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Previous issue date: 2012-03-20 === Population aging has been leading to the increase in chronic degenerative disorders, among them musculoskeletal and joint diseases (MJD), of which low back pain is among the most prevalent and symptomatic in the elderly. The MJDs result in functional disabilities that negatively impact on the independence and quality of life of the elderly. Hence, profile determination of MJD is important for the management and planning of health actions. Thus, this dissertation presents two studies: one aims on (1) characterizing the elderly with MJD of the rehabilitation center (RC) at Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS), in refference to demographic and health profile, type of physical therapy treatment, service funding, and outcome, and also among these, the aim to (2) characterize those with low back pain. This cross-sectional study used retrospective data from medical records of 1203 elderly (age, sex, residence, type of treatment funding, clinical diagnosis), all treated from July 2004 to March 2010. Of the 890 medical records of elderly patients with MJD, data concerning medication, comorbidities, signs and symptons, physical therapy treatment, number of sessions and outcome were collected. These data were analyzed using the SPSS software where a level (α) of 5% was adopted as a decision criteria. For the total of elderly subjects the average age was 70,1 (+- 7,9) years and among them predominated women (66.7%) who resided near the RC (45%), and distant (55%), including surrounding towns, whose treatment was funded by health care plans (54,4%). There was significant prevalence of MJD (74%, p <0.0001) compared to other groups of diseases (respiratory, genitourinary, nervous, amputations and others), which showed significant association with the female sex, while the male sex was associated with diseases of the respiratory and circulatory systems. The most frequent MJDs were arthropathies (25.6%) and back problems (34.6%) and, among the latter, the most common were low back pain (14.4%). Hypertension was the most frequently reported comorbidity (50.3%) and antihypertensive drugs the most frequently used (34.7%). Pain was the most frequent symptom (97.7%), followed by limitation of range of motion (48.2%). The most widely used physical therapy treatments were kinesiotherapy (72.9%) associated with electrotherapy (60,2%). The most frequent treatment response was relief of pain (98,2% of valid cases n=227). As for outcome, 106 patients (45,9% of valid cases n = 231) had release from treatment. Regarding the elderly referred for low back pain (69.98 ? 8.4 years), 53% had only low back pain, 21% lumbar sciatic pain and 26% low back pain associated with other diseases. Also among them the majority were women (69.8%), complaining of pain (99.2%), whose physical therapy treatment consisted of kinesiotherapy and electrotherapy (87%). The results of this dissertation indicated that the MJDs and nonspecific low back pain were quite prevalent, specially in women with hypertension, making use of antihypertensive drugs, treated with kinesiotherapy and electrotherapy for pain and motion range limitation. Considering Physical Therapy as being of fundamental importance to the functional recovery of the elderly, and, therefore, their independence, rethinking the current care model emerges are imperative in the face of pressing demographic changes. === O envelhecimento da popula??o leva ao incremento dos dist?rbios cr?nico-degenerativos, entre eles as doen?as osteomusculares e articulares (DOMA), das quais as lombalgias est?o entre as mais prevalentes e sintom?ticas em idosos. As DOMA resultam em defici?ncias funcionais que impactam negativamente na independ?ncia e na qualidade de vida de idosos. Deste modo, determinar o perfil daqueles acometidos por DOMA ? importante para a gest?o e o planejamento de a??es em sa?de. Assim, a presente disserta??o ? composta por dois estudos que tiveram como objetivo (1) caracterizar os idosos com DOMA, atendidos no Centro de Reabilita??o (CR) da Pontif?cia Universidade Cat?lica do Rio Grande do SUL (PUCRS), quanto ao perfil demogr?fico e de sa?de, tipo de tratamento fisioterap?utico, financiamento do servi?o e desfecho e, dentre esses, (2) realizar a mesma caracteriza??o daqueles com lombalgia. Para a realiza??o deste estudo transversal e retrospectivo, foram revisados 1203 prontu?rios de idosos (idade, sexo, bairro de resid?ncia, financiamento do servi?o, diagn?stico cl?nico), todos atendidos de julho de 2004 a mar?o de 2010. Dos 890 prontu?rios de idosos com DOMA, foram coletadas informa??es sobre medicamentos, comorbidades, sinais e sintomas, tratamentos fisioterap?uticos realizados, n?mero de sess?es e desfecho. Os dados foram analisados atrav?s do software SPSS e o n?vel de signific?ncia adotado () foi de 5%. Para o total de idosos a m?dia de idade foi 70,1?7,9 anos, predominaram mulheres (66,7%), com resid?ncia pr?xima (45%) e bairros distantes (55%) incluindo residentes da regi?o metropolitana e tratamento financiado pelo sistema de sa?de suplementar atrav?s de cooperativa m?dica (54,4%). Houve preval?ncia significativa das DOMA (74%; p<0,0001) em compara??o aos outros grupos de doen?as (aparelho respirat?rio, geniturin?rio, nervoso, amputa??es e outras), as quais apresentaram associa??o significativa com o sexo feminino, enquanto o sexo masculino ficou associado a doen?as dos aparelhos respirat?rio e circulat?rio. As DOMA mais prevalentes foram as artropatias (25,6%) e as dorsopatias (34,6%) e, dentre as ?ltimas, as mais frequentes foram ?s lombalgias (14,4%). A hipertens?o arterial sist?mica foi a comorbidade mais relatada (50,3%) e os anti-hipertensivos os medicamentos mais frequentemente utilizados (34,7%). A dor foi o sintoma mais encontrado (97,7%), seguido de limita??o da amplitude de movimento (ADM; 48,2%). Os tratamentos fisioterap?uticos mais utilizados foram a cinesioterapia (72,9%) e a eletroterapia (60,2%). O n?mero m?dio de sess?es realizadas foi 20,8?26,7 sess?es. Na resposta ao tratamento (resolutividade), a melhora da dor foi a mais frequente (98,2% dos casos v?lidos - n=227). Quanto ao desfecho, 106 pacientes (45,9% dos casos v?lidos n=231) tiveram alta. Em rela??o aos idosos encaminhados por lombalgia, 53% tinham lombalgia isolada, 21% lombociatalgia e 26% lombalgia associada a outras doen?as. Com m?dia de idade de 69,98?8,4 anos, tamb?m entre eles a maioria era mulher (69,8%), com queixa de dor (98,4), cujo tratamento fisioterap?utico (87%) consistiu de cinesioterapia e eletroterapia. Assim conclui-se que as DOMA e a lombalgia foram muito prevalentes nessa amostra, predominantemente de mulheres, com hipertens?o, em uso de anti-hipertensivos, onde foram tratadas com cinesioterapia e eletroterapia para dor e limita??o da ADM. Considerando que a Fisioterapia ? fundamental para a recupera??o da funcionalidade do idoso e, portanto, da sua independ?ncia, repensar o acesso universal e refor?ar a necessidade de CRs com uma proposta integrada de assist?ncia, surge como uma necessidade imperativa diante das prementes mudan?as demogr?ficas.
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