Prevenção de quedas em idosos atendidos em um ambulatório didático de geriatria
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Data
2019-02-22
Autores
MOLIGA, AUGUSTA FABIANA
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Universidade Estadual Paulista (Unesp)
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RESUMO Introdução: O envelhecimento está ligado à capacidade de adaptação do indivíduo aos rigores e agressões do meio ambiente. As limitações funcionais provenientes do envelhecimento tornam o idoso mais vulnerável à quedas que levam desde pequenas lesões físicas até consequências irreversíveis. A fisioterapia busca manter e melhorar a funcionalidade, autonomia e qualidade de vida destes idosos. Objetivo: Identificar as características dos pacientes do ambulatório de geriatria do Centro de Saúde Escola que sofreram quedas, avaliar o risco de novas quedas e analisar o efeito de um protocolo de exercícios físicos na redução do risco de quedas em idosos. Método: Estudo prospectivo de uma série de casos, a amostra foi composta por 97 idosos com 60 anos ou mais e histórico de quedas no último ano, que após critérios de inclusão, foram submetidos à avaliação fisioterapêutica com aplicação dos testes Timed Up and Go (TUG) e Escala de Equilíbrio de Berg, divididas em avaliação inicial e final, durante um protocolo de reabilitação com uma hora de duração cada sessão, duas sessões por semana, composta por aquecimento, fortalecimento, treino de equilíbrio e alongamento ou relaxamento, totalizando 32 sessões. Resultado: Dos 56 indivíduos que concluíram o tratamento, 10 (17,9%) eram do sexo masculino e 46 (89,1%) do sexo feminino. A média de idade dos pacientes foi de 75(±8,6) anos. A média do número de quedas foi de 4,2(±2,6) e a média do número de medicamentos utilizados foi de 4,7(±2,7). Houve diferença estatisticamente significante entre os escores dos dois instrumentos de avaliação (TUG e Escala de equilíbrio de Berg) antes e depois da intervenção (p<0,001). Houve uma correlação positiva, embora fraca, entre o número de quedas e o número de medicamentos utilizados pelos pacientes. Não houve diferença estatisticamente significante entre as proporções de deficiência visual e auditiva em relação aos grupos “uma queda” e “duas ou mais quedas” (p=1,0; p=0,43). Porém, nota-se um maior número absoluto de quedas nos idosos com deficit visual. Não houve diferença estatisticamente significativa entre o número de quedas e as variáveis “morar sozinho ou não” e “categorias de números de medicações utilizados” (p=1,0; p=0,43). Conclusão: De acordo com os dados apresentados podemos concluir que a prática de exercício físico regular com fortalecimento muscular e treino de equilíbrio, melhoram a independência funcional e reduzem o tempo de velocidade da marcha, sendo fator favorável na prevenção do risco de quedas em idosos Descritores: Idosos, Prevenção, Quedas, Saúde Básica
ABSTRACT Introduction: Aging is linked to the individual's ability to adapt to the rigors and aggressions of the environment. The functional limitations of aging make the elderly vulnerable to falls from small physical injuries to irreversible consequences. Physiotherapy seeks to maintain and improve the functionality, autonomy and quality of life of these elderly people. Objective: To identify the characteristics of the patients in the geriatric outpatient clinic of the School Health Center who suffered falls, to evaluate the risk of further falls and to analyze the effect of a rehabilitation protocol for the elderly. Method: Prospective study of a series of cases, the sample consisted of 97 elderly individuals aged 60 years or older and a history of falls in the last year, who, after inclusion criteria, underwent a physical therapy evaluation using the Timed Up and Go tests ( TUG) and Berg Balance Scale, divided into initial and final evaluation, during a one-hour rehabilitation protocol each session, two sessions per week, consisting of warm-up, strengthening, balance training and stretching or relaxation, totaling 32 sessions. Outcome: Of the 56 individuals who completed treatment, 10 (17.9%) were male and 46 (89.1%) were female. The mean age of the patients was 75 (± 8.6) years. The mean number of falls was 4.2 (± 2.6) and the mean number of medications used was 4.7 (± 2.7). There was a statistically significant difference between the scores of the two assessment instruments (Timed Up and Go and Berg Balance Scale) before and after the intervention (p <0.001). There was a positive, albeit weak, correlation between the number of falls and the number of medications used by the patients. There was no statistically significant difference between the proportions of visual and hearing impairment in relation to the "one drop" and "two or more falls" groups (p = 1.0; p = 0.43). However, there is a greater absolute number of falls in the elderly with visual deficit. There was no statistically significant difference between the number of falls and the variables "living alone or not" and "categories of medication numbers used" (p = 1.0; p = 0.43). Conclusion: According to the data presented, we can conclude that the practice of regular physical exercise with muscle strengthening and balance training, improve functional independence and reduce gait speed time, being a favorable factor in preventing the risk of falls in the elderly. Descriptors: Elderly, Prevention, Falls, Basic Health
ABSTRACT Introduction: Aging is linked to the individual's ability to adapt to the rigors and aggressions of the environment. The functional limitations of aging make the elderly vulnerable to falls from small physical injuries to irreversible consequences. Physiotherapy seeks to maintain and improve the functionality, autonomy and quality of life of these elderly people. Objective: To identify the characteristics of the patients in the geriatric outpatient clinic of the School Health Center who suffered falls, to evaluate the risk of further falls and to analyze the effect of a rehabilitation protocol for the elderly. Method: Prospective study of a series of cases, the sample consisted of 97 elderly individuals aged 60 years or older and a history of falls in the last year, who, after inclusion criteria, underwent a physical therapy evaluation using the Timed Up and Go tests ( TUG) and Berg Balance Scale, divided into initial and final evaluation, during a one-hour rehabilitation protocol each session, two sessions per week, consisting of warm-up, strengthening, balance training and stretching or relaxation, totaling 32 sessions. Outcome: Of the 56 individuals who completed treatment, 10 (17.9%) were male and 46 (89.1%) were female. The mean age of the patients was 75 (± 8.6) years. The mean number of falls was 4.2 (± 2.6) and the mean number of medications used was 4.7 (± 2.7). There was a statistically significant difference between the scores of the two assessment instruments (Timed Up and Go and Berg Balance Scale) before and after the intervention (p <0.001). There was a positive, albeit weak, correlation between the number of falls and the number of medications used by the patients. There was no statistically significant difference between the proportions of visual and hearing impairment in relation to the "one drop" and "two or more falls" groups (p = 1.0; p = 0.43). However, there is a greater absolute number of falls in the elderly with visual deficit. There was no statistically significant difference between the number of falls and the variables "living alone or not" and "categories of medication numbers used" (p = 1.0; p = 0.43). Conclusion: According to the data presented, we can conclude that the practice of regular physical exercise with muscle strengthening and balance training, improve functional independence and reduce gait speed time, being a favorable factor in preventing the risk of falls in the elderly. Descriptors: Elderly, Prevention, Falls, Basic Health
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Palavras-chave
Prevenção, Saúde basica, Idosos, Quedas, Elderly, Prevention, Falls, Basic health