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Influence of dual task in balance of elderly after femoral fracture

Grant number: 13/08744-9
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): December 01, 2013
Effective date (End): November 30, 2014
Field of knowledge:Interdisciplinary Subjects
Principal Investigator:Karina Gramani Say
Grantee:Isadora Costa Carriço
Home Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

Abstract

Brazil has currently high number of hospitalizations for hip fracture, which has been considered an epidemic. Expenditures of Public Health with seniors who are admitted by the Unified Health System (SUS) reached 57.61 million dollars in 2009. It is observed that many seniors after fracture can not return to previous functional level. Besides functionality, the concern is the mortality rate after surgery, only in 2005 were 1,304 deaths from fractures of the femur, and in 2009 this number reached to 1,478 deaths across the country. The hospitalization for hip fracture is the health indicator chosen to evaluate the National Health Policy for the Elderly (PNSPI). However, there are few studies assessing the prevalence of this event in the inner cities, the conditions of postural control and functionality of the elderly after hip fracture and how this situation is impacting on quality of life, activities of daily living, cognition and fear of fall. Furthermore, it is important to know how the performance of dual-task can change postural control after the fall event and consequently the femur fracture. Thus, the aim of this study is to evaluate the influence of dual task on postural control and cognitive performance of elderly people in different age groups after hip fracture. The elderly constitute two groups: elderly people with hip fracture after a fall (GIF) with 20 elderly divided according to age, with 10 subjects each: Group 1 elderly (GIF1) 60-75 years Group 2 Elderly (gif2) over 75 years and a control group of subjects without fracture (GC) with 20 subjects without hip fracture divided according to the same age group (GC1: 60-75 years GC2: 75 years). The elderly of both groups will be assessed for balance (Berg Balance Scale), mobility (TUG), gait (POMA) and Dymanic Gait Index (DGI), in addition to tests to assess cognition of the elderly (MMSE) and the Clock Test (TR). Postural control is evaluated by means of the following variables Pressure Center (CP) area, mean sway amplitude, average speed and frequency of oscillation forces mediolateral (ML) and anteroposterior (AP). Will be used a force platform (Bertec Mod) frequently 100Hz/canal collection. The CP data will be collected and stored for further processing in Matlab language (version 7.0) for a specific routine, and Butterworth filter with a cutoff frequency of 5 Hz. In the test positions (bipedal and semi-tandem), individuals will remain for 30 seconds, in 3 replications in two conditions, eyes open and then with eyes closed. In the sequel, will be repeated the same tests associated with dual-task backwards evoke the days of the week and after holding a tray containing a glass almost full of water under this tray. The data will undergo appropriate statistical analysis. The results of this research will help to understand the impact of dual-tasking on postural control in elderly patients who suffered femur fractures and guiding public policy in the prevention and monitoring of health conditions of the elderly after hip fracture.