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Between identity dynamics and historic temporalities by Gabriela Pellegrino Soares Is there a Latin American literature? This is a multidimensional questionnaire consisting of 36 items, subdivided into eight scales or components: functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects and mental health. The SF36 was analyzed by the final score ranging from zero to one hundred points obtained by calculating the raw scale , in which zero reflects the worst health status and one hundred, the best It is a widely used test in clinical practice for functional evaluation of older adults.

It comprises three stages, each with a score of up to four points, totaling the final score of at most 12 points. In the first stage, the individual remains initially in orthostatic position with the feet in parallel, then with the feet in semi-tandem and then in tandem stance. In the second stage, the gait velocity was measured in a four-meter course, dividing the distance traveled by the time spent.

In the third stage, the time the older adult takes to perform the chair stand test for five times was measured The total score of the SPPB was the sum of the results of the balance tests, gait velocity and lower limb strength. The individuals who obtained between zero and six points were classified as low performance, between seven and nine points, intermediate performance, and between 10 and 12, high performance.

Statistical analysis was performed using the software SPSS The Shapiro-Wilk test was used to analyze the normal distribution of continuous variables, and the data are presented as mean and standard deviation. The sample characterization variables were compared between the groups by unidirectional variance analysis one way or Kruskal-Wallis test, according to the normality test, with Tuckey post hoc test, if necessary. The comparison of the distribution of categorical variables between the groups was performed by the Chi-square test and is presented in absolute numbers and relative frequencies.

The chi-square test was used to analyze the results of SPPB. Figure 1 shows the flow of volunteers in the study. Initially, 86 patients were referred for possible participation in the research, but 50 were excluded because they presented clinical signs compatible with BPPV during the speech-language pathology assessment.

After the interventions began, an individual from the LG group abandoned treatment due to a job opportunity at the same time and two missed more than four sessions, one from the LG group and one from the VR group. Thus, 33 users who completed the study were analyzed, 29 Table 2 shows the intragroup and intergroup analyses of the quality of life of the patients at the initial and final moments.

The intra-group analysis of the results of the SF36 reveals that the individuals who underwent VR treatment showed a significant improvement in the quality of life in the domains limitation by physical aspects, general health status, vitality and social aspects.

The individuals who underwent the LG integrative complementary treatment obtained statistically significant improvement in all domains, including, besides the aforementioned, functional capacity, pain, emotional aspects and mental health. The individuals in CG did not differ in the two assessments in any domain.

It is possible to perceive by ANOVA followed by Tukey post hoc test that the interventions caused different variations between the groups. The variation caused by the LG integrative complementary intervention was higher than the variation observed in the CG for the domains functional capacity, limitation by physical aspects and general health status, and also higher than the variation found after the VR intervention in the domain pain.

The variation caused by the VR intervention was higher than the variation observed in the CG in the domains limitation by physical aspects and social aspects. In the intergroup comparison, we verified a significant difference between the variations caused by the interventions between the LG and CG groups in the general health domain.

In other words, the integrative complementary treatment improved the quality of life in relation to the general health aspect when compared with the CG. Figure 2 shows the results of the SPPB at the initial and final moments. In this clinical trial, the effects of LG after 12 weeks of intervention were investigated, and the results elucidate positive implications of LG on the quality of life of individuals with dizziness in the functional capacity aspects, limitation by physical aspects and general health status.

The LG and VR interventions showed similar results, except in the domain pain, in which the LG obtained better results. Such findings indicate the positive effects of a complementary integrative practice advocated by the Ministry of Health 3 in improving the quality of life of patients with dizziness, one of the main complaints of the patient in PHC 5. The literature is incisive when proposes the benefits of oculomotor activities, of body and cephalic rotation, of static and dynamic balance as promoters of habituation and vestibular compensation in patients with dizziness 4 , 8 , 9 , 17 , From this perspective, the hypothesis of this study is that the LG is beneficial to patients with dizziness arising from non-central causes, positively impacting the functional capacity and quality of life of patients with dizziness In the PHC.

The fact that the variations in the quality of life scores did not differ between the LG and the VR groups, except for the domain pain, with more expressive results in the LG group, indicates the real possibility of the patient with dizziness, duly indicated by the physician of the PHC, to participate in the LG as an alternative effective treatment to improve the quality of life.

These findings are the base of the functions of solvability and accountability of PHC, as well as the principles of accessibility, integrality, continuity, bonding and humanization PHC and especially the FHS, with its longitudinality, territorial and cultural immersion, facilitate the exploitation of therapeutic bonds and the use of community resources of various types, constituting a strong and important affinity between the integrative complementary practices and health care Given this context, LG enhances a strong partnership in the care of the individual with dizziness.

Table 1 shows that the participants of this research did not differ in the socio-demographic aspects, body function and structure, limitations by activities and other health conditions. The sample was mainly composed of women, older women, with visual alterations and reports of anxiety, common symptoms in the individual with dizziness Moreover, limitations involving locomotion were reported by a large part of the participants, as well as the presence of hypertension, morbidity also associated with functional decline, higher risk of falls and dizziness The similarity and homogeneity of the groups in the initial evaluation were confirmed by the statistical analyses of the outcomes quality of life and functional capacity, which did not differ between the groups.

The analysis of the results in the context of PHC requires a differentiated approach of the domains general health, functional capacity and limitation by physical aspects, which significantly improved in the individuals participating in the LG. This can be explained because this technique aims to deal with the subjects in their integrality, that is, in addition to stimulating ocular fixation, postural stability and neuronal plasticity as the conventional VR, it has proven benefits in reducing osteomuscular pain, in the gain in range of motion, muscular strength and flexibility, as well as in the reduction in stress and psychosomatic consequences caused by diseases 12 , In clinical trials in PHC with individuals with dizziness, the method of vestibular rehabilitation intervention proved to be effective in reducing the impact of dizziness on the quality of life of the participants, which were evaluated by the Dizziness Handcap Inventory before and after intervention 8 , 9 , In this study, the LG and VR interventions did not differ in relation to the general health, functional capacity, vitality, mental health, emotional and social aspects, i.

These findings indicate the advancement in the integral care of the subject, improving the care of patients with dizziness, who have in the PHC their first contact.

When analyzing the results of SPPB, no statistically significant difference was found between the groups at the initial and final moments. However, a change in the performance of the individuals submitted to the interventions was observed Figure 2. Such findings can be justified by the literature, which describes better results of SPPB in active older adults compared with the sedentary ones 25 and improvement in the functional capacity of older individuals undergoing physical activity The functional capacity of the older adults is known to be associated with their quality of life 27 and can be improved through interventions performed in primary health care.

Thus, we believe that LG, an integrative and complementary practice advocated by the Ministry of Health 3 , is a relevant strategy to optimize such aspects and reduce the risk of falls in older adults, minimizing negative health outcomes, including the restriction of activities and the decline in functional and physical performance.

No clinical trials were found in the literature to verify the effectiveness of LG as a therapeutic strategy to reduce dizziness symptoms. Among the integrative and complementary practices, there are records of the effects of Tai Chi on the improvement of balance 10 , of yoga in postural control 28 and of acupuncture in the improvement of vestibular migraine 29 , in addition to ongoing research to verify the effect of acupuncture on chronic dizziness This study, of unprecedented character, provides scientific evidence of the benefits of LG in the care of individuals with dizziness in PHC.

Studies evaluating the integrative complementary practices are essential in the national and international contexts, since they contribute significantly to the health care of the world population 1 and to the construction of care networks focused on the subjects in their social or family contexts. Moreover, they value knowledge or non-biomedical practices, experiences and care techniques, stimulus to self-healing, active participation and empowerment of patients Based on the results presented, LG improves the quality of life of individuals with dizziness, without altering the functional capacity.

The improvement observed covered more domains of quality of life than a traditional treatment modality, the VR. Therefore, it is a useful rehabilitation strategy in PHC for the treatment of people with dizziness. However, the effects of LG on long-term clinical and functional parameters still need to be investigated. Todos os participantes assinaram o termo de consentimento livre e esclarecido. O tamanho da amostra foi baseado no estudo de Yardley et al.

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Foi realizada no software SPSS National Center for Biotechnology Information , U. Journal List Rev Saude Publica v.