Um estudo piloto sobre medo e risco de queda: o impacto de um programa de exercício multicomponente de 8 meses em adultos idosos residentes na comunidade
Agências Suporte
- This research was funded by national funds through the Portuguese Foundation for Science and Technology, I.P., grant number UID/04748/2020 and grant number UID/04045/2020
Resumo
A sarcopenia é a perda de massa e força muscular relacionada com a idade e tem sido associada a um risco aumentado de quedas em adultos mais velhos. Este estudo teve como objetivo examinar o impacto do efeito de um programa de exercício multicomponente de 8 meses em idosos residentes na comunidade. Usamos uma estratégia inclusiva para examinar a viabilidade de um programa de exercícios três vezes por semana. Idade acima de 60 anos, capacidade de ficar em pé e andar com ou sem equipamento auxiliar, ser inativo fisicamente, ter autorização médica e morar na comunidade foram todos os critérios de elegibilidade. O teste Timed-up and Go e a Escala de Equilíbrio de Berg foram usados para examinar o risco de queda. A Fall-Efficacy Scale International foi utilizada para examinar o medo de cair. O programa de exercícios comunitários envolveu trinta e cinco participantes, a idade média foi de 67,54 anos (DP = 3,81) e 71% eram do sexo feminino. As taxas de adesão variaram de 76% a 100%, em média. Houve uma tendência significativa para uma melhora clinicamente importante no timed-up and go test (t = 4,66; p < 0,001; d = 0,20), escala de equilíbrio de Berg (t = -11,20; p < 0,001; d = 1,47) e escala de eficácia de queda internacional (t = 5,81; p < 0,001; d = 0,88). Este estudo forneceu evidências preliminares de que um programa de exercícios de baixo custo baseado na comunidade de 8 meses pode ser eficaz para melhorar a agilidade, o equilíbrio e diminuir o medo de cair em idosos. O programa de exercícios forneceu os dados necessários para projetar futuros ensaios controlados randomizados que podem ser implementados na comunidade de maneira ecologicamente viável.
Downloads
Referências
American College of Sports Medicine (2009). Progression models in resistance training for healthy adults. Medicine and Science in Sports and Exercise, 41(3), 3. https://doi.org/10.1249/MSS.0b013e3181915670
American College of Sports Medicine (2021). ACSM’s guidelines for exercise testing and prescription (Eleventh edition). Wolters Kluwer.
3. Ángeles, C.-M. M., Laura, A.-M., Consuelo, C.-S. M., Manuel, R.-R., Eva, A.-C., & Covadonga, G.-P. A. (2022). The effect that the Otago Exercise Programme had on fear of falling in community dwellers aged 65–80 and associated factors. Archives of Gerontology and Geriatrics, 99, 104620. https://doi.org/10.1016/j.archger.2022.104620
Ashburn, A., Fazakarley, L., Ballinger, C., Pickering, R., McLellan, L. D., & Fitton, C. (2007). A randomised controlled trial of a home-based exercise programme to reduce the risk of falling among people with Parkinson’s disease. Journal of Neurology, Neurosurgery & Psychiatry, 78(7), 678–684. https://doi.org/10.1136/jnnp.2006.099333
Ato, M., López-García, J. J., & Benavente, A. (2013). Un sistema de clasificación de los diseños de investigación en psicología. Annals of Psychology, 29(3), 1038–1059. https://doi.org/10.6018/analesps.29.3.178511
Barzilai, N., Cuervo, A. M., & Austad, S. (2018). Aging as a Biological Target for Prevention and Therapy. JAMA, 320(13), 1321–1322. https://doi.org/10.1001/jama.2018.9562
Beard, J. R., & Bloom, D. E. (2015). Towards a comprehensive public health response to population ageing. The Lancet, 385(9968), 658–661. https://doi.org/10.1016/S0140-6736(14)61461-6
Berg, K. (1989). Measuring balance in the elderly: Preliminary development of an instrument. Physiotherapy Canada, 41, 304–311. https://doi.org/10.3138/ptc.41.6.304
Borg, G. (1998). Borg’s perceived exertion and pain scales (pp. viii, 104). Human Kinetics.
Borges-Machado, F., Silva, N., Farinatti, P., Poton, R., Ribeiro, Ó., & Carvalho, J. (2021). Effectiveness of Multicomponent Exercise Interventions in Older Adults With Dementia: A Meta-Analysis. The Gerontologist, 61(8), 8. https://doi.org/10.1093/geront/gnaa091
Briguglio, M., Giorgino, R., Dell'Osso, B., Cesari, M., Porta, M., Lattanzio, F., Banfi, G., & Peretti, G. M. (2020). Consequences for the Elderly After COVID-19 Isolation: FEaR (Frail Elderly amid Restrictions). Frontiers in Psychology, 11, 565052. https://doi.org/10.3389/fpsyg.2020.565052
Chang, S.-H., Chiang, C.-C., & Chien, N.-H. (2023). Efficacy of a multicomponent exercise training program intervention in community-dwelling older adults during the COVID-19 pandemic: A cluster randomized controlled trial. Geriatric Nursing, 49, 148–156. https://doi.org/10.1016/j.gerinurse.2022.11.019
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587
Delbaere, K., Close, J. C. T., Mikolaizak, A. S., Sachdev, P. S., Brodaty, H., & Lord, S. R. (2010). The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study. Age and Ageing, 39(2), 210–216. https://doi.org/10.1093/ageing/afp225
Donovan, N. J., & Blazer, D. (2020). Social Isolation and Loneliness in Older Adults: Review and Commentary of a National Academies Report. The American Journal of Geriatric Psychiatry, 28(12), 1233–1244. https://doi.org/10.1016/j.jagp.2020.08.005
Faulkner, J. A., Larkin, L. M., Claflin, D. R., & Brooks, S. V. (2007). Age-Related Changes in the Structure and Function of Skeletal Muscles. Clinical and Experimental Pharmacology and Physiology, 34(11), 1091–1096. https://doi.org/10.1111/j.1440-1681.2007.04752.x
Figueira, H. A., Figueira, O. A., Corradi-Perini, C., Martínez-Rodríguez, A., Figueira, A. A., da Silva, C. R. L., & Dantas, E. H. M. (2021). A Descriptive Analytical Study on Physical Activity and Quality of Life in Sustainable Aging. Sustainability, 13(11), 5968. https://doi.org/10.3390/su13115968
Forte, P., Pinto, P., Barbosa, T. M., Morais, J. E., & Monteiro, A. M. (2021). The effect of a six-month multicomponent training in elderly’s body composition and functional fitness – A before-after analysis. Motricidade, 17(1), 1. https://doi.org/10.6063/motricidade.20221
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I.-M., Nieman, D. C., & Swain, D. P. (2011). Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise. Medicine & Science in Sports & Exercise, 43(7), 1334. https://doi.org/10.1249/MSS.0b013e318213fefb
García-Hermoso, A., Ramirez-Vélez, R., Sáez de Asteasu, M. L., Martínez-Velilla, N., Zambom-Ferraresi, F., Valenzuela, P. L., Lucia, A., & Izquierdo, M. (2020). Safety and Effectiveness of Long-Term Exercise Interventions in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Medicine, 50(6), 1095–1106. https://doi.org/10.1007/s40279-020-01259-y
Hadjistavropoulos, T., Carleton, R. N., Delbaere, K., Barden, J., Zwakhalen, S., Fitzgerald, B., Ghandehari, O. O., & Hadjistavropoulos, H. (2012). The relationship of fear of falling and balance confidence with balance and dual tasking performance. Psychology and Aging, 27(1), 1–13. https://doi.org/10.1037/a0024054
Iamtrakul, P., Chayphong, S., Jomnonkwao, S., & Ratanavaraha, V. (2021). The Association of Falls Risk in Older Adults and Their Living Environment: A Case Study of Rural Area, Thailand. Sustainability, 13(24), 13756. https://doi.org/10.3390/su132413756
Jung, K., & Choi, Y. (2023). Factors Influencing Physical Activity and Exercise in Older Adults during COVID-19 in South Korea. Sustainability, 15(9), 7482. https://doi.org/10.3390/su15097482
Kang, S., Hwang, S., Klein, A. B., & Kim, S. H. (2015). Multicomponent exercise for physical fitness of community-dwelling elderly women. Journal of Physical Therapy Science, 27(3), 911–915. https://doi.org/10.1589/jpts.27.911
Kendrick, D., Kumar, A., Carpenter, H., Zijlstra, G. A. R., Skelton, D. A., Cook, J. R., Stevens, Z., Belcher, C. M., Haworth, D., Gawler, S. J., Gage, H., Masud, T., Bowling, A., Pearl, M., Morris, R. W., Iliffe, S., & Delbaere, K. (2014). Exercise for reducing fear of falling in older people living in the community. Cochrane Database of Systematic Reviews, 11, Article 11. https://doi.org/10.1002/14651858.CD009848.pub2
Kumar, A., Delbaere, K., Zijlstra, G. A. R., Carpenter, H., Iliffe, S., Masud, T., Skelton, D., Morris, R., & Kendrick, D. (2016). Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis. Age and Ageing, 45(3), 3. https://doi.org/10.1093/ageing/afw036
Kwok, B. C., & Pua, Y. H. (2016). Effects of WiiActive exercises on fear of falling and functional outcomes in community-dwelling older adults: A randomized control trial. Age and Ageing, 45(5), 5. https://doi.org/10.1093/ageing/afw108
Li, Y., Gao, Y., Hu, S., Chen, H., Zhang, M., Yang, Y., & Liu, Y. (2023). Effects of multicomponent exercise on the muscle strength, muscle endurance and balance of frail older adults: A meta-analysis of randomised controlled trials. Journal of Clinical Nursing, 32(9), 1795-1805. https://doi.org/10.1111/jocn.16196
Lopez, P., Radaelli, R., Taaffe, D. R., Newton, R. U., Galvão, D. A., Trajano, G. S., Teodoro, J. L., Kraemer, W. J., Häkkinen, K., & Pinto, R. S. (2021). Resistance Training Load Effects on Muscle Hypertrophy and Strength Gain: Systematic Review and Network Meta-analysis. Medicine & Science in Sports & Exercise, 53(6), 1206. https://doi.org/10.1249/MSS.0000000000002585
Mancini, M., & Horak, F. B. (2010). The relevance of clinical balance assessment tools to differentiate balance deficits. European Journal of Physical and Rehabilitation Medicine, 46(2), 239–248.
Marques, D. L., Neiva, H. P., Marinho, D. A., & Marques, M. C. (2022). Manipulating the Resistance Training Volume in Middle-Aged and Older Adults: A Systematic Review with Meta-Analysis of the Effects on Muscle Strength and Size, Muscle Quality, and Functional Capacity. Sports Medicine, 53, 503-518. https://doi.org/10.1007/s40279-022-01769-x
Monteiro, A. M., Rodrigues, S., Matos, S., Teixeira, J. E., Barbosa, T. M., & Forte, P. (2022). The Effects of 32 Weeks of Multicomponent Training with Different Exercises Order in Elderly Women’s Functional Fitness and Body Composition. Medicina, 58(5), 5. https://doi.org/10.3390/medicina58050628
Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., Macera, C. A., & Castaneda-Sceppa, C. (2007). Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise, 39(8), 1435–1445. https://doi.org/10.1249/mss.0b013e3180616aa2
Ng, C. A. C. M., Fairhall, N., Wallbank, G., Tiedemann, A., Michaleff, Z. A., & Sherrington, C. (2019). Exercise for falls prevention in community-dwelling older adults: Trial and participant characteristics, interventions, and bias in clinical trials from a systematic review. BMJ Open Sport - Exercise Medicine, 5(1), 1. https://doi.org/10.1136/bmjsem-2019-000663
Oliveira, B., Matos, I., Neto, G., Rodrigues, F., Monteiro, D., Lattari, E., Machado, S. (2021). A 16-week intervention on mood and life quality in elderly: testing two exercise programs. Cuadernos de Psicología del Deporte, 21(2), 24-31. https://doi.org/10.6018/cpd.433571
Phelan, E. A., Aerts, S., Dowler, D., Eckstrom, E., & Casey, C. M. (2016). Adoption of Evidence-Based Fall Prevention Practices in Primary Care for Older Adults with a History of Falls. Frontiers in Public Health, 4. https://www.frontiersin.org/articles/10.3389/fpubh.2016.00190
Priego, T., Martín, A. I., González-Hedström, D., Granado, M., & López-Calderón, A. (2021). Role of hormones in sarcopenia. In G. Litwack (Ed.), Vitamins and Hormones (Vol. 115, pp. 535–570). Academic Press. https://doi.org/10.1016/bs.vh.2020.12.021
Ramsey, K. A., Rojer, A. G. M., D’Andrea, L., Otten, R. H. J., Heymans, M. W., Trappenburg, M. C., Verlaan, S., Whittaker, A. C., Meskers, C. G. M., & Maier, A. B. (2021). The association of objectively measured physical activity and sedentary behavior with skeletal muscle strength and muscle power in older adults: A systematic review and meta-analysis. Ageing Research Reviews, 67, 101266. https://doi.org/10.1016/j.arr.2021.101266
Reed, J. L., & Pipe, A. L. (2014). The talk test: A useful tool for prescribing and monitoring exercise intensity. Current Opinion in Cardiology, 29(5), Article 5. https://doi.org/10.1097/HCO.0000000000000097
Rikli, R. E., & Jones, C. J. (2013). Development and Validation of Criterion-Referenced Clinically Relevant Fitness Standards for Maintaining Physical Independence in Later Years. The Gerontologist, 53(2), 255–267. https://doi.org/10.1093/geront/gns071
Rodrigues, F., Amaro, N., Matos, R., Mendes, D., Monteiro, D., & Morouço, P. (2022). The impact of an exercise intervention using low-cost equipment on functional fitness in the community-dwelling older adults: A pilot study. Frontiers in Physiology, 13. https://www.frontiersin.org/articles/10.3389/fphys.2022.1039131
Rodrigues, F., Bento, T., Cid, L., Neiva, H., Teixeira, D., Moutão, J., Marinho, D., & Monteiro, D. (2018). Can interpersonal behavior influence the persistence and adherence to physical exercise practice in adults? A systematic review. Frontiers in Psychology, 9, 2141. https://doi.org/10.3389/fpsyg.2018.02141
Rodrigues, F., Cid, L., Forte, P., Gonçalves, C., Machado, S., Neiva, H., Teixeira, D., & Monteiro, D. (2020). The perception of enjoyment in youth, adults, and elderly: a comparative study. Cuadernos de Psicología del Deporte, 20(2), 26-36. https://doi.org/10.6018/cpd.403391
Rodrigues, F., Domingos, C., Monteiro, D., & Morouço, P. (2022). A Review on Aging, Sarcopenia, Falls, and Resistance Training in Community-Dwelling Older Adults. International Journal of Environmental Research and Public Health, 19(2), 2. https://doi.org/10.3390/ijerph19020874
Rodrigues, F., Jacinto, M., Figueiredo, N., Monteiro, A. M., & Forte, P. (2023). Effects of a 24-Week Low-Cost Multicomponent Exercise Program on Health-Related Functional Fitness in the Community-Dwelling Aged and Older Adults. Medicina, 59(2), 2. https://doi.org/10.3390/medicina59020371
Rodrigues, F., Macedo, R., Teixeira, D., Cid, L., & Monteiro, D. (2021). Analysis of the exercise behavior in gym exercisers across two years. Cuadernos de Psicología del Deporte, 21(1), 282-292. https://doi.org/10.6018/cpd.433261
Rubenstein, L. Z. (2006). Falls in older people: Epidemiology, risk factors and strategies for prevention. Age and Ageing, 35(2), 37–41. https://doi.org/10.1093/ageing/afl084
Samuel, L. J., Wright, R., Granbom, M., Taylor, J. L., Hupp, C., Roberts Lavigne, L. C., & Szanton, S. L. (2021). Community-dwelling older adults who are low-income and disabled weathering financial challenges. Geriatric Nursing, 42(4), 901–907. https://doi.org/10.1016/j.gerinurse.2021.04.025
Schoene, D., Heller, C., Aung, Y. N., Sieber, C. C., Kemmler, W., & Freiberger, E. (2019). https://doi.org/10.2147/CIA.S197857
Sherrington, C., Fairhall, N., Kwok, W., Wallbank, G., Tiedemann, A., Michaleff, Z. A., Ng, C. A. C. M., & Bauman, A. (2020). Evidence on physical activity and falls prevention for people aged 65+ years: Systematic review to inform the WHO guidelines on physical activity and sedentary behavior. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 1. https://doi.org/10.1186/s12966-020-01041-3
Silva Tavares, G. M., Palma Pacheco, B., Valle Gotllieb, M. G., Kassic Müller, D. V., & Moraes Santos, G. (2020). Interaction between cognitive status, fear of falling, and balance in elderly persons. Clinics, 75. https://doi.org/10.6061/clinics/2020/e1612
Smith, M. L., Towne, S. D., Herrera-Venson, A., Cameron, K., Horel, S. A., Ory, M. G., Gilchrist, C. L., Schneider, E. C., DiCocco, C., & Skowronski, S. (2018). Delivery of Fall Prevention Interventions for At-Risk Older Adults in Rural Areas: Findings from a National Dissemination. International Journal of Environmental Research and Public Health, 15(12), 12. https://doi.org/10.3390/ijerph15122798
Soh, S. L. (2022). Falls efficacy: The self-efficacy concept for falls prevention and management. Frontiers in Psychology, 13, 1011285. https://doi.org/10.3389/fpsyg.2022.1011285
Soper, D. (2022). Factorial Calculator [Software], Version 4.0. 2022. Available online: https://www.danielsoper.com/statcalc (accessed on15 December 2022)
Sullivan-Marx, E. M., Mangione, K. K., Ackerson, T., Sidorov, I., Maislin, G., Volpe, S. L., & Craik, R. (2011). Recruitment and Retention Strategies Among Older African American Women Enrolled in an Exercise Study at a PACE Program. The Gerontologist, 51(suppl_1), S73–S81. https://doi.org/10.1093/geront/gnr001
Teodoro, J. L., da Silva, L. X. N., Fritsch, C. G., Baroni, B. M., Grazioli, R., Boeno, F. P., Lopez, P., Gentil, P., Bottaro, M., Pinto, R. S., Izquierdo, M., & Cadore, E. L. (2019). Concurrent training performed with and without repetitions to failure in older men: A randomized clinical trial. Scandinavian Journal of Medicine & Science in Sports, 29(8), 1141–1152. https://doi.org/10.1111/sms.13451
United Nations. (2020). World Population Ageing 2019 (ST/ESA/SER. A/444); United Nations, Department of Economic and Social Affairs, Population Division: New York, NY, USA.
Walston, J. D. (2012). Sarcopenia in older adults. Current Opinion in Rheumatology, 24(6), 623. https://doi.org/10.1097/BOR.0b013e328358d59b
Wang, Q. X., Ye, Z. M., Wu, W. J., Zhang, Y., Wang, C. L., & Zheng, H. G. (2022). Association of Fear of Falling With Cognition and Physical Function in Community-Dwelling Older Adults. Nursing Research, 71(5), 387–393. https://doi.org/10.1097/NNR.0000000000000608
Wetherell, J. L., Bower, E. S., Johnson, K., Chang, D. G., Ward, S. R., & Petkus, A. J. (2018). Integrated Exposure Therapy and Exercise Reduces Fear of Falling and Avoidance in Older Adults: A Randomized Pilot Study. The American Journal of Geriatric Psychiatry, 26(8), 849–859. https://doi.org/10.1016/j.jagp.2018.04.001
World Medical Association (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053
Yardley, L., Beyer, N., Hauer, K., Kempen, G., Piot-Ziegler, C., & Todd, C. (2005). Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age and Ageing, 34(6), 614–619. https://doi.org/10.1093/ageing/afi196
Zhao, Y. L., Alderden, J., Lind, B., & Stibrany, J. (2019). Risk factors for falls in homebound community-dwelling older adults. Public Health Nursing, 36(6), 772–778. https://doi.org/10.1111/phn.12651
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.
