Fisioterapia - PPGFthttps://repositorio.ufscar.br/handle/ufscar/81922024-03-29T06:09:46Z2024-03-29T06:09:46ZFuncionalidade de crianças e adolescentes com síndrome de Down: impacto de fatores contextuaisBrugnaro Marques, Beatriz Helenahttps://repositorio.ufscar.br/handle/ufscar/196082024-03-08T12:54:47Z2024-02-22T00:00:00ZFuncionalidade de crianças e adolescentes com síndrome de Down: impacto de fatores contextuais
Brugnaro Marques, Beatriz Helena
This thesis aimed to explore the functioning of children and adolescents with Down syndrome (DS), and analyze the impact of contextual factors on it. This investigation was based on four studies developed before, during and after the easing of social distancing due to the covid-19 pandemic. Study I aimed to compare, in children with DS, functioning and environmental factors before and during the social distancing imposed by the covid-19 pandemic and determine which social, physical, behavioral and functioning aspects during distancing were correlated with each other. There was a significant increase in the frequency and involvement of participation at home and in the impact perceived by parents on the child's possibility to participate in daily activities, as well as a significant reduction in social support received by the caregiver. Furthermore, greater socio-emotional difficulties were associated with lower parental satisfaction as well as less physical activity. Therefore, the beginning of the pandemic affected the functionality of children with DS in several ways. Study II investigated, from the caregivers' perspective, the feasibility of remotely assessing the functioning of children and adolescents with disabilities during the covid-19 pandemic and the contextual factors related to feasibility. Remote assessment was considered easy and feasible by caregivers. Viability scores were inversely related to maternal age. The multiple linear regression model shows that the family's higher socioeconomic level, the mother's younger age, stricter social distancing, longer periods of social distancing from the mother, undergoing therapy during the pandemic and mothers who did not work explain 20.4% of the health feasibility score of remote assessment. Study III investigated whether participation opportunities at home (frequency and involvement) for children and adolescents with DS are associated with functional skills related to the domains of daily activities, mobility, social/cognitive and responsibilities. It was found that greater frequency of participation at home was significantly correlated with better results in the domains of daily activities, social/cognitive and responsibility. The involvement outcome was also significantly (positively) correlated with daily activities, social/cognitive and responsibility. The mobility domain was not correlated with frequency and involvement. Study IV aimed to describe current home participation (frequency, involvement), the caregiver's desire for change in the participation of children/adolescents with DS and home environmental factors. Additionally, explore the interrelations of personal and environmental factors with the caregiver's current participation and desire for change from caregivers. It was found that children's participation was highest in managing personal care and lowest in activities related to school. Most caregivers wanted changes in homework and household chores. Greater frequency of participation was related to male gender, less rigorous social distancing from caregivers and children receiving therapies. Greater involvement was related to the younger age of the children and greater environmental support. The older age of the children was associated with a greater desire for change in the caregiver. The findings obtained in this thesis contribute to advances in the investigation of the functioning of children and adolescents with DS, shedding light on factors that can be the target of clinical investigation and future research.
2024-02-22T00:00:00ZApreciação corporal de mulheres brasileiras com e sem dor relacionada à dismenorreia primária: estudo transversalFirão, Caren Beatrizhttps://repositorio.ufscar.br/handle/ufscar/195772024-03-04T12:36:50Z2024-02-05T00:00:00ZApreciação corporal de mulheres brasileiras com e sem dor relacionada à dismenorreia primária: estudo transversal
Firão, Caren Beatriz
Primary dysmenorrhea (PD) is a common condition in women of reproductive age characterized by abdominal pain that occurs during the menstrual cycle in the absence of pelvic pathology. Recently, studies of chronic pain have found an association between the presence of pain and body image distortions. The aim of this study was to verify the association between PD related pain and body appreciation. Brazilian women aged 18 to 52 years were invited to participate in the study via social media and were divided into two groups: PD group (n=1.742; 28.3±6.9 years) and no PD group (n=680; 30.2±7 years). Participants completed an online questionnaire that included sociodemographic and gynecologic questions, the Numerical Rating Scale (NRS) to assess the pain severity, and the Body Appreciation Scale-2 (BAS-2) to assess the body appreciation. Data were analyzed using multiple linear regression. The PD group had significantly lower body appreciation compared to the no PD group (p <0.001).
2024-02-05T00:00:00ZDesenvolvimento de um instrumento para identificação e análise da influência dos fatores contextuais no período gestacionalSilva, Clara Maria de Araujohttps://repositorio.ufscar.br/handle/ufscar/195572024-02-29T13:42:16Z2024-02-16T00:00:00ZDesenvolvimento de um instrumento para identificação e análise da influência dos fatores contextuais no período gestacional
Silva, Clara Maria de Araujo
During the gestational period, numerous physiological adaptations occur to facilitate the maternal body's adjustment to fetal growth. It is crucial to consider the context in which pregnant women are situated, identifying potential social inequalities. However, in the literature, tools assessing contextual factors personal, economic, social, and cultural aspects of Brazilian pregnant women are scarce. Objective: Develop an instrument based on the International Classification of Functioning to identify and assess the influence of contextual factors during the gestational period in Brazilian women. Methods: A methodological study was conducted for instrument development using the Delphi Method and COSMIN guidelines. Ethical approval was obtained (CAEE: 63878222.1.0000.5504). The study comprised the following stages: 1- Definition of the construct, 2- Item selection and formulation; 3- Pre-test, with data collection from March to July 2023. Descriptive analysis characterized study participants. Data from the instrument construction process underwent specific analyses for each stage. Descriptive analyses identified relevant contextual factors and pre-test results. Bardin's discourse analysis was employed for qualitative data, and the instrument's content validity index assessed the instrument. Results: The study involved 22 experts in stage 2, evenly divided between subject experts and the target audience. In stage 3, 21 pregnant women participated, diverse in geographic location, mostly married or in stable unions, with high educational levels. Instrument development results showed variation in expert agreement on contextual factors' relevance, with the support network (90.9%), physical activity (72.7%), age, and prenatal care (63.6%) being the most relevant. Factors like profession, number of previous pregnancies, housing arrangement, and space for the newborn were considered relevant by 54.6% of experts. Factors such as mobility, race/ethnicity, education, housing conditions, and family income had agreement percentages below 50%. Regarding feasibility, the instrument was deemed easy, quick, and easily understandable for completion. Conclusion: Divergence exists between healthcare professionals and pregnant women regarding relevant contextual factors. Nevertheless, the developed instrument was considered suitable, relevant, and comprehensible, potentially serving as a valuable tool for research and clinical practice. The instrument comprises three assessment sections: the first being the cover page, the second covering personal factors, and the third addressing environmental factors. The cover page and personal factors sections enable the identification of individual respondent characteristics potentially correlating with measures found in the environmental factors section concerning the type of influence (positive or negative) of these factors. For measurement purposes, only responses from the environmental factors section are utilized.
2024-02-16T00:00:00ZO efeito da compressão por ataduras elásticas na dor e função em indivíduos com osteoartrite de joelho: ensaio clínico controlado randomizadoFerrari, Angelica Vianahttps://repositorio.ufscar.br/handle/ufscar/195132024-02-27T13:40:23Z2024-02-23T00:00:00ZO efeito da compressão por ataduras elásticas na dor e função em indivíduos com osteoartrite de joelho: ensaio clínico controlado randomizado
Ferrari, Angelica Viana
Compression is widely used in combination with cryotherapy and other non-pharmacological physical agents to control musculoskeletal pain. However, there is still a lack of evidence regarding its possible effects on modulating this type of pain. This study evaluated the effect of compression by elastic bandages on pain and physical function in individuals with knee osteoarthritis (KOA). Methods: Randomized, three-arm, prospectively registered trial, blinded assessors, allocation concealment, and intention-to-treat analysis. Participants: Ninety individuals with KOA, of both sexes, between 40 and 75 years of age, with current pain > 4 cm on the 10 cm visual analogue scale (VAS). Intervention: For four days, the experimental group used an elastic bandage compressed on the painful knee for 20 minutes; the sham group used elastic bandages without compression; and the control group did not use a dressing. Outcome measures: Primary outcomes were visual analogue scale (VAS) pain and pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included self-reported (WOMAC) and objective physical function (step tests; 30-second sit-to-stand test; 40-m brisk walk test) and global change rating scale. Measurements were taken at day 1, day 6 and 12 weeks. Results: Immediately after the intervention, the mean difference between the groups in the stiffness, function and total index subscales were statistically significant, favoring the experimental group and the sham group, compared to the control, but without reaching the minimum clinically important difference (MCID). At the same time, the experimental group reached the MCID in the pain variable after the 9-step test when compared to the control group. For the other times and comparisons there were no significant results. Conclusion: The application of elastic bandage compression to the knee of individuals with KOA was not superior to a sham intervention and a negative control in reducing pain and improving physical function. Trial Registration: NCT04724902.
2024-02-23T00:00:00Z