Capacidade física, aeróbica e o risco fisiológico de quedas em idosos: dados do estudo multicêntrico do perfil clínico-funcional dos idosos dos municípios de Belo horizonte, Diamantina e Alfenas

Abstract

Population aging is an event observed worldwide in developed and developing countries. Biopsychosocial changes compatible with the aging process and the presence of chronic degenerative diseases favor the loss of physical and aerobic capacity, functional independence and autonomy of the aging population, increasing the number of falls and their consequences. The cause of falls in the elderly is multifactorial, mainly environmental and physiological factors. Physiological factors are related to the aging process itself, such as reduced functional capacity, presence of comorbidities, sensory deficits, muscle weakness and postural instability. Knowing that some fall factors may be modifiable knowledge of physical and aerobic capacity changes among the elderly is important to contribute to therapeutic approaches in the area of rehabilitation, preventing future falls and their complications. The objective of this study was to verify if there is an association between physical capacity and aerobic capacity tests and the risk of falls in the elderly in the community of Belo Horizonte. This is a cross-sectional exploratory observational study of the multicenter project titled "Functional clinical profile of community elderly in the cities of Belo Horizonte, Diamantina e Alfenas". The convenience sub-sample was composed of community-dwelling elderly people from the city of Belo Horizonte, over 65 years of age. For the characterization of the sample, a questionnaire elaborated by the responsible researchers was used. The physiological risk of falls was evaluated by the short version of the Physiological Profile Assessment (PPA), considered a gold standard for this purpose, with a predictive validity of 75%. The PPA consists of five tests: visual contrast sensitivity, proprioception, knee extension muscle strength, hand reaction time and body oscillation. Physical capacity was assessed by the Short Physical Performance Battery (SPPB). The SPPB is composed of three tests that assess the balance, gait speed and strength of the lower limbs. The aerobic capacity was evaluated by the Incremental Shuttle Walk test (ISWT). The ISWT is a test that indirectly evaluates cardiorespiratory capacity. The sample number was chosen through previous studies that studied the physiological risk of falls in community-dwelling elderly people in Belo Horizonte. A descriptive analysis was used with mean, percentage and standard deviation for the characterization of the sample. The normality of the data was verified using the Shapiro Wilk test. Pearson's correlation coefficient was used to evaluate the degree of correlation between the variables with normal distribution and Spearman's test for data with non-normal distribution. Statistical analysis of the data considered a level of significance of = 5% with a 95% confidence interval. The Statistical Package for the Social Sciences-SPSS (IBM SPSS Data Collection) version 19.0 was used for data analysis. Fifty-nine community-dwelling elderly people, with a mean age of 71.8 (SD = 5.0) years, participated in the study. 41% of the elderly presented a mild physiological risk for falls. The overall mean of PPA results was 0.4 (SD = 0.4), characterized as a mild physiological risk for falls. Regarding the SPPB performance, 76% of the elderly had good performance during the test, presenting an average of 10.4 (SD = 1.7) of the points obtained. The average distance covered in the ISWT test was 281 (SD = 111.7) meters, a result below the expected average for community-dwelling elderly. Both the SPPB (r = -0.527) and the ISWT (r = -0.459) had a statistically significant correlation (p <0.001) with to predict the physiological risk of falls. The results of the study demonstrated that there is a significant correlation between PPA and the SPPB and ISWT tests. The tests used are simple to use and should be encouraged to be applied in clinical practice because they have a moderate correlation with PPA and can detect the risk of falls in the elderly in the community. The SPPB evaluates a greater number of domains involved in the event and presents a slightly better correlation with the PPA. The worst performance of the elderly in the SPPB and the ISWT would be an alert for the risk of falls in the elderly, allowing physiotherapists preventive and rehabilitation measures. The assessment of the risk of falls allows health professionals to take preventive measures to prevent the occurrence of this geriatrics and gerontology giant.