Em idosos, a prática de exercício físico reduz o medo de cair se comparado a idosos sedentários? uma revisão de literatura

Abstract

Background: Fear of falling is a modifiable risk factor for falls in the elderly. Several studies claim that regular physical exercise reduces the incidence of falls in the elderly, but information about the influence of physical exercise in reducing the fear of falling in this population is still scarce. It is also unclear which type of exercise has the greatest benefits and what is the ideal frequency to reduce the fear of falling. Objectives: This study aimed to verify the result of interventions with physical exercise in fear of falling in the elderly. The secondary objectives were to verify which type of exercise is most suitable and which is the ideal frequency to perform the activity. Methods: A search for articles was carried out from March to July 2020 in the Medline and PEDro databases. The sample included individuals aged 60 or over, of both sexes, without excluding associated health conditions. An individual analysis of titles and abstracts was performed, excluding studies that did not have content related to the objectives of this review. Results: 10 systematic reviews, 52 randomized clinical trials and six quasi-experimental studies were found. There is an association between the regular practice of physical exercises and the reduction of fear of falling both in the elderly who live in the community and in institutionalized elderly. Multifactorial exercises, Tai Chi Chuan, Yoga, Nitendo Wii-fit, aerobic exercises and isolated muscle balance or resistance training were found to reduce the fear of falling. There was great heterogeneity in the frequency, duration, period of interventions, in the previous clinical conditions of the samples and in the measurement instruments used. Discussion: Multifactorial exercises are possibly effective in reducing the fear of falling because they involve the management of more than one risk factor for falls. Considering the same type of intervention, the duration of the session, the frequency and time of intervention apparently were not as determinant as the sample's previous health condition and the measurement instruments within a conduct focused on reducing the fear of falling. Conclusion: Regular physical exercise can apparently contribute to reducing the fear of falling in elderly people who live in the community or are institutionalized. The exercise modality most found among the studies was the multifactorial intervention, but studies of greater methodological rigor are necessary to enhance the specificity of the therapeutic approach regarding the fear of falling.