Efeito dos exercícios físicos na prevenção de quedas em idosos institucionalizados com comprometimento cognitivo: uma revisão narrativa

Abstract

Introduction: Falls in institutionalized elderly people with cognitive impairment are a collective and public health problem, which can result in fractures, injuries, functional restrictions, worsening of cognitive conditions, hospitalizations and death. Physical exercise can help maintain and improve the physical functions of institutionalized elderly people with cognitive impairment, reducing falls. Objective: To investigate and verify the effects of physical exercise in preventing falls in institutionalized elderly people with cognitive impairment and/or dementia. Methodology: This study is a narrative review that sought to identify the best physical exercise programs to prevent falls in institutionalized elderly people with cognitive impairment. Randomized controlled clinical trials that investigated the risk of falls were included through tests associated with falls, monitoring their occurrence during and/or after interventions. The inclusion criteria were participants aged 60 or over, living in long-term care institutions, and that the studies used physical exercise as the main or combined intervention, presenting results on the reduction of falls. Results: This narrative review included six studies with institutionalized elderly people with cognitive impairment, totaling 1,401 participants. Exercise programs emphasized strengthening and balance, varying in frequency (1-3 times per week) and duration (12 weeks to 12 months). Four studies observed a statistically significant reduction in the number of falls, number of elderly people who fell, multiple falls and number of falls with injuries. Conclusion: This review suggests that strengthening and balance exercises are effective in reducing falls, multiple falls and falls with injuries, in addition to improving secondary outcomes such as TUG, sitting and standing, balance tests and urinary continence, in institutionalized elderly people with cognitive decline. However, there is a need to standardize protocols to facilitate application by health professionals in this context. Future studies are needed, even with limitations, to guide additional clinical practices.