Efeitos do fortalecimento muscular na melhora da marcha e funcionalidade de idosos hemiplégicos: uma revisão de literatura

Abstract

The Stroke is a pathological condition with high prevalence in the elderly, causing significant motor deficits, stressing the muscle weakness which leads to impairment of gait and function. The aim of this study was to assess the methodological quality and effectiveness of muscle strengthening to improve gait and function of chronic hemiplegic elderly patients. A review of studies on muscle strengthening in the databases of Medline, SciELO, PubMed, Portal.periodicos.Capes, Pedro, Lilacs, Library of Montreal, and manual search was performed. Studies with individuals aged greater than or equal to 60 years old, chronic stroke survivors, submitted to strength training alone or with co-intervention aiming to improve gait and function, with methodological quality of at least grade 4 according to the scale Pedro were included. Of the 40 publications found, nine met the inclusion criteria and were published between 2000 and 2010. Some authors have justified the improvement in gait through muscle strengthening, based on neurological changes, motor unit recruitment and increased muscle strength. Other studies related the gait improvement to the training of elements such as motor coordination and balance. Muscle strengthening proved to be an effective approach to improve gait and function of hemiplegic elderly, although it has not found enough physiological support to justify such gains. Considering these limitations and heterogeneity of the methodologies in the articles analyzed, further studies are needed to establish more evidence of the strengthening effect on the improvement in gait and function.