pressure (COP) oscillations. While complexity has been shown to be task dependent, the relationship between sway complexity and level of task challenge is currently unclear. This study tested whether MSE can detect short-term changes in postural control in response to increased standing balance task difficulty in healthy young adults and compared this response to that of a traditional measure of postural steadiness, root mean square of velocity (VRMS).Methods: COP data from 20 s of quiet stance were analyzed when 30 healthy young adults stood on the following surfaces: on floor and foam with eyes open and closed and on the compliant side of a Both Sides Up (BOSU) ball with eyes open. Complexity index (CompI) was derived from MSE curves.Results: Repeated measures analysis of variance across standing conditions showe...

Readmissions due to traffic accidents at a general hospital.

Abstract: Objetivo:verificar la ocurrencia y las causas de reinternaciones hasta un ano despues del alta de hospitalaria, debido a accidentes de trafico.Metodos:fueron incluidas victimas de traumas multiples, por accidentes de trafico, admitidas en una Unidad de Terapia Intensiva. Fueron recolectados de las fichas medicas de los pacientes: datos sociodemograficos, circunstancias del accidente, regiones corporeas afectados y causa de la readmision.Resultados:de las 109 victimas de accidentes de trafico, la mayoria eran hombres jovenes y adultos. El mayor numero de internaciones por accidentes se relaciono con motociclistas (56,9%). Las causas de retorno al hospital fueron: necesidad de continuar el tratamiento quirurgico (63,2%), infeccion de sitio quirurgico (26,3%) y caida relacionada a las secuelas fisicas del trauma (10,5%), siendo la tasa de reinternacion de 174/1.000 personas/ano.Conclusion:la tasa de readmision hospitalaria en la poblacion estudiada es semejante a las encontradas en otros estudios. Victimas de traumas graves de extremidades necesitan de multiples procedimientos quirurgicos, mayor tiempo de internacion hospitalaria y rehabilitacion prolongada.

Readmissões por acidentes de trânsito em um hospital geral

Abstract: Objetivo:verificar a ocorrencia e as causas de reinternacoes ate um ano apos a alta de hospitalizacoes, devido a acidentes de trânsito.Metodos:foram incluidas vitimas de traumas multiplos, por acidentes de trânsito, admitidas numa Unidade de Terapia Intensiva. Dados sociodemograficos, circunstâncias do acidente, regioes corporais atingidas e causa da readmissao foram coletados dos prontuarios dos pacientes.Resultados:das 109 vitimas de acidentes de trânsito, a maioria eram homens jovens e adultos. O maior numero de internacoes por acidentes envolveu motociclistas (56,9%). As causas de retorno ao hospital foram: necessidade de continuidade do tratamento cirurgico (63,2%), infeccao de sitio cirurgico (26,3%) e queda relacionada as sequelas fisicas do trauma (10,5%), sendo a taxa de reinternacao de 174/1.000 pessoas/ano.Conclusao:a taxa de readmissao hospitalar na populacao estudada e semelhante as encontradas em outros estudos. Vitimas de traumas graves de extremidade necessitam de multiplos procedimentos cirurgicos, maior tempo de internacao hospitalar e reabilitacao prolongada.

Síntomas depresivos somáticos y cognitivo-afectivos entre pacientes con enfermedad cardíaca: diferencias por sexo y edad

Abstract: ste es un artculo de acceso aierto distriuido ajo los trminos de la icencia Creative Commons Reconocimientoo Comercial CC Csta licencia permite a otros distriuir remezclar retocar y crear a partir de tu ora de modo no comercial y a pesar de ue sus nuevas oras GHEHQVLHPSUHPHQFLRQDUWH\PDQWHQHUVHVLQ?QHVFRPHUFLDOHVQRHVWiQoliados a licenciar sus oras derivadas ajo las mismas condicionesCorrespondencia:Carina Aparecida Marosti DessotteUniversidade de Sao Paulo. Escola de Enfermagem de Ribeirao PretoDepartamento de Enfermagem Geral e EspecializadaAv. Bandeirantes, 3900Bairro: Monte AlegreCEP: 14040-902, Ribeirao Preto, SP, BrasilE-mail: camarosti@usp.br

Sintomas depressivos somáticos e cognitivo-afetivos entre pacientes com doença cardíaca: diferenças por sexo e idade

Abstract: OBJECTIVE: this study investigated the association of somatic and cognitive-affective symptoms with sex and age, among patients hospitalized with heart disease. METHOD: this study was a secondary analysis of two previous observational studies totaling 531 patients with heart disease, hospitalized from 2005 to 2011 in two public hospitals in Ribeirao Preto, state of Sao Paulo, Brazil. Somatic and cognitive-affective symptoms were assessed using the subscales of the Beck Depression Inventory - I (BDI-I). RESULTS: of 531 participants, 62.7% were male, with a mean age 57.3 years (SD= 13.0) for males and 56.2 years (SD= 12.1) for females. Analyses of variance showed an effect of sex (p<0.001 for somatic and p=0.005 for cognitive-affective symptoms), but no effect of age. Women presented with higher mean values than men in both BDI-I subscales: 7.1 (4.5) vs. 5.4 (4.3) for somatic, and 8.3 (7.9) vs. 6.7 (7.2) for cognitive-affective symptoms. There were no differences by age for somatic (p=0.84) or cognitive-affective symptoms (p=0.84). CONCLUSION: women hospitalized with heart disease had more somatic and cognitive-affective symptoms than men. We found no association of somatic and cognitive-affective symptoms with age. Future research for these patients could reveal whether these differences according to sex continue throughout the rehabilitation process.

Poster 344 Injury in Ultramarathon Runners and its Association with Foot Strike Pattern and Gait Characteristics

Abstract: Examination demonstrated no tenderness along the left knee joint lines and full active/passive ROM without pain or clicking. At 16th week post treatment, repeat MRI revealed intrasubstance signal in the posterior horn with extension into the inferior articular surface, compatible with meniscal repair. Discussion: This is a 21-year-old man with a history of repetitive left knee medial meniscal tears refractory to multiple surgical interventions resulting in 6 years of left knee pain and functional limitations. Within 11 weeks of receiving mesenchymal stem cells, adipose tissue, and PRP injection therapy the patient’s pain resolved. Conclusion: Autologous bone marrow mesenchymal stem cell therapy maybe a viable alternative in patients with meniscal tears. Further studies are warranted before this can be recommended as a standard of care, however this case demonstrates the potential efficacy of this novel treatment modality.