Rastreio de Ocorrência de Quedas e Análise Retrospetiva numa População com Doença de Parkinson

Rui Prado Costa, Diogo Costa, Patrícia Costa, Maria José Festas

Resumo


Introdução: As quedas são comuns na doença de Parkinson aumentando a incapacidade e a morbidade. A participação em programas de reabilitação e a modificação de fatores de risco podem melhorar os resultados. Pretendeu-se caraterizar uma população com doença de Parkinson, nomeadamente a autoperceção do equilíbrio e a participação em programas de reabilitação e encontrar possíveis associações com a ocorrência de quedas.

Métodos: Estudo retrospetivo e transversal, compreendendo todos os doentes com doença de Parkinson de uma Unidade de Saúde Familiar. Foram definidos dois grupos, os que caíram e os que não caíram anteriormente. Os fatores sociodemográficos, a participação em programas de reabilitação, a pontuação na escala Activities-specific Balance Confidence (ABC-16) e outros fatores de risco foram colhidos através de questionário administrado por telefone e complementado com os registos clínicos. Foi realizada uma análise comparativa entre ambos os grupos, foi calculado o valor de corte para a pontuação da escala ABC-16 e foi realizada uma regressão logística para determinação do efeito das variáveis na probabilidade de ocorrência de quedas.

Resultados: Trinta e quatro doentes foram elegíveis após aplicação dos critérios de exclusão, dos quais 29,4% eram fisicamente ativos. No ano precedente, 41,2% realizaram programa de reabilitação e 18 reportaram pelo menos um episódio de queda. O modelo de regressão logística explicou 70% da variância das quedas reportadas (p < 0,005, sensibilidade 87%; especificidade 94%): a pontuação baixa na escala ABC-16 (OR: 0.94), a não participação em programas de reabilitação (OR: 15,3) e o género feminino (OR: 11,4) aumentaram a probabilidade de episódios de queda durante o ano precedente. Foi determinado o valor de corte de 63 para a pontuação da escala ABC-16.

Conclusão: A aplicação remota de um questionário incluindo a escala ABC-16 pode representar uma ferramenta de rastreio para avaliar o risco de queda na doença de Parkinson. O género feminino e a não participação em programas de reabilitação esteve associada a história de quedas. Estes achados enfatizam a necessidade de implementação de programas de prevenção de quedas nesses doentes.


Palavras-chave


Doença de Parkinson/complicações; Doença de Parkinson/reabilitação; Equilíbrio Postural; Quedas Acidentais/prevenção e controlo

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Referências


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DOI: http://dx.doi.org/10.25759/spmfr.300

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