Geriatria e prevenção de quedas em idosos institucionalizados: comparação entre treinamento de equilíbrio e intervenções multimodais
Resumo
Este artigo abordou a prevenção de quedas em idosos institucionalizados, um tema de grande relevância na geriatria devido ao impacto das quedas na saúde e na qualidade de vida dessa população. Diante disso, o problema identificado foi a alta incidência de quedas entre idosos que vivem em instituições de longa permanência, agravada pela presença de múltiplos fatores de risco, como a fragilidade física, o declínio cognitivo e as condições ambientais inadequadas. Diante desse cenário, o estudo teve como objetivo analisar a eficácia das intervenções multimodais na prevenção de quedas em comparação com intervenções isoladas, visando determinar quais estratégias proporcionam os melhores resultados na redução de quedas e na melhoria da funcionalidade dos idosos. Para alcançar esses objetivos, a metodologia adotada consistiu em uma revisão da literatura, que permitiu reunir e analisar criticamente estudos relevantes sobre o tema, em que foram selecionados artigos que abordavam o treinamento de equilíbrio e as intervenções multimodais, além de outras estratégias preventivas aplicadas em populações de idosos institucionalizados. Os estudos incluídos foram analisados quanto à eficácia das diferentes abordagens, considerando a redução da incidência de quedas, a melhora na função física e cognitiva, e a qualidade de vida dos participantes. Os resultados obtidos indicaram que as intervenções multimodais, que combinam diferentes tipos de exercícios e estratégias terapêuticas, foram mais efetivas na prevenção de quedas em idosos institucionalizados em comparação com intervenções isoladas. Essas intervenções demonstraram uma redução na incidência de quedas e melhorias na estabilidade postural, força muscular, função cognitiva e qualidade de vida dos idosos. Logo, reitera-se que a adoção de programas multimodais em instituições de longa permanência é imprescindível para a implementação de estratégias preventivas eficazes, promovendo um envelhecimento mais saudável para os idosos.
Referências
ALMEIDA, Arthur José Pontes Oliveira de; RIBEIRO, Thais Porto; MEDEIROS, Isac Almeida de. Aging: molecular pathways and implications on the cardiovascular system. Oxidative medicine and cellular longevity, v. 2017, n. 1, p. 7941563, 2017.
BAREIS, Natalie et al. Association between psychotropic medication polypharmacy and an objective measure of balance impairment among middle-aged adults: results from the us national health and nutrition examination survey. CNS drugs, v. 32, p. 863-871, 2018.
BARNETT, Anne et al. Community-based group exercise improves balance and reduces falls in at-risk older people: a randomised controlled trial. Age and Ageing, v. 32, n. 4, p. 407-414, 2003.
BENVENUTI, Francesco et al. Effectiveness of a physical activity intervention on mobility performance in older persons: a randomized controlled trial. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, v. 65, n. 5, p. 528-537, 2010.
BROWN, Carolyn J. et al. Barriers to mobility during hospitalization from the perspectives of older patients and their nurses and physicians. Journal of Hospital Medicine, v. 2, n. 5, p. 305-313, 2005.
CAMERON, Ian D.; DALLAS, Paul. Preventing falls in older people: A systematic review of all factors. Journal of Aging and Health, v. 30, n. 4, p. 651-664, 2018.
CAMPBELL, A. John et al. Prevention of falls in a general practice setting: a randomized controlled trial. The Lancet, v. 353, n. 9147, p. 93-97, 1999.
CHU, Leung-Wing et al. The effectiveness of a multi-component intervention on falls and fall-related injuries among community-dwelling older people in Hong Kong. Age and Ageing, v. 40, n. 1, p. 1-7, 2011.
COLLINS, Brittany C.; LAAKKONEN, Eija K.; LOWE, Dawn A. Aging of the musculoskeletal system: How the loss of estrogen impacts muscle strength. Bone, v. 123, p. 137-144, 2019.
CRUZ, Alessandra de Oliveira et al. Prevalence of falls in frail elderly users of ambulatory assistive devices: a comparative study. Disability and Rehabilitation: Assistive Technology, v. 15, n. 5, p. 510-514, 2020.
CUNHA, Luís Filipe Correia da; BAIXINHO, Cristina Lavareda; HENRIQUES, Maria Adriana. Preventing falls in hospitalized elderly: design and validation of a team intervention. Revista da Escola de Enfermagem da USP, v. 53, p. e3479, 2019.
CURTIS, Elizabeth et al. Determinants of muscle and bone aging. Journal of cellular physiology, v. 230, n. 11, p. 2618-2625, 2015.
DIEGEL, Kelly L.; DANILENKO, Dimitry M.; WOJCINSKI, Zbigniew W. The integumentary system. Fundamentals of Toxicologic Pathology, p. 791-822, 2018.
ECKSTROM, Elizabeth et al. Physical activity and healthy aging. Clinics in geriatric medicine, v. 36, n. 4, p. 671-683, 2020.
ELLIOTT, Jonathan E. et al. Aging-related changes in respiratory system mechanics and morphometry in mice. American Journal of Physiology-Lung Cellular and Molecular Physiology, v. 311, n. 1, p. L167-L176, 2016.
FERREIRA, Lidiane Maria de Brito Macedo et al. Prevalence of falls and evaluation of mobility among institutionalized elderly persons. Revista brasileira de geriatria e gerontologia, v. 19, n. 06, p. 995-1003, 2016.
FILIPPI, Massimo et al. The ageing central nervous system in multiple sclerosis: the imaging perspective. Brain, p. awae251, 2024.
FRANCIS, Richard M. et al. Multi-modal interventions to improve balance in older adults. Journal of Geriatric Physical Therapy, v. 34, n. 4, p. 175-182, 2011.
GATES, Stephen et al. Systematic review of accuracy of fall prediction tools in the elderly residential care setting. Journal of the American Geriatrics Society, v. 56, n. 8, p. 1647-1653, 2008.
GAZIBARA, Tatjana et al. Falls, risk factors and fear of falling among persons older than 65 years of age. Psychogeriatrics, v. 17, n. 4, p. 215-223, 2017.
GILL, Thomas M.; GANGULY, Rupali; KANE, Robert L. Health-related quality of life: Application and interpretation in aging research. Journal of Gerontology: Medical Sciences, v. 71, n. 5, p. 609-616, 2016.
GILLESPIE, Lesley D. et al. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, n. 9, 2012.
GROSSMAN, David C. et al. Interventions to prevent falls in community-dwelling older adults: US preventive services task force recommendation statement. Jama, v. 319, n. 16, p. 1696-1704, 2018.
HASLINGER, Wolfram et al. A novel device to preserve physical activities of daily living in healthy older people. Journal of aging and physical activity, v. 23, n. 4, p. 569-579, 2015.
IRAZOKI, Eider et al. Technologies for cognitive training and cognitive rehabilitation for people with mild cognitive impairment and dementia. A systematic review. Frontiers in psychology, v. 11, p. 648, 2020.
JONGSIRIYANYONG, Sukanya; LIMPAWATTANA, Panita. Mild cognitive impairment in clinical practice: a review article. American Journal of Alzheimer's Disease & Other Dementias®, v. 33, n. 8, p. 500-507, 2018.
KHAN, Sadiya S.; SINGER, Benjamin D.; VAUGHAN, Douglas E. Molecular and physiological manifestations and measurement of aging in humans. Aging cell, v. 16, n. 4, p. 624-633, 2017.
KHOW, Kareeann SF; VISVANATHAN, Renuka. Falls in the aging population. Clinics in geriatric medicine, v. 33, n. 3, p. 357-368, 2017.
LACROIX, André et al. Effects of exercise interventions on physical fitness and health-related quality of life in older adults with hearing loss: A systematic review and meta-analysis. Ageing Research Reviews, v. 37, p. 59-68, 2017.
LINEHAN, Eimear; FITZGERALD, Denise. Ageing and the immune system: focus on macrophages. European Journal of Microbiology and Immunology, v. 5, n. 1, p. 14-24, 2015.
LORD, Stephen R.; SHERRINGTON, Catherine; MENZ, Hylton B.; CLOSE, Jacqueline C. T. Falls in older people: Risk factors and strategies for prevention. Cambridge: Cambridge University Press, 2003.
MARICONDA, Massimo et al. The determinants of mortality and morbidity during the year following fracture of the hip: a prospective study. The bone & joint journal, v. 97, n. 3, p. 383-390, 2015.
MARMELEIRA, JOSÉ. Exercício multimodal: uma estratégia de intervenção no envelhecimento. CATARINA PEREIRA JORGEBRAVO, p. 281, 2020.
NELSON, Miriam E. et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation, v. 116, n. 9, p. 1094, 2007.
RODRIGUES, Irene B. et al. Efficacy of balance and strengthening exercise programs on quality of life, balance and strength outcomes in older women with osteoporosis: A systematic review and meta-analysis. Journal of Aging Research, 2014.
ROSE, Debra J.; OSTEGAARD, Anna I.; SMITH, Jeremy T. The role of exercise in fall prevention. Clinics in Geriatric Medicine, v. 33, n. 3, p. 231-249, 2017.
SANTOS, Jéssica de Castro et al. Social representation of elderly people on falls: structural analysis and in the light of Neuman. Revista Brasileira de Enfermagem, v. 71, n. suppl 2, p. 851-859, 2018.
SHERRINGTON, Catherine et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. British Journal of Sports Medicine, v. 53, n. 24, p. 1747-1756, 2019.
SHUMWAY-COOK, Anne et al. Effectiveness of a community-based multifactorial fall risk reduction program in active older adults: A randomized controlled trial. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, v. 62, n. 12, p. 1420-1427, 2007.
SILVA, Karla Mayane et al. Efeitos de 16 semanas de exercícios multimodais na capacidade funcional e cognitiva em idosos. Arquivos de Ciências da Saúde da UNIPAR, v. 27, n. 8, p. 4770-4784, 2023.
SILVA, Marcia Regina; NIEROTKA, Rosane Paula; FERRETTI, Fátima. Quedas em idosos: uma realidade complexa.. Revista FisiSenectus, v. 7, n. 1, p. 1-2, 2019.
SOENEN, Stijn et al. The ageing gastrointestinal tract. Current Opinion in Clinical Nutrition & Metabolic Care, v. 19, n. 1, p. 12-18, 2016.
SOFIATTI, Stéfanny et al. A importância da fisioterapia na capacidade funcional de idosos com risco de quedas. Revista Brasileira Militar de Ciências, v. 7, n. 17, 2021.
THOMAS, Ewan et al. Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine, v. 98, n. 27, p. e16218, 2019.
TIELAND, Michael; TROUWBORST, Inez; CLARK, Brian C. Skeletal muscle performance and ageing. Journal of cachexia, sarcopenia and muscle, v. 9, n. 1, p. 3-19, 2018.
VAN DEN BELD, Annewieke W. et al. The physiology of endocrine systems with ageing. The Lancet Diabetes & Endocrinology, v. 6, n. 8, p. 647-658, 2018.
VIEIRA, Edgar R.; PALMER, Richard C.; CHAVES, Paulo HM. Prevention of falls in older people living in the community. Bmj, v. 353, 2016.
VÖLTER, Christiane et al. Sensory dysfunction in old age. Deutsches Ärzteblatt International, v. 118, n. 29-30, p. 512, 2021.
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Copyright (c) 2024 Gabriela Candida de Albuquerque Carbone, Filipe Marques Rodrigues, Amanda Moreira Lima, Joyce de Almeida Nogueira, Marjorie Correia de Andrade, Brida Magalhães Teixeira Macedo, Ana Beatriz da Silva Batista, Isadora Liana Braz Dias, Isadora Liana Braz Dias, Matheus Olímpio Batista Cavalcante, Gabriel Patrício Santos de Medeiros

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