Intervenção fonoaudiológica na prevenção de quedas no envelhecimento / Speech therapy´s intervention for falling prevention in aging

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.

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.

Quality of Life and Gait in Elderly Group

Abstract Introduction The process of aging could lead to seniors being more prone to falls, which affects their quality of life. Objective The objective of this study is to investigate the relationship between quality of life and gait in the elderly. Methods We used World Health Organization Quality of Life-Brief (WHOQOL-Brief) Brazilian version and the Dynamic Gait Index to assess fifty-six volunteers from the northeast of Brazil. Ages ranged from 60 to 85 years. Results The Dynamic Gait Index, which indicates the probability of falls, resulted in 36.3% of the sample presenting abnormal results. There was correlation between domain 2 (psychological) and domain 4 (environment) with domain 1(Physical) and domain 3 (Social); a negative correlation between age and Domain 2; correlation between Question 1 (How would you rate your quality of life?) and domains 1, 2, and 4 and no correlation between questions 1 and 2 (How satisfied are you with your health?). Question 2 was correlated with all of the domains. There was negative association between question 1 and falls, and a slight correlation between the Dynamic Gait Index scores and Question 1. Conclusion The self-perception of the study group about their quality of life was either good or very good, even though a considerable percentage of individuals had suffered falls or reported gait disturbances.

Eficácia de programa de prevenção de quedas em idosos / Efficacy in Falls Prevention Programs for the Elderly / Efectividad del programa de prevención de caídas en ancianos

Introdução:O envelhecimento dos sistemas envolvidos no equilíbrio corporal pode causar eventos de quedas e piorar a qualidade de vida de idosos. Objetivo: verificar a eficácia de um programa de prevenção a quedas em idosos socialmente ativos. Método: 60 idosos foram submetidos à Avaliação da Mobilidade Orientada pelo Desempenho (Performance Oriented Mobility Assessment ­ POMA) e à Escala de eficácia de quedas ­ Internacional ­ Brasil (Falls Efficacy Scale International ­ FES I-Brasil)l que avaliam, respectivamente, a tendência e o medo de quedas. Aqueles com escores alterados participaram de um programa de intervenção durante oito semanas consecutivas e foram reavaliados. Resultados: Na avaliação do equilíbrio orientado, 70,0% dos idosos apresentaram risco moderado, 5,0 % risco alto e 25,0% risco baixo para queda, ocorrendo associação siginificante e inversamente proporcional com a idade. No término do programa, verificou-se associação entre os resultados iniciais e finais nos testes, visto que ocorreu a redução total do risco alto e elevação do risco baixo para 68,0%. Verificou-se a diminuição com a preocupação com quedas frente à associação significante entre o medo de quedas inicial e a reavaliação. Conclusão: A proposta se mostrou eficaz uma vez que diminuiu o risco de quedas melhorando, consequentemente, o equilíbrio corporal dos voluntários da pesquisa. Promoveu, ainda, a redução com a preocupação de futuras quedas, principalmente nos idosos mais longevos.

Introduction: The aging of systems involved in body balance can cause fall episodes and worsen life quality in the elderly. Objective: To verify the efficacy of a fall prevention program in socially active elderly. Method: 60 elderly were submitted to a Performance Oriented Mobility Assessment and to the Falls Efficacy Scale International FES I-Brasil that evaluate, respectively, the tendency and the fear of falling. Those with altered scores participated in an intervention program during eight consecutive weeks and were reevaluated. Results: In the oriented balance evaluation, 70.0% of the elderly presented moderate risk, 5.0% high risk and 25.0% for low fall risk, resulting in a significant relationship to age. At the end of the program it was confirmed the relationship between initial outcomes and final tests, noticing there was a total reduction of high risk and an increase of low risk to 68.0%. The reduction of falling fear was confirmed in view of the significant relationship between the initial fall fears and the reevaluation. Conclusion: The proposal was effective once the falling fears diminished, improving, consequently, body balance with those who volunteered in the research. It even promoted the reduction of future falling concerns, especially with older seniors.

Introducción: El envejecimiento de los sistemas involucrados en el equilibrio del cuerpo, puede provocar episodios de caídas y empeorar la calidad de vida en los ancianos. Objetivo: Verificar la eficacia de un programa de prevención de caídas en ancianos socialmente activos. Métodos: 60 ancianos fueron sometidos a la Evaluación del Desempeño de la Mobilidad y la Eficacia de Caidas en la Escala Internacional. (Performance Oriented Mobility Assessment e Falls Efficacy Scale International), para evaluar, respectivamente, la tendencia y el miedo a caerse. Aquellas personas con puntuación alterada participaron en un programa de intervención durante ocho semanas consecutivas y fueron reevaluados. Resultados: En la evaluación del equilibrio orientado, el 70,0% de los sujetos presentaron riesgo moderado de caerse, 5,0% alto y de un bajo riesgo de 25,0%. En los extremos del programa, hubo una relación entre los resultados de las pruebas iniciales y finales, así como la reducción total de alto riesgo y un bajo riesgo que alcanzó 68,0%. Se confirmó una disminución del miedo de caerse frente a la relación significativa entre el miedo inicial y la revaluación. Conclusión: La propuesta mostró ser eficaz una vez que disminuyó el riesgo de caídas, mejorando, consecuentemente, el equilibrio corporal de los voluntarios en la investigación.También promovió la reducción con la preocupación de futuras caída, sobre todo en los más ancianos.

Equilíbrio funcional e orientado em idosos institucionalizados / Functional and oriented balance in institutionalized elderly

Introdução: Desequilíbrio afeta a qualidade de vida de idosos. Objetivo: verificar a ocorrência para quedas em idosos asilares de Sergipe. Método: Utilizou-se o Teste de Equilíbrio Orientado pelo Desempenho e Escala de Equilíbrio de Berg. Resultados: 56,1% da amostra apresentou risco de quedas na Escala de Equilíbrio de Berg com associação significante com idade e tendência para o gênero feminino. No Teste do Equilíbrio Orientado pelo Desempenho, 27,5% estiveram alterados. Constatou-se a associação entre risco de quedas nos dois testes. Conclusão: Ocorreu associação significante para risco de queda em idosos institucionalizados, principalmente nos de gênero feminino e nos mais velhos.

Introduction: Balance disorder affects the quality of life in elderly. Purpose: to verify the occurence of falls in institutionalized elderly of Sergipe. Method: It was used the Performance Oriented Mobility Assessment of Gait and Balance and Berg Balance Scale. Results: 56.1% of the sample presented risk of falls in the Berg Balance Scale with significant association with age and tendency for females. 27.5% presented abnormal results in Performance Oriented Mobility Assessment of Gait. It was found the association between risks of falls in both tests. Conclusion: there was significant association for risk of falls in institutionalized elderly, mainly in the female and older.