http://repositorio.ufc.br/handle/riufc/62034 2026-06-20T00:50:44Z http://repositorio.ufc.br/handle/riufc/86831 Título: Capacidade discriminativa do teste de degrau de 6 minutos na identificação da baixa capacidade funcional em pacientes com insuficiência cardíaca Autor(es): Costa, Amanda Silva da Abstract: Introduction: Cardiovascular diseases (CVD) are the leading cause of death and disability- adjusted life years (DALYs) worldwide. In Brazil, heart failure (HF) stands out for the significant increase in hospitalizations and deaths, especially among the elderly. This condition reduces the functional capacity of patients, negatively impacting their quality of life. Assessment of physical fitness is essential for clinical management, and the 6-minute step test (6MST) is a practical alternative to the traditional 6-minute walk test (6MWT), especially in contexts with structural limitations. However, its applicability in HF still requires further investigation. Objective: To identify the cutoff point in the 6MST that is related to preserved functional exercise capacity in patients with heart failure. Methods: Cross-sectional, observational, and quantitative study, carried out between October 2022 and May 2024 at the Cardiology Outpatient Clinic of Hospital Universitário Walter Cantídio (UFC). A total of 112 adult patients diagnosed with HF (HFrEF, HFpEF, or HFmrEF) were included, excluding those with contraindications to physical exertion or limiting comorbidities. Participants underwent clinical evaluation, NYHA functional classification, 6-minute walk test (6MWT), quadriceps muscle strength assessment with a dynamometer, and 6-minute step test (6MST). Sociodemographic, anthropometric, and clinical variables were collected. Statistical analysis involved normality tests (Shapiro-Wilk), Pearson and Spearman correlations, ROC curve, and multiple linear regression, considering a significance level of p<0.05. The study was approved by the Human Research Ethics Committee, under opinion No. 6,066,757. Results: The total sample consisted of 112 participants, predominantly elderly women, overweight, preserved ejection fraction, and NYHA functional class I or II. In the 6MWT, patients walked, on average, 76.2% of the predicted distance, and in the 6MST, 67.5% of the expected steps (p<0.0001). Approximately 82.1% walked more than 300 meters in the 6MWT, indicating good functional capacity. The 6MST showed a moderate correlation with the 6MWT (r=0.689; p<0.001) and a weak to moderate correlation with quadriceps strength. In the regression analysis, advanced age, female gender, lower muscle strength and reduced ejection fraction were associated with worse performance in the 6MST. The ROC curve identified the cutoff point of 77 steps in the 6MST as indicative of preserved functional capacity, with a specificity of 90% and sensitivity of 78%. Conclusion: The 6MST proved to be an effective and accessible tool for functional assessment in patients with HF, showing good correlation with traditional tests and clinical parameters. Its application can optimize the planning of cardiovascular rehabilitation programs and expand access to functional assessment in different care contexts. Tipo: Dissertação 2025-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/86475 Título: Avaliação da mobilidade funcional por meio do Timed Up & Go (TUG) em indivíduos idosos com DPOC: o uso do protocolo em velocidade usual ou máxima interfere em sua interpretação? Autor(es): Melo, Natália Gomes Abstract: Introduction: The Timed Up & Go (TUG) test assesses functional mobility and has gained relevance in Chronic Obstructive Pulmonary Disease (COPD), primarily affecting elderly individuals. In this population, the TUG has been suggested for fall risk screening and as a measure of physical performance related to nutritional assessment. It can also be used in different physical performance assessment scenarios, in addition to demonstrating consistent measurement properties. The original protocol requires individuals to walk at their usual speed, but over the years, another protocol at maximum speed has been suggested. Due to the relatively subtle difference in test execution, many researchers have used both variations in individuals with COPD, sometimes treating them as interchangeable, which can be problematic. Objective: To compare the time in the usual TUG with the time in the maximum TUG, and to verify if the time in the maximum TUG is able to predict the time in the usual TUG in elderly individuals with COPD. Methods: A cross-sectional study that included clinically stable individuals diagnosed with COPD, aged 60 years or older, and without conditions that could compromise or confound the results of the assessment. An initial assessment was performed to obtain sociodemographic (e.g., sex, age), anthropometric (e.g., weight, height), and clinical (pulmonary function, impact of dyspnea, health status) data. Functional mobility was assessed using two TUG protocols: TUG_usual and TUG_max (the test consists of asking the individual to walk a pre-established 3- meter path, starting and returning to a seated position, and timing the time required to complete it; in TUG_usual, the usual speed was requested, while in TUG_max, the maximum speed was requested). Results: One hundred and eighty elderly individuals with COPD were included, with a mean age of 72 (67-77) years, mostly female (56%), and a mean post-bronchodilator 1-second expiratory volume of 56 ± 19% of predicted. The median time in the usual TUG was 12.0 (10.49- 14.53) seconds, statistically greater than in the maximum TUG of 9.31 (7.91-11.11) seconds (p<0.0001), with a difference between the two tests of 2.74 (1.83-3.85) seconds. One hundred and nine (61%) individuals presented reduced functional mobility in the usual TUG and 91 (51%) in the maximum TUG. There was a discrepancy in classification between the two protocols in 36 individuals (20% of the sample). Both protocols showed a reasonable correlation with the age variable, in addition to showing a weak or no correlation with the mMRC variable (p<0.0001). A regression analysis indicated that the TUG_usual time can only be predicted for men, based on the TUG_max time and age using the following equation: TUG_usual time = -0.806 + (1.027 x TUG_max time) + (0.047 x age); R2 = 0.85, p<0.001. Conclusion: The TUG_usual time is statistically greater than the TUG_max time in elderly patients with COPD. Furthermore, approximately 20% of the sample differed in the classification of reduced functional mobility between the protocols, suggesting that the protocols are not interchangeable. However, for men, the TUG_usual time can be acceptably predicted from the TUG_max time and age. Tipo: Dissertação 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/84217 Título: Análise da incapacidade ancorada no modelo biopsicossocial e sua relação com determinantes sociais da saúde na pessoa idosa com dor lombar Autor(es): Braga, Camila Ceron Cossa Abstract: Disability resulting from low back pain (LBP) in older adults reflects the impact on the functioning of this population. Despite this, studies in this area do not explore whether social determinants of health (SDH) influence the protection or increase of disability, and patient-reported outcome measures (PROMs) are unclear in reflecting functioning. This dissertation aims to investigate whether social determinants of health (SDH) influence disability in older adults twelve months after the episode, as well as to identify whether PROMs cover LD-related disability/functioning in the context of aging. In product 1, a systematic review was conducted of disability in older adults with chronic DL, assessing whether the PROMs used to obtain these results are consistent with the ICF structure and the related Geriatric Core Set. A search was conducted in the main health databases, such as PubMed, Embase, Lilacs, and the Virtual Health Library (VHL). Of the 24 studies included, eight PROMs were identified to assess disability in older adults with DL. The main and additional concepts of the PROMs were linked to identify the corresponding International Classification of Functioning, Disability, and Health (ICF) codes, which were then compared with the Geriatric Core Set codes. This product showed that the PROMs that assess disability in older adults with DL do not reflect functioning in the aging scenario. We concluded that further studies are needed to create appropriate PROMs to assess disability in older adults with DL. In product 2, a longitudinal study was conducted using data from the “Back Complaints in the Elders” database in Brazil, BACE-Brasil, to investigate the association between DSS and disability in older adults with acute DL twelve months after the onset of the episode. The independent variables analyzed were DSS and the dependent variable was the Roland-Morris Disability Questionnaire (RMDQ), which assesses disability resulting from LDS at baseline and twelve months after the episode. We revealed, through multivariate logistic regression, these higher income and education levels, as well as darker skin color, were associated with lower disability rates.These findings increased the chance of disability reduction by 1.26, 1.04, 2.1, and 2.4 times, respectively. Health professionals should take these socioeconomic variables into account to better understand the process of recovery from disability in aging. Finally, researchers need to develop PROMs that reflect functioning to cover aspects of aging in disability resulting from DL in older adults, and clinicians must understand that variables such as low income, low education, and skin color influence disability recovery in older adults with DL. Tipo: Dissertação 2025-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/82281 Título: Criação e validação de conteúdo de instrumento de avaliação do engajamento de crianças nas aulas de Educação Física Escolar Autor(es): Marques, Lara Almeida Abstract: The literature indicates that most instruments for assessing student engagement in Physical Education (PE) classes are self-report questionnaires, typically applied to older children. Therefore, this study aimed to develop and validate the content of an observational instrument to assess engagement among elementary school children, both with and without disabilities. The instrument was constructed in four stages: (i) development of the first version, (ii) pilot study, (iii) relevance analysis, and (iv) restructuring. Content validation, data analysis, and verification of reliability and trustworthiness were conducted by a panel of five expert judges. A pilot study was then carried out with 15 students, of both sexes, from two private schools in Fortaleza, Ceará. Results indicated that the criterion of Language Clarity generated the greatest divergence among expert judges, particularly within the behavioral dimension of engagement. In terms of student participation, 10 students demonstrated adequate active engagement, while 5 students scored between 2.2 and 2.4, suggesting the need for improvements. In conclusion, the instrument proved to be effective in assessing engagement in PE contexts and may support health and education professionals in monitoring children across diverse social environments, contributing to a better understanding of individual social participation, an essential component of child development. Tipo: Dissertação 2025-01-01T00:00:00Z