Intervenção fonoaudiológica na prevenção de quedas no envelhecimento
Speech therapy´s intervention for falling prevention in aging
Carlos Kazuo Taguchi; Brenda Carla Lima Araújo; Leonardo Santos de Santana; Raissa Valença de Souza Santos; Jacqueline Pitanga Teixeira; Allan Robert da Silva
Resumo
Objetivo: Verificar a eficácia de uma intervenção fonoaudiológica para diminuição do risco de quedas. Método: Estudo exploratório e de intervenção em que 148 voluntários socialmente ativos, de ambos os sexos, com média de 68,6(±6,5) anos foram avaliados pelo Dynamic Gait Index (DGI)–Brazilian brief e o Timed Up and Go (TUG). Todos os voluntários, com e sem risco para quedas, foram convidados para o programa de intervenção realizado em cinco semanas consecutivas, com duração de 50 minutos baseados nos exercícios de Cawthorne e Cooksey. Destes, 72 com 68,1(±6,5) anos, com e sem riscos para quedas, que participaram de, pelos menos, três encontros foram reavaliados. Foram utilizados o teste de Wilcoxon, Qui-quadrado, Spearman e Matriz de Correlação, com p≤5,0%. Resultados: Inicialmente, 37(25,0%) e 106(71,6%) dos voluntários apresentaram, respectivamente, riscos para quedas no DGI–Brazilian brief e no TUG. Verificou-se correlação negativa do DGI-Brazilian brief (p=0,034) e positiva com o TUG (p=0,0071) com a idade e entre os dois instrumentos (p=0,00000016). Na comparação dos dados iniciais e finais de 72 voluntários averiguou-se correlação positiva no DGI-Brazilian brief e TUG no teste do Qui-quadrado e de Wilkoxon. Foi observado melhor desempenho nestes testes após a intervenção. Conclusão: A intervenção foi eficaz, uma vez que diminuiu o risco para quedas e melhorou o desempenho da marcha e equilíbrio funcional e dinâmico.
Palavras-chave
Abstract
Purpose: to verify the effectiveness of a Speech Therapy intervention program to decrease the risk of falls in elderly people. Methods: Exploratory and intervention study where upon 148 volunteers from community, both genders, with an average of 68.6(± 6.5) years were submitted to the Dynamic Gait Index (DGI)- Brazilian brief and the Timed Up and Go (TUG). Volunteers with or without potential risk for falling were invited to participate in a 50-minutes long intervention program carried out for five consecutive weeks, based on Cawthorne and Cooksey exercises. Seventy-two volunteers 68.1(±6.5) years presented in at least three meeting, were reassessed. The results were analyzed by Wilcoxon, Chi-square, Spearman and Correlation Matrix tests, with p≤5.0%. Results: Thirty-seven (25.0%) and 106 (71.6%) participants presented, respectively, risks for falls in the DGI–Brazilian brief and TUG. There was negative correlation between the DGI-Brazilian brief (p=0.034) and positive with the TUG (p=0.0071) with age and both instruments (p=0.00000016). Through the comparison the initial and final data a positive correlation was found for the DGI-Brazilian brief and for TUG in the Chi-square test and by Wilcoxon’s. Better performance was observed in both tests after the intervention. Conclusion: The intervention was effective in decreasing the risk for falls and improving gait performance, and functional and dynamic balance.
Keywords
Referências
1) Cruz DT, Ribeiro LC, Vieira MT, Teixeira MTB, Bastos RR, Leite ICG. Prevalência de quedas e fatores associados em idosos. Rev Saude Publica. 2012;46(1):138-46. http://dx.doi.org/10.1590/S0034-89102011005000087 PMid:22183513.
» http://dx.doi.org/10.1590/S0034-89102011005000087
2) Hopewell S, Adedire O, Copsey BJ, Boniface GJ, Sherrington C, Clemson L, et al. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database Syst Ver. 2018;7(7):CD012221. http://dx.doi.org/10.1002/14651858.CD012221.pub2 PMid:30035305.
» http://dx.doi.org/10.1002/14651858.CD012221.pub2
3) Ang CG, Low SL, How CH. Approach to falls among the elderly in the community. Singapore Med J. 2020;61(3):116-21. http://dx.doi.org/10.11622/smedj.2020029
» http://dx.doi.org/10.11622/smedj.2020029
4) Alves LV, Taguchi CK, Oliveira IL, Sousa MGC. Evaluation the tendency to falls in elderly from Sergipe. Rev CEFAC. 2014;16(5):1389-96. http://dx.doi.org/10.1590/1982-0216201425312
» http://dx.doi.org/10.1590/1982-0216201425312
5) Pellicer-García B, Antón-Solanas I, Ramón-Arbués E, García-Moyano L, Gea-Caballero V, Juárez-Vela R. Risk of falling and associated factors in older adults with a previous history of falls. Int J Environ Res Public Health. 2020;17(11):4085. http://dx.doi.org/10.3390/ijerph17114085 PMid:32521701.
» http://dx.doi.org/10.3390/ijerph17114085
6) Silveira MB, Filippin LI. Timed Up and Go como ferramenta de screening para fragilidade em idosos fisicamente ativos. Cad Saude Colet. 2017;25(4):389-93. http://dx.doi.org/10.1590/1414-462x201700040251
» http://dx.doi.org/10.1590/1414-462x201700040251
7) Fhon JRS, Rodrigues RAP, Neira WF, Huayta VMR, Robazzi MLC. Fall and its association with the frailty syndrome in the elderly: systematic review with meta-analysis. Rev Esc Enferm USP. 2016;50(6):1005-13. http://dx.doi.org/10.1590/s0080-623420160000700018 PMid:28198967.
» http://dx.doi.org/10.1590/s0080-623420160000700018
8) Magnani PE, Porto JM, Genovez MBNA, Zanellato NFC, Alvarenga IC, Santos PF, et al. What is the best clinical assessment tool for identification of adults aged ≥80 years at high risk of falls? Physiotherapy. 2020;110:63-9. PMid:32349866.
9) Martins HO, Bernardo KMA, Martins MS, Alfieri, FM. Controle postural e o medo de cair em idosos fragilizados e o papel de um programa de prevenção de quedas. Acta Fisiátrica. 2016;23(3):113-9.
10) Shubert TE, Smith ML, Jiang L, Ory MG. Disseminating the otago exercise program in the United States: perceived and actual physical performance improvements from participants. J Appl Gerontol. 2018;37(1):79-98. http://dx.doi.org/10.1177/0733464816675422 PMid:27794055.
» http://dx.doi.org/10.1177/0733464816675422
11) Pagliosa LC, Renosto A. Effects of a health promotion and fall prevention program in elderly individuals participating in interaction groups. Fisioter Mov. 2014;27(1):101-9. http://dx.doi.org/10.1590/0103-5150.027.001.AO11
» http://dx.doi.org/10.1590/0103-5150.027.001.AO11
12) Taguchi CK, Santos TFO, Nascimento RS, Silva AR, Raposo OFF, Teixeira JP. Efficacy in Falls Prevention Programs for the Elderly. Distúrb Comun. 2016;28(2):286-94.
13) Tricco AC, Thomas SM, Veroniki AA, Hamid JS, Cogo E, Strifler E, et al. Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis. JAMA. 2017;318(17):1687-99. http://dx.doi.org/10.1001/jama.2017.15006 PMid:29114830.
» http://dx.doi.org/10.1001/jama.2017.15006
14) Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019; 1(1):CD012424. http://dx.doi.org/10.1002/14651858.CD012424.pub2
» http://dx.doi.org/10.1002/14651858.CD012424.pub2
15) Taguchi CK, Costa ÉP, Alves LV, Santos LK, Silva ERO, Araújo BCL, et al. Clinical application of dynamics gait index: brazilian brief version. Adv Aging Res. 2018;7(6):113-8. http://dx.doi.org/10.4236/aar.2018.76009
» http://dx.doi.org/10.4236/aar.2018.76009
16) Dutra MC, Cabral ALL, Carvalho GA. Brazilian version of Timed Up and Go test. Revista Interfaces, Saude. Humanas e Tecnologia. 2016;3(9):81-8.
17) Taguchi CK, Bohlsen YA. Reabilitação vestibular In: Boechat EM, Menezes PL, Couto CM et al. Tratado de Audiologia. Rio de Janeiro: Editora Guanabara – Koogan; 2015. p. 551-65.
18) Siqueira FV, Facchini LA, Piccini RX, Tomasi E, Thumé E, Silveira DS, et al. Prevalência de quedas em idosos e fatores associados. Rev Saude Publica. 2007;41(5):749-56. http://dx.doi.org/10.1590/S0034-89102007000500009 PMid:17923896.
» http://dx.doi.org/10.1590/S0034-89102007000500009
19) Wu YZ, Liu HW, Liu PPS, Peng LN, Lin SZ, Loh CH. Age-stratified differences of physical capacity in rural community-dwelling Taiwanese older women: a cross-sectional study. Arch Gerontol Geriatr. 2020;90:104123. http://dx.doi.org/10.1016/j.archger.2020.104123 PMid:32531646.
» http://dx.doi.org/10.1016/j.archger.2020.104123
20) Fujita K, Iijima H, Eguchi R, Kuroiwa T, Sasaki T, Yokoyama Y, et al. Gait analysis of patients with distal radius fracture by using a novel laser Timed Up-and-Go system. Gait Posture. 2020;80:223-7. http://dx.doi.org/10.1016/j.gaitpost.2020.06.005 PMid:32540778.
» http://dx.doi.org/10.1016/j.gaitpost.2020.06.005
21) Lins MEM, Marques APO, Leal MCC, Barros RLM. Frailty risk in community-dwelling elderly assisted in Primary Health Care and associated factors. Saúde Debate. 2019;43(121):520-9. http://dx.doi.org/10.1590/0103-1104201912118
» http://dx.doi.org/10.1590/0103-1104201912118
22) Tavares DI, Pereira MB, Braz MM. Perfil dos estudos de quedas com idosos: revisão integrativa. Rev Kairós — Gerontologia. 2017;20(3):207-22.
23) Carvalho VL, Clementino AA, Magalhães EQFF, Silva EMB, Baggio JAO. Prevalence of falls among elderly participants of a health promotion group and comparison of balance tests to detect risk of falls. Fisioter Mov. 2017;30(3):519-25. http://dx.doi.org/10.1590/1980-5918.030.003.ao10
» http://dx.doi.org/10.1590/1980-5918.030.003.ao10
24) Staples WH, Kays A, Richman R. Examination of the correlation between physical and psychological measures in communit wyelling older adults. Clin Interv Aging. 2020;15:293-300. http://dx.doi.org/10.2147/CIA.S239053 PMid:32184578.
» http://dx.doi.org/10.2147/CIA.S239053
25) Santos AC, Ferreira CP, Silva KC, Araújo VV, Lima F. Exercícios de Cawthorne e Cooksey em idosas: melhora e equilíbrio. Fisioter Mov. 2008;21(4):129-36.
26) Carol MS, Peñas LB, Sala LB, Peñas CB, Roset JA, Novellas JA. Applicability and limitation of physical performance tests for frailty screening on discharge from an intermediate care hospital. Rev Esp Geriatr Gerontol. 2020;55(4):212-5. http://dx.doi.org/10.1016/j.regg.2020.02.002 PMid:32245649.
» http://dx.doi.org/10.1016/j.regg.2020.02.002
27) Vincent S, Joseph J. The combined effectiveness of gaze stability exercise and Otago exercise on balance and fall risk in elderly people. Intern J M Exerc Sci. 2017;3(3):390-401. http://dx.doi.org/10.36678/ijmaes.2017.v03i03.008
» http://dx.doi.org/10.36678/ijmaes.2017.v03i03.008
28) Cederbom S, Bjerk M, Bergland A. A qualitative study exploring physical therapists’ views on the Otago Exercise Programmed for fall prevention: a stepping stone to “age in place” and to give faith in the future. Physiother Theory Pract. 2020;1-9. http://dx.doi.org/10.1080/09593985.2020.1731895 PMid:32090667.
» http://dx.doi.org/10.1080/09593985.2020.1731895
29) Joung HJ, Lee Y. Effect of creative dance on fitness, functional balance and mobility control in the elderly. Gerontology. 2019;65(5):537-46.
30) Silva VM, Arruda ASF, Silva LSV, Pontes FL Jr, Cachioni M, Melo RC. Effectiveness of a multiple intervention programme for the prevention of falls in older adults persons from a University of the Third. Rev Bras Geriatr Gerontol. 2019;22(4):e190032.
Submetido em:
18/09/2020
Aceito em:
30/11/2020
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