Efeitos de um treinamento físico sobre o equilíbrio estático e dinâmico de mulheres idosas residentes na área de abrangência do Programa Saúde da Família de São Carlos
Aveiro, Mariana Chaves
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IBGE estimative for relative Brazilian elderly participation was 9.49% in 2008 and 29.75% in 2050. However, the country has been organized to define public policy to elderly people. Health Family Program has been presented as a strategy to consolidate this policy. Physical therapy participates of this system with a different perspective. It is also performing prevention and health promotion practices. If it‟s known functional mobility and fall risks between among elderly people, could contribute for a health diagnostic that direct decisions related to therapeutic projects in Health Family Unit with the purpose of falls and disability prevention. Despite of it has been established that different training exercise programs could be efficient to prevent falls and disability, it is not known the effects of a low-intensity resistance, balance and coordination program with great adhesion among community-dwelling elderly women. Objectives: The purpose of this study was to assess the mobility and risk for falls in elderly people living in Health Family program area and to analyze the effects of a group-based low intensity exercise training program for mobility, postural control, isometric torque, isokinetic torque, power and time acceleration and quality of life among community-dwelling elderly women. Methods: Initially, elderly from Health Family Program area were evaluated through Mini-Mental State Examination (MMSE) and Timed Up & Go test (TUG) and answered about fall events in the last year. After, elderly women were invited to a group-based low intensity exercise training program for 12 weeks. Women that consent to participate were randomized through sealed envelopes. Training group performed stretching exercises, ankle and knee muscle strengthening and balance training for 12 weeks, two days per week under the supervision of a physiotherapist. Participants in the control group did not undergo any training and were instructed to maintain their usual level of physical activity. 28 community-dwelling elderly women completed the study. They were evaluated through isometric peak torque and isokinetic peak torque, power and time acceleration 60 e 120/s; postural control at stable force platform BERTEC at bipodal stance with eyes opened and closed and unipodal and tandem stance; mobility by Timed Up & Go test; functional balance by Berg Balance Scale; and, quality of life by World Health Organization quality of life questionnaire abbreviated version (WHOQOL-bref). Statistical analyses were performed by ANOVA Kruskal-Wallis, Mann Whitney U, Wilcoxon and Chi-square tests. The level of significance used for all comparisons was 5% (p ≤ 0.05). Results: Participants who had suffered at least one fall in the last year presented the worst value in the TUG when compared to non-fallers (p<0.001). Women prevalence were higher for fallers (p<0.001). No significant association was found between falls and cognitive impairment by MMSE (p=0.11). TUG performance presents significant difference for different elderly age groups (p<0.001). Training group presented a significant improvement to Psychological Domain after 12-week training. Control group presented a significant impairment for General Score and Physical and Psychological Domais. Training group also presented a significant increase to isokinetic peak torque at 60/s for knee flexors, knee extensors and ankle plantar flexors; power at 60/s for knee extensors and knee flexors, ankle dorsiflexors and plantar flexors. It was also observed a significant increase to isokinetic peak torque at 120/s knee flexors and extensors; power at 120/s for knee flexors and extensors. Time acceleration presented a significant decrease for knee extensors and ankle dorsiflexors at 60°/s and knee extensors at 120°/s. Furthermore, training group presented a significant improvement to performance at TUG that was maintained after 12 weeks that the training finished. Conclusion: Low-intensity group-based exercise training program may be efficient to improve knee isometric peak torque and knee and ankle isokinetic peak torque, power and time acceleration and performance at TUG.