Efeitos de 4 semanas do programa de treinamento multicomponente (Vivifrail) na fragilidade e capacidade funcional de idosos que vivem em residências
Resumo
Neste estudo, foram determinados os efeitos de um programa individualizado de exercícios multicomponentes de quatro semanas (Vivifrail) sobre a fragilidade física e a incapacidade funcional em idosos residentes em casas de repouso. Quatorze indivíduos institucionalizados (idade 81,7 ± 9,7 anos) se voluntariaram para completar 4 semanas do programa de exercícios individualizado Vivifrail (5 dias por semana), de acordo com seu nível inicial: A, incapacidade; B, fragilidade; C, pré-fragilidade e D, robusto. Os treinamentos foram conduzidos por educadores físicos e esportivos certificados. Onze participantes completaram as 4 semanas com níveis muito altos de participação (96%). A capacidade funcional (escore SPPB) melhorou em todos os participantes (+46,6%, p < 0,001, ES = 0,79) e testes: levantar da cadeira (45,6% faster, p = 0,003, ES = 1,43), velocidade de caminhada 4m (19.3% faster, p = 0,033, ES = 0,38) e 6 m (19,3% faster, p = 0,033, ES = 0,38) e teste Timed Up and Go (23,2% faster, p = 0,004, ES = 0,35). Incapacidade e sarcopenia diminuíram significativamente (SARC-F, p = 0,026, ES = 0,59; Lawton index, p = 0,013, ES = 0,87). Pessoas que iniciaram com níveis de incapacidade (A), fragilidade (B) e pré-fragilidade (C) apresentaram melhores resultados. Seis dos nove participantes que iniciaram com a condição física ou pré-fragilidade (66,7%) reverteram essa condição após a intervenção. Além disso, 33% dos participantes que não conseguiram realizar os testes funcionais (sentar, levantar e andar) na linha de base, conseguiram concluí-los após a intervenção. Esses importantes benefícios em tão pouco tempo (4 semanas) podem estar relacionados a três elementos principais: individualização do programa, frequência diária e motivação do treinamento direcionado.
Downloads
Referências
Altman D. G. (1991) Practical statistics for medical research. Chapman and Hall.
Ato, M., López-García, J. J., & Benavente, A. (2013). Un sistema de clasificación de los diseños de investigación en psicología. Anales de Psicología, 29(3), 1038-1059. http://dx.doi.org/10.6018/analesps.29.3.178511
Blasco-Lafarga, C., Sanchis-Sanchis, R., Sanchis-Soler, G., San Inocencio-Cuenca, D., & Llorens-Soriano, P. (2018). Entrenamiento Neuromotor en pacientes ancianos pluripatológicos en las Unidades de Hospitalización a Domicilio: estudio piloto. Cuadernos De Psicología Del Deporte, 19(1), 95-105. https://doi.org/10.6018/cpd.333631
Bodine, S. C. (2013). Disuse-induced muscle wasting. The International Journal of Biochemistry & Cell Biology, 45(10), 2200–2208. https://doi.org/10.1016/j.biocel.2013.06.011
Cadore, E. L., Casas-Herrero, A., Zambom-Ferraresi, F., Idoate, F., Millor, N., Gómez, M., Rodriguez-Mañas, L., & Izquierdo, M. (2014). Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age, 36(2), 773–785. https://doi.org/10.1007/s11357-013-9586-z
Cano, A., Dargent, G., Carriazo, A., López-Samaniego, L., Apostolo, J., Campos, E., Holland, C., Varela-Nieto, I., Luz Sánchez-Sánchez, M., Illario, M., Iaccarino, G., Roller, R. E., Goossens, E., Vollenbroek-Hutten, M., Pais, S., Schena, F., Musian, D., Alvino, S., Maggio, M., … Obbia, P. (2018). Tackling frailty and functional decline: Background of the action group A3 of the European innovation partnership for active and healthy ageing. Maturitas, 115, 69–73. https://doi.org/10.1016/j.maturitas.2018.06.009
Cesari, M., Prince, M., Thiyagarajan, J. A., De Carvalho, I. A., Bernabei, R., Chan, P., Gutierrez-Robledo, L. M., Michel, J.-P., Morley, J. E., Ong, P., Rodriguez Manas, L., Sinclair, A., Won, C. W., Beard, J., & Vellas, B. (2016). Frailty: An Emerging Public Health Priority. Journal of the American Medical Directors Association, 17(3), 188–192. https://doi.org/10.1016/j.jamda.2015.12.016
Courel-Ibáñez, J., & Pallarés, J. G. (2019). Effects of β-hydroxy-β-methylbutyrate (HMB) supplementation in addition to multicomponent exercise in adults older than 70 years living in nursing homes, a cluster randomized placebo-controlled trial: the HEAL study protocol. BMC Geriatrics, 19(1), 188. https://doi.org/10.1186/s12877-019-1200-5
Courel-Ibáñez, Vetrovsky, Dadova, Pallarés, & Steffl. (2019). Health Benefits of β-Hydroxy-β-Methylbutyrate (HMB) Supplementation in Addition to Physical Exercise in Older Adults: A Systematic Review with Meta-Analysis. Nutrients, 11(9), 2082. https://doi.org/10.3390/nu11092082
de Souto Barreto, P., Morley, J. E., Chodzko-Zajko, W., H. Pitkala, K., Weening-Djiksterhuis, E., Rodriguez-Mañas, L., Barbagallo, M., Rosendahl, E., Sinclair, A., Landi, F., Izquierdo, M., Vellas, B., & Rolland, Y. (2016). Recommendations on Physical Activity and Exercise for Older Adults Living in Long-Term Care Facilities: A Taskforce Report. Journal of the American Medical Directors Association, 17(5), 381–392. https://doi.org/10.1016/J.JAMDA.2016.01.021
Fairhall, N., Sherrington, C., Lord, S. R., Kurrle, S. E., Langron, C., Lockwood, K., Monaghan, N., Aggar, C., & Cameron, I. D. (2014). Effect of a multifactorial, interdisciplinary intervention on risk factors for falls and fall rate in frail older people: A randomised controlled trial. Age and Ageing, 43(5), 616–622. https://doi.org/10.1093/ageing/aft204
Freiberger, E., Häberle, L., Spirduso, W. W., & Rixt Zijlstra, G. A. (2012). Long‐term effects of three multicomponent exercise interventions on physical performance and fall‐related psychological outcomes in community‐dwelling older adults: a randomized controlled trial. Journal of the American Geriatrics Society, 60(3), 437–446. https://doi.org/10.1111/j.1532-5415.2011.03859.x
García-Molina, R., Ruíz-Grao, M. C., Noguerón-García, A., Martínez-Reig, M., Esbrí-Víctor, M., Izquierdo, M., & Abizanda, P. (2018). Benefits of a multicomponent Falls Unit-based exercise program in older adults with falls in real life. Experimental Gerontology, 110, 79–85. https://doi.org/10.1016/j.exger.2018.05.013
Gutiérrez-Valencia, M., Izquierdo, M., Lacalle-Fabo, E., Marín-Epelde, I., Ramón-Espinoza, M. F., Domene-Domene, T., Casas-Herrero, Á., Galbete, A., & Martínez-Velilla, N. (2018). Relationship between frailty, polypharmacy, and underprescription in older adults living in nursing homes. European Journal of Clinical Pharmacology, 74(7), 961–970. https://doi.org/10.1007/s00228-018-2452-2
INE. (2013). Población residente en establecimientos colectivos.
Izquierdo, M. (2019). Multicomponent physical exercise program: Vivifrail. Nutricion Hospitalaria, 36(Ext2), 50–56. https://doi.org/10.20960/nh.02680
Izquierdo, M., Casas-Herrero, A., Zambm-Ferraresi, F., Martínez-Velilla, N., Alonso-Bouzón, C., Rodríguez-Mañas, L., & VIVIFRAIL. (2017). A Practical Guide for Prescribing a Multi-Component Physical Training Program to prevent weakness and falls in People over 70. http://www.vivifrail.com/resources/send/3-documents/21-guide
Izquierdo, M., Rodriguez-Mañas, L., Casas-Herrero, A., Martinez-Velilla, N., Cadore, E. L., & Sinclair, A. J. (2016). Is It Ethical Not to Precribe Physical Activity for the Elderly Frail? Journal of the American Medical Directors Association, 17(9), 779–781. https://doi.org/10.1016/j.jamda.2016.06.015
Lopez, P., Izquierdo, M., Radaelli, R., Shurzzi, G., Grazioli, R., Pinto, R. S., & Cadore, E. L. (2017). Effectiveness of Multimodal Training on Functional Capacity in Frail Older People: A Meta-Analysis of Randomized Controls Trials. Journal of Aging and Physical Activity, 1–36. https://doi.org/10.1123/japa.2017-0188
Martínez-Velilla, N., Casas-Herrero, A., Zambom-Ferraresi, F., Sáez de Asteasu, M. L., Lucia, A., Galbete, A., García-Baztán, A., Alonso-Renedo, J., González-Glaría, B., Gonzalo-Lázaro, M., Apezteguía Iráizoz, I., Gutiérrez-Valencia, M., Rodríguez-Mañas, L., & Izquierdo, M. (2019). Effect of Exercise Intervention on Functional Decline in Very Elderly Patients During Acute Hospitalization. JAMA Internal Medicine, 179(1), 28. https://doi.org/10.1001/jamainternmed.2018.4869
Morley, J. E., Vellas, B., van Kan, G. A., Anker, S. D., Bauer, J. M., Bernabei, R., Cesari, M., Chumlea, W. C., Doehner, W., Evans, J., Fried, L. P., Guralnik, J. M., Katz, P. R., Malmstrom, T. K., McCarter, R. J., Gutierrez Robledo, L. M., Rockwood, K., von Haehling, S., Vandewoude, M. F., & Walston, J. (2013). Frailty consensus: a call to action. Journal of the American Medical Directors Association, 14(6), 392–397. https://doi.org/10.1016/j.jamda.2013.03.022
O’Caoimh, R., Galluzzo, L., Rodríguez-Laso, Á., Van der Heyden, J., Ranhoff, A. H., Lamprini-Koula, M., Ciutan, M., López-Samaniego, L., Carcaillon-Bentata, L., Kennelly, S., Liew, A., & Work Package 5 of the Joint Action ADVANTAGE. (2018). Prevalence of frailty at population level in European ADVANTAGE Joint Action Member States: a systematic review and meta-analysis. Annali Dell’Istituto Superiore Di Sanita, 54(3), 226–238. https://doi.org/10.4415/ANN_18_03_10
Richardson, D. L., Duncan, M. J., Jimenez, A., Juris, P. M., & Clarke, N. D. (2019). Effects of movement velocity and training frequency of resistance exercise on functional performance in older adults: a randomised controlled trial. European Journal of Sport Science, 19(2), 234–246. https://doi.org/10.1080/17461391.2018.1497709
Sáez de Asteasu, M. L., Martínez-Velilla, N., Zambom-Ferraresi, F., Ramírez-Vélez, R., García-Hermoso, A., Cadore, E. L., Casas-Herrero, Á., Galbete, A., & Izquierdo, M. (2020). Changes in muscle power after usual care or early structured exercise intervention in acutely hospitalized older adults. Journal of Cachexia, Sarcopenia and Muscle, jcsm.12564. https://doi.org/10.1002/jcsm.12564
Santos-Eggimann, B., Cuenoud, P., Spagnoli, J., & Junod, J. (2009). Prevalence of Frailty in Middle-Aged and Older Community-Dwelling Europeans Living in 10 Countries. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 64A(6), 675–681. https://doi.org/10.1093/gerona/glp012
Tarazona-Santabalbina, F. J., Gómez-Cabrera, M. C., Pérez-Ros, P., Martínez-Arnau, F. M., Cabo, H., Tsaparas, K., Salvador-Pascual, A., Rodriguez-Mañas, L., & Viña, J. (2016). A Multicomponent Exercise Intervention that Reverses Frailty and Improves Cognition, Emotion, and Social Networking in the Community-Dwelling Frail Elderly: A Randomized Clinical Trial. Journal of the American Medical Directors Association, 17(5), 426–433. https://doi.org/10.1016/j.jamda.2016.01.019
Travers, J., Romero-Ortuno, R., Bailey, J., & Cooney, M. T. (2019). Delaying and reversing frailty: a systematic review of primary care interventions. British Journal of General Practice, 69(678), e61–e69. https://doi.org/10.3399/bjgp18X700241
Valenzuela, P. L., Castillo-García, A., Morales, J. S., Izquierdo, M., Serra-Rexach, J. A., Santos-Lozano, A., & Lucia, A. (2019). Physical exercise in the oldest old. Comprehensive Physiology, 9(4), 1281–1304. https://doi.org/10.1002/cphy.c190002
Wang, H., Lu, N., Chen, T., He, H., Lu, Y., & Tu, X. M. (2014). Log-transformation and its implications for data analysis. Shanghai Archives of Psychiatry, 2014, Vol. 26, No. 2, 26(2), 105–109. https://doi.org/10.3969/j.issn.1002-0829.2014.02.009
WHO (2016). World Health Statistics 2016: Monitoring health for the SDGs.
Yan, T., Wilber, K. H., & Simmons, W. J. (2011). Motivating high-risk older adults to exercise: Does coaching matter? Home Health Care Services Quarterly, 30(2), 84–95. https://doi.org/10.1080/01621424.2011.569670
Las obras que se publican en esta revista están sujetas a los siguientes términos:
1. El Servicio de Publicaciones de la Universidad de Murcia (la editorial) conserva los derechos patrimoniales (copyright) de las obras publicadas, y favorece y permite la reutilización de las mismas bajo la licencia de uso indicada en el punto 2.
2. Las obras se publican en la edición electrónica de la revista bajo una licencia Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España (texto legal). Se pueden copiar, usar, difundir, transmitir y exponer públicamente, siempre que: i) se cite la autoría y la fuente original de su publicación (revista, editorial y URL de la obra); ii) no se usen para fines comerciales; iii) se mencione la existencia y especificaciones de esta licencia de uso.
3. Condiciones de auto-archivo. Se permite y se anima a los autores a difundir electrónicamente las versiones pre-print (versión antes de ser evaluada) y/o post-print (versión evaluada y aceptada para su publicación) de sus obras antes de su publicación, ya que favorece su circulación y difusión más temprana y con ello un posible aumento en su citación y alcance entre la comunidad académica. Color RoMEO: verde.
