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- The effects of different types of dual tasking on balance in healthy older adultsPublication . Barros, Graça Monteiro de; Melo, Filipe; Domingos, Josefa; Oliveira, Raul; Silva, Luís; Fernandes, Júlio Belo; Godinho, CatarinaNumerous of our daily activities are performed within multitask or dual task conditions. These conditions involve the interaction of perceptual and motor processes involved in postural control. Age-related changes may negatively impact cognition and balance control. Studies identifying changes related to dual-task actions in older people are need. This study aimed to determine the effects of different types of dual-tasking on the balance control of healthy older adults. The sample included 36 community-living older adults, performing two tests—a sway test and a timed up-and-go test—in three conditions: (a) single motor task; (b) dual motor task; and (c) dual motor task with cognitive demands. Cognitive processes (dual-task and cognition) affected static balance, increasing amplitude (p < 0.001) and frequency (p < 0.001) of the center of mass displacements. Dynamic balance revealed significant differences between the single motor condition and the other two conditions during gait phases (p < 0.001). The effect of dual-tasking in older adults suggests that cognitive processes are a main cause of increased variability in balance and gait when under an automatic control. During sit-to-stand, turning, and turn-to-sit movements under dual-tasking, the perceptive information becomes the most important focus of attention, while any cognitive task becomes secondary.
- A novel boot camp program to help guide personalized exercise in people with Parkinson diseasePublication . Domingos, Josefa; Dean, John; Cruickshank, Travis M.; Śmiłowska, Katarzyna; Fernandes, J. B.; Godinho, CatarinaGiven the variety of exercise programs available for people with Parkinson’s disease (PD), such individuals may struggle to make decisions about what exercise to perform. The objective of this study was to assess the usefulness, satisfaction, and preferences regarding participation in a PD-personalized educational and exercise boot camp program. Attendees participated in a four-day program consisting of exercise sessions, workshops, and social activities. We collected demographic and clinical information. We assessed satisfaction and preferences immediately after. At one-month follow-up, participants assessed usefulness and changes in exercise habits. Eight individuals diagnosed with PD, with a mean age of 59.5 ± 6.8 years, participated. All participants felt “very satisfied” and likely to attend future events. The two favorite sessions were: cognitive stepping and dance-based movements. At one-month follow-up, participants considered the program “very useful” and reported changes in their exercise routine. Our results suggest that the boot camp program was considered useful and capable of influencing participants’ exercise habits.
- Professionals’ self-reported difficulties towards integrating dual task training in care for people with Parkinson’s DiseasePublication . Domingos, Josefa; Dean, John; Fernandes, Júlio Belo; Godinho, CatarinaBackground: Despite the growing use of dual task training (DTT) in clinical practice with people with Parkinson Disease (PD), there is still limited evidence on how to best implement it. Data regarding professionals’ difficulties when integrating such practices are critical as a first step to generate further guidance on how to apply it. The aim of this study was to identify the difficulties perceived by professionals to integrate dual task in their practice. Methods: A descriptive, observational and cross-sectional study was conducted using a web-based survey. Convenience sampling was used to recruit exercise and healthcare professionals working with people with PD through various social media channels. Data were collected and then analyzed thematically using the method of constant comparisons. The study report follows the consolidated criteria for reporting qualitative research (COREQ) checklist. Results: Of the 205 eligible responses, 68.8% were Physiotherapist. The majority of the participants reported having Parkinson-specific training (91.7%) and 59.0% applied DTT in individual one-on-one sessions. We identified ten categories of difficulties faced by professionals. Conclusions: Professionals struggle to integrate DTT into PD clinical care. Challenges were identified and the most significant refer to difficulties in managing the chronicity of the disease and lack of patient compliance with home exercises. Understanding current challenges towards dual task exercise will help to reflect upon strategies to be applied effectively and safe.
- Is being physically active enough or do people with Parkinson’s disease need structured supervised exercise? Lessons learned from COVID-19Publication . Domingos, Josefa; Familia, Carlos; Fernandes, Júlio Belo; Dean, John; Godinho, CatarinaSocial isolation imposed by the COVID-19 pandemic negatively impacted people’s lifestyles and daily activities. In this work we compared pre- and post-pandemic clinical outcomes in people with Parkinson’s disease, to assess differences according to the type of behaviour and exercise habits adopted by participants. After two months of COVID-19 lockdown, we assessed: changes in exercise behaviour; motor and non-motor aspects of daily life experiences (MDS-UPDRS I & II); activities of daily living (The Schwab & England scale); quality of life (Parkinson Disease Questionnaire); sleep (Parkinson Disease Sleep Scale); falls; and Clinical Global Impression Change. Twenty-seven individuals aged between 57 and 92 years old participated; from these, ten individuals (37%) completely interrupted physical activities, while seventeen (63%) maintained some level of active lifestyle. Regardless of whether they remained active or not, all participants perceived a significant worsening of their clinical condition, reporting an increase in difficulties completing daily activities or chores (37%) and worsening of their health condition (51.8%). The quantifiable influence of exercise habits was borderline for the group who kept active. The active group seem to have a better self-perception of their health condition, although it was not enough to show a clear benefit. People with Parkinson’s disease should be informed that being physically active may not be enough and more structured exercise could be needed.
- Competências de investigação desenvolvidas pela pós-graduação: transferência para a prática clínica em enfermagemPublication . Ferreira, Rogério; Mestre, Teresa Dionísio; Fernandes, Júlio Belo; Sousa, Luís; José, Helena; Fonseca, César; Ferreira, Óscar; Baixinho, Cristina LavaredaObjetivo: Explorar o modo como as competências de investigação, desenvolvidas através da pós-graduação em enfermagem, transferem-se para a prática clínica. Método: estudo qualitativo, exploratório e descritivo, desenvolvido com base em um grupo focal em outubro de 2021, utilizando uma amostra intencional de oito enfermeiros pós-graduados de uma instituição de saúde da região do Baixo Alentejo, Portugal. Para a análise de dados, foi realizada a análise de conteúdo de Bardin. Os participantes e dois revisores legitimaram os resultados. Além disso, os critérios consolidados para verificação de pesquisa qualitativa foram aplicados a este estudo para garantir a qualidade do relatório de pesquisa. Resultados: da análise de dados emergiram três categorias: 1) Transferência das competências de investigação para a prática clínica, 2) constrangimentos ao desenvolvimento da investigação e 3) expectativas em relação ao desenvolvimento da investigação em enfermagem. Conclusão: O reconhecimento pelas competências de investigação nos contextos da prática, o envolvimento da equipe, a melhoria dos resultados dos cuidados de enfermagem, a maior compreensão do processo de investigação, comunicação dos resultados e transferência do conhecimento para a clínica são contributos das competências de investigação pela pós-graduação. Os achados deste estudo podem contribuir para o desenvolvimento de políticas de educação em saúde e enfermagem.