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Francisco Eduardo Costa Cardosohttp://lattes.cnpq.br/4158841513358745Aline Scianni Alvimhttp://lattes.cnpq.br/6922615681702256Henrique Ballalai FerrazCarlos Roberto de Mello Riederhttp://lattes.cnpq.br/5091889823863828Arthur Pena Ferreira2022-10-26T13:30:09Z2022-10-26T13:30:09Z2022-04-28http://hdl.handle.net/1843/46626Introdução: Quedas estão associadas com injúrias, medo de cair, diminuição da mobilidade funcional e piora na qualidade de vida. Entretanto, pouco se sabe sobre os fatores potencialmente contribuintes para ocorrência de quedas na Doença de Huntington (DH) assim como sobre as circunstâncias nas quais elas ocorrem. Objetivos: Investigar as características clínicas potencialmente associadas com o aumento do risco de quedas na DH, assim como as circunstâncias nas quais as quedas ocorrem e suas consequências. Métodos: Dados demográficos e clínicos foram obtidos através de entrevista, revisão do prontuário e exame físico. Instrumentos para avaliação de risco de quedas (TUG), sintomas motores (UHDRS, UPDRS), distúrbios da marcha (10MWT, FOG), distúrbios cognitivos (MEEM, FAB, FDT, Hayling,Ekman), alterações comportamentais (Irritability Scale, BIS-11, BDI-II, NPI-Q) e distúrbios do equilíbrio (BBS) foram aplicado em todos pacientes. Resultados: Foram obtidos dados de 40 pacientes e 24 (60%) apresentaram ≥ 2 quedas nos últimos 6 meses e foram considerados “caidores recorrentes”. Idade, idade de início da doença e duração da doença (DCL) não diferiram entre os grupos. Em contrapartida, a dose de neurolépticos medida em equivalentes de Olanzapina (OE) foi maior no grupo dos “caidores recorrentes.” Os pacientes “caidores recorrentes” também apresentaram pior performance no desempenho da UHDRS-TMS, UPDRS, BBS e mais coreia do que os “não-caidores”. Houve também diferença estatística na comparação dos tempos de escolha e alternância do FDT indicando pior desempenho cognitivo do grupo dos “caidores recorrentes” no teste. “Caidores- recorrentes” também apresentaram mais comportamento motor aberrante do que os “não- caidores”. Não houve diferença na comparação dos parâmetros espaço-temporais da marcha estudados, assim como no desempenho do TUG. Ambos os grupos apresentaram altos índices de medo de queda. Somente o modelo contento o BBS alcançou significância estatística na regressão logística. Cerca de 80% das quedas ocorreram dentro de casa, caminhar foi o ato mais comum durante as quedas. Ainda, 40% das quedas foram classificadas como intrínsecas. Conclusão: As quedas são frequentes na DH assim como o medo de cair. Nosso estudo sugere que o risco de quedas na doença de Huntington seja multifatorial. Altas doses de neurolépticos, coreia, sintomas cognitivos e comportamentais e particularmente distúrbios do equilíbrio contribuem para ocorrência de quedas na HD.Introduction: Falls are associated with injuries, fear of falling, decreased functional mobility and worsening in quality of life. However, little is known about the potentially contributing factors to the occurrence of falls in Huntington's Disease (HD) as well as the circumstances in which they occur. Objectives: To investigate clinical features potentially associated with an increased risk of falls in HD, as well as the circumstances in which falls occur and their consequences.Methods: Demographic and clinical data was obtained through interviews, chart review and physical examination. Instruments for fall risk assessment (TUG), motor symptoms (UHDRS, UPDRS), gait disorders (10MWT, FOG), cognitive disorders (MMSE, FAB, FDT, Hayling, Ekman), behavioral changes (Irritability Scale, BIS- 11, BDI-II, NPI-Q) and balance disorders (BBS) were applied to all patients.Results: Data from 40 patients was obtained and 24 (60%) had ≥ 2 falls in the last 6 months and were considered “recurrent fallers”. Age, age of disease onset and disease duration (DCL) did not differ between groups. In contrast, the dose of neuroleptics measured in olanzapine equivalents (EO) was higher in the “recurrent fallers” group. The “recurrent fallers” also showed worse performance in the execution of the UHDRS-TMS, UPDRS, BBS and more chorea than the “non-fallers”. There was also a statistical difference in the comparison of times of choice and alternation of the FDT, indicating worse cognitive performance of the “recurrent fallers” group in the test. “Recurrent fallers” also showed more aberrant motor behavior than “non-fallers”. There was no difference in the comparison of the spatio-temporal gait parameters studied, nor in the TUG performance. Both groups had high rates of fear of falling. Only the model containing the BBS reached statistical significance in the logistic regression. About 80% of falls occurred indoors, walking was the most common act during falls. In addition, 40% of falls were classified as intrinsic. Conclusion: Falls are frequent in HD as well as the fear of falling. Our study suggests that the risk of falls in Huntington's disease is multifactorial. High doses of neuroleptics, chorea, cognitive and behavioral symptoms and particularly balance disorders contribute to the occurrence of falls in HD.porUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em Ciências Aplicadas à Saúde do AdultoUFMGBrasilhttp://creativecommons.org/licenses/by-nc-nd/3.0/pt/info:eu-repo/semantics/openAccessDoença de HuntingtonAcidentes por QuedasEquilíbrio PosturalAntipsicóticosCoreiaTranstornos Neurológicos da Marcha.Dissertação AcadêmicaDoença de HuntingtonQuedasDistúrbios de marchaDistúrbios do equilíbrioNeurolépticosInstabilidade posturalQuedas na doença de Huntingtoninfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSElicense.txtlicense.txttext/plain; charset=utf-82118https://repositorio.ufmg.br/bitstream/1843/46626/3/license.txtcda590c95a0b51b4d15f60c9642ca272MD53ORIGINALQuedas na Doença de Huntington.pdfQuedas na Doença de Huntington.pdfapplication/pdf3103843https://repositorio.ufmg.br/bitstream/1843/46626/1/Quedas%20na%20Doen%c3%a7a%20de%20Huntington.pdf7cd30d543d056320bd1f2b2980bb749cMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8811https://repositorio.ufmg.br/bitstream/1843/46626/2/license_rdfcfd6801dba008cb6adbd9838b81582abMD521843/466262022-10-26 10:30:09.581oai:repositorio.ufmg.br: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ório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2022-10-26T13:30:09Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
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