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      Association between the level of functional independence and the subjective experience of pain in older adults after hip replacement Translated title: Associação entre nível de independência funcional e percepção subjetiva da dor em idosos no pós-operatório de artroplastia de quadril Translated title: Asociación entre el nivel de independencia funcional y la percepción subjetiva del dolor en adultos mayores en el postoperatorio de artroplastia de cadera

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          Abstract

          ABSTRACT Hip replacement (HR) is a surgery that replaces the injured joint with a prosthesis. The postoperative period can reduce functional independence and affect the subjective experience of pain in older adults. This study evaluated the association between the level of functional independence and the subjective experience of pain in older adults who underwent HR. This cross-sectional descriptive quantitative association study used the functional independence measure (FIM) to assess the level of functional independence and the visual analogue scale (VAS) to analyze the subjective experience of pain. Spearman’s correlation test was used to evaluate the association between FIM and VAS and simple linear regression to analyze the influence of one variable on another (p≤0.05). This study evaluated 48 older adults, with a mean age of 71.5±9 years, of which 37.5% (n=18) were men and 62.5% (n=30) were women. The mean VAS and FIM values were 3.5 (±1.6) and 107 (±17.82), respectively, and they had a significant and inverse association (p=0.006; r=−0.389; R2=0.142). This study showed an inversely proportional relationship between the subjective experience of pain and the level of functional independence in older patients who underwent HR. Therefore, health professionals should pay more attention to pain in these patients in order to optimize their functional recovery and increase their functional independence.

          Translated abstract

          RESUMO A artroplastia de quadril (AQ) é um procedimento cirúrgico que consiste na substituição da articulação lesionada por uma prótese. O pós-operatório pode reduzir a independência funcional e repercutir na percepção subjetiva da dor em idosos. O estudo avaliou a associação entre o nível de independência funcional e a percepção subjetiva da dor em idosos submetidos à AQ. Trata-se de um estudo transversal, descritivo, quantitativo e de associação. A medida de independência funcional (MIF) foi utilizada para avaliar o nível de independência funcional, e a escala visual analógica (EVA) foi empregada para avaliar a percepção subjetiva da dor. O teste de correlação de Spearman foi utilizado para verificar a associação entre a MIF e a EVA, e uma regressão linear simples, para analisar a influência de uma variável sobre a outra (p≤0,05). Um total de 48 idosos foram avaliados, com média de idade de 71,5±9 anos, em que 37,5% (n=18) pertenciam ao sexo masculino e 62,5% (n=30) ao feminino. A avaliação da EVA mostrou uma média de 3,5 (±1,6), enquanto a MIF, 107 (±17,82). Observamos uma associação significante e inversa com p=0,006 e com r de −0,389, com R2 de 0,142. Este estudo mostrou que há uma relação inversamente proporcional entre a sensação subjetiva da dor e o nível de independência funcional de idosos no pós-operatório de AQ. A partir disso, é necessário que os profissionais da saúde deem mais atenção ao quadro álgico desses idosos, visando otimizar sua recuperação funcional a fim de aumentar sua independência funcional.

          Translated abstract

          RESUMEN La artroplastia de cadera (AC) es un procedimiento quirúrgico que reemplaza la articulación lesionada por una prótesis. El postoperatorio puede reducir la independencia funcional y afectar la percepción subjetiva del dolor en el anciano. Este estudio evaluó la asociación entre el nivel de independencia funcional y la percepción subjetiva del dolor en ancianos sometidos a AC. Se trata de un estudio transversal, descriptivo, cuantitativo y de asociación. La medida de independencia funcional (MIF) se utilizó para evaluar el nivel de independencia funcional, y la escala visual analógica (EVA), para estimar la percepción subjetiva del dolor. Se aplicaron la prueba de correlación de Spearman para verificar la asociación entre MIF y EVA, y una regresión lineal simple para analizar la influencia de una variable sobre la otra (p≤0,05). Participaron 48 ancianos, de edad media de 71,5±9 años; de los cuales el 37,5% (n=18) eran del sexo masculino y el 62,5% (n=30) del sexo femenino. La media de la evaluación de EVA fue de 3,5 (±1,6), mientras que la de MIF, de 107 (±17,82). Hubo una asociación significativa e inversa con p=0,006 y con r de −0,389, con R2 de 0,142. Este estudio demostró una relación inversamente proporcional entre la sensación subjetiva de dolor y el nivel de independencia funcional de los ancianos en el postoperatorio de AC. Por lo tanto, es necesario que los profesionales de la salud tengan mayor atención al dolor de esta población, con el objetivo de optimizarle la recuperación funcional y, así, aumentar su independencia funcional.

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          Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review

          The Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), and Pain Severity subscale of the Brief Pain Inventory (BPI-PS) are the most frequently used instruments to measure pain intensity in low back pain. However, their measurement properties in this population have not been reviewed systematically. The goal of this study was to provide such systematic evidence synthesis. Six electronic sources (MEDLINE, EMBASE, CINAHL, PsycINFO, SportDiscus, Google Scholar) were searched (July 2017). Studies assessing any measurement property in patients with nonspecific low back pain were included. Two reviewers independently screened articles and assessed risk of bias using the COSMIN checklist. For each measurement property, evidence quality was rated as high, moderate, low, or very low (GRADE approach) and results were classified as sufficient, insufficient, or inconsistent. Ten studies assessed the VAS, 13 the NRS, 4 the BPI-PS. The 3 instruments displayed low or very low quality evidence for content validity. High-quality evidence was only available for NRS insufficient measurement error. Moderate evidence was available for NRS inconsistent responsiveness, BPI-PS sufficient structural validity and internal consistency, and BPI-PS inconsistent construct validity. All VAS measurement properties were underpinned by no, low, or very low quality evidence; likewise, the other measurement properties of NRS and BPI-PS. PERSPECTIVES: Despite their broad use, there is no evidence clearly suggesting that one among VAS, NRS, and BPI-PS has superior measurement properties in low back pain. Future adequate quality head-to-head comparisons are needed and priority should be given to assessing content validity, test-retest reliability, measurement error, and responsiveness.
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            Enhanced recovery after surgery for hip and knee arthroplasty: a systematic review and meta-analysis

            Objectives To collect data of randomised controlled trials (RCTs) and clinical controlled trials (CCTs) for evaluating the effects of enhanced recovery after surgery on postoperative recovery of patients who received total hip arthroplasty (THA) or total knee arthroplasty (TKA). Methods Relevant, published studies were identified using the following key words: arthroplasty, joint replacement, enhanced recovery after surgery, fast track surgery, multi-mode analgesia, diet management, or steroid hormones. The following databases were used to identify the literature consisting of RCTs or CCTs with a date of search of 31 December 2016: PubMed, Cochrane, Web of knowledge, Ovid SpringerLink and EMBASE. All relevant data were collected from studies meeting the inclusion criteria. The outcome variables were postoperative length of stay (LOS), 30-day readmission rate, and total incidence of complications. RevMan5.2. software was adopted for the meta-analysis. Results A total of 10 published studies (9936 cases) met the inclusion criteria. The cumulative data included 4205 cases receiving enhanced recovery after surgery (ERAS), and 5731 cases receiving traditional recovery after surgery (non-ERAS). The meta-analysis showed that LOS was significantly lower in the ERAS group than in the control group (non-ERAS group) (p<0.01), and there were fewer incidences of complications in the ERAS group than in the control group (p=0.03). However, no significant difference was found in the 30-day readmission rate (p=0.18). Conclusions ERAS significantly reduces LOS and incidence of complications in patients who have had THA or TKA. However, ERAS does not appear to significantly impact 30-day readmission rates.
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              Perioperative Pain Management in Hip and Knee Arthroplasty

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                Author and article information

                Journal
                fp
                Fisioterapia e Pesquisa
                Fisioter. Pesqui.
                Universidade de São Paulo (São Paulo, SP, Brazil )
                1809-2950
                2316-9117
                2023
                : 30
                : e22012823en
                Affiliations
                [2] Brasília Distrito Federal orgnameUniversidade de Brasília Brazil ft.liana@ 123456gmail.com
                [6] Pinheiro orgnameUniversidade Federal do Maranhão Brazil tamiresbarradas@ 123456gmail.com
                [5] Brasília Distrito Federal orgnameUniversidade de Brasília Brazil lidia.bezerra@ 123456gmail.com
                [1] Brasília Distrito Federal orgnameUniversidade de Brasília Brazil jeffcasilva@ 123456gmail.com
                [4] São Carlos orgnameUniversidade Federal de São Carlos Brazil rezende.murilo@ 123456gmail.com
                [3] Brasília Distrito Federal orgnameUniversidade de Brasília Brazil tamisdp@ 123456gmail.com
                Article
                S1809-29502023000100202 S1809-2950(23)03000000202
                10.1590/1809-2950/e22012823en
                f824ec6d-7bd2-4cbc-bf2a-b442636b3b9c

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 31 July 2022
                : 07 January 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 0
                Product

                SciELO Brazil

                Categories
                Original Research

                Arthroplasty, Replacement, Hip,Idoso,Artroplastia de Quadril,Estado Funcional,Anciano,Artroplastia de Reemplazo de Cadera,Elderly,Functional Status

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