IPTSP - Artigos publicados em periódicos

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Agora exibindo 1 - 20 de 1879

Comparação da eficácia entre CPAP Bolha e CPAP Convencional em recém-nascidos pré-termo na Unidade de Terapia Intensiva Neonatal: uma revisão sistemática
(2026) Oliveira, Cibelle Luiza; Oliveira, Altafico Fernandes de; Siqueira, Clóvis Henrique de Melo; Aguiar, Mariana Balduino; Matsunaga, Natasha Yumi
Introduction: Preterm newborns frequently require care in a neonatal intensive care unit (NICU) and respiratory support, such as conventional continuous continuous airway pressure (CCPAP) and bubble continuous airway pressure (BCPAP), used to assist respiratory function. Objective: This study described the results and efficacy of bubble CPAP versus conventional CPAP in the treatment of preterm newborns (PTNBs) in the NICU. Methods: This is a systematic review conducted according to the PRISMA method, with searches in the PubMed, Physiotherapy Evidence Database (PEDro), National Center for Biotechnology Information (NCBI), Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature (LILACS), Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, and Virtual Health Library (VHL) databases. Descriptors related to CPAP and preterm newborns were used. Methodological quality was assessed using the PEDro scale. Results: Of the 860 articles identified, 9 studies with a PEDro score greater than 7 were included, totaling 937 PTNBs. In 55.5% of the studies, BCPAP showed better results compared to CCPAP, with fewer complications and shorter hospital stays. In the remaining studies, the results were similar between the methods. Conclusion: The findings indicate that BCPAP may offer clinical advantages, associated with its simplicity, lower cost, and reduction of complications, although some of the literature demonstrates equivalent efficacy between the two devices. In most of the studies analyzed, BCPAP proved more advantageous than VCPAP in the treatment of preterm newborns in neonatal intensive care units.
Impacto da obesidade no controle da asma e na função pulmonar de crianças asmáticas: um estudo transversal
(2026) Camargo, Aika Loiany Andrade de; Sousa, Melina Bequer de; Matsunaga, Natasha Yumi; Fernandes, Raquel Vidica
INTRODUCCIÓN: El asma y la obesidad infantil son desafíos crecientes para la salud pública mundial. Se reconoce que la obesidad dificulta el control del asma en niños, con mecanismos fisiopatológicos que contribuyen a la disfunción pulmonar. Comprender esta compleja interacción es crucial para un manejo clínico efectivo y el desarrollo de estrategias de salud apropiadas. OBJETIVOS: El objetivo principal fue analizar el impacto de la obesidad en el control del asma y la función pulmonar en niños asmáticos. MÉTODOS: Se realizó un estudio transversal con 165 niños y adolescentes asmáticos seguidos en clínicas ambulatorias especializadas. Los datos de las historias clínicas se utilizaron para evaluar el índice de masa corporal (IMC) mediante puntuaciones Z para clasificar el sobrepeso/obesidad, el control del asma (criterios GINA y Prueba de Control del Asma - ACT) y la función pulmonar (espirometría). La significación estadística se estableció en p < 0,05. RESULTADOS: La muestra tenía una edad media de 11,00 ± 3,21 años, con un 61,21% de participantes varones y un 34,50% con sobrepeso/obesidad. Se observó una asociación significativa entre el sobrepeso/obesidad y un peor control del asma (GINA: p=0,047; ACT: p=0,041). Sin embargo, no se observaron diferencias significativas en la mayoría de los parámetros espirométricos convencionales entre los grupos. CONCLUSIONES: La obesidad en niños asmáticos se asoció significativamente con un peor control de la enfermedad, incluso en ausencia de alteraciones marcadas en las pruebas de función pulmonar tradicionales. Esto refuerza la necesidad de enfoques integrados, que incluyan la monitorización nutricional y la promoción de la actividad física, en el manejo del asma pediátrico.
Um olhar para o processo de estruturação de grupos na atenção psicossocial
(2025) Sousa, Johnatan Martins; Farinha, Marciana Gonçalves; Vale, Raquel Rosa Mendonça do; Nunes, Fernanda Costa; Esperidião, Elizabeth
The group structure refers to the aspects that enable the formation and permanence of the group and are indispensable for its functioning. The objective of the present study was to describe the process of structuring group practices in Psychosocial Care Centers for Alcohol and Drugs from the perspective of professionals. Thirty workers from four services in the central region of Brazil participated. It consisted in a qualitative study of the research-intervention type. A professional profile questionnaire, conversation circles, and a field diary were used for collecting data, which were subsequently submitted to thematic content analysis. Gaps were evident, pointing to the urgent need for permanent health education on theoretical and practical assumptions of group technology.
Associação entre broncoconstrição induzida pelo exercício e umidade do ar em crianças e adolescentes com asma
(2025) Máximo, Bárbara Pimenta Novais; Silva, Matheus Henrique Guimarães da; Quirino, Nathália Dantas Marques; Costa, Lusmaia Damaceno Camargo; Costa, Paulo Sérgio Sucasas da; Matsunaga, Natasha Yumi; Fernandes, Raquel Vidica
Heart rate recovery after six-minute walk test, pulmonary function, dyspnea, and functional status after covid-19
(2026) Fonseca, Adriano Luís; Oliveira, Miriã Cândida; Fonseca, Daniela Rosana Pedro; Afonso, João Pedro Ribeiro; Paixão, Heren Nepomuceno Costa; Ribeiro Júnior, Jairo Belém Soares; Alves, Larissa Rodrigues; Fernandes, Tiago Vieira; Marconi, Daniel Grossi; Andraus, Rodrigo Antonio Carvalho; Matsunaga, Natasha Yumi
Introduction: Coronavirus disease 2019 (COVID-19) can cause persistent cardiovascular alterations, including autonomic dysfunction. Heart rate (HR) recovery (HRR) after exercise is a simple marker of autonomic modulation associated with functional capacity and clinical prognosis. Evaluating HRR during the six-minute walk test (6MWT) may help identify residual functional limitations in diverse patients. Objective: To compare pulmonary function, maximal inspiratory pressure (MIP), functional capacity, dyspnea, fatigue, and functional status in post-COVID-19 patients. Methods: This cross-sectional study included 75 adults (mean age: 47.6 ± 13.1 years; 54.7% male) who recovered from COVID-19 divided into 2 groups based on HRR 1 min after the 6MWT: delayed (≤12 beats/min); and non-delayed (>12 beats/min). Pulmonary function, MIP, exercise capacity (via 6MWT), dyspnea, muscle fatigue, and functional status were assessed. Results: Based on HRR 1 min after 6MWT, 27 (36%) participants were classified with abnormal HRR and 48 (64%) with normal HRR. There were statistical differences between the groups regarding demographic or clinical characteristics, pulmonary function, MIP, muscle fatigue, or functional status (p > 0.05). The delayed HRR group exhibited a smaller reduction in HR in first minute of recovery (ΔHR = 6 vs. 23 beats/min), higher baseline HR (p = 0.010), and greater dyspnea (p = 0.020). Furthermore, this group exhibited worse functional performance in the 6MWT, with shorter distance walked (437.33 vs. 494.27 m; p = 0.019) and a lower percentage of predicted distance (74.66 ± 12.98% vs. 82.94 ± 15.71%; p = 0.023) compared with the non-delayed HRR group. Conclusion: Delayed HRR post-COVID-19 was associated with poorer functional performance and greater dyspnea, regardless of pulmonary function. The blunted reduction in HRR after exertion suggests impaired cardiovascular autonomic modulation, possibly related to attenuated vagal reactivation, which may contribute to exercise intolerance observed in this population.
Correlação entre função respiratória e aptidão cardiorrespiratória em adultos e idosos com covid longa
(2025) Moraes, Tais Nayara Silva de; Silva, Lorena Caroline Lopes da; Cardoso, Gilmar Junior Alves; Aguiar, Jhully Souza Garcia; Baldan, Cristiano Schiavinato; Fonseca, Daniela Rosana Pedro; Matsunaga, Natasha Yumi
Introduction: Long Covid (LC) is defined as the persistence of signs and symptoms of Covid-19 for more than four weeks. Objective: Correlate respiratory function and cardiorespiratory fitness in adults and elderly people with CL. Method: This was a cross-sectional, prospective, multicenter study conducted with adults and elderly individuals with CL from the teaching clinics of Universidade Paulista–UNIP. A structured form with sociodemographic information and COVID-19 management was administered, and peak flow tests were performed to assess peak expiratory flow (PEF) and peak cough flow (PCF). Manovacuometry was performed to assess maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP). Cardiorespiratory fitness was assessed using the one-minute sit-to-stand test (SST1) and the six-minute walk test (6MWT). Result: A total of 109 adults and elderly individuals with CL, median age 51 [21–90] years, 45% male, were included. A positive and moderate correlation was observed between the PCF and the percentage of the predicted 6MWT distance (p<0.001, r=0.500), and positive correlations were observed between PCF and PEF (p<0.001, r=0.640), PCF and MEP (p=0.041, r=0.198), PEF and MEP (p=0.016, r=0.280), and MIP and MEP (p<0.001, r=-0.769). Conclusion: A correlation was found between respiratory function and cardiorespiratory tests, in which the greater the PFT strength, the greater the distance covered in the 6MWT.
Avaliação do conhecimento de fisioterapeutas sobres as técnicas de desmame ventilatório em adultos
(2025) Moraes, Tais Nayara Silva de; Adorno, Thamer Lucca; Costa, Claudino da; Oliveira, Maevy Dellayama Pereira de; Caetano, Andressa Pereira; Passos, Xisto Sena; Spicacci, Felipe Bueno; Matsunaga, Natasha Yumi
Introduction: Carrying out an assertive weaning protocol together with the team is an extremely important action, since it is capable of reducing complications such as muscle weakness, immobility, ventilator-induced lung injury, in addition to reducing hospitalization time and increasing survival and quality of life of patients in the ICU. Objective: To assess the knowledge of physiotherapists on weaning techniques in adults. Methods: This is a cross-sectional, observational and analytical study, carried out with physiotherapy professionals working in the ICU. This research carried out data collection through a questionnaire in the form of a quiz carried out online by the Google Forms platform, containing, TCLE, sociodemographic data and questions related to weaning protocols. Results: A total of 68 intensive care physiotherapists from 12 states of Brazil were evaluated, 58.8% of whom were from the State of Goiás. Regarding the weaning protocol, it was found that 97.1% of the professionals use the spontaneous breathing test (ERT), with preference for the PSV and duration of 30 to 120 minutes. It was observed that 82.4% discuss the weaning protocol with the multidisciplinary team, and that in physical therapists with more than 5 years of work in the ICU, 100% feel able in relation to the criteria for initiation of weaning. Conclusion: In the present study, it was found that, in general, the knowledge of physical therapists is satisfactory in relation to the weaning protocols recommended by the Brazilian guideline. In addition, it was found that training and longer experience time provide greater safety in weaning management.
Adversidades do isolamento e o papel dos exercícios na qualidade de vida de mulheres idosas
(2025) Libanio, Juliana Paula Balestra Soares; Galvão, Marcus Vinicius Alves; Nunes, Fernanda Costa; Chaveiro, Neuma
OBJECTIVE: To understand older women's perceptions of quality of life in the context of the COVID-19 pandemic. METHODS: This qualitative, exploratory, and descriptive study used a sociodemographic questionnaire and semi-structured interviews for data collection. The interviews were audio recorded, fully transcribed, and analyzed using Bardin’s content analysis methodology. Sixteen older women aged between 60 and 80 from the municipality of Inhumas-GO participated in the study. RESULTS: Most participants (62.5%) were widowed, Catholic, retired, had an income ranging from one to three minimum wages, lived in their own homes, and had an average of two children. The analysis revealed four main categories: material and financial living conditions, intra- and interpersonal relationships, healthy lifestyle habits, and health. CONCLUSIONS: The pandemic significantly impacted the quality of life of elderly women, generating adverse effects related to social isolation, mental health, and financial insecurity. On the other hand, it also fostered coping strategies based on support networks and resilience.
Grupo terapêutico de dança circular na atenção psicossocial: significados da participação na perspectiva dos usuários
(2025) Favoretto, Carolina Cristina Rodrigues; Antunes, Priscilla de Cesaro; Sousa, Johnatan Martins; Caixeta, Camila Cardoso; Nunes, Fernanda Costa
This study aimed to understand the meanings of participation in a circular dance therapy group for the life experience and psychosocial care of users of a Psychosocial Care Center. This is a participatory research study with a qualitative approach, conducted in a Psychosocial Care Center in a municipality in the state of Goiás, Brazil. Eleven users participated, and data collection methods included: group discussions, participant observation, field diary, and analysis of medical records. The data were subjected to thematic content analysis. Two categories were constructed: 1. Emotions and reflections; 2. Listening to and feeling the body, which highlight the meanings of the circular dance group in the lives of the users. The study evidenced the transformative potential of the circular dance group in promoting the well-being and mental health of the users.
Roda da vida: instrumento de autocuidado e educação continuada para profissionais de saúde mental
(2025) Sousa, Johnatan Martins; Landim, Joyce Soares Silva; Farinha, Marciana Gonçalves; Lucchese, Roselma; Caixeta, Camila Cardoso; Paranaguá, Thatianny Tanferri de Brito; Nunes, Fernanda Costa; Bezerra, Ana Lúcia Queiroz
Objectives: to analyze the use of the Wheel of Life as a self-care and Continuing Health Education tool for mental healthcare professionals in psychosocial care settings. Methods: qualitative intervention research guided by the Experiential Learning Cycle. Four workshops were held with 30 professionals from two Psychosocial Care Centers in central Brazil. Data collection involved the use of a professional profile questionnaire, the Wheel of Life, and field diary notes. The data were subjected to thematic content analysis. Results: two categories emerged: Repercussions of the Wheel of Life for self-care; and Wheel of Life as an instrument for managing problems. Final Considerations: the study showed that the Wheel of Life is a tool that can be combined with Continuing Health Education processes, in addition to promoting reflections among professionals on the importance of practicing self-care to care for others.
Relação terapêutica e cuidado centrado na pessoa na atenção psicossocial: um olhar para a comunicação
(2025) Sousa, Johnatan Martins; Farinha, Marciana Gonçalves; Pinho, Eurides Santos; Paranaguá, Thatianny Tanferri de Brito; Nunes, Fernanda Costa; Bezerra, Ana Lúcia Queiroz
Objective: to analyze the types of communication used by mental health professionals during psychosocial care, from the perspective of person-centered care. Method: qualitative intervention research. Thirty professionals from two Psychosocial Care Centers in central Brazil participated. Four meetings were implemented in a workshop format, and data collection was carried out using a professional profile questionnaire, a group technique for pairing typical communication forms, and notes in a field diary, which were submitted to thematic content analysis. Results: the types of communication used were: threats, moral lessons, ignoring the user's problem, giving orders, contradictory statements, advice, suggestions, disingenuous support, incisive communication, non-judgmental communication, redirecting parents’ attention of children and adolescents treated at the Psychosocial Care Center, and supportive and clarifying communication. Conclusions: the study made it possible to broaden the understanding of the types of communication used by mental health teams during care.
Cuidado centrado na pessoa na atenção psicossocial: o que pensam, sentem e fazem os profissionais?
(2025) Sousa, Johnatan Martins; Farinha, Marciana Gonçalves; Lucchese, Roselma; Paranaguá, Thatianny Tanferri de Brito; Nunes, Fernanda Costa; Bezerra, Ana Lúcia Queiroz
Objective: to understand professionals’ perceptions and experiences regarding person-centered care in psychosocial care. Method: This is a qualitative intervention research study guided by the Person-Centered Clinical Method framework and conducted with 30 professionals from two Psychosocial Care Centers in central Brazil. Experiential workshops, group techniques, field diary notes, and a professional questionnaire were used to collect data, which were then subjected to thematic content analysis. Results: there is an ambivalence between thinking and acting, with some professionals’ thinking based on asylum logic and others on the psychosocial care model. The contrast between positive feelings (e.g., love, hope, faith) and negative feelings (e.g., sadness, fear, danger, and judgment of patients) influences professionals’ practice. Final considerations: actions such as understanding and respecting patients, developing protagonism, individualizing treatment, developing the Singular Therapeutic Project, resocializing, and offering health education promote person-centered care.
Pesquisa participativa baseada na comunidade: desvendando a construção do Comitê de Assessoria Comunitária para a proteção ao abuso de drogas
(2025) Dias, Paula Candida da Silva; Caixeta, Camila Cardoso; Silva, Eroy Aparecida da; Vila, Vanessa da Silva Carvalho; Nunes, Fernanda Costa; Sousa, Johnatan Martins
It is important to mobilize several formal and informal institutions to formulate actions aimed at the problems arising from drug abuse and addiction from the perspective of building networks. Therefore, the alliance between a Higher Education Institution (HEI) and the community is essential to build scientific knowledge based on everyone's experiences. Therefore, the objective was to describe the process of building the Community Advisory Committee (CAC) to formulate strategies for forming networks to protect against drug abuse. This is a community-based participatory research conducted with 23 people from a neighborhood in the metropolitan region of Goiânia, in central Brazil. To build the data, three meetings were implemented, recorded in audio format, photos and notes in a field diary, and participant observation and self-completion forms were used. The data were subjected to thematic content analysis, with the help of the QSR Nvivo software. The thematic category “Formation of the Community Advisory Committee” emerged, revealing the dynamics of the natural formation of a group. The study made it possible to understand the group's own movement towards the creation of the Community Advisory Committee (CAC), in which the suggestions and demands of its members were welcomed during the investigative process.
Acolhimento centrado na pessoa em centros de atenção psicossocial: fatores impulsores nas perspectivas dos profissionais
(2025) Sousa, Johnatan Martins; Farinha, Marciana Gonçalves; Lucchese, Roselma; Nunes, Fernanda Costa; Bezerra, Ana Lúcia Queiroz
Reception in the health area, especially in mental health, represents an ethical stance and a fundamental care practice that seeks to promote accessibility, attentive listening and respect for the singularities of individuals. It is not just a physical space or a specific moment, but rather an approach that permeates the entire care relationship between health professionals and users of public and private services, with a view to promoting readiness to meet demand. The objective of this study was to analyze the driving factors for person-centered reception in psychosocial care, from the perspective of professionals. This is a qualitative intervention-type research carried out with 30 professionals from two Psychosocial Care Centers in the central region of Brazil. Four group meetings were implemented in the format of workshops following the Experiential Learning Cycle framework. A professional profile questionnaire, dramatization technique and notes in a field diary were used to collect data. Bardin’s thematic content analysis was used to process the data, from which emerged the thematic category “Driving factors for person-centered care in psychosocial care” and three categories related to professionals, work processes, users and families. The research made it possible to identify potential for person-centered care. Therefore, the visualization of positive points by professionals in relation to their practice has the power to encourage them to continue doing their best to welcome people in a humane way.
Avaliação dos fatores de risco para distúrbios respiratórios do sono em crianças e adolescentes com asma
(2025) Alcântara, Drielli Noêmia de Castro Rezende; Goulart, Thalma Tibúrcio Venâncio; Oliveira, Altafico Fernandes de; Ribeiro, Bárbara Bernadelli; Matias, Beatriz Barreira; Oliveira, Cibelle Luiza; Queiroz, Letycia Wiwia Soares; Silva, Matheus Henrique Guimarães da; Quirino, Nathália Dantas Marques; Costa, Lusmaia Damaceno Camargo; Costa, Paulo Sérgio Sucasas da; Matsunaga, Natasha Yumi
Introduction: The presence of sleep-disordered breathing (SDB) can lead to daytime sleepiness, attention deficits, mood disorders and neurodevelopmental changes in children and adolescents, especially if associated with comorbidities such as asthma and rhinitis. Aim: To assess the risk factors for sleep-disordered breathing in children and adolescents with asthma. Methods: This was a cross-sectional, prospective study of children and adolescents with asthma aged between six and 18 years, from the Pediatric Pulmonology outpatient clinics at the Hospital das Clínicas of the Federal University of Goiás (UFG). The Asthma Control Test (ACT) and Childhood Asthma Control Test (c-ACT) questionnaires were used to assess asthma control, the Rhinitis Control Assessment Test (RCAT) for rhinitis control and the sleep disorders in Children Scale (SDSC). In addition, spirometry was performed to assess lung function and blood eosinophil and IgE values were analyzed. Results:107 patients with asthma took part in the study, 66 (61.7%) of whom were male, with a mean age of 10.93±3.10 years. DRS were present in 40 (37.4%) patients, in which statistically significant associations were observed with the level of asthma control by GINA p=0.004 and ACT 0.029, level of rhinitis control p<0.001 and BMI p=0.012. As risk factors, uncontrolled rhinitis was 5.94 times more likely, and obesity was 3.21 times more likely. Conclusion: Uncontrolled AR and obesity were considered the main risk factors for RHD in children and adolescents with asthma.
Unveiling the role of stua in transcription regulation in trichophyton rubrum: from global regulation dynamics to the ph-responsive program control
(2025) Santana, Leonardo Martins; Fratucci, Monise Fazolin Petrucelli; Sanches, Pablo Rodrigo; Martinez-Rossi, Nilce Maria; Rossi Filho, Antonio
The dermatophyte Trichophyton rubrum is the primary causative agent of a cutaneous disease known as dermatophytosis. To establish an infection, this fungus coordinates many mechanisms related to biochemical processes, physiological adaptation, and transcriptional networks. Transcription factors (TFs) are the main proteins that elicit biological responses when T. rubrum interacts with keratinized tissues and promotes defense responses to prevent fungal colonization. In this study, we investigated the role of the TF StuA, a recently described T. rubrum protein, in controlling this fungal transcriptional program in response to glucose and keratin. This approach, based on RNA sequencing data, revealed at least 33 TF genes differentially expressed in glucose or keratin. We also showed that StuA regulates the pH signaling transcription factor, PacC, a relevant TF recruited for keratin assimilation in T. rubrum. Furthermore, we demonstrated that StuA modulates positively pacC and influences alternative splicing events of pacC transcripts in keratin cultures. Our findings revealed that StuA represses pacC transcription in a co-culture with keratinocytes and modulates the expression of the pal pathway genes, besides suggesting that StuA is pivotal for pH recognition responses and nutrient assimilation in the host. As a follow-up study, our results shed light on discovering new targets to treat dermatophytosis and elucidating transcriptional networks that are fundamental to T. rubrum pathogenesis.
From sugar uptake to bioethanol: regulation of sugar transporters in fungal cell factories
(2026) Taveira, Iasmin Cartaxo; Paula, Renato Graciano de; Pereira, Lucas Matheus Soares; Santos, Yago Queiroz dos; Maués, David Batista; Simon, Thiago de Andrade; Santana, Leonardo Martins; Silva, Roberto do Nascimento
The conversion of lignocellulosic biomass into second-generation (2G) bioethanol depends not only on efficient enzymatic hydrolysis but also on optimized microbial sugar uptake and regulation. In fungal cell factories, sugar transporters of the Major Facilitator Superfamily (MFS) represent critical engineering targets, as they govern substrate entry while simultaneously shaping intracellular signaling and carbon utilization programs. This review synthesizes current knowledge on the regulatory architecture controlling fungal sugar transporters, integrating evolutionary diversification, dual-affinity transport systems, and the coordinated uptake of hexoses and pentoses. We examine how glucose and xylose availability is translated into metabolic responses through interconnected signaling pathways, including cAMP–PKA, calcium–calcineurin, and carbon catabolite repression. Special attention is given to filamentous fungi of industrial relevance, such as Trichoderma, Aspergillus, and Neurospora, in which transporters function not only as carriers but also as transceptors that couple nutrients sensing to transcriptional control of enzyme production and central metabolism. We further discuss emerging evidence for post-translational regulation of transporters, highlighting phosphorylation-dependent mechanisms as underexplored yet promising levers for strain improvement. By consolidating regulatory principles and engineering opportunities, this review provides a framework for rational manipulation of sugar transport systems to enhance sugar co-consumption, cellulase production, and overall performance of fungal platforms for sustainable bioethanol production.
Prediction factors of fear of falling in older adults assessed by the icf domains: gender, social participation, and walking speed
(2025) Bueno, Guilherme Augusto Santos; Menezes, Ruth Losada de; Martins, Anabela Correia
Objective: The International Classification of Function, Disability, and Health (ICF) may be an ideal comprehensive model for fall risk assessment. However, information associating ICF and fear of falling among community-dwelling older adults remains unclear. This study aimed to investigate the associated factors that predict the fear of falling in the older adults classified by the ICF. Materials and Methods: Data were collected from 340 community-dwelling older adults aged 65 years and older. They were assessed for their personal aspects, health status, functional skills, and social participation profile; the fear of falling was self- reported. Multivariate logistic regression analysis was used to determine prediction models for fear of falling. Results: Gender (OR 2.77; 95%CI 1.62 - 4.72, p < 0.001), walking speed (OR 0.19; 95%CI 0.09 - 042, p<0,001), and social participation (OR 2.35; 95%CI 1.39 - 3.95, p p<0,001), composed a model that may predict up to 64% (AUC = 0.794, p<0,001) of the fear of falling among community-dwelling older adults. Conclusion: The association of the predictors of fear of falling identified that women have more restriction on social participation and reduced walking speed as factors that contribute to increased fear of falling in community-dwelling older adults.
Gait changes after intramedullary nailing versus total hip arthroplasty for hip fractures in older adults
(2025) Fagotti, Lorenzo; Menezes, Ruth Losada de; Ribeiro, Darlan Martins; Santana, Maykon Lacerda de; Maranho, Daniel Augusto Carvalho; Funghetto, Silvana Schwerz
This study aimed to investigate potential differences in spatiotemporal gait parameters and clinical outcomes between older adults undergoing intramedullary nailing (IN) and those undergoing total hip arthroplasty (THA) for unilateral hip fractures. A secondary objective was to identify predictors of postoperative falls in older adults following surgical treatment for hip fractures. We conducted a prospective study involving 42 community-dwelling older adults, assessed 6 months post-surgery. Of these participants, 21 (14 females, 7 males; mean age 76.0 ± 8.6 years) underwent IN, while the remaining 21 (10 females, 11 males; mean age 75.3 ± 7.7 years) received THA. Primary outcomes included gait speed and step width for both treatment groups, while secondary outcomes included the incidence of postoperative falls and additional clinical and spatiotemporal gait parameters. The mean gait speed was 73.5 ± 26.8 cm/s for the IN group and 79.7 ± 27.5 cm/s for the THA group (P = .46). Step width was significantly lower in the IN group (15.7 ± 2.7 cm) compared to the THA group (17.9 ± 3.3 cm; P < .05, effect size = 0.7). Postoperative falls were reported by 13 patients (31%) overall, with no significant differences between the 2 treatment groups. Multivariate logistic regression analysis identified an increased step width (≥18 cm, OR = 5.24; 95% CI: 0.98–27.97; χ² = 1.66, P = .05) as a potential independent risk factor for postoperative falls, while a higher modified Harris Hip score (≥80 points) was an independent protective factor (OR = 0.18; 95% CI: 0.03–0.97; χ² = ‐1.69; P = .04). The area under the curve was 0.889 (95% CI: 0.809–0.989; P < .001). The optimal cutoff point for the highest sensitivity (100%) and specificity (65.5%) was 0.217. Model accuracy for predicting postoperative falls was 76.2%. In conclusion, both IN and THA resulted in favorable clinical outcomes and comparable gait speeds following hip fracture surgery in older adults, though step width was greater in the THA group. Despite the high overall incidence of postoperative falls, no significant differences in fall occurrence were observed between the 2 treatment groups. Abbreviations: BMI = body mass index, GDS = geriatric depression scale, IN = intramedullary nailing, mHHS = modified Harris Hip score, MMSE = minimental state examination, THA = total hip arthroplasty.
The effects of the Home-based Older People’s Exercises (HOPE) protocol on functional capacity, falls risk, fear of falling, and quality of life in older Brazilian women with sarcopenia
(2025) Pinheiro, Hudson Azevedo; Martins, Larissa de Souza; Dias, Maria Paula Bastos; Menezes, Ruth Losada de
This study aimed to investigate the effects of the Home-based Older People’s Exercise (HOPE) program on functional capacity, falls risk, fear of falling, and quality of life in sarcopenic older women living in the Brazilian Federal District. The intervention involved 20 elderly women diagnosed with sarcopenia who participated in a 12-week exercise regimen, twice a week, focusing on functional mobility, strength, and balance. Results showed significant improvements in functional capacity, including better performance in mobility tests and increased muscle strength. Specifically, the Short Physical Performance Battery (SPPB) and handgrip strength improved, and the risk of falls, as well as the fear of falling, decreased significantly. However, no changes were observed in muscle mass. Additionally, quality of life, assessed through the EQ-5D scale, showed marked improvement. Despite the lack of muscle mass changes, the program demonstrated its efficacy in improving mobility, strength, and psychological aspects related to fall risk. The findings suggest that the HOPE protocol can be a valuable, low-cost intervention for improving the health and independence of frail, sarcopenic older adults.

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