Efeito de um programa com exercícios supervisionados e não supervisionados em fatores de risco de queda em idosos residentes na comunidade: ensaio clínico randomizado controlado

Abstract

Introduction: The high incidence of falls in the elderly, associated with high morbidity and increased economic costs for treatment of injuries, make it a public health problem that requires a strong need for preventive strategies with public policies for health care. Despite the consistency regarding the effectiveness of exercise in reducing the risk of falls, it is necessary to study how this strategy can be inserted into the logic of basic care by the Family Health Strategy, achieving greater capillarity in the care network. Objective: The objective of this research is to evaluate the effects of a program with supervised and unsupervised exercise on risk factors of falls in elderly community residents. Material and Methods: This is a randomized controlled trial, conducted with a sample of 35 individuals of both sexes randomly assigned to three experimental conditions: supervised group (n = 13), unsupervised group (n = 12) and control group (n = 10). They were submitted to a pre-intervention assessment that included collection of demographic data, clinical and Berg Balance Scale and the following outcome measures for analysis: One Leg Stance; Timed Up and Go Test; Efficacy Scale International Falls- Brazil and gait speed. The intervention consisted of an exercise program with 50 minutes in length, held two times a week for a period of 8 weeks. Data analysis was performed using the statistical program Statistical Package for Social Sciences (SPSS) 17.0, adopting the significance level of 5%. Results: The results showed that the sample consisted mostly of elderly women with a mean age of 71.54 years (± 5.51). No fall in the previous year of the survey was reported by 25.7% of the volunteers, while 34.3% reported having fallen once and 40% had recurrent falls. In comparison within groups after the intervention there was an improvement in functional balance measured by the Berg Balance Scale in supervised (p = 0.00) and unsupervised groups (p = 0.01), but not in the control group. The analysis of static equilibrium by the application of One Leg Stance showed significant improvement in the supervised group (p = 0.03). There was no significant difference between groups for any of the variables studied (p> 0.05). Conclusion: In active elderly population, independent, living in community, a program with supervised or unsupervised exercise may be effective in reducing risk factors related to the fall.