Palavras-chave
Envelhecimento
Estruturas Residenciais para Pessoas Idosas
Quedas
estado funcional
Como Citar
Resumo
O norte de Portugal apresenta uma elevada taxa de envelhecimento, associada a condições como sarcopenia, diminuição do equilíbrio e da força muscular. O objetivo deste estudo foi avaliar o impacto do programa de exercícios de Otago (PEO) na funcionalidade e, de forma secundária, na perceção de saúde e no medo de cair em idosos residentes em estruturas residenciais no Alto Minho. Realizou-se um estudo pré-experimental com 37 participantes (83,46 ± 6,53 anos) sendo a maioria mulheres (75,60%). O PEO foi implementado durante oito semanas, com avaliação da funcionalidade antes e após a intervenção utilizando os testes 30 seconds Sit to Stand (30 STS), Timed Up and Go (TUG), 4 Stage Balance Test "Modified" (4 SBTM), 15 seconds Step Test (15 SST) e 10 meters Walking Speed (10 MWS). A perceção de saúde e o medo de cair foram avaliados através de um questionário. Após a intervenção, observou-se uma melhoria significativa na funcionalidade, com aumento das repetições do 30 STS (6,69 ± 4,35 para 9,16 ± 5,35; p < 0,001) e redução do tempo do TUG (p = 0,006). No entanto, não foram encontradas diferenças significativas do 15 SST (p = 0,142) e do 10 MWS (p = 0,815). Houve uma melhoria significativa do equilíbrio dinâmico (4 SBTM, p < 0,001), mas não da perceção de saúde ou do medo de cair (p > 0,05). Conclui-se que o PEO melhora a força muscular, mobilidade e equilíbrio dinâmico, sem afetar a perceção de saúde ou o medo de cair.
Referências
AbdulRaheem Y. (2023). Unveiling the Significance and Challenges of Integrating Prevention Levels in Healthcare Practice. Journal of primary care & community health, 14, 21501319231186500. https://doi.org/10.1177/21501319231186500
Barbosa, P. M., Martins, A. C., Santos, P. C., Dias, R., Pereira, P., Pinto, B., Moniz, R., Casaca, A. C., Silva, R., Melo, C., Silva, A. L., Bigode, M. J., Mendes, H., & da Silva, M. G. (2020). The MOVE.TE Falls Prevention and Management Program: lessons learnt in the Portuguese context. Journal of frailty, sarcopenia and falls, 5(2), 42–46. https://doi.org/10.22540/JFSF-05-042
Bayles, M. P., & Swank, A. M. (2018). ACSM’s exercise testing and prescription. Wolters Kluwer Health.
Botelho, F., Silva, C., & Cruz, F. (2010). Epidemiologia explicada – Viéses. Acta Urologica, 3, 47–52. www.apurologia.pt
Buja, A., Rabensteiner, A., Sperotto, M., Grotto, G., Bertoncello, C., Cocchio, S., Baldovin, T., Contu, P., Lorini, C., & Baldo, V. (2020). Health Literacy and Physical Activity: A Systematic Review. Journal of physical activity & health, 17(12), 1259–1274. https://doi.org/10.1123/jpah.2020-0161
Carneiro, J. A., Gomes, C. A. D., Durães, W., Jesus, D. R., Chaves, K. L. L., Lima, C. A., Costa, F. M. D., & Caldeira, A. P. (2020). Negative self-perception of health: prevalence and associated factors among elderly assisted in a reference center. Autopercepção negativa da saúde: prevalência e fatores associados entre idosos assistidos em centro de referência. Ciencia & saude coletiva, 25(3), 909–918. https://doi.org/10.1590/1413-81232020253.16402018
Cannataro, R., Cione, E., Bonilla, D. A., Cerullo, G., Angelini, F., & D'Antona, G. (2022). Strength training in elderly: An useful tool against sarcopenia. Frontiers in sports and active living, 4, 950949. https://doi.org/10.3389/fspor.2022.950949
Casaca, A., Silva, A. L., Silva, A. R., Martins, A., Pinto, B., Melo, C., Silva, M., Conde, M., Santos, P. C., Barbosa, P. M., Pereira, P., & Moniz, R. (2017). MOVE.TE – SAÚDE E MOVIMENTO FISIOTERAPIA NA PREVENÇÃO DE QUEDAS DO ADULTO MAIS VELHO: Vol. II.
Chiu, H.-L., Yeh, T.-T., Lo, Y.-T., Liang, P.-J., & Lee, S.-C. (2021). The effects of the Otago Exercise Programme on actual and perceived balance in older adults: A meta-analysis. PloS ONE, 16(8), e0255780. https://doi.org/10.1371/journal.pone.0255780
Clemson, L., Fiatarone Singh, M. A., Bundy, A., Cumming, R. G., Manollaras, K., O'Loughlin, P., & Black, D. (2012). Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. BMJ (Clinical research ed.), 345, e4547. https://doi.org/10.1136/bmj.e4547
Divya, N., Praveena, S. P., Saipriyaa, M., Meyammai, S., Winnie, T. E., & Pavithra, R. (2023). A Systematic Review on Comparison between Otago Exercise Program and Balance Exercise in Balance and Fall Risk among elderly with Knee Osteoarthritis. International Journal of Physiotherapy and Research, 11(5), 4628–4641. https://doi.org/10.16965/ijpr.2023.153
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). "Mini-mental state". A folsteinpractical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research, 12(3), 189–198. https://doi.org/10.1016/0022-3956(75)90026-6
Karkauskiene et al., 2023
Kim, Y., Vakula, M. N., Bolton, D. A. E., Dakin, C. J., Thompson, B. J., Slocum, T. A., Teramoto, M., & Bressel, E. (2022). Which Exercise Interventions Can Most Effectively Improve Reactive Balance in Older Adults? A Systematic Review and Network Meta-Analysis. Frontiers in aging neuroscience, 13, 764826. https://doi.org/10.3389/fnagi.2021.764826
Kocic, M., Stojanovic, Z., Nikolic, D., Lazovic, M., Grbic, R., Dimitrijevic, L., & Milenkovic, M. (2018). The effectiveness of group Otago exercise program on physical function in nursing home residents older than 65years: A randomized controlled trial. Archives of gerontology and geriatrics, 75, 112–118. https://doi.org/10.1016/j.archger.2017.12.001
Lee, D., & Tak, S. H. (2023). A concept analysis of fear of falling in older adults: insights from qualitative research studies. BMC geriatrics, 23(1), 651. https://doi.org/10.1186/s12877-023-04364-5
Leung, K. W., Sum, K. R., & Yang, Y. J. (2021). Patterns of Sedentary Behavior among Older Adults in Care Facilities: A Scoping Review. International journal of environmental research and public health, 18(5), 2710. https://doi.org/10.3390/ijerph18052710
Liew, L. K., Tan, M. P., Tan, P. J., Mat, S., Majid, L. A., Hill, K. D., & Mazlan, M. (2019). The Modified Otago Exercises Prevent Grip Strength Deterioration Among Older Fallers in the Malaysian Falls Assessment and Intervention Trial (MyFAIT). Journal of geriatric physical therapy (2001), 42(3), 123–129. https://doi.org/10.1519/JPT.0000000000000155
Liu-Ambrose, T., Donaldson, M. G., Ahamed, Y., Graf, P., Cook, W. L., Close, J., Lord, S. R., & Khan, K. M. (2008). Otago home-based strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial. Journal of the American Geriatrics Society, 56(10), 1821–1830. https://doi.org/10.1111/j.1532-5415.2008.01931.x
Marques, E. A., Baptista, F., Santos, R., Vale, S., Santos, D. A., Silva, A. M., Mota, J., & Sardinha, L. B. (2014). Normative functional fitness standards and trends of Portuguese older adults: cross-cultural comparisons. Journal of aging and physical activity, 22(1), 126–137. https://doi.org/10.1123/japa.2012-0203
NICE. (2018, March 22). Overview | Physical activity and the environment | Guidance | NICE. https://www.nice.org.uk/guidance/ng90
PORDATA. (2021). Censos de 2021. Obtido de PORDATA EStatísticas Sobre Portugal e Europa: https://www.pordata.pt/censos/resultados/escolaridadeeemprego- portugal-361
Roman de Mettelinge, T., & Cambier, D. (2015). Understanding the relationship between walking aids and falls in older adults: a prospective cohort study. Journal of geriatric physical therapy (2001), 38(3), 127–132. https://doi.org/10.1519/JPT.0000000000000031
Rossi, P. H., Lipsey, M. W., & Freeman, H. E. (2004). Evaluation: A Systematic Approach (7th ed.). Sage Publications.
Sakano, Y., Murata, S., Goda, A., & Nakano, H. (2023). Factors Influencing the Use of Walking Aids by Frail Elderly People in Senior Day Care Centers. Healthcare (Basel, Switzerland), 11(6), 858. https://doi.org/10.3390/healthcare11060858
Santos, Borges, & Menezes, 2013
Sherrington, C., Fairhall, N., Wallbank, G., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. (2020). Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review. British journal of sports medicine, 54(15), 885–891. https://doi.org/10.1136/bjsports-2019-101512
Sherrington, C., Whitney, J. C., Lord, S. R., Herbert, R. D., Cumming, R. G., & Close, J. C. (2008). Effective exercise for the prevention of falls: a systematic review and meta-analysis. Journal of the American Geriatrics Society, 56(12), 2234–2243. https://doi.org/10.1111/j.1532-5415.2008.02014.x
Siggeirsdóttir, K., Jónsson, B. Y., Jónsson, H., Jr, & Iwarsson, S. (2002). The timed 'Up & Go' is dependent on chair type. Clinical rehabilitation, 16(6), 609–616. https://doi.org/10.1191/0269215502cr529oa
Thies, S. B., Bates, A., Costamagna, E., Kenney, L., Granat, M., Webb, J., Howard, D., Baker, R., & Dawes, H. (2020). Are older people putting themselves at risk when using their walking frames?. BMC geriatrics, 20(1), 90. https://doi.org/10.1186/s12877-020-1450-2
Van der Heide, I., Wang, J., Droomers, M., Spreeuwenberg, P., Rademakers, J., & Uiters, E. (2013). The relationship between health, education, and health literacy: results from the Dutch Adult Literacy and Life Skills Survey. Journal of health communication, 18 Suppl 1(Suppl 1), 172–184. https://doi.org/10.1080/10810730.2013.825668
Yang, Y., Hu, X., Zhang, Q., & Zou, R. (2016). Diabetes mellitus and risk of falls in older adults: a systematic review and meta-analysis. Age and ageing, 45(6), 761–767. https://doi.org/10.1093/ageing/afw140
Yang, Y., Wang, K., Liu, H., Qu, J., Wang, Y., Chen, P., Zhang, T., & Luo, J. (2022). The impact of Otago exercise programme on the prevention of falls in older adult: A systematic review. Frontiers in public health, 10, 953593. https://doi.org/10.3389/fpubh.2022.953593
Zijlstra, G. A., van Haastregt, J. C., van Rossum, E., van Eijk, J. T., Yardley, L., & Kempen, G. I. (2007). Interventions to reduce fear of falling in community-living older people: a systematic review. Journal of the American Geriatrics Society, 55(4), 603–615. https://doi.org/10.1111/j.1532-5415.2007.01148.x
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-NãoComercial-SemDerivações 4.0.
Direitos de Autor (c) 2025 Odete Maria Azevedo Alves, Ana Luísa Santos Paz de Carvalho, Ana Marta Antunes Francisco, Mariana Jesus Pinho, Camila Carvalho, Hélder Miguel Martins, Cristina Mesquita, Sofia Rocha Lopes, Paula Clara Ribeiro Santos