Efeito de 37 semanas de exercício físico no controle postural e na funcionalidade de idosos ativos: comparação entre um programa para estabilidade e orientação postural e um programa não convencional de musculação
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Data
2018-01-25
Autores
Jiménez, Alejandra María Franco
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Universidade Estadual Paulista (Unesp)
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Introdução: No envelhecimento, o sistema neuromuscular e somatossensorial são comprometidos, afetando o controle postural. Destacam-se alterações na orientação dos segmentos corporais, redução da força e da flexibilidade e diminuição no equilíbrio. Tais mudanças podem ser acentuadas ou prematuras decorrentes ao descondicionamento físico, as quais podem ser revertidas, retardadas ou atenuadas com a prática do exercício físico. Embora diversos tipos de intervenção tenham sido explorados e apresentem diversos benefícios para o controle postural, os efeitos de um programa que integre conteúdos da orientação e estabilidade postural e um programa não convencional de musculação não estão muito claros. Objetivo: Determinar os efeitos de um programa de exercício físico para o controle postural (PCP) e de um programa de não convencional (PCM) nas variáveis: Estabilidade postural em condições combinadas de base de suporte e de informação visual, orientação postural e funcionalidade. Materiais e Método: Participaram do estudo 56 idosos distribuídos em 2 grupos, de acordo com a modalidade de exercício praticada, sendo que 33 conformaram o grupo PCP e 23 o grupo PCM. O desenho experimental incluiu avaliações em três momentos (pré-intervenção, pós1 e pós2). A estabilidade postural foi avaliada em base bipodal estável (BE) e instável (BI - uso da espuma), nas condições de olhos abertos e vendados, por meio de uma plataforma de força. A orientação postural no plano sagital por meio do Sistema de Avaliação Postural (SAPO). A funcionalidade através dos testes: Postural-locomotion-manual-PLM e Timed Up and Go-TUG. O nível de atividade física por meio do Questionário de Baecke Modificado para Idosos. As variáveis analisadas foram: área, velocidade média total (VMT) e Room Mean Square (RMS) do centro de pressão (CoP), ângulo quadril, orientação horizontal da pelve, e desempenho nos testes funcionais. O grupo PCP desenvolveu 7 componentes de treinamento: sistema sensorial, ginástica postural, resistência muscular, força rápida, flexibilidade, e, estabilidade e orientação postural aplicadas a AVDs e o grupo PCM 4: resistência muscular, agilidade, coordenação e equilíbrio. Ambos os programas tiveram duração de 37 semanas, frequência de 3 sessões semanais e 60 minutos de duração cada sessão. Resultados: Para a estabilidade em base instável e a funcionalidade, ambas intervenções tiveram maior efeito nas 16 semanas iniciais e uma redução nas seguintes 17 semanas. No entanto, essa redução não ultrapassou os valores da pré-intervenção. Especificamente foi observada diminuição da área, VMT e RMS do CoP em BI com supressão visual e diminuição no tempo do PLM e do TUG. Conclusão: As intervenções propostas após 37 semanas promoveram melhoras na estabilidade e funcionalidade. Tais melhoras podem estar relacionadas ao melhor processamento de informação proprioceptiva e vestibular, adaptações no sistema neuromuscular e mudanças nas estratégias motoras. Desta forma, as intervenções propostas parecem ser alternativas eficazes para a população idosa.
Introduction: In aging, the neuromuscular and somatosensory systems are compromised, affecting postural control (PC). Changes in the orientation of body segments, reduction of strength and flexibility, and a decrease in balance are highlighted. Such changes may be marked or premature due to physical deconditioning, which can be reversed, delayed or attenuated with the practice of physical exercise. Although several types of intervention have been explored and have several benefits for CP, the effects of a program that includes a content of orientation and postural stability and an unconventional resistance training program are not very clear. Objetive: To determine the effects of a physical exercise program for postural control (PPC) and a resistance training program (RTP) on the following variables: Postural stability in combined support base conditions and visual information, postural orientation, and functionality. Materials and methods: Fifty-six elderly people were distributed in 2 groups according to the exercise modality participated in the study, of which 33 were the PPC group and 23 were the RTP group. The experimental design included evaluations at three moments (preintervention, post 1, and post 2). Postural stability was evaluated on a stable bipodal base (SB) and unstable (UB –foam floor), under the open-eyed conditions, through of a force platform. The postural orientation in the sagittal plane through the Postural Evaluation System (PES). The functionality through the tests: Posturallocomotion- manual (PLM) and Timed Up and Go (TUG). The level of physical activity through the Modified Baecke Questionnaire for the Elderly. The variables analyzed were: area, total mean velocity (TMV) and Room Mean Square (RMS) of the pressure center (CoP), hip angle, horizontal pelvic orientation, and performance in functional tests. The PPC group developed 7 training components: sensory system, postural gymnastics, muscular resistance, rapid force, flexibility, stability and postural orientation applied to daily living activities and the RTP group 4: muscular resistance, agility, coordination and balance. Both programs had duration of 37 weeks, frequency of 3 weekly sessions and 60 minutes duration each session. Results: For stability on unstable basis and functionality, both interventions had a greater effect in the initial 16 weeks and a reduction in the following 17 weeks. However, this reduction did not exceed the pre-intervention values. Specifically, decreased area, TMV and RMS of CoP in UB with visual suppression and decrease in PLM and TUG time were observed. Conclusion: The proposed interventions promoted improvements in stability and functionality. Such improvements may be associated with better processing of proprioceptive and vestibular information, adaptations in the neuromuscular system and changes in motor strategies. In this way, the proposed interventions seem to be effective alternatives for the elderly population.
Introduction: In aging, the neuromuscular and somatosensory systems are compromised, affecting postural control (PC). Changes in the orientation of body segments, reduction of strength and flexibility, and a decrease in balance are highlighted. Such changes may be marked or premature due to physical deconditioning, which can be reversed, delayed or attenuated with the practice of physical exercise. Although several types of intervention have been explored and have several benefits for CP, the effects of a program that includes a content of orientation and postural stability and an unconventional resistance training program are not very clear. Objetive: To determine the effects of a physical exercise program for postural control (PPC) and a resistance training program (RTP) on the following variables: Postural stability in combined support base conditions and visual information, postural orientation, and functionality. Materials and methods: Fifty-six elderly people were distributed in 2 groups according to the exercise modality participated in the study, of which 33 were the PPC group and 23 were the RTP group. The experimental design included evaluations at three moments (preintervention, post 1, and post 2). Postural stability was evaluated on a stable bipodal base (SB) and unstable (UB –foam floor), under the open-eyed conditions, through of a force platform. The postural orientation in the sagittal plane through the Postural Evaluation System (PES). The functionality through the tests: Posturallocomotion- manual (PLM) and Timed Up and Go (TUG). The level of physical activity through the Modified Baecke Questionnaire for the Elderly. The variables analyzed were: area, total mean velocity (TMV) and Room Mean Square (RMS) of the pressure center (CoP), hip angle, horizontal pelvic orientation, and performance in functional tests. The PPC group developed 7 training components: sensory system, postural gymnastics, muscular resistance, rapid force, flexibility, stability and postural orientation applied to daily living activities and the RTP group 4: muscular resistance, agility, coordination and balance. Both programs had duration of 37 weeks, frequency of 3 weekly sessions and 60 minutes duration each session. Results: For stability on unstable basis and functionality, both interventions had a greater effect in the initial 16 weeks and a reduction in the following 17 weeks. However, this reduction did not exceed the pre-intervention values. Specifically, decreased area, TMV and RMS of CoP in UB with visual suppression and decrease in PLM and TUG time were observed. Conclusion: The proposed interventions promoted improvements in stability and functionality. Such improvements may be associated with better processing of proprioceptive and vestibular information, adaptations in the neuromuscular system and changes in motor strategies. In this way, the proposed interventions seem to be effective alternatives for the elderly population.
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Atividade física, Equilíbrio, Alinhamento postural, Envelhecimento, Physical activity, Balance, Postural alignment, Aging