Desenvolvimento do equilíbrio postural e prevenção de quedas em idosos: estratégias de intervenção
Resumo
O equilíbrio postural é relevante para a estabilidade corporal, tanto em repouso quanto em movimento, e torna-se mais vulnerável com o envelhecimento devido à perda de força muscular, flexibilidade e problemas de visão, aumentando o risco de quedas graves em idosos. A prevenção eficaz de quedas inclui programas de exercícios específicos para melhorar o equilíbrio, visando promover segurança e qualidade de vida. Objetivo: Investigar as estratégias de prevenção de quedas focadas no aprimoramento do equilíbrio postural em idosos. Metodologia: Este estudo se trata de uma revisão integrativa, onde foram realizadas buscas nas bases de dados como Pubmed, Embase e Lilacs, no período de 2012 a 2024. Resultados: De 504 artigos inicialmente identificados, 492 foram analisados após a remoção de duplicatas, resultando na seleção final de 40 artigos que atenderam aos critérios de elegibilidade. Conclui-se que, vários programas de treinamento de equilíbrio postural foram eficientes na redução do risco de quedas entre idosos, incluindo estratégias como treinamento com perturbação e uso de jogos de realidade virtual, que emergiram como tendências promissoras para melhorar a estabilidade e minimizar os impactos negativos das quedas nesta população.
Referências
Allin, LJ, Brolinson, PG, Beach, BM, Kim, S., Nussbaum, MA, Roberto, KA, e Madigan, ML (2020). Perturbation-based balance training targeting both slip- and trip-induced falls among older adults: a randomized controlled trial. BMC Geriatrics, 20(1). https://doi.org/10.1186/s12877-020-01605-9
Ambrens, M., Alley, S., Oliveira, JS, To, Q., Delbaere, K., Vandelanotte, C., e Tiedemann, A. (2022). Effect of eHealth-delivered exercise programmes on balance in people aged 65 years and over living in the community: a systematic review and meta-analysis of randomised controlled trials. BMJ Open, 12(6), e051377. https://doi.org/10.1136/bmjopen-2021-051377
Arghavani, H., Zolaktaf, V., e Lenjannejadian, S. (2020). Comparing the effects of anticipatory postural adjustments focused training and balance training on postural preparation, balance confidence and quality of life in elderly with history of a fall. Aging Clinical and Experimental Research, 32(9), 1757-1765. https://doi.org/10.1007/s40520-019-01358-5
Bae, J., e Cho, S.-I. (2014). Effects of community-based comprehensive fall prevention program on muscle strength, postural balance and fall efficacy in elderly people. Journal of Korean academy of nursing, 44(6), 697. https://doi.org/10.4040/jkan.2014.44.6.697
Devasahayam, AJ, Farwell, K., Lim, B., Morton, A., Fleming, N., Jagroop, D., Raabeae, A., Saumuer, TM, e Mansfield, A. (2022). The effect of reactive balance training on falls in daily life: An updated systematic review and meta-analysis. Physical Therapy, 103(1). https://doi.org/10.1093/ptj/pzac154
Długosz-Boś, M., Filar-Mierzwa, K., Stawarz, R., Ścisłowska-Czarnecka, A., Jankowicz-Szymańska, A., e Bac, A. (2021). Effect of three months Pilates training on balance and fall risk in older women. International Journal of Environmental Research and Public Health, 18(7), 3663. https://doi.org/10.3390/ijerph18073663
Donath, L., Faude, O., Bridenbaugh, SA, Roth, R., Soltermann, M., Kressig, RW, e Zahner, L. (2014). Transfer effects of fall training on balance performance and spatiotemporal gait parameters in healthy community-dwelling older adults: A pilot study. Journal of aging and physical activity, 22(3), 324-333. https://doi.org/10.1123/japa.2013-0010
Gerards, M., Marcellis, R., Senden, R., Poeze, M., de Bie, R., Meijer, K., e Lenssen, A. (2023). The effect of perturbation-based balance training on balance control and fear of falling in older adults: a single-blind randomised controlled trial. BMC Geriatrics, 23(1). https://doi.org/10.1186/s12877-023-03988-x
Gimmon, Y., Riemer, R., Kurz, I., Shapiro, A., Debbi, R., e Melzer, I. (2018). Perturbation exercises during treadmill walking improve pelvic and trunk motion in older adults. A randomized control trial. Archives of Gerontology and Geriatrics, 75, 132-138. https://doi.org/10.1016/j.archger.2017.12.004
Hamed, A., Bohm, S., Mersmann, F., e Arampatzis, A. (2018). Exercises of dynamic stability under unstable conditions increase muscle strength and balance ability in the elderly. Scandinavian Journal of Medicine & Science in Sports, 28(3), 961-971. https://doi.org/10.1111/sms.13019
Hewitt, J., Goodall, S., Clemson, L., Henwood, T., e Refshauge, K. (2018). Progressive resistance and balance training for falls prevention in long-term residential aged care: A cluster randomized trial of the sunbeam program. Journal of the American Medical Directors Association, 19(4), 361-369. https://doi.org/10.1016/j.jamda.2017.12.014
Jagdhane, S., Kanekar, N., e Aruin, A.S. (2016). The effect of a four-week balance training program on anticipatory postural adjustments in older adults: A pilot feasibility study. Current Aging Science, 9(4), 295-300. https://doi.org/10.2174/1874609809666160413113443
Josephs, S., Pratt, M.L., Calk Meadows, E., Thurmond, S., e Wagner, A. (2016). The effectiveness of Pilates on balance and falls in community dwelling older adults. Journal of Bodywork and Movement Therapies, 20(4), 815-823. https://doi.org/10.1016/j.jbmt.2016.02.003
Kurz, I., Gimmon, Y., Shapiro, A., Debi, R., Snir, Y., e Melzer, I. (2016). Unexpected perturbations training improves balance control and voluntary stepping times in older adults - a double blind randomized control trial. BMC Geriatrics, 16(1). https://doi.org/10.1186/s12877-016-0223-4
Liu-Ambrose, T., Davis, JC, Best, JR, Dian, L., Madden, K., Cook, W., Hsu, CL, e Khan, KM (2019). Effect of a home-based exercise program on subsequent falls among community-dwelling high-risk older adults after a fall: A randomized clinical trial. JAMA: The Journal of the American Medical Association, 321(21), 2092. https://doi.org/10.1001/jama.2019.5795
Liu-Ambrose, T., Davis, JC, Falck, RS, Best, JR, Dao, E., Vesely, K., Ghag, C., Rosano, C., Hsu, CL, Dian, L., Cook, W., e Madden, KM, e Khan, KM (2020). Exercise, processing speed, and subsequent falls: A secondary analysis of a 12-month randomized controlled trial. The Journals of Gerontology. Series A, 76(4), 675-682. https://doi.org/10.1093/gerona/glaa239
Mesquita, L.S. de A., Carvalho, F.T. de, Freire, L.S. de A., Neto, O.P., e Zângaro, R.A. (2015). Effects of two exercise protocols on postural balance of elderly women: a randomized controlled trial. BMC Geriatrics, 15(1). https://doi.org/10.1186/s12877-015-0059-3
Montero-Alía, P., Miralles-Basseda, R., López-Jiménez, T., Muñoz-Ortiz, L., Jiménez-González, M., Prat-Rovira, J., Albarrán-Sánchez, JL, Manresa-Domínguez, JM, Andreu-Concha, CM, Rodríguez-Pérez, MC, Martí-Cervantes, JJ, Sañudo-Blanco, L., Sánchez-Pérez, CA, e Dolader-Olivé, S., e Torán-Monserrat, P. (2019). Controlled trial of balance training using a video game console in community-dwelling older adults. Age and Ageing, 48(4), 506-512. https://doi.org/10.1093/ageing/afz047
Nematollahi, A., Kamali, F., Ghanbari, A., Etminan, Z., e Sobhani, S. (2016). Improving balance in older people: A double-blind randomized clinical trial of three modes of balance training. Journal of aging and physical activity, 24(2), 189-195. https://doi.org/10.1123/japa.2014-0286
Nørgaard JE, Andersen S., Ryg, J., Stevenson, AJT, Andreasen, J., Oliveira, AS, Danielsen, MB, e Jorgensen, MG (2023). Effect of treadmill perturbation-based balance training on fall rates in community-dwelling older adults: A randomized clinical trial. JAMA Netw Open, 6(4), e238422. http://dx.doi.org/10.1001/jamanetworkopen.2023.8422
Okubo, Y., Osuka, Y., Jung, S., Rafael, F., Tsujimoto, T., Aiba, T., Kim, T., e Tanaka, K. (2015). Walking can be more effective than balance training in fall prevention among community‐dwelling older adults. Geriatrics & Gerontology International, 16(1), 118-125. https://doi.org/10.1111/ggi.12444
Okubo, Y., Sturnieks, D.L., Brodie, M.A., Duran, L., e Lord, S.R. (2019). Effect of reactive balance training involving repeated slips and trips on balance recovery among older adults: A blinded randomized controlled trial. The Journals of Gerontology. Series A, 74(9), 1489-1496. https://doi.org/10.1093/gerona/glz021
Oliveira, M.R. de, Silva, R.A. da, Dascal, J.B., e Teixeira, D.C. (2014). Effect of different types of exercise on postural balance in elderly women: A randomized controlled trial. Archives of Gerontology and Geriatrics, 59(3), 506-514. https://doi.org/10.1016/j.archger.2014.08.009
Ouzzani, M., Hammady, H., Fedorowicz, Z., e Elmagarmid, A. (2016). Rayyan—a web and mobile app for systematic reviews. Systematic Reviews, 5(1). https://doi.org/10.1186/s13643-016-0384-4
Pai, Y.-C., Bhatt, T., Yang, F., e Wang, E. (2014). Perturbation training can reduce community-dwelling older adults’ annual fall risk: A randomized controlled trial. The Journals of Gerontology. Series A, 69(12), 1586-1594. https://doi.org/10.1093/gerona/glu087
Patti, A., Zangla, D., Sahin, FN, Cataldi, S., Lavanco, G., Palma, A., e Fischietti, F. (2021). Physical exercise and prevention of falls. Effects of a Pilates training method compared with a general physical activity program: A randomized controlled trial. Medicine, 100(13), e25289. https://doi.org/10.1097/md.0000000000025289
Pereira, C.B., e Kanashiro, A.M.K. (2022). Falls in older adults: a practical approach. Arquivos de neuro-psiquiatria, 80(5 suppl 1), 313-323. https://doi.org/10.1590/0004-282x-anp-2022-s107
Phoobangkerdphol, C., Limampai, P., Dasri, S., e Kuptniratsaikul, V. (2022). Walking meditation versus balance training for improving balance abilities among older adults with history of fall: A randomized controlled trial. Clinical Rehabilitation, 36(4), 538-549. https://doi.org/10.1177/02692155211068232
Pirauá, ALT, Cavalcante, BR, Oliveira, VMA, Beltrão, NB, Batista, GA, Pitangui, ACR, Behm, D., e Araújo, RC (2019). Effect of 24‐week strength training on unstable surfaces on mobility, balance, and concern about falling in older adults. Scandinavian Journal of Medicine & Science in Sports, 29(11), 1805-1812. https://doi.org/10.1111/sms.13510
Prasertsakul, T., Kaimuk, P., Chinjenpradit, W., Limroongreungrat, W., e Charoensuk, W. (2018). The effect of virtual reality-based balance training on motor learning and postural control in healthy adults: a randomized preliminary study. Biomedical Engineering Online, 17(1). https://doi.org/10.1186/s12938-018-0550-0
Rieger, M.M., Papegaaij, S., Pijnappels, M., Steenbrink, F., e van Dieën, J.H. (2020). Transfer and retention effects of gait training with anterior-posterior perturbations to postural responses after medio-lateral gait perturbations in older adults. Clinical Biomechanics, 75, 104988. https://doi.org/10.1016/j.clinbiomech.2020.104988
Rieger, M.M., Papegaaij, S., Steenbrink, F., van Dieën, J.H., e Pijnappels, M. (2024). Effects of perturbation-based treadmill training on balance performance, daily life gait, and falls in older adults: REACT randomized controlled trial. Physical Therapy & Rehabilitation Journal, 104(1). https://doi.org/10.1093/ptj/pzad136
Roaldsen, K.S., Halvarsson, A., Sahlström, T., e Ståhle, A. (2014). Task-specific balance training improves self-assessed function in community-dwelling older adults with balance deficits and fear of falling: a randomized controlled trial. Clinical Rehabilitation, 28(12), 1189-1197. https://doi.org/10.1177/0269215514534087
Roller, M., Kachingwe, A., Beling, J., Ickes, D.-M., Cabot, A., e Shrier, G. (2017). Pilates Reformer exercises for fall risk reduction in older adults: A randomized controlled trial. Journal of Bodywork and Movement Therapies, 22(4), 983-998. https://doi.org/10.1016/j.jbmt.2017.09.004
Sato, K., Kuroki, K., Saiki, S., e Nagatomi, R. (2015). Improving walking, muscle strength, and balance in the elderly with an exergame using Kinect: A randomized controlled trial. Games for Health, 4(3), 161-167. https://doi.org/10.1089/g4h.2014.0057
Sohn, J., e Kim, S. (2015). Falls study: Proprioception, postural stability, and slips. Bio-medical materials and engineering, 26(s1), S693-S703. https://doi.org/10.3233/bme-151361
Szanton, SL, Clemson, L., Liu, M., Gitlin, LN, Hladek, MD, LaFave, SE, Roth, DL, Marx, KA, Felix, C., Okoye, SM, Zhang, X, Bautista, S., e Granbom, M. (2020). Pilot outcomes of a multicomponent fall risk program integrated into daily lives of community-dwelling older adults. Journal of Applied Gerontology: The Official Journal of the Southern Gerontological Society, 40(3), 320-327. https://doi.org/10.1177/0733464820912664
Thomas, M., e Kalicinski, M. (2016). The effects of slackline balance training on postural control in older adults. Journal of Aging and Physical Activity, 24(3), 393-398. https://doi.org/10.1123/japa.2015-0099
Thomas, E., Battaglia, G., Patti, A., Brusa, J., Leonardi, V., Palma, A., e Bellafiore, M. (2019). Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine, 98(27), e16218. https://doi.org/10.1097/md.0000000000016218
Tisher, K., Mann, K., VanDyke, S., Johansson, C., e Vallabhajosula, S. (2019). Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk. Physiotherapy Theory and Practice, 35(4), 305-317. https://doi.org/10.1080/09593985.2018.1444116
Yang, C.-M., Chen Hsieh, J. (Scott), Chen, Y.-C., Yang, S.-Y., e Lin, H.-C. K. (2020). Effects of Kinect exergames on balance training among community older adults: A randomized controlled trial. Medicine, 99(28), e21228. https://doi.org/10.1097/md.0000000000021228
Yeşilyaprak, S.S., Yıldırım, M.Ş., Tomruk, M., Ertekin, Ö., e Algun, Z.C. (2016). Comparison of the effects of virtual reality-based balance exercises and conventional exercises on balance and fall risk in older adults living in nursing homes in Turkey. Physiotherapy Theory and Practice, 32(3), 191-201. https://doi.org/10.3109/09593985.2015.1138009
Yousefi Babadi, S., e Daneshmandi, H. (2021). Effects of virtual reality versus conventional balance training on balance of the elderly. Experimental Gerontology, 153(111498), 111498. https://doi.org/10.1016/j.exger.2021.111498
Zahedian-Nasab, N., Jaberi, A., Shirazi, F., e Kavousipor, S. (2021). Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial. BMC Geriatrics, 21(1). https://doi.org/10.1186/s12877-021-02462-w
Zhao, Y., Chung, P.-K., e Tong, T. K. (2017). Effectiveness of a balance-focused exercise program for enhancing functional fitness of older adults at risk of falling: A randomised controlled trial. Geriatric Nursing, 38(6), 491-497. https://doi.org/10.1016/j.gerinurse.2017.02.011
Biografias Autor
http://lattes.cnpq.br/3416874995674113
http://lattes.cnpq.br/3359913228033689
http://lattes.cnpq.br/6421092690739361
Direitos de Autor (c) 2024 Lecturas: Educación Física y Deportes
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
