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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(09): 592-598
DOI: 10.1590/0004-282X20180087
Article

Determinants of the use of physiotherapy services among individuals with Parkinson's disease living in Brazil

Determinantes do uso de serviço de fisioterapia entre indivíduos com doença de Parkinson que vivem no Brasil
Fátima Rodrigues-de-Paula
1   Universidade Federal de Minas Gerais, Departamento de Fisioterapia, Belo Horizonte MG, Brasil
,
Raquel de Carvalho Lana
1   Universidade Federal de Minas Gerais, Departamento de Fisioterapia, Belo Horizonte MG, Brasil
,
Larissa Karlla Rodrigues Lopes
1   Universidade Federal de Minas Gerais, Departamento de Fisioterapia, Belo Horizonte MG, Brasil
,
Francisco Cardoso
2   Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brasil
,
Ana Raquel Rodrigues Lindquist
3   Universidade Federal do Rio Grande do Norte, Departamento de Fisioterapia, Natal RN, Brasil
,
Maria Elisa Pimentel Piemonte
4   Universidade de São Paulo, Departamento de Fisioterapia, São Paulo SP, Brasil
,
Clynton Lourenço Correa
5   Universidade Federal do Rio de Janeiro, Departamento de Fisioterapia, Rio de Janeiro RJ, Brasil
,
Vera Lúcia Israel
6   Universidade Federal do Paraná, Universidade de Fisioterapia, Curitiba PR, Brasil
Universiade de Fisioterapia, Brasil
,
Felipe Mendes
7   Universidade de Brasília, Departamento de Fisioterapia, Brasília DF, Brasil
,
Lidiane Oliveira Lima
8   Universidade Federal do Ceará, Departamento de Fisioterapia, Fortaleza CE, Brasil
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ABSTRACT

To identify the factors affecting the use of physiotherapy services among individuals with Parkinson's disease (PD) living in Brazil.

Methods: Overall, 479 individuals with idiopathic PD, of both sexes, at any stage of the Hoehn & Yahr (HY) scale, and from seven capital cities in Brazil were recruited from 2014 to 2016. Multivariate logistic regression was the main statistical tool. For the construction of the logistic model, the association of the dependent variable “physiotherapy” with the independent sociodemographic/economic and clinical variables: age, education, family income, time of PD since onset, HY, the activities of daily living and motor subscales of the Unified Parkinson's Disease Rating Scale, cognitive aspects, depressive symptoms, fear of falling, freezing gait, history of falls, physical activity level, gait speed, walking performance and balance, were verified.

Results: The 479 individuals had an average age of 65.2 ± 11.0 years, 88% were in the HY I-III stages and 43.4% were under physiotherapy treatment. The analysis identified two determinant variables related to the use of the physiotherapy service: level of education (OR = 1.24) and walking performance (OR = 0.82). Decreased walking performance and a higher educational level increased the use of a physiotherapy service in individuals with PD living in Brazil.

Conclusions: The present study shows that individuals with PD, residents from different regions of Brazil, have limited access to physiotherapy services. In addition, the Brazilian Public Health Care System, as well as local programs, need to target PD individuals with a low educational level to improve their access to physiotherapy services. Goals should aim towards the development of physical exercise programs to improve the patients’ functional performance for a longer period.

RESUMO

Descrever a utilização do serviço de fisioterapia e identificar os fatores que determinam o uso desse serviço entre indivíduos com doença de Parkinson (DP) que vivem no Brasil.

Métodos: No total, 479 indivíduos com DP idiopática, de ambos os sexos, em qualquer estágio da escala de Hoehn & Yahr (HY) e de sete capitais do Brasil foram recrutados durante 2014 a 2016. A análise de regressão logística multivariada foi a principal ferramenta de análise estatística. Para a construção do modelo logístico foi investigada a associação da variável dependente “fisioterapia” com variáveis independentes sociodemográficas, econçmicas e clínicas: idade, educação, renda familiar, tempo de DP desde o início, HY, domínio motor e atividade de vida diária da Unified Parkinson´s Disease Rating Scale, aspectos cognitivos, sintomas depressivos, medo de queda, congelamento marcha, história de quedas, nível de atividade física, velocidade de marcha, capacidade de caminhar e equilíbrio.

Resultados: 479 indivíduos apresentaram média de 65,2 ± 11,0 anos, 88% tiveram HY = I-III e 43,4% faziam fisioterapia para a DP. A análise identificou duas principais variáveis determinantes do uso da fisioterapia: educação (OR = 1,24) e capacidade de caminhada (OR = 0,82). A diminuição da capacidade de caminhar e maior nível educacional aumentam o uso da fisioterapia em indivíduos com doença de Parkinson vivendo no Brasil.

Conclusões: O presente estudo mostra que indivíduos com DP, residentes de diferentes regiões do Brasil, têm acesso limitado aos serviços de fisioterapia. Além disso, o Sistema Brasileiro de Saúde Pública, bem como os programas locais, precisam atingir pessoas de DP com baixo nível educacional para melhorar seu acesso aos serviços de fisioterapia. Os objetivos devem ser para o desenvolvimento de programas de exercícios físicos para melhorar o desempenho funcional dos pacientes por um período mais longo.

Keywords:

Parkinson disease - physical therapy specialty - education - gait

Palavras-chave:

doença de Parkinson - fisioterapia - educação - marcha

Support

CNPq




Publication History

Received: 27 September 2017

Accepted: 05 June 2018

Article published online:
22 August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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