Efeitos da prática de exercício físico sobre o desempenho da marcha e da mobilidade funcional em idosos

Prevalence of falls in frail elderly users of ambulatory assistive devices: a comparative study

Aim: The aim of this study was to verify the prevalence of falls in frail users of ambulatory assistive devices (AAD) and compare with controls.Materials and methods: Nineteen frail elderly users of AAD (G1) and 31 non-users (G2) participated in the study. The occurrence of falls, at the last 6 months, was collected by an interview with the patient and the caregiver. Cognitive status was assessed by the Mini Mental State Examination, functional capacity by the Pfeffer's Questionnaire and Modified Barthel's Index, the frail level by a functional stratification and the risk of falls by the Timed Up and Go (TUG) test. T-Student test was used to compare independent variables. The significance level was set at 5%.Results: Both groups G1 and G2 were homogeneous in relation to the functional and sociodemographic variables. G1 reported more falls in the last 6 months, but most of the participants did not use AAD at the time of the fall. Transferences were the main reason for falls in G1 and stumble in the street in G2.Conclusion: Elderly users of AAD fall out when they are not using the walk device.IMPLICATIONS FOR REHABILITATIONFalling is the second leading cause of death from unintentional injuries in the world. Fall prevention programmes prescribe ambulatory assistive devices, such as walking sticks, crutches and walkers device and walking training with a physiotherapist to provide independence, safety, satisfaction, adherence and psychosocial benefits. However, studies have showed a higher prevalence of falls in frail elderly users of ambulatory-assistive devices.In our study, we verified if users of the ambulatory-assistive devices were using it at the moment of the fall. We found that frail elderly fall down when they are not using the walk device during their activities of day living. Thus, education strategies should be developed to encourage the use of ambulatory-assistive devices by the frail elderly previously evaluated by physiotherapists. Prevalence of falls in this population could reduce if frail elderly users of ambulatory assistive devices really use it during the activities of daily living.

Acupuncture Treatment in Elderly People with Sarcopenia: Effects on the Strength and Inflammatory Mediators

INTRODUCTION

Sarcopenia is defined as the progressive loss of skeletal muscle mass, associated with aging. A multidisciplinary approach has been increasingly prioritized in elderly care. A technique that has been widely used by the seniors is acupuncture.

OBJECTIVES

To analyse the effects of acupuncture in muscle strength and in inflammatory markers of older people with sarcopenia.

METHODS

The sample was composed by 53 elderly people, aged over 60 years. Inclusion criteria were as follows: male and female seniors, sedentary and who were not under acupuncture treatment during the survey period. Assessment of body composition, handgrip strength, and functional test and IL-6, IL-10, and TNF-α cytokines analyses were performed. After verification of the physical examination, the subjects were divided into two groups (sarcopenic and nonsarcopenic). The first group was then randomized (by drawing lot) to be further divided into two subgroups: G1, composed of sarcopenic elderly people who received acupuncture intervention, and G2, composed of sarcopenic elderly people who did not receive intervention. The nonsarcopenic elderly people composed the group 3 (G3) and did not receive acupuncture intervention. ANOVA Split Plot was performed for intergroup comparison. For intragroup evaluation, ANOVA was conducted for repeated measures. For the delta values, ANCOVA was performed with the pretest as covariant. A p < 0.05 significance level was adopted.

RESULTS

26 older people concluded the collections. There was no statistically significant difference between the G1 group and the other ones regarding the assessed variables (muscle mass, muscle strength, functionality, and inflammatory markers).

CONCLUSION

The results allow us to infer that it is possible that the conducted intervention protocol has not produced any significant effects in the studied population. UTN number: RBR-8df2h4.

Proprioceptive activities to postural balance of the elderly - systematic review

Abstract Introduction: Proprioceptive activities are commonly described for control of the postural balance of the elderly in order to avoid falls. But, there is no consensus on which ones can significantly improve balance or on intervention and assessment protocols. Objective: To investigate which proprioceptive activities are specific to static and dynamic postural balance of the elderly through a systematic review. Method: This is a systematic review based on PRISMA recommendation, by surveying PubMed, Medline, LILACS, Scielo and EBSCO databases. The period considered for the search was from 2006 to 2016, using the following descriptors - aged, proprioception, exercise therapy, and postural balance for articles in English, Portuguese or Spanish. Randomized and non-randomized clinical trials were included using the PEDro scale to analyze the methodological quality of the studies. Results: Eight articles were included with different protocols, without standardization of evaluation and intervention, but, which demonstrated improvement of functional abilities. Different kinds of walk, muscular strengthening exercises, stretching, postural oscillations and Yoga patterns for the improvement of functional abilities. Conclusion: The association of static and dynamic activities can contribute to the improvement of functional abilities, but it cannot be affirmed that they are specific for postural control, given the lack of standardization of exercise protocols and evaluation tools.

Application on mobile platform “Idoso Ativo” (Active Aging): exercises for lower limbs combining technology and health

Abstract Introduction: The introduction of a healthy lifestyle for the elderly from regular physical exercise is linked to physical independence and social wellness. The increasing integration of technology, including in the elderly’s health area, extends an innovative and interactive approach towards the specific aspects of aging. Objective: To report the development of the application "Idoso Ativo” (Active Aging) with proposed exercises for the elderly population’s lower limbs. Methods: The study belongs to the type ‘original paper’ which describes the development and accomplishment of the application for the health of the elderly. The study had the participation of an elderly model to perform exercises and video recording. The study was approved by the Research Ethics Committee of UCB and supported by CNPQ. Results: The Software development proposal involved interdisciplinary work for the selection of exercises for posture, balance and gait, development of the application and the use of a specific programming language with presentation of exercises on screens for easy understanding for the elderly public. Conclusion: The application developed can be adopted as a proposal in scientific studies in the physical therapy area and applied as an innovative resource combining health promotion and disease prevention.

Multisensory and closed kinetic chain exercises on the functional capacity and balance in elderly women: blinded randomized clinical trial

Abstract Introduction: The aging process causes losses that lead to decreased balance, gait speed and functional capacity and, therefore, there is a need of specific protocols to work preventively these variables, which will contribute to the decrease in the frequency of falls in this population. Objective: Verify the effect of a program of multisensory and closed kinetic chain exercises on the functional capacity and balance in elderly women. Methods: Randomized clinical trial masked (blind). Subjects were 32 elderly women from the Centro de Convivência of the Bauru Department of Social Welfare (Secretaria de Bem-Estar Social de Bauru) distributed in two groups: control (CG = 15) and experimental (EG = 17). Interventions: The program of multisensory and closed kinetic chain exercises was applied during an hour, once a week, for 12 weeks. Main measures: Functional capacity was measured by Timed Up and Go (TUG) and the 10-meter walking test (TC10) and their balance by the Berg Balance Scale (BBS). Results: Regarding the comparison between the moments M1 and M2 of the EG after the intervention, there was a statistically significant increase in the functional capability (p = 0.00006), walking speed (p = 0.0008) and balance (p = 0.0006). Conclusion: The multisensory and closed kinetic chain-training program indicated a beneficial effect in the improvement of the elderly women balance and functional performance.

Socioeconomic and health characteristics of older adults cared for by a multiprofessional family health team

Abstract Introduction: Population aging may give rise to a greater burden of diseases and disabilities, leading to the greater use of health services and the need for studies of the aged population. Health care teams and specialized residency programs constitute a strategy for the monitoring of older adults’ health status. Objective: To investigate the socioeconomic profile and health status of older adults in different age groups cared for by a multiprofessional family health team. Methods: This cross-sectional, quantitative study was conducted with 249 older adults registered in a Family Health Strategy (FHS) program in Uberaba, MG, Brazil. Socioeconomic and health status data were collected through home interviews using a structured questionnaire. Chi-square analysis was used for descriptive and bivariate analyses (p < 0.05). Results: Most older adults aged 60-70 years were functionally independent, married and had a mean monthly income of 1-3 times the Brazilian minimum wage. Older adults aged 70 - 79 years made use of 1 - 3 medications and had morbidities such as depression, cataract and glaucoma. There was a greater proportion of illiterates in the age group 80 years or over. Conclusion: Socioecnomic and health status were associated with age groups. Of note, there was a higher prevalence of medication use and morbidities among older adults aged 70 -79 years. The knowledge of these characteristics helps FHS team members to implement more accurate and customized strategies and interventions to deliver more effective and efficient care to older adults. Moreover, participation in a multiprofessional team provides an interdisciplinary learning and work experience for health professionals.

Physical activity programs for elderly persons: an evaluation of Brazilian scientific production using the RE-AIM framework

The RE-AIM framework is a model that analyzes both the external and internal validity of health programs. It proposes that programs should be evaluated based on five key dimensions: reach, effectiveness/efficiency, adoption, implementation and maintenance. The aim of the present study was to conduct a systematic review of physical activity programs for elderly persons published in Brazilian scientific literature using the RE-AIM framework. A total of 26 articles included in four scientific databases from 1993 to 2013 were identified and coded using a validated 52-item RE-AIM abstraction tool. Using the RE-AIM dimensions, indicators of reach (47.2%), effectiveness (36.3%), and implementation (27.5%) were reported more often than indicators of adoption (6.4%) and maintenance (4.7%). Only two articles were included in all five RE-AIM dimensions. Despite the increasing number of interventions targeting the elderly, few address the dimensions proposed by the RE-AIM framework, reducing their potential generalizability outside their original settings, and their overall external validity.