• Cervicalgia, discapacidad cervical y factores asociados en estudiantes y músicos del Conservatorio Nacional de Música

      Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-02-02)
      Objectives: to determine the presence of neck pain and the neck disability index in the students of the National Conservatory of Music as well as to evaluate their associated factors. Materials and methods: A cross-sectional study was conducted in Lima, Peru. The population was formed by students from the National Conservatory of Music, who were evaluated through a self-report survey of neck pain in the last 3 months, neck disability, as well as evaluating the presence of temporomandibular disorders. The association was assessed by calculating the adjusted prevalence ratios. Results: A total of 211 individuals were included, mean age ± standard deviation was 22.0 ± 2.0 years and the majority were male (70.0%). The neck pain prevalence was 69.4%; 45.6% had moderate disability and 45.0% presented mild disability. Playing bowed string instruments was associated with neck pain (RP 1.34 95% CI 1.15 - 1.57). An association between Temporomandibular Disorders (TMD) and neck pain(TMD moderate-severe) was found (RP 1.65 95% CI 0.99 - 2.75). The association between TMD with neck disability (TMD (absent-slight) was demonstrated: RP 2.81 CI 95% 1.00-7.84 and p = 0.048; TMD Moderate / Severe: RP 3.86 CI 95%: 1.39- 10.70 and p = 0.009) Conclusion: The association between neck pain and the practice with bowed string instruments was corroborated. An association of TMD with neck pain and neck disability was found. This also supports the association with neck disability. The active pauses and physical activity programs are tools that help to reduce neck pain. This leads to have less people predisposed to suffer neck disability.
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    • Comparación de las capacidades funcionales entre pacientes que reciben hemodiálisis y diálisis peritoneal en el Hospital Nacional Edgardo Rebagliati Martins Lima- Perú

      Moscoso Porras, Miguel; Becerra Bravo, Giancarlo; Yurivilca Espinoza, Melissa; Garcia Bonilla, Miluska Estefani; Villavicencio Carranza, Mirko (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-12-13)
      Objective: To assess differences in the functional capacity score in patients receiving hemodialysis and peritoneal dialysis. Material and methods: A cross-sectional study was conducted out in Lima, Peru. Participants were patients receiving hemodialysis and peritoneal dialysis from the Nephrology Department of Hospital Nacional Edgardo Rebagliati Martins y sus redes asistenciales. The Functional capacity score was measured through a six-question survey and the application of the Short Physical Performance Battery (SPPB). Differences were identified through mean ration using a Poisson regression analysis. Results: A total of 144 patients, with a mean age of 54 years, were included in this study. Patients undergoing peritoneal dialysis had higher score that those receiving hemodialysis (mean ratio = 1.20, p <0.05). This difference remain significant even after adjusting for age, gender, work activity and comorbidities (mean ratio = 1.25, p <0.05). Conclusions: Patients receiving peritoneal dialysis present better functional capacity when compared to patients receiving hemodialysis.
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    • Dolor de hombro y factores asociados en personas con discapacidad física que usan silla de ruedas en un instituto de rehabilitación en Lima, Perú

      Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-02-22)
      Aim: To determine the shoulder pain level and associated factors among wheelchair users. Material and Methods: A cross-sectional study was conducted among wheelchair users who attend a Rehabilitation Institute, at the Amputated and Spinal Cord Injury Departments. A census was conducted through a self-administered survey including the Wheelchair Users’ Shoulder Pain Index (WUSPI) questionnaire. For data analysis, multiple linear regression was used. Results: The population comprised 351 individuals, the mean age was 43.78 ± 14.17 years, 47.58% were female; 81.48 % had spinal cord injury. Shoulder pain prevalence was 100%. The adjusted model showed that “spinal cord injury” diagnosis, manual wheelchair; time spent in the wheelchair, where the chair was acquired and the number of transfers during the weekend—were statistically associated with the presence of shoulder pain (p<0.05). Conclusions: Shoulder pain is associated with medical diagnosis, type of wheelchair, hours spent in the wheelchair, where the patient acquired the chair and the number of transfers in the previous weekend. These findings may be useful to screen at-risk sub populations.
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    • Dolor musculoesquelético y capacidad en el trabajo en personal administrativo de una universidad privada en Lima-Perú

      Bravo Cucci, Sergio; Fiestas Saldarriaga, Fabián; Geri Romero, Alejandra; Melgarejo Ghiggo, Jeannette (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-12-12)
      Objetivo: Evaluar la asociación entre la intensidad del dolor musculoesquelético a nivel cervical y lumbar con la capacidad para el trabajo en personal administrativo de oficina en una universidad de Lima, Perú. Materiales y Métodos: Se realizó un estudio observacional transversal analítico en 391 personas. Se recolectaron los datos a partir de un cuestionario propio y la versión larga de WAI en español, la cual fue dicotomizada en pobre- moderado: 7-36 y bueno- muy bueno: 37-49. Las variables categóricas se expresaron como proporción y las variables numéricas como medias. Se utilizó chi cuadrado para medir la asociación entre variables categóricas y suma de rangos de Wilcoxon para medir asociación entre variables numéricas. Se realizó regresión logística para valorar la asociación independiente de dolor musculoesquelético en cervical y lumbar y la capacidad en el trabajo en el último año. Se realizó un modelo ajustado a la edad, sexo y práctica deportiva. Resultados: El odd ratio (OR), intervalos de confianza al 95% y los valores de p de la asociación cruda y ajustada entre las variables de interés. Dicotomizada la variable EVA (de 0-3 y 4-10) el dolor lumbar OR de 4.45 (p ≤ 0.001) y OR ajustado a 4.15 (p ≤0.001). Para el dolor cervical a nivel crudo se obtuvo OR de 2.28 (p=0.015) y ajustado 2.15 (p= 0.025), respecto a los que no tuvieron dolor. Conclusiones: Se encontró asociación entre la intensidad dolor lumbar y cervical (EVA mayor a 3) con tener una capacidad laboral (pobre moderada).
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    • Efectos de la aplicación de un programa de gimnasia laboral para reducir la prevalencia de cervicalgia en estudiantes que cursan el sétimo y octavo ciclo de la Escuela de Odontología de la Universidad Peruana de Ciencias Aplicadas-UPC

      Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2014-09-03)
      La cervicalgia es un problema de salud ocupacional en los odontólogos y está presente desde las prácticas del pregrado. Se realizó un estudio cuasi experimental para evaluar el efecto de un programa de gimnasia laboral en todos los estudiantes de cuarto año de un escuela de odontología de Lima para reducir la prevalencia de cervicalgia. El programa duró seis semanas, consistía en dos charlas para que realicen ejercicios de estiramiento de 5 minutos 3 veces por día y un recordatorio diario por mensaje de texto. 31 estudiantes fueron evaluados al inicio y final de la intervención, 13/31 manifestaron no haber realizado los ejercicios. Se encontró que la prevalencia de cervicalgia en las últimos 4 semanas se redujo de 90,3% a 71,0% (p=0,034) y la intensidad del dolor se redujo de 5,4 a 3,6 (p=0,009). El programa demostró reducir la cervicalgia, futuras intervenciones deben buscar alternativas para incrementar la adherencia.
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    • Efectos de un programa de pausa activa más folletos informativos en la disminución de molestias musculoesqueléticas en trabajadores del área administrativa de una institución pública en Lima, Perú.

      Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-02-22)
      Purpose: To demonstrate the effect of an active pause program plus informative leaflets in reducing the perception of musculoskeletal discomfort on administrative employees from a public entity of Lima, Peru. Materials and methodology: A quasi-experimental non randomised study on administrative employees from two branches of a public institution was conducted. The initial and final measurement included frequency and intensity of musculoskeletal discomfort using Nordic Musculoskeletal Questionnaire NMQ. The intervention after the initial measurement was for eight weeks. A total of 372 individuals were invited to participate, 135 individuals in the intervention group, who received an program active pause supervised and informative leaflets and 127 in the control group, who received only informative leaflets. The program consisted on breathing, stretching and muscle warm-up exercises. Furthermore, information leaflets were handed once a week. Outcome: Average participants’ age was 38 years old. The physical anatomy structures most affected were the neck and mid-back area. During the last seven days the intervention group suffered a decreased of 20% regarding prevalence of the musculoskeletal discomfort on the neck (p<0,001), and 17% on the low-back area (p<0,001). The controlled group showed a decrease on prevalence only in the mid-back area (p=0,029). In terms of discomfort severity, in the final measurement, the intervention group experienced a greater decrease in all areas included in the NMQ (p<0,05). Conclusion: Active pause program plus leaflets decreased musculoskeletal discomfort in office employees. Therefore, it can be implemented at other public or private entities with similar characteristics.
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    • Factores Asociados y Alteraciones del Neurodesarrollo más frecuentes en el Recién Nacido Prematuro, registrados en el servicio de Terapia Física de un hospital público de Perú entre enero del 2015 a diciembre del 2016

      Becerra Bravo, Giancarlo; Bravo Cucci, Sergio; Ingar Romero, Renzo (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-09-26)
      Objective: To identify the associated factors and to describe the most frequent neurodevelopmental alterations in a population of premature babies in Lima. Methodology: Cross-sectional analytical study realized at the San Bartolome Hospital from January 2015 to December 2016; the data were extracted from the Clinical Histories of the Archives Service, the evaluations were done by the professionals in charge, according to the clinical practice guide. These data were age and perinatal history of the mother, gestational age, weight, APGAR score and gender of the newborn. The test we used were T Student, Chi-square, Fisher's Exact Test and the sum of wilcoxon ranges; for the Ratio of Prevalence Crude and Adjusted were based on the Generalized Linear Model of Poisson with Robust Variances. Results: 480 clinical histories were included; the gestational age was 33.97±2.43 weeks with a weight of 1.860±0.480grams. There was no statistically significant association with the diagnoses in Physical Therapy p=0.054; however, not all preterm babies were diagnosed. Conclusions: Maternal age influences on the age of birth p=0.030 and some perinatal antecedents of the mother such as previous abortion p=0.026 and pre-eclampsia p≤0.001 as associated factors for premature birth.
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    • Falta de adherencia en la terapia física en pacientes con dolor y transtornos músculo esqueléticos: incidencia y factores de riesgo

      Mayta-Tristan, Percy; Coello Talavera, Diana; Rojas Motta, Noelia Fernanda (Universidad Peruana de Ciencias Aplicadas (UPC), 2015-07-01)
      Objective. To determine the incidence and risk factors to the non-adherence to physiotherapy treatment in patients with pain and musculoskeletal disorders attending a Teaching Clinic in Lima, Peru. Material and Methods. Retrospective cohort study, it included all new patients seen by pain and skeletal muscle disorders in period 2012-2014. Non adherence was measure (less than 8 sessions attended) and demographic factors. We calculated crude and adjusted relative risk (aRR). Results. We included 549 patients,: 68,3% women, 37,2% had 60 or more years , the most frequent injuries were located on the legs (34,2%) and lumbar (24,6%). We found an incidence of non-adherence of 56,4% (95% CI: 52,2 to 60,7%) and was associated to reside away from the clinic (aRR:1,34; 95%CI: 1,16 to 1,57) and less than 40 years (aRR: 1,27; 95%CI:1,04 to 1,54). Conclusion. There is a high incidence of non-adherence to physiotherapy related to distance and age of patients, so it must find strategies to increase adherence.
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    • Prevalencia de síntomas musculoesqueléticos en choferes de empresa de transporte privados

      Becerra Bravo, Giancarlo; Mayta-Tristan, Percy; Quelopana Díaz, Jazmine Andrea; Zambrano Sánchez, Carmen Givelly (Universidad Peruana de Ciencias Aplicadas (UPC), 2016-10-05)
      Objectives: To determine the frequency and factors associated with the presence of musculoskeletal symptoms (EMS) in drivers of a private transport company of Lima, Peru. Methods: Cross-sectional study was conducted on 170 male drivers had measured the frequency of EMS during the past seven days in the neck, shoulder, upper back, elbow, wrist, lumbar, hip, knee and feet with the Nordic questionnaire. It was evaluated the association with demographic factors and labor using prevalence ratios adjusted (RPa). Results: The average age was 39,73; the average hours of work was 9,56 and the average number of years of work was 4.70. The 77.7% of the population presented discomfort in any area of the body in the last year, 60.6% presented discomfort in any area of the body in the last week, the most frequent were the lumbar area (28.2%) and cervical (22.9%). The people who work as driver four or more years are more likely to have some SME (RPa: 1.54; CI95: 1,17-2,02) or low back pain (RPa: 1.73; IC95%: 1,01-2,97) in the last seven days. Conclusions: There is a high frequency of EMS in drivers of the company concerned, it will be necessary to develop strategies for the reduction and ergonomic risk prevention in the workplace and avoid the development of disabling symptoms.
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    • Prevalencia de trastornos musculoesqueléticos y factores asociados en fisioterapeutas y masajistas que aplican técnicas de masajes en Lima Metropolitana, 2017

      Maguiña Quispe, Jorge Luis; Gutierrez Rojas, Arturo Kalef; Cordero Zevillanos, Vilma Gabriela; Vilca Ninahuaman, Adriana Milagros (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-12-12)
      Objetivo: Estimar la prevalencia de trastornos musculoesqueléticos (TME) y sus factores asociados en fisioterapeutas manuales y masajistas que aplican la técnica de masaje. Método: Nosotros ejecutamos un estudio observacional transversal analítico en 173 sujetos (82 fisioterapeutas y 91 masajistas) que aplican la técnica de masaje sobre camilla en Lima metropolitana. Se utilizaron 4 instrumentos, el cuestionario de recolección de datos (CRD) el cual incluía el Cuestionario Internacional de actividad Física (IPAQ), el Cuestionario Específico Musculoesquelético Nórdico de Kuorinka (CEMNK) y el Cuestionario sobre Productividad Laboral y Deterioro de las Actividades por Dolor (WPAI: PAIN questionnaire). Para los análisis, se utilizaron las pruebas estadísticas de T de Student, U-Mann-Whitney y un modelo lineal generalizado con función de enlace log y familia poisson y varianzas robustas para el cálculo de Razones de Prevalencias (RP) crudas y ajustadas estratificado por profesión. Resultados: La muestra final incluyó 82 fisioterapeutas y 91 masajistas, la prevalencia total de TME fue (143/173) 82.7% [IC 95%; 76.2 – 87.6], el cual varió entre fisioterapeutas (70/82) 85.4% [IC 95%; 75.7 – 91.6] y masajistas (73/91) 80.2% [IC 95%; 70.6 – 87.3]. El mayor porcentaje de dolor o molestia se presentó en la región cervical (fisioterapeutas: 62.2% - masajistas: 53%) y lumbar (fisioterapeutas: 46% - masajistas 32%). Con relación a la productividad laboral los fisioterapeutas se ven más afectados que los masajistas (71.43% versus 65.75%) al igual que las actividades de vida diaria (AVD). En el análisis ajustado no se encontró resultados estadísticamente significativos. Conclusiones: Los fisioterapeutas presentan mayor prevalencia de TME, alto porcentaje de dolor en las zonas afectadas y una importante afección en la productividad laboral en comparación con los masajistas.
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    • Prevalencia y factores asociados a la inestabilidad de tobillo en estudiantes de danza contemporánea

      Moscoso Porras, Miguel Giancarlo; Becerra Bravo, Giancarlo; Jara Trujillo, Rollindeivis; Sotelo Almanza, Nelly Anthuanet; Valencia Lupa, Ana Luz; Soto Maldonado, Rosa Stefany (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-07-05)
      Objectives: To determine the prevalence and explore factors associated with ankle instability in contemporary dance students from Peru. Materials and methodology: A cross-sectional analytical study was conducted in four higher institutions of superior artistic training in contemporary dance. Dancers were recruited through a census. A self-report questionnaire of personal and medical records was applied. To assess ankle instability, we used the Identification of Functional Ankle Instability (IdFAI) questionnaire. We calculated 95% confidence intervals (95%CI) to estimate the prevalence of instability, associated factors were analyzed with prevalence ratios (PR) using Poisson regression models. Outcome: 125 participants, mean age 22,1 years, completed all the assessments. Among the, 90, 4% were women. 47,2% (95%CI= 38,2-56,3) had at least one unstable ankle. We found an association between previous injuries in the lower limbs and the presence of instability in the left ankle (PR=1,78; 95% CI=1,09-2,93). Conclusion: 47,2% of contemporary dancers had at least an unstable ankle. Furthermore, having a previous injury in the lower limb was associated with instability in the left ankle.
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    • Prevalencia y factores asociados a la lumbalgia y discapacidad por dolor lumbar en vigilantes de Miraflores, Lima 2016

      Becerra Bravo, Giancarlo; Pereyra Elías, Reneé; Lazarte Argandoña, Graciela Alejandra; Eslava Parra, Danai Barbara (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-07-14)
      Objective: Evaluate the prevalence of low back pain, the disability caused by this and the associated factor in watchmen in a district of Lima. Methods: It has been made a cross-sectional study of watchmen in Miraflores, Lima. The sampling was performed by clusters. The low back pain was measured by the Nordic questionnaire for low back pain and lumbar disability was measured with the Oswestry questionnaire. Additionally, the physical activity was measured by the short version of the International Questionnaire of Physical Activity (IPAQ-SF) and sociodemographic data. The prevalence of low back pain was calculated and the crude and adjusted prevalence ratios were calculated with their 95% confidence intervals using Poisson regression with robust variance. Results. The study includes 335 people. 98% were men, the median age was 42 (IQR:21). The 55.8% had a minimum level of physical activity. The prevalence of low back pain was 65.3% and the disability was 26.6%. the seated time was found [RPa: 2,21; IC95%=1,45-3,38] and age [RPa: 1,58; IC95%= 1,01-2,47] as factors associated with disability. Conclusion: Two out of three watchmen had low back pain and one in four had disability for low back pain.
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    • Ruralidad y uso de servicios informales de salud en personas con discapacidad de Perú: Análisis de una encuesta nacional

      Moscoso Porras, Miguel; Retto Tafur, Katerine Estefanny (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-12-10)
      Objetivo: Determinar la relación entre el uso de servicios informales de salud en personas con discapacidad del Perú y su relación con residir en una zona rural. Metodología: Se realizó un estudio transversal analítico de la Encuesta Nacional Especializada de Discapacidad (ENEDIS), que se ejecutó durante mayo del 2012 a marzo del 2013. En ENEDIS se reclutó a personas en Perú que reportaron algún tipo de discapacidad. Los datos fueron extraídos del Instituto Nacional de Estadística (INEI) y una serie de preguntas de la ENEDIS con relación al uso los servicios informales de salud y posibles determinantes. Se analizó el uso de los servicios informales de salud en zonas rurales con el software Stata 13.0 (StataCorp, TX, US) las variables categóricas fueron presentadas como frecuencias y porcentajes. Por último, se realizó el análisis de regresión de Poisson simple y múltiple para el cálculo de las razones de prevalencia (RP), intervalos de confianza de 95% y valores p. Resultados: Se incluyeron en el análisis a 20 601 personas con discapacidad en Perú, se halló que la probabilidad de buscar servicios informales de salud es 38% menor en personas que viven en zonas rurales (RP=0.62, p<0.001), cuando la enfermedad que presentan, las personas con discapacidad, no está relacionada a su discapacidad. Conclusiones: Se encontró que las personas con discapacidad que viven en zonas rurales usan menos servicios informales de salud en comparación a las personas que residen en zonas urbanas, cuando la enfermedad que presentan no está relacionada a su discapacidad. Objective: to determine then relationship between the use of informal health services in persons with disabilities in Peru and their relationship with residing in a rural area. Methods: An analytical study of the national survey about disability (ENEDIS), it was carried out in May 2012 to March 2013. In ENEDIS were recruited, people in Peru who reported some type of disability. The data were extracted from the national institute of statistic (INEI) and a set of specific questions from ENEDIS regarding the use of informal health services and possible determinants. The use of informal health services in rural areas was analyzed with the Stata 13.0 software (StataCorp, TX, USA). The categorical variables were presented as frequencies and percentages. finally, a simple and multiple Poisson regression analysis was performed to calculate the prevalence ratios (RP), 95% confidence intervals and values. Result: the possibilities of using informal service is 37% lower in people living in rural areas (p <0.001), when the disease they present is related to disability. Conclusions: People with disabilities living in rural areas use fewer informal health services compared to people who live in urban areas, when the disease they present is not related to their disability.
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    • Validación concurrente y de criterio del Test TEPSI en niños de 2 a 5 años

      Bravo Cucci, Sergio David; Becerra Bravo, Giancarlo; Ishisaka Yreijo, Nicole Juun; De la Cruz Corzo, Jaill (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-12-12)
      Objetivo: Establecer la validez del Test TEPSI con el Test de Denver II para la evaluación del desarrollo psicomotor en niños de 2 a 5 años. Materiales y métodos: Se realizó un estudio observacional de tipo transversal analítico en Lima, Perú. La población estuvo conformada por 124 niños de la I.E.E N° 6075 José María Arguedas, distrito de Chorrillos. Procedimientos: Se evaluó el desarrollo psicomotor de cada participante con ambos test, iniciando con el Test de Denver II, el cual se eligió como el estándar de oro y culminando con el Test TEPSI. Resultados: En un 20,16% de los niños evaluados con el Test TEPSI, y en 69,35% de evaluados con el Test Denver II, se observó sospecha de retraso en el desarrollo psicomotor. La validez del Test TEPSI con el Test Denver II en niños de 2 a 5 años en el test global fue baja, debido a su baja sensibilidad de 29,10% y valor predictivo negativo de 38,40%. Sin embargo, algunos de estos valores mejoraron al realizarse el análisis por áreas de los test. Conclusiones: Se concluyó que el Test TEPSI y Denver II son instrumentos confiables para evaluar el desarrollo psicomotor en niños de 2 a 5 años. Sin embargo, aunque se encontró una alta correlación entre ambos, el Test TEPSI en comparación con el Test Denver II, no puede identificar los casos o sospechas de retraso en el desarrollo por su baja sensibilidad y valor predictivo negativo.
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    • Valoración funcional y etapificación de la dismovilidad en adultos mayores al ingreso hospitalario a una Clínica Geriátrica especializada del Seguro Social en ESSALUD en Lima, Perú, 2013

      Becerra Bravo, Giancarlo; Retamal, Milagros; Segura, Eddy R.; Navarrete Vilca, Talia Brigitte (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-06-28)
      Background: Hospital admission in the elderly has an impact on functional capacity and quality of life. This study aimed to identify the association between the degree of functional dependence and degree of dysmobility in the elderly adult patient. Methods: We reviewed 180 medical charts of subjects admitted within the november-december 2013 period. Functionality was assessed with the Katz and Barthel Indexes while the degree of dysmobility was assessed with the etapification of the dysmobility scale. We analyzed the dichotomized dysfunction as the outcome variable in a GLM Log-Poisson regression to calculate crude and adjusted Prevalence Ratios (PR). Results: 50,6% were women and the mean age was 79,5 years with an standard deviation of 8,3. A total of 46,7% were categorized as Katz G (completely dependent), while 3,9% had an 1A or 1B dysmobility staging (biped). Subjects with Katz C/D/E stages had an aPR: 23,9 [95%CI: 3,1-185,6] to exhibit 1/2 (biped) dysmobility stage, while subjects with Katz A/B had an aPR: 100,0 [95%CI: 14,9-670,5], in both cases compared to subjects with Katz F/G stages. Conclusion: There is an association between functionality and dysmobility among elderly hospitalized patients at admission. We recommend all health professionals take into account this relationship during the comprehensive physiotherapeutic evaluation of the elderly patient in order to better individualize their assessment and treatment.
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