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- The balance confidence scale, health status and a multitasking evaluation protocol in the elderlyPublication . Coutinho, António; Pinheira, Vítor; Rodrigues, Abel; Cordeiro, Nuno; Leitão, CatarinaFalls are a serious health problem for elderly people. In Portugal, falls are about 70 % of accidents in the elderly. The aging process can be understood as the set of changes structural and functional, namely in motor, sensory and cognitive functions. These changes interfere with functional performance, with the execution of activities of daily living (ADL), quality of life (QOL) and mobility functional. After a fall elderly develops a fear of falling related with low levels of balance confidence. Furthermore, the ability to maintain dynamic balance during postural task involves more attentional demands and high levels of environment control. The ability to perform a Dual Task (DT) is essential for the elderly, as it allows functional independence. However, in the elderly population this capacity may be reduced, since the elderly may have limitations in the hablity of information processing because the implementation of DT requires more attention resources. Another of the capacities affected by the implementation of DT in elderly population is gait.The main objectives are: to evaluate an Experimental Protocol (EP)of Dual Task including Gait, Motor and cognitive challenges; to correlate scores of EP with scores of The Activities-Specific Balance Confidence Scale, SF-12 and MMSE and with the difference between TUG and Cognitive TUG. An experimental protocol was tested in four different occasions to evaluate functional performance related in walking, cognition and coordination in double and Emultiple tasks, along a path (6mx0.4m). Eight different tasks conjugations were tested: a) walking straight, b) counting back, c) coordinating the upper limbs and d) overcoming the obstacle. We also used a Balance Confidence Scale and SF-12. The score of the experimental protocol is done by counting errors. Execution of double task, motor and cognitive, focused on 4 components: coordination, muscle strengthening, dual-task and balance. 4 weeks program, with a total of 12 sessions. Evaluation: T0 (pre-intervention), T1 (post-intervention) and T2 (follow-up 1 month after) T3 . SF-12, MMSE, 6 Meter Experimental Protocol and kinematic evaluation. A sociodemographic characterization was used. Most complex tasks of the experimental protocol (Task 7: walk in straight line, overcome obstacle with upper limb coordination, and Task 8: walk in straight line, overcome obstacle with upper limb coordination and count backward) had significant correlations with Balance Confidence, with health status (MMSE), in mental health domain SF-12, but strongest in physical health domain. This happens in all four moments of evaluation. In our conclusion we can use tasks 7 and 8 of the experimental protocol to evaluate the cognitive, motor and coordination levels using o much more quickly and easy way for the elderly. A much more extensive and intensive study must be done.
- Chronic pain and functional mobility : relationships and impact on the quality of life of the elderlyPublication . Morais, Eduarda; Pinheira, VítorIndividual ageing is defined as a progressive process of change. Chronic pain is more than a sensory event because it involves emotional and behavioural responses. It causes consequences at a psychological, social, and economic level and a physical level with limitations in mobility. Limitations may result in a decrease in functional capacity and social participation, affecting the quality of life of the elderly. Observational, cross-sectional, correlational and comparative study, with a sample of 48 elderly people. This sample was divided into two subgroups, the group with chronic pain (n=31) and without chronic pain (n=17). The Numerical Pain Scale (NPS) was applied to assess the intensity of chronic pain, the Time up and go (TUG) test to assess functional mobility and a quality of life (QoL) scale WHOQOL-Bref. The data collected was analysed using the SPSS programme. Results: Statistically significant differences were found in QoL's "Physical" domain between individuals with and without chronic pain (p=0.032). No statistically significant differences were found in the TUG values between the sample subgroups (p=0.126). A negative correlation was observed between the maximum intensity of chronic pain and the physical domain of QoL (r=-0.505). No statistically significant correlations were found between the maximum pain intensity and the TUG values, nor between the TUG values and the QL domains. It was not possible to verify that chronic pain influences functional mobility in elderly people. However, chronic pain was shown to have a negative impact on the physical domain of QL.
- Quality of life and levels of training of professional caregiversPublication . Beringuilho, Fátima; Saraiva, Horácio; Pinheira, VítorINTRODUCTION: The increasing elderly population associated with increased human longevity and therefore a higher prevalence of chronic disease and higher levels of disability, brings out the importance of a new professional group considered crucial to the care process in a dignified and qualified in geriatric institutions: formal caregivers. OBJECTIVES: To evaluate and compare the profile, levels of training and quality of life of professional caregivers from geriatric organizations. METHODS: This is an exploratory, descriptive, comparative, correlational and cross-sectional study. We used a quantitative research, whose convenience sample consisted of 254 subjects from 15 institutions for the elderly of Portugal, subdivided into two groups: Group SFL (nonprofit) and CFL group (for-profit). For data collection a questionnaire was used to characterize the sociodemographic and work sample, a questionnaire for training standards and WHOQOL-BREF. RESULTS: There were differences between the profile of caregivers of institutions and nonprofit organizations in terms of age, marital status, number of children, educational attainment, years of activity in the current institution, years of activity as a professional caregiver and simultaneity with informal care. Nonprofits institutions caregivers have a greater number of training and lower average training per year that caregivers of for-profit institutions. Caregivers showed impairment of quality of life and no differences were observed between both groups. Finally, there were higher levels of quality of life physical domain (p = 0.038), psychological (p = 0.003) and social (p = 0.009) in patients who report having training in the area in which they work. CONCLUSION: There were differences in the profile of both groups, the largest number of formations in the nonprofit group and impaired quality of life, formal caregivers, with no differences between groups. Trained individuals have better quality of life in the physical, psychological and social domains.
- Results from a home based exercise protocol to elderly people with osteoarthritisPublication . Pinheira, Vítor; Gonçalves, Bárbara; Pereira, Sara; Rodrigues, Abel; Gonçalves, Rui SolesIntroduction: Osteoarthritis is one of the most commom problems in elderly populations and the most commom cause of disability. Knee is one of the most affected joint and the loss of range of motion and function will limit daily activities and the mobility. Self-management programs with exercises performed at home may be a useful therapy. These programs are based on the quadriceps strengthening exercises, low aerobic strength in order to improve the functional state, pain and aerobic capacity. Objectives: Evaluate the effectiveness of an exercise protocol performed at home on improving the functionality, mobility and health related quality of life of elderly people with knee osteoarthritis. Materials and Methods: Exploratory, descriptive and longitudinal study. 44 subjects have been selected according to the inclusion criteria (age ¡Ý 65 years with symptoms of knee osteoarthritis) and exclusion (inability to perform gait, hip osteoarthritis and prosthetics hip or knee). The subjects made an initial assessment (T0) before beginning the protocol (applied during 8 weeks, daily, in the summer of 2013) performed at home and meeting occasionally in groups, with the researcher, to correct the learned exercises, clarify questions and add some exercises or progressions. After the 8 weeks was applied an new assessment (T1) and the follow-up is taken in T2 and T3, (respectively, at 3 and 6 months later). In the assessment was used the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Timed Up and Go Test (TUG) and the SF-12. Data from changes in daily routine of the subjects are also collected. The protocol was applied by two physical therapists. Results: Between T0 and T1 the subjects present better results in the analyzed variables. Between T1 and T2, these improvement appear be related with the maintenance of the protocol. Conclusion: An home based exercise protocol to elderly people with osteoarthritis revealed results in mobility. The maintenance of the results is related with the continuity of the protocol and with changes in the daily activities.
- Mobilidade urbana das pessoas idosas: o papel estruturas de mobilidade vertical para a participação social : o caso da cidade da CovilhãPublication . Tomé, Ana; Pinheira, Vítor; Moreira, Maria João GuardadoO principal objetivo deste estudo foi avaliar o impacto que as estruturas de mobilidade urbana vertical (IMUV) têm na vida quotidiana das pessoas idosas que vivem em bairros com desníveis topográficos. A recolha dos dados realizou-se em abril e maio de 2019, na cidade da Covilhã onde há desníveis topográficos acentuados e em que existem 4 estruturas de mobilidade urbana vertical. A amostra integra 109 sujeitos com 65 ou mais anos, que responderam a um questionário elaborado pelos investigadores do projecto. A média de idade é de 73,50 anos, 53,2% possui o 1º Ciclo como grau de ensino, 68,8% reside com o cônjuge ou companheiro/a, 71,6% indica não ter dificuldades de mobilidade e 54,1% considera o seu estado de saúde “Normal”, ou “Bom” (23,9%). Dos inquiridos, 78% residem há mais de 10 anos na atual casa/bairro (78%), 11,9% sempre residiram na mesma casa/bairro e 90,8% gostaria de continuar a viver na mesma casa/bairro. A maioria (53,2%) utiliza “Muito” as estruturas de mobilidade urbana vertical e 64,8% utiliza-as pelos menos três vezes por semana. A maioria considera estas estruturas cómodas e de fácil acesso, contudo, 79,8% mudava ou melhorava algo nas estruturas existentes. Ainda assim, 60,5% considera estas estruturas “Boas” ou “Muito Boas”. A maioria dos inquiridos revela que a utilização destas estruturas permitiu aumentar a frequência com que usufruem do espaço público, visitor pessoas ou aceder a servicos, contribuindo para melhorar a sua mobilidade, qualidade de vida e participação social.
- From traditional games to robotic games: ethical issues with eldersPublication . Gonçalves, Paulo; Santos, Samuel; Lourenço, Bernardo; Pereira, Cristina; Pinheira, Vítor; Moreira, Maria João Guardado; Silva, SimãoThis paper presents and discusses ethical issues related with the interaction of elderly people with robots while playing cognitive games. Four games were developed from classical nursing homes cognitive games, to incrementally increase its difficulty. The last one does include interaction with a robot. Several ethical issues were tackled to obtain a proper system with robots: those ethical issues were raised during the design phase and the interaction with the elders. As example of ethical issues tackled: beneficience - do not harm, and the deception and infantilisation of elderly. The games are based in objects with different shapes and colours to be positioned by the elder in pre-defined positions of a 3x3 arena, on the floor. The system then interacts with the elder given him/her the respective score, after performing image processing techniques to the image of the arena. The game with the robot consists to knock down objects in the arena, by pushing them outside the area using a car-like tele-operated robot, by the elders. The system was validated in two nursing homes, by performing experiments in the last months, and it is ethically proper.
- Sexuality in the elderly: knowledge and attitudes of professional caregiversPublication . Senra, Ana Margarida Magalhães; Saraiva, Horácio; Pinheira, VítorINTRODUCTION: Sexuality in the elderly still remains a taboo, especially in the institutional context. Demographic changes have been occurring these past few years which led to an increase in the number of institutionalized elders, as an attempt to respond their needs. OBJECTIVES: This study aims to know the levels of knowledge and attitudes of the professional caregivers, how these are related and how these relate with the socio demographic variables. METHODS: Quantitative, exploratory, comparative and correlational study. Convenience sample of professional caregivers (n=329), which accepted to participate by answering to the Aging Sexual Knowledge and Attitudes Scale (ASKAS), which allowed the knowledge and attitudes measure about sexuality in the elderly. RESULTS: There is a positive correlation between the knowledge levels and the attitudes and, generally, the caregivers present good knowledge levels and the attitudes about sexuality in the elderly are permissive. However, there is a difference between the qualified technicians and the auxiliary staff, as the former present better knowledge levels and more permissive attitudes. Generally, the individuals with higher educational qualifications also present higher knowledge levels and more permissive attitudes. None of subjects referred attending any kind of training or education in this area. Single individuals present better knowledge levels and more permissive attitudes than the married ones. The older individuals present less permissive attitudes as well as the more experienced caregivers. CONCLUSION: The knowledge is related with the attitudes about sexuality in the elderly. This topic remains a delicate subject for many of the individuals, especially for who work in an institutional context. Education and training of these caregivers and a continuous research play a key role in the quality of life of the elders and the quality of the provided services.
- Measuring ADL’s in elderly in community and institutionalized:preliminary results over a six months periodPublication . Pinheira, Vítor; Pinto, Soraia; Santos, SofiaPopulation aging is a global phenomenon. It is a progressive and irreversible multifactorial process. It is strongly influenced by the environment, in particular, lifestyles and stages of disease.Functional capacity can be evaluated through the basic activities of daily living (BADL’s) and instrumental activities of daily living (IADL’s) which are essential to the autonomy of the elderly.
- Interaction human-robot : a methodological proposal to evaluate actions performed by robots to elderlyPublication . Pereira, Cristina; Silva, Simão; Pinheira, Vítor; Gonçalves, PauloBackground Developing new assistive technologies is a challenge for an ageing society and a possible response to the needs of older people in the care process and a challenge to promote autonomous living. The interaction between elderly and robots may depend on the choice of activities that robots can developed and the how important it is for older people. Social Assistive Robots can contribute to a positive impact in elderly well-being and active ageing. Methods 31 elderly residents (10 men and 21 women) in a Portuguese nursing home were interviewed about their routines and interests. They were also assessed during 6 weeks, to evaluate interactions and activities initiative and involvement, using an scale adapted by authors from a Bertram and Pascal scale. This assessment was made by direct observation. The professionals and the director in the nursing home were also interviewed. Research results The adopted methodology allowed to identify the needs and interests of the elderly, and to classify the participants on the levels of social interactions, initiative and involvement in activities and social participation. Conclusions Some social, cognitive and physical activities were selected to be developed by a socially assisted robot and the evaluation process used in this research methodology will be used to evaluate the results of the intervention with a robot in social assistive domains, developed in a European Project INTERREG (EUROAGE).
- Developing a home-based exercise program for elderly people: aplication and overview on two rural portuguese communitiesPublication . Pinheira, Vítor; Aparício, Mariana; Cordeiro, NunoIntroduction: Physical activity and exercise in the elderly has main importance for improving health and quality of life. The exercise prevent incapacity and reduce chronic diseases impact. However most of this population remains sedentary according their lifestyle and increases the chances to becoming dependent of others. The implementation of one home-based program could be more effective for improving physical activity, but is necessary the individual's participation. Program adherence is modulated by psychological and social determinants, moreover low adherence levels are usualy in elderly that living alone and without regular exercise practice. Objectives: The main purpose of this study was to evaluate a home-based exercise program adherence and control his results during six months on elderly rural population. Methods: This study was made in two communities, counting with a sample of 16 participants. The assessment was made in two different moments (T0 and T1), corresponding to the beginning and to the end of the exercises program. A follow-up of 3 and 6 months was also accessed. The individuals performed the exercises twice a week for 8 weeks (in September/October 2013). Local and phone sessions were made by the physiotherapist for assessing the compression and execution of the domiciliary exercises. Adherence was measured by records made by the participants. Assessment includes TUG (mobility), SF-12 (health condition), IPAQ (physical activity levels) and MMSE (cognitive condition). Results: One of the communities perform the exercise program in a community space, with high team spirit and strong adherence. At the end of the program that participants had improvement their health condition, mobility and increase their physical activity levels. Conclusion: Perform an exercise program on community revealed high levels of participant's adherence to the exercise and introduced changes to the home--based program, improving the participation.