Desarrollo del equilibrio postural y prevención de caídas en personas mayores: estrategias de intervención

Resumen

El equilibrio postural es relevante para la estabilidad corporal, tanto en reposo como en movimiento, y se vuelve más vulnerable con el envejecimiento debido a la pérdida de fuerza muscular, flexibilidad y problemas de visión, aumentando el riesgo de caídas graves en las personas mayores. La prevención eficaz de caídas incluye programas de ejercicio específicos para mejorar el equilibrio, con el objetivo de promover la seguridad y la calidad de vida. Objetivo: Investigar estrategias de prevención de caídas enfocadas a mejorar el equilibrio postural en personas mayores. Metodología: Este estudio es una revisión integradora, donde se realizaron búsquedas en bases de datos como Pubmed, Embase y Lilacs, desde 2012 hasta 2024. Resultados: De 504 artículos identificados inicialmente, se analizaron 492 luego de eliminar duplicados, resultando en la selección final de 40 artículos que cumplieron con los criterios de elegibilidad. Se concluye que varios programas de entrenamiento del equilibrio postural fueron eficientes para reducir el riesgo de caídas entre los ancianos, incluidas estrategias como el entrenamiento de perturbación y el uso de juegos de realidad virtual, que han surgido como tendencias prometedoras para mejorar la estabilidad y minimizar los impactos negativos de caídas en esta población.

Palabras clave: Personas mayores, Equilibrio postural, Accidentes por caídas

Referencias

Allin, LJ, Brolinson, PG, Beach, BM, Kim, S., Nussbaum, MA, Roberto, KA, e Madigan, ML (2020). Perturbation-based balance training targeting both slip- and trip-induced falls among older adults: a randomized controlled trial. BMC Geriatrics, 20(1). https://doi.org/10.1186/s12877-020-01605-9

Ambrens, M., Alley, S., Oliveira, JS, To, Q., Delbaere, K., Vandelanotte, C., e Tiedemann, A. (2022). Effect of eHealth-delivered exercise programmes on balance in people aged 65 years and over living in the community: a systematic review and meta-analysis of randomised controlled trials. BMJ Open, 12(6), e051377. https://doi.org/10.1136/bmjopen-2021-051377

Arghavani, H., Zolaktaf, V., e Lenjannejadian, S. (2020). Comparing the effects of anticipatory postural adjustments focused training and balance training on postural preparation, balance confidence and quality of life in elderly with history of a fall. Aging Clinical and Experimental Research, 32(9), 1757-1765. https://doi.org/10.1007/s40520-019-01358-5

Bae, J., e Cho, S.-I. (2014). Effects of community-based comprehensive fall prevention program on muscle strength, postural balance and fall efficacy in elderly people. Journal of Korean academy of nursing, 44(6), 697. https://doi.org/10.4040/jkan.2014.44.6.697

Devasahayam, AJ, Farwell, K., Lim, B., Morton, A., Fleming, N., Jagroop, D., Raabeae, A., Saumuer, TM, e Mansfield, A. (2022). The effect of reactive balance training on falls in daily life: An updated systematic review and meta-analysis. Physical Therapy, 103(1). https://doi.org/10.1093/ptj/pzac154

Długosz-Boś, M., Filar-Mierzwa, K., Stawarz, R., Ścisłowska-Czarnecka, A., Jankowicz-Szymańska, A., e Bac, A. (2021). Effect of three months Pilates training on balance and fall risk in older women. International Journal of Environmental Research and Public Health, 18(7), 3663. https://doi.org/10.3390/ijerph18073663

Donath, L., Faude, O., Bridenbaugh, SA, Roth, R., Soltermann, M., Kressig, RW, e Zahner, L. (2014). Transfer effects of fall training on balance performance and spatiotemporal gait parameters in healthy community-dwelling older adults: A pilot study. Journal of aging and physical activity, 22(3), 324-333. https://doi.org/10.1123/japa.2013-0010

Gerards, M., Marcellis, R., Senden, R., Poeze, M., de Bie, R., Meijer, K., e Lenssen, A. (2023). The effect of perturbation-based balance training on balance control and fear of falling in older adults: a single-blind randomised controlled trial. BMC Geriatrics, 23(1). https://doi.org/10.1186/s12877-023-03988-x

Gimmon, Y., Riemer, R., Kurz, I., Shapiro, A., Debbi, R., e Melzer, I. (2018). Perturbation exercises during treadmill walking improve pelvic and trunk motion in older adults. A randomized control trial. Archives of Gerontology and Geriatrics, 75, 132-138. https://doi.org/10.1016/j.archger.2017.12.004

Hamed, A., Bohm, S., Mersmann, F., e Arampatzis, A. (2018). Exercises of dynamic stability under unstable conditions increase muscle strength and balance ability in the elderly. Scandinavian Journal of Medicine & Science in Sports, 28(3), 961-971. https://doi.org/10.1111/sms.13019

Hewitt, J., Goodall, S., Clemson, L., Henwood, T., e Refshauge, K. (2018). Progressive resistance and balance training for falls prevention in long-term residential aged care: A cluster randomized trial of the sunbeam program. Journal of the American Medical Directors Association, 19(4), 361-369. https://doi.org/10.1016/j.jamda.2017.12.014

Jagdhane, S., Kanekar, N., e Aruin, A.S. (2016). The effect of a four-week balance training program on anticipatory postural adjustments in older adults: A pilot feasibility study. Current Aging Science, 9(4), 295-300. https://doi.org/10.2174/1874609809666160413113443

Josephs, S., Pratt, M.L., Calk Meadows, E., Thurmond, S., e Wagner, A. (2016). The effectiveness of Pilates on balance and falls in community dwelling older adults. Journal of Bodywork and Movement Therapies, 20(4), 815-823. https://doi.org/10.1016/j.jbmt.2016.02.003

Kurz, I., Gimmon, Y., Shapiro, A., Debi, R., Snir, Y., e Melzer, I. (2016). Unexpected perturbations training improves balance control and voluntary stepping times in older adults - a double blind randomized control trial. BMC Geriatrics, 16(1). https://doi.org/10.1186/s12877-016-0223-4

Liu-Ambrose, T., Davis, JC, Best, JR, Dian, L., Madden, K., Cook, W., Hsu, CL, e Khan, KM (2019). Effect of a home-based exercise program on subsequent falls among community-dwelling high-risk older adults after a fall: A randomized clinical trial. JAMA: The Journal of the American Medical Association, 321(21), 2092. https://doi.org/10.1001/jama.2019.5795

Liu-Ambrose, T., Davis, JC, Falck, RS, Best, JR, Dao, E., Vesely, K., Ghag, C., Rosano, C., Hsu, CL, Dian, L., Cook, W., e Madden, KM, e Khan, KM (2020). Exercise, processing speed, and subsequent falls: A secondary analysis of a 12-month randomized controlled trial. The Journals of Gerontology. Series A, 76(4), 675-682. https://doi.org/10.1093/gerona/glaa239

Mesquita, L.S. de A., Carvalho, F.T. de, Freire, L.S. de A., Neto, O.P., e Zângaro, R.A. (2015). Effects of two exercise protocols on postural balance of elderly women: a randomized controlled trial. BMC Geriatrics, 15(1). https://doi.org/10.1186/s12877-015-0059-3

Montero-Alía, P., Miralles-Basseda, R., López-Jiménez, T., Muñoz-Ortiz, L., Jiménez-González, M., Prat-Rovira, J., Albarrán-Sánchez, JL, Manresa-Domínguez, JM, Andreu-Concha, CM, Rodríguez-Pérez, MC, Martí-Cervantes, JJ, Sañudo-Blanco, L., Sánchez-Pérez, CA, e Dolader-Olivé, S., e Torán-Monserrat, P. (2019). Controlled trial of balance training using a video game console in community-dwelling older adults. Age and Ageing, 48(4), 506-512. https://doi.org/10.1093/ageing/afz047

Nematollahi, A., Kamali, F., Ghanbari, A., Etminan, Z., e Sobhani, S. (2016). Improving balance in older people: A double-blind randomized clinical trial of three modes of balance training. Journal of aging and physical activity, 24(2), 189-195. https://doi.org/10.1123/japa.2014-0286

Nørgaard JE, Andersen S., Ryg, J., Stevenson, AJT, Andreasen, J., Oliveira, AS, Danielsen, MB, e Jorgensen, MG (2023). Effect of treadmill perturbation-based balance training on fall rates in community-dwelling older adults: A randomized clinical trial. JAMA Netw Open, 6(4), e238422. http://dx.doi.org/10.1001/jamanetworkopen.2023.8422

Okubo, Y., Osuka, Y., Jung, S., Rafael, F., Tsujimoto, T., Aiba, T., Kim, T., e Tanaka, K. (2015). Walking can be more effective than balance training in fall prevention among community‐dwelling older adults. Geriatrics & Gerontology International, 16(1), 118-125. https://doi.org/10.1111/ggi.12444

Okubo, Y., Sturnieks, D.L., Brodie, M.A., Duran, L., e Lord, S.R. (2019). Effect of reactive balance training involving repeated slips and trips on balance recovery among older adults: A blinded randomized controlled trial. The Journals of Gerontology. Series A, 74(9), 1489-1496. https://doi.org/10.1093/gerona/glz021

Oliveira, M.R. de, Silva, R.A. da, Dascal, J.B., e Teixeira, D.C. (2014). Effect of different types of exercise on postural balance in elderly women: A randomized controlled trial. Archives of Gerontology and Geriatrics, 59(3), 506-514. https://doi.org/10.1016/j.archger.2014.08.009

Ouzzani, M., Hammady, H., Fedorowicz, Z., e Elmagarmid, A. (2016). Rayyan—a web and mobile app for systematic reviews. Systematic Reviews, 5(1). https://doi.org/10.1186/s13643-016-0384-4

Pai, Y.-C., Bhatt, T., Yang, F., e Wang, E. (2014). Perturbation training can reduce community-dwelling older adults’ annual fall risk: A randomized controlled trial. The Journals of Gerontology. Series A, 69(12), 1586-1594. https://doi.org/10.1093/gerona/glu087

Patti, A., Zangla, D., Sahin, FN, Cataldi, S., Lavanco, G., Palma, A., e Fischietti, F. (2021). Physical exercise and prevention of falls. Effects of a Pilates training method compared with a general physical activity program: A randomized controlled trial. Medicine, 100(13), e25289. https://doi.org/10.1097/md.0000000000025289

Pereira, C.B., e Kanashiro, A.M.K. (2022). Falls in older adults: a practical approach. Arquivos de neuro-psiquiatria, 80(5 suppl 1), 313-323. https://doi.org/10.1590/0004-282x-anp-2022-s107

Phoobangkerdphol, C., Limampai, P., Dasri, S., e Kuptniratsaikul, V. (2022). Walking meditation versus balance training for improving balance abilities among older adults with history of fall: A randomized controlled trial. Clinical Rehabilitation, 36(4), 538-549. https://doi.org/10.1177/02692155211068232

Pirauá, ALT, Cavalcante, BR, Oliveira, VMA, Beltrão, NB, Batista, GA, Pitangui, ACR, Behm, D., e Araújo, RC (2019). Effect of 24‐week strength training on unstable surfaces on mobility, balance, and concern about falling in older adults. Scandinavian Journal of Medicine & Science in Sports, 29(11), 1805-1812. https://doi.org/10.1111/sms.13510

Prasertsakul, T., Kaimuk, P., Chinjenpradit, W., Limroongreungrat, W., e Charoensuk, W. (2018). The effect of virtual reality-based balance training on motor learning and postural control in healthy adults: a randomized preliminary study. Biomedical Engineering Online, 17(1). https://doi.org/10.1186/s12938-018-0550-0

Rieger, M.M., Papegaaij, S., Pijnappels, M., Steenbrink, F., e van Dieën, J.H. (2020). Transfer and retention effects of gait training with anterior-posterior perturbations to postural responses after medio-lateral gait perturbations in older adults. Clinical Biomechanics, 75, 104988. https://doi.org/10.1016/j.clinbiomech.2020.104988

Rieger, M.M., Papegaaij, S., Steenbrink, F., van Dieën, J.H., e Pijnappels, M. (2024). Effects of perturbation-based treadmill training on balance performance, daily life gait, and falls in older adults: REACT randomized controlled trial. Physical Therapy & Rehabilitation Journal, 104(1). https://doi.org/10.1093/ptj/pzad136

Roaldsen, K.S., Halvarsson, A., Sahlström, T., e Ståhle, A. (2014). Task-specific balance training improves self-assessed function in community-dwelling older adults with balance deficits and fear of falling: a randomized controlled trial. Clinical Rehabilitation, 28(12), 1189-1197. https://doi.org/10.1177/0269215514534087

Roller, M., Kachingwe, A., Beling, J., Ickes, D.-M., Cabot, A., e Shrier, G. (2017). Pilates Reformer exercises for fall risk reduction in older adults: A randomized controlled trial. Journal of Bodywork and Movement Therapies, 22(4), 983-998. https://doi.org/10.1016/j.jbmt.2017.09.004

Sato, K., Kuroki, K., Saiki, S., e Nagatomi, R. (2015). Improving walking, muscle strength, and balance in the elderly with an exergame using Kinect: A randomized controlled trial. Games for Health, 4(3), 161-167. https://doi.org/10.1089/g4h.2014.0057

Sohn, J., e Kim, S. (2015). Falls study: Proprioception, postural stability, and slips. Bio-medical materials and engineering, 26(s1), S693-S703. https://doi.org/10.3233/bme-151361

Szanton, SL, Clemson, L., Liu, M., Gitlin, LN, Hladek, MD, LaFave, SE, Roth, DL, Marx, KA, Felix, C., Okoye, SM, Zhang, X, Bautista, S., e Granbom, M. (2020). Pilot outcomes of a multicomponent fall risk program integrated into daily lives of community-dwelling older adults. Journal of Applied Gerontology: The Official Journal of the Southern Gerontological Society, 40(3), 320-327. https://doi.org/10.1177/0733464820912664

Thomas, M., e Kalicinski, M. (2016). The effects of slackline balance training on postural control in older adults. Journal of Aging and Physical Activity, 24(3), 393-398. https://doi.org/10.1123/japa.2015-0099

Thomas, E., Battaglia, G., Patti, A., Brusa, J., Leonardi, V., Palma, A., e Bellafiore, M. (2019). Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine, 98(27), e16218. https://doi.org/10.1097/md.0000000000016218

Tisher, K., Mann, K., VanDyke, S., Johansson, C., e Vallabhajosula, S. (2019). Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk. Physiotherapy Theory and Practice, 35(4), 305-317. https://doi.org/10.1080/09593985.2018.1444116

Yang, C.-M., Chen Hsieh, J. (Scott), Chen, Y.-C., Yang, S.-Y., e Lin, H.-C. K. (2020). Effects of Kinect exergames on balance training among community older adults: A randomized controlled trial. Medicine, 99(28), e21228. https://doi.org/10.1097/md.0000000000021228

Yeşilyaprak, S.S., Yıldırım, M.Ş., Tomruk, M., Ertekin, Ö., e Algun, Z.C. (2016). Comparison of the effects of virtual reality-based balance exercises and conventional exercises on balance and fall risk in older adults living in nursing homes in Turkey. Physiotherapy Theory and Practice, 32(3), 191-201. https://doi.org/10.3109/09593985.2015.1138009

Yousefi Babadi, S., e Daneshmandi, H. (2021). Effects of virtual reality versus conventional balance training on balance of the elderly. Experimental Gerontology, 153(111498), 111498. https://doi.org/10.1016/j.exger.2021.111498

Zahedian-Nasab, N., Jaberi, A., Shirazi, F., e Kavousipor, S. (2021). Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial. BMC Geriatrics, 21(1). https://doi.org/10.1186/s12877-021-02462-w

Zhao, Y., Chung, P.-K., e Tong, T. K. (2017). Effectiveness of a balance-focused exercise program for enhancing functional fitness of older adults at risk of falling: A randomised controlled trial. Geriatric Nursing, 38(6), 491-497. https://doi.org/10.1016/j.gerinurse.2017.02.011

Biografía del autor/a

Marckson da Silva Paula,

http://lattes.cnpq.br/3416874995674113

Jani Cléria Pereira Bezerra,

http://lattes.cnpq.br/3359913228033689

Neilson Duarte Gomes,

http://lattes.cnpq.br/6421092690739361

Publicado
2024-10-06
Cómo citar
Paula, M. da S., Bezerra, J. C. P., & Gomes, N. D. (2024). Desarrollo del equilibrio postural y prevención de caídas en personas mayores: estrategias de intervención. Lecturas: Educación Física Y Deportes, 29(317), 210-230. https://doi.org/10.46642/efd.v29i317.7754
Sección
Artículos de Revisión