Associação entre a ocorrência de quedas e o desempenho em testes de caminhada de campo em mulheres idosas não institucionalizadas
Data
2010
Autores
Bardin, Marcela Grigol 
Orientadores
Dourado, Victor Zuniga
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
INTRODUÇÃO: Os idosos tem se revelado um crescente grupo populacional, cujos riscos de
saúde ganharam destaque em meio à sociedade. A incidência de quedas nesta população
compõe um dos principais fatores que aumentam a morbimortalidade e por isso necessita ser
evitada. O timed up and go (TUG) é uma ferramenta estabelecida para a avaliação do
equilíbrio e/ou risco de quedas em indivíduos idosos. O teste de caminhada incremental
(incremental shuttle walk test – ISWT) foi desenvolvido para avaliar a aptidão
cardiorrespiratória em pacientes com doenças cardiopulmonares. Devido ao seu caráter de
idas e vindas rápidas em um espaço delimitado, levantamos a hipótese de que o desempenho
no ISWT possa apresentar associação com a ocorrência de quedas e correlação com o
equilíbrio em indivíduos idosos não institucionalizados. OBJETIVO: O presente estudo teve
como objetivo avaliar e comparar as associações existentes entre as performances obtidas no
ISWT e no TUG e a ocorrência de quedas em mulheres idosas não institucionalizadas.
MÉTODOS: Foram avaliadas 19 mulheres idosas (66 + 6anos). As participantes realizaram
dois ISWT e três TUG. O ISWT consistiu em caminhar em corredor plano coberto de 10 m
em velocidade progressiva, com incrementos de 0,17 m/s a cada minuto ditado por sinais
sonoros gravados em um Compact Disc. A distância percorrida no ISWT (ISWD) foi avaliada
em metros e como percentual dos valores previstos. O TUG foi realizado em percurso de 3 m
utilizando-se uma cadeira padronizada com apoio para a coluna e para os braços. O indivíduo
foi orientado a levantar-se da cadeira, caminhar 3 metros, virar-se, voltar e sentar-se na
cadeira novamente o mais rápido possível. O equilíbrio foi avaliado por meio da escala de
equilíbrio de Berg (EEB). Das 19 participantes, 10 sofreram ao menos duas quedas no último
ano e foram alocadas no grupo designado quedas (GQ), sendo as nove restantes componentes
do grupo controle que não sofreram quedas (GNQ). RESULTADOS: As participantes
apresentaram valores médios do IMC representativos de obesidade grau I (31+4,5). A
distância média caminhada no ISWT apresentou-se dentro da normalidade (99+33%). O
tempo necessário para realizar o TUG foi de 7,29s (+1,12). O escore total médio da EEB foi
de 52 (+3) . O GQ apresentou pior performance (P < 0,05) no TUG (7,98 + 0,95 vs. 6,52 +
0,72 s), na EEB (50 + 3 vs. 54 + 1 pontos) e no ISWT em valores percentuais (93 + 19 vs. 114
+ 20 %prev.). O GQ apresentou, adicionalmente, menores valores percentuais da FC atingida
ao final do primeiro ISWT (62 + 9 vs. 74 + 14 %). Houve correlações significativas da ISWD
com o TUG (r = -0,667; p = 0,002) e com o escore da EEB (r = 0,547; p = 0,015).
CONCLUSÃO: o ISWT apresentou associação significativa com a ocorrência de quedas e
correlação consistente com a mobilidade física e o equilíbrio. Nossos resultados sugerem a
utilidade do ISWT como ferramenta de avaliação simultânea da aptidão cardiorrespiratória e
do equilíbrio em mulheres idosas. O quanto o treinamento com exercícios capaz de melhorar a
performance no ISWT poderia resultar em prevenção da ocorrência de quedas e melhora do
equilíbrio nessa população deveria ser investigado em estudos futuros
INTRODUCTION: The importance of assuring elderly health has been receiving attention of the whole society. The great incidence of falls in this group is one of the most important causes of its morbidity and must be avoided. The timed up and go test (TUG) is an established tool for the assessment of balance and/or risk of falls in older people. The incremental shuttle walk test (ISWT) was developed to assess cardiorespiratory fitness in patients with cardiopulmonary diseases. Since ISWT requires rapid walking back and forth around a limited space, we hypothesized that performance in ISWT might be associated with the occurrence of falls and also might be correlated to balance in non-institutionalized older people. OBJECTIVE: This study aimed to evaluate and compare the associations of ISWT and TUG performances and the occurrence of falls in non-institutionalized older women. METHODS: We evaluated 19 older women (66 + 6). All participants performed two ISWT and three TUG. The ISWT consisted of walking on a flat 10 m corridor while increasing speed in increments of 0.17 m/s each minute dictated by audio signals recorded on a Compact Disc. The distance traveled on ISWT (ISWD) was measured in meters and as a percentage of predicted. The TUG was carried on a 3 m corridor using a standard chair with back and arm support. The subject was instructed to rise from a chair, walk 3 m, turn around, go back and sit in the chair again as quickly as possible. Balance was assessed using Berg Balance Scale (BBS). Of the 19 participants, 10 experienced at least two falls in the last year and were allocated in the so-called falls group (FG), and the remaining nine of participants composed the control group who did not fall (NF). RESULTS: The participants had mean BMI representative of mild obesity (31+4). The average distance walked in ISWT was normal compared to predicted values (99+33%). The time required to perform TUG was 7,29s (+1,12) . The mean BBS total score was 52 (+3) . The GQ presented worse performance (P <0.05) in TUG (7.98 + 0.95 vs. 6.52 + 0.72 s), BBS (50 + 3 vs. 54 + 1 points) and ISWT in percentages (93 + 19 vs. 114 + 20 % pred). The GQ also presented lower percentages of the maximal heart rate achieved at the end of the first ISWT (62 + 9 vs. 74 + 14 %). Significant correlations of ISWD with TUG (r = -0.667, p = 0.002) and BBS total score (r = 0.547, p = 0.015) were observed. CONCLUSION: The ISWT was significantly associated with occurrence of falls and presented consistent correlation with physical mobility and balance. Our results suggest the usefulness of ISWT as a tool for simultaneous assessment of cardiorespiratory fitness and balance in older women. Whether the exercise training that can improve ISWD could also prevent falls and improve balance in this population should be investigated in future studies.
INTRODUCTION: The importance of assuring elderly health has been receiving attention of the whole society. The great incidence of falls in this group is one of the most important causes of its morbidity and must be avoided. The timed up and go test (TUG) is an established tool for the assessment of balance and/or risk of falls in older people. The incremental shuttle walk test (ISWT) was developed to assess cardiorespiratory fitness in patients with cardiopulmonary diseases. Since ISWT requires rapid walking back and forth around a limited space, we hypothesized that performance in ISWT might be associated with the occurrence of falls and also might be correlated to balance in non-institutionalized older people. OBJECTIVE: This study aimed to evaluate and compare the associations of ISWT and TUG performances and the occurrence of falls in non-institutionalized older women. METHODS: We evaluated 19 older women (66 + 6). All participants performed two ISWT and three TUG. The ISWT consisted of walking on a flat 10 m corridor while increasing speed in increments of 0.17 m/s each minute dictated by audio signals recorded on a Compact Disc. The distance traveled on ISWT (ISWD) was measured in meters and as a percentage of predicted. The TUG was carried on a 3 m corridor using a standard chair with back and arm support. The subject was instructed to rise from a chair, walk 3 m, turn around, go back and sit in the chair again as quickly as possible. Balance was assessed using Berg Balance Scale (BBS). Of the 19 participants, 10 experienced at least two falls in the last year and were allocated in the so-called falls group (FG), and the remaining nine of participants composed the control group who did not fall (NF). RESULTS: The participants had mean BMI representative of mild obesity (31+4). The average distance walked in ISWT was normal compared to predicted values (99+33%). The time required to perform TUG was 7,29s (+1,12) . The mean BBS total score was 52 (+3) . The GQ presented worse performance (P <0.05) in TUG (7.98 + 0.95 vs. 6.52 + 0.72 s), BBS (50 + 3 vs. 54 + 1 points) and ISWT in percentages (93 + 19 vs. 114 + 20 % pred). The GQ also presented lower percentages of the maximal heart rate achieved at the end of the first ISWT (62 + 9 vs. 74 + 14 %). Significant correlations of ISWD with TUG (r = -0.667, p = 0.002) and BBS total score (r = 0.547, p = 0.015) were observed. CONCLUSION: The ISWT was significantly associated with occurrence of falls and presented consistent correlation with physical mobility and balance. Our results suggest the usefulness of ISWT as a tool for simultaneous assessment of cardiorespiratory fitness and balance in older women. Whether the exercise training that can improve ISWD could also prevent falls and improve balance in this population should be investigated in future studies.
Descrição
Citação
BARDIN, Marcela Grigol. Associação entre a ocorrência de quedas e o desempenho em testes de caminhada de campo em mulheres idosas não institucionalizadas. 2010. 30 f. Trabalho de conclusão de curso de graduação (Fisioterapia) - Instituto de Saúde e Sociedade (ISS), Universidade Federal de São Paulo (UNIFESP), Santos, 2010.