Prevalência do tratamento fisioterapêutico em adultos mais velhos com doença pulmonar obstrutiva crônica: resultados do ELSI-Brasil
Prevalence of physical therapy treatment in older adults with chronic obstructive pulmonary disease: results from ELSI-Brazil
Resumo
Introdução: Embora o tratamento fisioterapêutico seja recomendado no manejo de pessoas com Doença Pulmonar Obstrutiva Crônica (DPOC), o encaminhamento para esse serviço ainda é insuficiente. Objetivo: Verificar a prevalência do tratamento fisioterapêutico em indivíduos mais velhos com DPOC no Brasil e os fatores associados. Métodos: Estudo transversal com dados da segunda onda do Estudo Longitudinal de Saúde dos Idosos Brasileiros (2019-2021). O desfecho foi a realização de tratamento fisioterapêutico autorreferida por indivíduos com DPOC. Variáveis sociodemográficas e de saúde foram consideradas exposições. Utilizou-se regressão de Poisson para estimar razões de prevalência (RP) brutas e ajustadas, com intervalos de confiança (IC) de 95%. Resultados: Foram analisados dados de 333 indivíduos, a maioria mulheres (59,0%), com idade entre 50 e 59 anos (49,0%). Apenas 11,6% (IC95% 7,9-16,7) dos indivíduos relataram realizar tratamento fisioterapêutico. Maiores taxas de prevalência foram observadas entre homens, com idade mais avançada, com maior escolaridade, ex-tabagistas, em uso de oxigenioterapia e com internação nos últimos 12 meses. Na análise ajustada, o sexo masculino (RP: 2,18; IC95%: 1,13-4,19) e a internação hospitalar mantiveram-se associados ao desfecho (RP: 2,19; IC95%: 1,01-4,77). Além disso, indivíduos que nunca estudaram (RP: 0,26; IC95%: 0,08-0,86) ou que estudaram de 1 a 4 anos (RP: 0,44; IC95%: 0,20-0,92) apresentaram menor prevalência do tratamento. Conclusão: A baixa prevalência do tratamento fisioterapêutico entre os adultos mais velhos com DPOC, especialmente entre os menos escolarizados, evidencia desigualdades no acesso. Esses achados sugerem a necessidade de estratégias que ampliem a oferta e o encaminhamento a este tratamento, especialmente para os grupos mais vulneráveis.
Palavras-chave: Doença Pulmonar Obstrutiva Crônica; Serviços de Fisioterapia; Prevalência
https://doi.org/10.47066/2966-4837.2024.0016pt
Palavras-chave
Abstract
Background: Although physiotherapeutic treatment is recommended in the management of people with Chronic Obstructive Pulmonary Disease (COPD), referrals to this service remain insufficient. Aim: To assess the prevalence of physiotherapeutic treatment among older adults with COPD in Brazil and its associated factors. Methods: Cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019–2021). The outcome was the self-reported use of physiotherapeutic treatment by individuals with COPD. Sociodemographic and health-related variables were considered as exposures. Poisson regression was performed to estimate crude and adjusted prevalence ratios (PR) with 95% confidence intervals (CI). Results: Data from 333 individuals were analyzed, most of whom were women (59.0%) and aged 50 to 59 years (49.0%). Only 11.6% (95%CI: 7.9–16.7) reported undergoing physiotherapeutic treatment. Higher prevalence rates were observed among men, older individuals, those with higher educational levels, former smokers, users of oxygen therapy, and those hospitalized in the past 12 months. In the adjusted analysis, male (PR: 2.18; 95%CI: 1.13–4.19) and recent hospitalization (PR: 2.19; 95%CI: 1.01–4.77) remained significantly associated with the outcome. Moreover, individuals with no formal education (PR: 0.26; 95%CI: 0.08–0.86) or with 1 to 4 years of education (PR: 0.44; 95%CI: 0.20–0.92) showed a lower prevalence of physiotherapeutic treatment. Conclusion: The low prevalence of physiotherapeutic treatment among older adults with COPD—particularly among those with lower education—highlights existing inequalities in access. These findings underscore the need for strategies to expand service availability and referral pathways, especially for the most vulnerable populations.
Keywords: Chronic Obstructive Pulmonary Diseases; Physical Therapy; Prevalence
https:// doi.org/10.47066/2966-4837.2024.0016en
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Submitted date:
01/21/2025
Accepted date:
06/20/2025
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