Barriers and facilitators of domain-specific physical activity: a systematic review of reviews.

BACKGROUND: Knowing what facilitates and hinders physical activity behaviour across domains (leisure, travel, work or education, and household) is central for the development of actions for more active lifestyles. Thus, the aim of this systematic review of reviews was to summarize the evidence on barriers and facilitators of domain-specific physical activity. METHODS: We included systematic reviews with or without meta-analysis that investigated the association between modifiable barriers and facilitators and levels of domain-specific physical activity. Reviews published until September 2020 were retrieved from PubMed, ISI Web of Science, Scopus, Regional Library of Medicine (BIREME), and PsycNET, and from the reference list of selected articles. Each review was screened by two independent reviewers for eligibility. Data extracted from selected papers included methodological aspects (number of primary studies, study designs, and age groups); physical activity domains and barriers and facilitators investigated; and direction of association. For each pair of barrier/facilitator and domain-specific physical activity, we recorded the number of positive, negative, and null associations reported across reviews. Quality assessment of each systematic review was performed using the AMSTAR-2 tool. RESULTS: Forty-four systematic reviews were selected. The evidence base was largest for leisure-time followed by travel-related physical activity. A very small number of reviews included physical activity in work, educational and domestic settings. Across all physical activity domains, factors related to the built environment were more abundant in the reviews than intra and interpersonal factors. Very consistent positive associations were observed between a range of intrapersonal factors and leisure-time physical activity, as well as moderately consistent evidence of positive association for general social support and support from family members. Evidence of moderate consistency was found for the positive association between transport-related physical activity and positive beliefs about consequences, walkability, and existence of facilities that support active travel. Evidence on barriers and facilitators for physical activity at work, educational, and domestic settings was limited in volume and consistency. CONCLUSIONS: Efforts and resources are required to diversify and strength the evidence base on barriers and facilitators of domain-specific physical activity, as it is still limited and biased towards the leisure domain and built environment factors. TRIAL REGISTRATION: PROSPERO CRD42020209710.

Clustering of Physical Activity and Sedentary Behavior Associated With Body Composition in Brazilian Older Adults.

This study described the clustering patterns of moderate to vigorous physical activity and sedentary time (ST) according to handgrip strength and investigated the association between identified clusters of fat and lean mass in older adults from southern Brazil. Objective measures were used for moderate to vigorous physical activity, ST, and body composition outcomes. Two-step cluster and linear regression analyses were conducted according to handgrip strength. Three clusters were identified: all-day sitters, sitters, and active sitters. The prevalence of clusters in the low-strength group was 58.2%, 22.8%, and 19.0%, respectively, while the prevalence of clusters in the high-strength group was 42.1%, 34.8%, and 23.1%, respectively. All-day sitters had 2.6% more fat mass than active sitters with low strength. High levels of ST characterized all cluster profiles; low strength, lack of moderate to vigorous physical activity, and high ST levels among older adults may indicate a subpopulation at a greater risk of overweight and obesity-related diseases.

Physical Activity Guidelines for the Brazilian Population: Recommendations Report.

BACKGROUND: This article presents the recommendations from the Physical Activity Guidelines for the Brazilian Population. METHODS: A steering committee composed of a chair, 6 experts in physical activity, and representatives from the Ministry of Health/Brazil, Pan American Health Organization, Brazilian Society of Physical Activity and Health designed the guidelines, which was implemented by 8 working groups, as follows: (1) understanding physical activity, (2) children up to 5 years old, (3) children and youth from 6 to 17 years old, (4) adults, (5) older adults (60 years and above), (6) physical education at school, (7) pregnant and postpartum women, and (8) people with disabilities. The methodological steps included evidence syntheses, hearings with key stakeholders, and public consultation. RESULTS: Across 8 chapters, the guidelines provide definitions of physical activity and sedentary behavior, informing target groups on types of physical activity, dosage (frequency, intensity, and duration), benefits, and supporting network for physical activity adoption. The guidelines are openly available in Portuguese, Spanish, English, and Braille and in audio versions, with a supplementary guide for health professionals and decision makers, and a report about the preparation and references. CONCLUSIONS: The Physical Activity Guidelines for the Brazilian Population provide evidence-based recommendations, being a public-directed resource to contribute to the physical activity promotion in Brazil.

Physical Activity Guidelines for the Brazilian Population: Development and Methods.

BACKGROUND: This article describes the process and methods used in the development of the first ever Physical Activity Guidelines for the Brazilian Population. METHODS: The steering committee established 8 working groups based on other guidelines and the Brazilian agenda for public health and physical activity (PA) promotion: (1) understanding PA; (2) children up to 5 years; (3) children and youth (6-17 y); (4) adults; (5) older adults (60 years and above); (6) physical education at school; (7) pregnant and postpartum women; and (8) people with disabilities. Working groups were formed to (1) synthesize the literature on each topic; (2) conduct workshops with stakeholders, health professionals, researchers, and the public; and (3) prepare a draft chapter for open online consultation. RESULTS: The document provides guidance for the population on the benefits of being active and recommendations regarding the amount (frequency, intensity, and duration) of PA recommended across all chapters. It also includes information on supporting networks for PA. CONCLUSIONS: The PA guidelines are widely accessible in Portuguese, including versions in English, Spanish, audiobook, and Braille, and will assist policy makers and professionals from several sectors to promote PA. The ultimate goal is to increase population levels of PA in Brazil.

[Physical activity and mental health status among elderly people]. / Atividade física e estado de saúde mental de idosos.

OBJECTIVE: To evaluate the association between physical activity level and mental health status among elderly people. METHODS: This was a population-based survey with a probabilistic sample of 875 elderly people from a city of Southern Brazil, in 2002. The International Physical Activity Questionnaire and the Brazil Old Age Schedule questionnaire were applied. The mental health problems evaluated were depressions and dementia. Total physical activity (leisure-time, occupation, transportation and housework). After descriptive and bivariate analyses, adjusted analyses were performed by means of logistic regression, with adjustment for the factors of total physical activity, leisure-time activity and depression and dementia scores. RESULTS: There were statistically significant inverse associations between dementia and depression with total physical activity and leisure-time physical activity. The odds ratio for total physical activity adjusted for dementia among sedentary subjects in comparison with active subjects was 2.74 (95% CI: 1.85; 4.08), while the respective value adjusted for depression was 2.38 (95% CI: 1.70; 3.33). CONCLUSIONS: The results reinforce the importance of active lifestyles for preventing mental health problems among elderly people. It is inferred that the physical activity was able to reduce and/or delay the risks of dementia, although it cannot be stated that dementia is avoided through physical activity.

Circumstances and consequences of falls among the older adults in Florianopolis. Epi Floripa Aging 2009.

The objective was to investigate the cir-cumstances and consequences of falling and risk factors associated with limitations in performing activities after falling. The study is part of the cross-sectional population based survey, conducted in 2009/2010, which involved 1,705 older adults (60 years and older) living in Florianopolis, SC. From the affirmative answer to the question of whether any falls occurred in the 12 months preceding the study, we investigated the circumstances and consequences of falls through a structured questionnaire. Descriptive analysis and binary logistic regression were used, with significance level of 5%. The prevalence of fall was 19% (14.3% for men and 21.5% for women). Most older adults fell while walking, 43.2% inside their homes. The main cause of falling was stumbling due to irregularities on the ground. 71% of those who fell reported injury, and 14.8% reported limitations in performing activities after the fall. There was a significant association between limitations in performing activities after the occurrence of falls and fractures. Preventing falls should be a public health concern, given that relatively easy changes can reduce the risk of falls.

Associated factors of depressive symptoms in the elderly: EpiFloripa study.

OBJECTIVE: To estimate the prevalence and associated factors of depressive symptoms in the elderly. METHODS: Cross-sectional population based epidemiological study (The EpiFloripa Elderly survey) was carried out in two stage clusters, census tracts and households, with 1.656 elderly individuals in Florianópolis, SC. The prevalence of depressive symptoms (outcome) was obtained using Geriatric Depression Scale (GDS-15) and its associations with socio-demographic, health, behavioral and social variables were assessed. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were calculated using Poisson regression. RESULTS: Depressive symptoms were observed in 23.9% of the elderly individuals (95%CI 21.84;26.01). In the fi nal model, depressive symptoms were associated with: 5 to 8 years of schooling (PR = 1.50, 95%CI 1.08;2.08); one to four years of schooling (PR = 1.62, 95%CI 1.18;2.23) and no schooling (PR = 2.11, 95%CI 1.46;3.05); being in a worse financial condition than at the age of 50 (PR = 1.33, 95%CI 1.02;1.74); cognitive impairment (PR = 1.45, 95%CI 1.21;1.75); perceiving their health to be regular (PR = 1.95, 95%CI 1.47;2.60) or poor (PR = 2.64, 95%CI 1.82;3.83); functional dependence (PR =1.83, 95%CI 1.43;2.33) and chronic pain (PR = 1.35, 95%CI 1.10;1.67). Factors with protective effects were: being in the 70 to 79 year old age group (PR = 0.77, 95%CI 0.64;0.93); physical activity in leisure time (PR = 0.75, 95%CI 0.59;0.94); participation in social or religious groups (PR = 0.80, 95%CI 0.64;0.99) and having sexual relations (PR = 0.70, 95%CI 0.53;0.94). CONCLUSIONS: Adverse clinical situations, being socioeconomically disadvantaged and low social and sexual activity were associated with depressive symptoms in the elderly.

Effectiveness and maintenance of behavior change and exercise programs on depressive symptoms in older adults / Efetividade e manutenção de programas de mudança de comportamento e de exercícios físicos sobre os sintomas depressivos de idosos

The aim of the study was to compare the effectiveness and maintenance of two health promotion programs on depressive symptoms (DS) of older adults. The research was conducted with the network of primary health care in a southern capital of Brazil. In total, 119 older adult participants were allocated into different groups: behavior change (BCG; n=40), exercise (EG; n=51) and control (CG; n=28), assessed at baseline (A1) and followed-up at three (A2), six (A3) and twelve months (A4). BCG attended "VAMOS Vida Ativa Melhorando a Saúde" (in English, Active Living Improving Health) program while EG attended aerobic gymnastic sessions. The DS were measured by the Geriatric Depression Scale (GDS-15) and level of physical activity (LPA) through accelerometers. Results show that only BCG reduced the number of older adults with high DS (A1=9; A2=4) and this reduction was maintained after six (A3=3) and twelve months (A4=4). Six older adults became physically active (BCG=3; EG=2; CG=1) after the intervention. However, there was no LPA maintenance after six and twelve months, once the frequency of insufficiently active older adults increased or was similar to baseline. When comparing DS, an interaction was found between group and assessment (F=2.94, p=0.01) for BCG, highlighting the reduction (A1=4.0; A2=2.5) and maintenance (A3=2.6; A4=2.8) of mean DS in this group. The results indicate that behavior change programs may bring benefits to the mental health of older adults and the VAMOS program seems to be a viable option for older adults in the community.

Objetivou-se comparar a efetividade e a manutenção de dois programas de promoção da saúde sobre os sintomas depressivos (SD) da população idosa. A pesquisa foi desenvolvida no âmbito da rede de atenção primária à saúde de uma capital do sul do Brasil. Participaram 119 idosos alocados nos grupos: mudança de comportamento - GMC (n=40), exercício físico - GEF (n=51) e controle - GC (n= 28), avaliados no baseline (A1), após três (A2), seis (A3) e 12 meses (A4). O GMC participou do "VAMOS ­ Vida Ativa Melhorando a Saúde" e o GEF de aulas de ginástica. Os SD foram avaliados pela Geriatric Depression Scale (GDS-15) e o nível de atividade física (NAF) por acelerômetro. Os resultados indicam que após a intervenção, somente no GMC houve redução do número de idosos com SD elevados (A1=9; A2=4) e essa redução se manteve após seis (A3=3) e doze meses (A4=4). Em relação ao NAF, após a intervenção, seis idosos tornaram-se fisicamente ativos (GMC=3; GEF=2 e GC=1). Todavia, não foi observada manutenção do NAF após seis e doze meses, uma vez que a frequência de idosos insuficientemente ativos aumentou ou foi semelhante ao baseline. Na comparação dos SD, identificou-se interação grupo versus avaliação (F=2,94, p=0,01) para o GMC, destacando redução (A1=4,0; A2=2,5) e manutenção (A3=2,6; A4=2,8) das médias dos SD nesse grupo. Os resultados sinalizam que programas de mudança de comportamento podem oportunizar benefícios à saúde mental dos idosos e que o programa VAMOS mostrou-se uma possibilidade viável de desenvolvimento no contexto comunitário para esta população.

"Convivência" groups: building active and healthy communities of older adults in Brazil.

In old age, social groups can be a crucial component for health and well-being. In 2009-2010, a follow-up survey was carried out in Florianópolis, Brazil to understand the impact of a variety of programs established since 2002 that were designed to enhance social activities among the older adult population. This study employed two surveys within the population of older adults in Florianópolis. The first survey interviewed a total of 875 older adults in 2002, and the second survey involved 1,705 older adults between 2009 and 2010. By 2010, many new programs were offered in the community and the enrollment of older adults in social programs followed similar trends. "Convivência" groups stood out as extremely popular social groups among this population. This paper discusses some of the potential outcomes associated with participation in "convivência" groups.

Orientações para utilização de acelerômetros no Brasil / Instructions for accelerometer use in Brazil

O objetivo do presente estudo foi apresentar um conjunto de orientações para a utilização de acelerômetros no Brasil. O método consistiu na revisão e síntese de artigos que utilizaram acelerômetros como instrumento de medida objetiva da atividade física. Com base nesses estudos, buscou-se apresentar orientações para as fases pré-coleta (seleção do acelerômetro; testagem da calibração dos acelerômetros, atualização de firmware; estudo piloto; e definição de protocolo), coleta (distribuição dos acelerômetros; contato com participantes; e devolução dos acelerômetros) e pós-coleta (processamento; transformação e interpretação dos dados; e comparabilidade dos dados) do uso de acelerômetros. São descritos procedimentos para facilitar as tomadas de decisões relacionadas ao uso desses dispositivos, bem como para obtenção de dados de acelerometria válidos e reprodutíveis. As orientações são uma iniciativa de pesquisadores da área a fim de proporcionar um avanço metodológico nas medidas objetivas da atividade física. A adoção das orientações pode facilitar a padronização dos procedimentos empregados e a comparabilidade de resultados entre estudos com acelerômetros no Brasil.

The aim of this study was to develop instructions for using accelerometers to measure physical activity in Brazil. This manuscript is a review and synthesis of scientific papers that have used accelerometers for objective physical activity assessment in different age groups as well as studies providing directions for using activity monitors in large-scale studies. In this study, we present instructions for the pre-data collection (selection of monitor; unit calibration, firmware update, pilot study, protocol definition), data collection (monitor distribution, contacting participants, monitor return) and post-data collection (data processing, transformation and interpretation) phases. We describe procedures for facilitating decision making related to using accelerometers, as well as for obtaining valid and reliable accelerometer physical activity data. This set of instructions is an initiative of a group of physical activity researchers with the purpose of contributing to methodologically advance the field of objective physical activity measurement in Brazil. The current set of instructions intend to facilitate the standardization of procedures for collecting physical activity data with accelerometers in Brazil and, thus, for ascertaining future comparability of data collected in different studies.

Características da atividade física nas instituições de longa permanência para idosos de Santa Catarina / Characteristics of physical activity in long - term care facilities for the elderly from the state of Santa Catarina, Brazil

O estudo objetivou descrever as atividades físicas desenvolvidas nas Instituições de Longa Permanência para Idosos (ILPI) em Santa Catarina (SC). Participaram do estudo 71 profissionais responsáveis pelas atividades físicas em suas respectivas instituições. Os principais objetivos das atividades físicas realizadas foram reabilitação (n=60) e aptidão funcional (n=52). A maior frequência das sessões foi a de duas vezes por semana (n=26). Os tipos de atividades mais realizadas são alongamentos (n=41) e exercícios resistidos (n=41). A maior adesão dos idosos se deu na recreação (n=12). Sugerem-se estudos mais aprofundados para obter maior compreensão do desenvolvimento de atividade física nessas entidades.

The present study aimed to describe the physical activities (PA) in Santa Catarina’s Long-Term Care Facilities for the elderly (LTCs). Participants were 71 professionals responsible for the PA in their respective institutions. The LTCs’ physical activities main goals were rehabilitation (n=60) and functional fi tness (n=52). The main frequency of interventions was two times a week (n=26). The most applied kinds of PA were stretching (n=41) and resisted exercises (n=41). The main adherence by the elderly was in the recreational activities (n=12). More studies are suggested aiming to a better understanding of the physical activity development in these facilities.

What is the intensity of exercise sessions of a physical exercise program for older adults? / Qual a intensidade das aulas de um programa de exercício físico para idosos?

Abstract The objectives of this study were to describe and determine the intensity of sessions of a physical exercise program (PEP) for older adults developed within the primary healthcare network of Florianópolis, and to compare the intensity of the sessions between groups using three cutoffs. Eight sessions involving 31 older adults divided into groups I and group II were analyzed. The total time spent during the sessions was considered. Intensity was measured with a triaxial accelerometer and classified according to three different cutoffs. Sociodemographic data, perceived health status, functional fitness, nutritional status and physical activity level at the beginning of the program were also evaluated. The majority of older adults was insufficiently active, was overweight, had low functional fitness, and reported that their health status did not impair physical activity. The mean time spent in moderate physical activity ranged from 1.4 and 16.3 min in group I and from 6.6 and 23.2 min in group II, with the difference being significant. The mean time spent in sedentary activities was 18.7 and 20.5 min for groups I and II, respectively. The findings suggest that the PEP sessions mainly consisted of light or sedentary activities and that the short time spent in more intense activities might be related to the characteristics of the group and to the teaching method adopted by the professionals.

Resumo O presente estudo objetivou descrever e verificar a intensidade das aulas de um programa de exercício físico (PEF) para idosos, desenvolvido na rede de atenção primária à saúde de Florianópolis - SC; e comparar os grupos quanto à intensidade das aulas, segundo três pontos de corte. Foram analisadas oito aulas, as quais envolveram 31 idosos, divididos nos grupos I e II. Utilizou-se tempo total despendido durante a aula, sendo a intensidade classificada por três diferentes pontos de corte e mensurada por acelerômetros triaxiais. Variáveis sociodemográficas; de saúde; aptidão funcional; estado nutricional e nível de atividade física (AF) ao iniciar o PEF também foram avaliados. Os resultados evidenciaram que ao iniciarem o PEF, a maioria dos idosos era pouco ativa, apresentava excesso de peso, baixa aptidão funcional e afirmou que o estado de saúde não dificultava a prática de AF. A média de tempo despendido por aula em AF moderada variou de 1,4 a 16,3 min no grupo I e de 6,6 a 23,2 min no grupo II, diferindo estatisticamente. O tempo médio geral das aulas em atividades sedentárias foi de 18,7 e 20,5 min para os grupos I e II, respectivamente. Os resultados indicam que as aulas do PEF caracterizaram-se, em sua maioria, por atividades de intensidade leve ou sedentárias e que o pouco tempo despendido em atividades mais intensas pode estar relacionado às características do grupo e à metodologia de ensino adotada pelos professores.

The work of physical education professionals in Family Health Support Centers (NASF): a national survey / Atuação do profissional de Educação Física nos Núcleos de Apoio à Saúde da Família: um levantamento nacional

Abstract This is a descriptive and quantitative national survey aimed at presenting Health Education practices (HE) developed by Physical Education professionals working at NASF in Brazil. Overall, 296 professionals participated in this study, stratified by Brazilian regions and NASF groupings. Electronic interviews were conducted regarding the activities developed at the unity where each NASF professional worked. The main activities reported were gymnastics (40.1%), and walking (29.4%), having as their priority public elderly people (68.8%), groups of hypertensive and diabetic patients (30.9%) and young people (48.3%), respectively. The most discussed topics in lectures and orientations was the importance of physical activity (51.4%) and the second most cited was the prevention/treatment of comorbities (32.3%). The community spaces most utilized by Physical Education professionals to develop activities were: public squares, community centers and schools in the southeastern and southern regions of Brazil, and religious entities in the northeastern and Midwestern regions. In conclusion, in spite of the diversity of activities developed in different regions of Brazil, there is predominance of traditional Physical Education contents, which reflect the need of permanent education of such professionals to improve the quality of services offered to the community.

Resumo Estudo de levantamento nacional descritivo e quantitativo que visa apresentar as práticas de Educação em Saúde (ES) desenvolvidas pelos Profissionais de Educação Física do NASF no Brasil. Participou uma amostra representativa de 296 profissionais, estratificada pelas regiões brasileiras e modalidades de NASF. Foi realizada uma entrevista telefônica sobre a caracterização das atividades de ES desenvolvidas no NASF nas quais o profissional atuava. As principais atividades referidas foram ginástica (40,1%) e caminhada (29,4%), tendo como público participante prioritário os idosos (68,8%), grupos de hipertensos e diabéticos (30,9%) e os jovens (48,3%), respectivamente. O primeiro tema mais abordado nas palestras e orientações em saúde foi sobre a importância da atividade física (51,4%) e o segundo mais citado foi prevenção/tratamento de comorbidades (32,3%). Os espaços comunitários mais utilizados pelo Profissional de Educação Física, além da Unidade de Saúde da Família, para realização das atividades de ES foram: praças, centros comunitários e escolas, nas regiões Sudeste e Sul, e entidades religiosas no Nordeste e Centro-Oeste. Conclui-se que, apesar da diversidade das ações promovidas nas diferentes regiões do Brasil, há uma predominância de atividades baseadas nos conteúdos tradicionais da Educação Física, refletindo a necessidade de educação permanente dos profissionais para potencializar a oferta de serviços à comunidade.

[Institutionalized elderly: functional capacity and physical fitness]. / O idoso institucionalizado: avaliação da capacidade funcional e aptidão física.

This study analyzed the relationship between physical fitness and functional capacity in 78 residents of long-stay institutions for low-income elderly located in five regions of Brazil. The majority of the sample consisted of women, and mean age was 77.4 years (SD = 7.9). Physical fitness was assessed with the AAHPERD test, adjusted for institutionalized elderly. The Katz scale was used for functional capacity. The five components of physical fitness rated fair for flexibility, coordination, agility, and aerobic endurance and good for strength. The mean general physical fitness (GPF) index was fair. According to the findings, the greater the degree of dependency in institutionalized elderly, the lesser their strength and GPF level; meanwhile, better coordination and agility are associated with greater independence for performing activities of daily living. The results can contribute to appropriate physical exercise programs for maintenance and/or recovery of functionality.

Adaptation of the AAHPERD test battery for institutionalized older adults / Bateria de testes da AAHPERD: adaptacao para idosos institucionalizados

The American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) test battery assesses the functional fitness of older adults in five motor fitness tests. The objective of this study was to adapt and test the AAHPERD in institutionalized older adults and to define normative values of functional fitness for this population. A pilot test was conducted on older adults living in nursing homes, which confirmed the need to adapt the flexibility and aerobic endurance tests. The first test was redesigned so that the elderly person did not have to sit on the floor. The second test was changed from a half-mile to a 6-minute walk. The tests were adapted and tested in a sample of 92 older adults from six long-term care homes. The successful application of the AAHPERD adapted for older adults living in nursing homes permitted the establishment of normative values for the five motor tests. The adapted version of the AAHPERD is an easily applied, low-cost tool of low risk since it was adapted to the physical and functional conditions of institutionalized older adults. This physical test battery will contribute to the evaluation of older adults and exercise prescription.

AAHPERD - American Alliance for Health, Physical Education, Recreation and Dance é uma bateria que avalia a aptidão funcional de idosos por meio de cinco testes físicos. O objetivo deste estudo foi adaptar a AAHPERD para testar em idosos institucionalizados e definir os valores normativos de aptidão funcional para esta população. Realizou-se um teste piloto em idosos institucionalizados, quando se confirmou a necessidade de adaptação dos testes de flexibilidade e de resistência aeróbia. O primeiro teste foi redesenhado para que o idoso não precisasse sentar-se no chão e no segundo, foi substituída a caminhada de meia milha pela caminhada de 6 minutos. A AAHPERD foi adaptada e submetida à testagem em uma amostra de 92 idosos residentes em seis Instituições de Longa Permanência para Idosos (ILPI). A aplicação bem sucedida da versão AAHPERD aos idosos institucionalizados permitiu a criação de valores normativos nos cinco testes físicos. Portanto, a AAHPERD adaptada é um instrumento de fácil aplicação, de baixo custo e de baixo risco na execução dos testes físicos, pois seus testes físicos foram adaptados para as condições físicas e funcionais de idosos institucionalizados. é uma bateria de testes físicos que contribuirá para a avaliação dos idosos e prescrição de exercícios.

Circunstâncias e consequências das quedas em idosos de Florianópolis. Epi Floripa Idoso 2009* / Circumstances and consequences of falls among the older adults in Florianopolis. Epi Floripa Aging 2009*

Objetivou-se investigar as circunstâncias e consequências das quedas e os fatores associados a limitações para realizar atividades após a queda. Este estudo é parte de um inquérito transversal, de base populacional e domiciliar, realizado em 2009/2010, do qual participaram 1.705 idosos (60 anos ou mais) residentes em Florianópolis, SC. Verificou-se a ocorrência de queda nos 12 meses anteriores ao estudo e, a partir da resposta afirmativa, investigaram-se as circunstâncias e consequências das quedas por meio de um questionário estruturado. Foram utilizadas a análise descritiva e a regressão logística binária, com nível de significância de 5%. Observou-se prevalência de 19% de quedas (14,3% para homens e 21,5% para as mulheres). A maioria dos idosos caiu enquanto caminhava, 43,2% dentro do domicílio. A principal circunstância da queda foi tropeço devido a irregularidades no chão. Em 71% dos idosos as quedas ocasionaram lesão e 14,8% mencionaram limitações para atividades após a queda. Verificou-se associação significante entre a limitação para realizar atividades após a queda e a ocorrência de fratura. Prevenir as quedas deve ser uma preocupação de saúde pública, visto que mudanças relativamente fáceis podem reduzir o risco de quedas.

The objective was to investigate the cir­cumstances and consequences of falling and risk factors associated with limitations in performing activities after falling. The study is part of the cross-sectional population based survey, conducted in 2009/2010, which involved 1,705 older adults (60 years and older) living in Florianopolis, SC. From the affirmative answer to the question of whether any falls occurred in the 12 months preceding the study, we investigated the circumstances and consequences of falls through a structured questionnaire. Descriptive analysis and binary logistic regression were used, with significance level of 5%. The prevalence of fall was 19% (14.3% for men and 21.5% for women). Most older adults fell while walking, 43.2% inside their homes. The main cause of falling was stumbling due to irregularities on the ground. 71% of those who fell reported injury, and 14.8% reported limitations in performing activities after the fall. There was a significant association between limitations in performing activities after the occurrence of falls and fractures. Preventing falls should be a public health concern, given that relatively easy changes can reduce the risk of falls.

Fatores associados aos sintomas depressivos em idosos: estudo Epi Floripa / Factores asociados a los sintomas depresivos en ancianos: estudio EpiFloripa / Associated factors of depressive symptoms in the elderly: Epi Floripa study

OBJETIVO Analisar a prevalência e fatores associados a sintomas depressivos em idosos. MÉTODOS Estudo epidemiológico transversal e de base domiciliar (inquérito Epi Floripa Idoso) com 1.656 idosos, realizado por conglomerados em dois estágios, setores censitários e domicílios, em Florianópolis, SC. A prevalência de sintomas depressivos (desfecho) foi obtida por meio da Geriatric Depression Scale (GDS-15), e testadas associações segundo variáveis sociodemográficas, de saúde, comportamentais e sociais. Foram calculadas razões de prevalências brutas e ajustadas com intervalo de 95% de confiança por regressão de Poisson. RESULTADOS A prevalência de sintomas depressivos foi de 23,9% (IC95% 21,84;26,01). Os fatores de risco associados no modelo final foram: escolaridade de cinco a oito anos (RP = 1,50; IC95% 1,08; 2,08), um a quatro anos (RP = 1,62; IC95% 1,18; 2,23) e nenhum ano de estudo (RP = 2,11; IC95% 1,46;3,05); situação econômica pior quando comparada com a que tinha aos 50 anos (RP = 1,33; IC95% 1,02;1,74); déficit cognitivo (RP = 1,45; IC95% 1,21;1,75); percepção de saúde regular (RP = 1,95; IC95% 1,47;2,60) e ruim (RP = 2,64; IC95% 1,82;3,83); dependência funcional (RP = 1,83; IC95% 1,43; 2,33); e dor crônica (RP = 1,35; IC95% 1,10;1,67). Grupo etário de 70 a 79 anos (RP = 0,77; IC95% 0,64;0,93); atividade física de lazer (RP = 0,75; IC95% 0,59;0,94); participação em grupos de convivência ou religiosos (RP = 0,80; IC95% 0,64;0,99); e ter relação sexual (RP = 0,70; IC95% 0,53;0,94) mostraram-se fatores protetores ao aparecimento dos sintomas depressivos. CONCLUSÕES Situação clínica adversa, desvantagem socioeconômica e pouca atividade social e sexual mostraram-se associadas aos sintomas depressivos em idosos. .

OBJETIVO Analizar la prevalencia y factores asociados a síntomas depresivos en ancianos. MÉTODOS Estudio epidemiológico transversal y de base domiciliar (pesquisa EpiFloripa Anciano ) con 1.656 ancianos, realizado por conglomerados en dos fases, sectores censitarios y domicilios, en Florianópolis, SC, Brasil. La prevalencia de síntomas depresivos (resultado) fue obtenida por medio de la Geriatric Depression Scale (GDS-15), y evaluadas asociaciones según variables sociodemográficas, de salud, comportamiento y sociales. Se calcularon tasas de prevalencia brutas y ajustadas con intervalo de 95% de confianza por regresión de Poisson. RESULTADOS La prevalencia de síntomas depresivos fue de 23,9% (IC95% 21,84;26,01). Los factores de riesgo asociados en el modelo final fueron: escolaridad de cinco a ocho años (RP = 1,50; IC95% 1,08; 2,08), uno a cuatro años (RP = 1,62; IC95% 1,18; 2,23) y ningún año de estudio (RP = 2,11; IC95% 1,46;3,05); situación económica peor al compararse con la que tenía a los 50 años (RP = 1,33; IC95% 1,02;1,74); déficit cognitivo (RP = 1,45; IC95% 1,21;1,75); percepción de salud regular (RP = 1,95; IC95% 1,47;2,60) y mala (RP = 2,64; IC95% 1,82;3,83); dependencia funcional (RP = 1,83; IC95% 1,43; 2,33) y dolor crónico (RP = 1,35; IC95% 1,10;1,67). Grupo etario de 70 a 79 años (RP = 0,77; IC95% 0,64;0,93); actividad física de placer (RP = 0,75; IC95% 0,59;0,94); participación en grupos de convivencia o religiosos (RP = 0,80; IC95% 0,64;0,99) y tener relación sexual (RP = 0,70; IC95% 0,53;0,94) se mostraron como factores protectores de la aparición de los síntomas depresivos. CONCLUSIONES Situación clínica adversa, desventaja socioeconómica y poca actividad social y sexual se mostraron asociados a los síntomas depresivos en ancianos. .

OBJECTIVE To estimate the prevalence and associated factors of depressive symptoms in the elderly. METHODS Cross-sectional population based epidemiological study (The Epi Floripa Elderly survey) was carried out in two stage clusters, census tracts and households, with1.656 elderly individuals in Florianópolis, SC. The prevalence of depressive symptoms (outcome) was obtained using Geriatric Depression Scale (GDS-15) and its associations with socio-demographic, health, behavioral and social variables were assessed. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were calculated using Poisson regression. RESULTS Depressive symptoms were observed in 23.9% of the elderly individuals (95%CI 21.84;26.01). In the final model, depressive symptoms were associated with: 5 to 8 years of schooling (PR = 1.50, 95%CI 1.08;2.08); one to four years of schooling (PR = 1.62, 95%CI 1.18;2.23) and no schooling (PR = 2.11, 95%CI 1.46;3.05); being in a worse financial condition than at the age of 50 (PR = 1.33, 95%CI 1.02;1.74); cognitive impairment (PR = 1.45, 95%CI 1.21;1.75); perceiving their health to be regular (PR = 1.95, 95%CI 1.47;2.60) or poor (PR = 2.64, 95%CI 1.82;3.83); functional dependence (PR =1.83, 95%CI 1.43;2.33) and chronic pain (PR = 1.35, 95%CI 1.10;1.67). Factors with protective effects were: being in the 70 to 79 year old age group (PR = 0.77, 95%CI 0.64;0.93); physical activity in leisure time (PR = 0.75, 95%CI 0.59;0.94); participation in social or religious groups (PR = 0.80, 95%CI 0.64;0.99) and having sexual relations (PR = 0.70, 95%CI 0.53;0.94). CONCLUSIONS : Adverse clinical situations, being socioeconomically disadvantaged and low social and sexual activity were associated with depressive symptoms in the elderly. .

Cenário de implantação do Núcleo de Apoio a Saúde da Família e a inserção do profissional de educação física / Deployment scenario the Support Nucleus Familys?s Healthy and the insertion of professional physical education

Objetivou-se caracterizar a implantação do Núcleo de Apoio á Saúde da Família (NASF) e analisar a inserção do Profissional de Educação Física, no Brasil. Trata-se de um estudo descritivo com dados secundários do Departamento de Informática do Sistema Único de Saúde e do cadastro das equipes de NASF, disponibilizado pelo Departamento da Atenção Básica. As variáveis selecionadas foram população do Brasil em 2010, população coberta pela saúde da família (SF), número de profissionais, equipes de SF e NASF. Foram adaptados indicadores de Teto de Implantação e Potencial de Expansão (PE) para verificar a implantação do NASF. A inserção do profissional de Educação Física, foi analisada pela proporção de profissionais de Educação Física em relação ao NASF e o número de Profissionais de Educação Física por população coberta pela SF, multiplicado pela constante 100.000. O teste Anova one way, com Post-Hoc de Tukey foi aplicado, pelo programa SPSS, versão 15.0, adotando significância de 5%. Os resultados apontam baixa adesão e elevado PE do NASF nos municípios, a maioria destes implantaram uma equipe de NASF. As cinco categorias mais recrutadas foram Fisioterapia, Psicologia, Nutrição, Serviço Social e Educação Física. Houve diferença na média de profissionais, sobretudo nas regiões Norte e Sudeste. A Educação Física está inserida em 49,2% das equipes de NASF, contudo o coeficiente de profissional por população coberta pela SF foi aproximadamente 1 para 100.000 pessoas. Nota-se a necessidade de investimento político e acadêmico para definição de estratégias coletivas que contribuam para a consolidação do NASF e integração do profissional de Educação Física na rede de assistência pública em saúde.

The purpose was to characterize the implementation of the Support Nucleus Familys?s Healthy (NASF) and analyze the insertion of Physical Education Professional in Brazil. This is a descriptive study based on secondary data from the Departament of Health System and NASF teams registration, provided by the Department of Primary Care. The variables selected were: population from Brazil in 2010, the population covered by the Family Health Program (FH), number of professional teams of FH and NASF. Indicators were adapted of maximum implantation and expansion potential (EP) to verify the implantation of NASF. Inclusion of Physical Education Professional in NASF was assessed by the proportion of Physical Education Professional in relation to NASF and to the number of Physical Education Professional per population covered by the FH. Was applied the ANOVA one way whit Tukey post-hoc test, using SPSS, version 15.0, adopting a 5% significance. Results showed low adherence and high EP in the counties of NASF, most of these have deployed one NASF team. The five professions more recruited were: Physiotherary, Psychology, Nutrition, Social Service and Physical Education. Differences were observed in average number of professional, especially in North and South regions. Physical Education is inserted in 49.2% of NASF teams, however the coefficient of population covered by professional for FH was approximately 1 per 100.000 people. It can be pointed the need for investiment to political and academic definition of collective strategies to help to strengthen NASF.

Aptidão física, exercícios físicos e doenças osteoarticulares em idosos / Physical fitness, physical exercise and osteoarticular diseases in older adults

O exercício físico regular auxilia na melhora da aptidão física e saúde do idoso, existindo dúvidas se ele compensa os efeitos prejudiciais das doenças osteoarticulares em participantes de programas de promoção de saúde. Objetivou-se avaliar a aptidão física de idosos participantes de programas de atenção à saúde considerando a prática de exercício físico regular e a presença de doenças osteoarticulares. Este estudo transversal constituiu-se de 891 idosos participantes em programas de exercício físico e de atividades educacionais/culturais que foram divididos em quatro grupos, conforme a prática de exercício físico e a presença de doenças osteoarticulares. Os dados foram coletados a partir da aplicação da ficha diagnóstica (características sociodemográficas e presença de doenças osteoarticulares), da avaliação das medidas antropométricas (massa corporal e estatura) e da aptidão física (bateria de testes para idosos - American Alliance for Health, Physical Education, Recreation and Dance). As análises estatísticas foram por meio dos testes Kruskall Wallis, Mann Whitney e Qui-Quadrado, p<0,05. Os idosos com doenças osteoarticulares praticantes de exercício físico tiveram melhor aptidão física do que os com a doença e não praticantes e os sem doenças osteoarticulares praticantes de exercício físico tiveram melhor aptidão física do que os sem doença e não praticantes. A coordenação, agilidade/equilíbrio dinâmico e resistência de força apresentaram diferenças signifi cantes entre os grupos, onde o grupo praticante de exercício físico apresentou melhores escores. Conclui-se que a prática de exercício físico pode atenuar os déficits funcionais resultantes das doenças osteoarticulares em idosos que participam de programas de promoção de saúde.

Physical exercise improves physical fitness and older adults? health conditions, there is doubts whether this can compensate the harmful effects of that participate in health promotion programs with osteoarticular diseases. The objective was to evaluate the physical fitness of older adults participating in community groups considering the practice of regular exercise and the presence of osteoarticular diseases. It is a cross-sectional study in which 891 elderly participants in exercise programs and educational/cultural activities of public institutions were recruited. They were divided into four groups according to physical exercise and the presence of osteoarticular diseases. A research tool identified sociodemographic characteristics, and presence of osteoarticular diseases (osteoarthritis, rheumatoid arthritis and osteoporosis). Anthropometric measurements (weight, height, waist and hip) and physical fitness (test battery - American Alliance for Health, Physical Education, Recreation and Dance) were applied. Kruskal Wallis, Mann Whitney and chi-square tests were used, p <0.05. Older adults who presented osteoarticular diseases and practiced exercise had better physical fitness than those with similar diseases but not exercise practitioners and the older adults without osteoarticular diseases and practiced exercise had better physical fitness than those without diseases but not exercise practitioners. The coordination, agility/dynamic balance and strength resistance showed significant differences among the groups, where the group who practiced physical exercise had better scores. This study indicates that physical exercise can reduce the functional deficits resulting from osteoarticular diseases of elderly that participate in health promotion programs.

Grupos de pesquisa sobre atividade física e envelhecimento no Brasil / Groups of research on physical activity and aging in Brazil

Objetivou-se identificar e caracterizar os grupos de pesquisa (GP) em atividade física e envelhecimento, bem como caracterizar a produção científica desses grupos. Foi utilizada a base de dados (corrente) do Diretório de Grupos de Pesquisa no Brasil do CNPq. Para a seleção dos GP, o critério adotado foi a identificação de, pelo menos, uma linha de pesquisa que contemplasse a relação atividade física e envelhecimento. Foram classificados como específicos, os GP que apresentavam mais de 50% de linhas de pesquisa vinculadas a temática investigada. A produção científica dos líderes (2006 até julho de 2011) foi avaliada de acordo com a Plataforma Lattes do CNPq. Os dados foram analisados descritivamente. Foram identificados 40 GP (19 específicos), 148 linhas de pesquisa e 808 investigadores (309 professores, 482 estudantes e 17 técnicos). A maioria dos GP foi formada entre os anos de 2004 e 2010; tinham até três linhas de pesquisa; localizavam-se nas regiões Sudeste e Sul do país e em instituições públicas (Federais ou Estaduais); a Educação Física foi a área de conhecimento predominante. Quanto à produção científica, dois GP destacaram em relação à produção de artigos. A produção mostrou-se concentrada em periódicos com estratos Qualis B2 e B1, sendo que os líderes dos GP eram coautores da maioria dos artigos. Os resultados encontrados evidenciam o baixo número de GP em algumas regiões do país e que além da produção científica estar concentrada em poucos GP, o conhecimento produzido tem sido veiculado, em sua maioria, em periódicos com baixo fator de impacto.

The objective was to identify and to characterize the research groups (RG) in physical activity and aging, as well as to characterize their scientific production. The CNPq Research Group Directory database (current) was used to locate the groups. The RG which had at least one research line related to physical activity and aging were selected, and those ones with more than 50% of research line related to the theme under investigation were classified as specific. The leader?s scientific production (2006 to July 2011) was analyzed according to CNPq Lattes Platform. The data were analyzed descriptively. Forty RG (19 specific), 148 research line and 808 researchers (309 professors, 482 students and 17 technicians) were identified. Most RG were formed between 2004 and 2010; had three research lines; located in the south and southeast regions of the country and in public institutions (federal or state); the Physical Education was the most common area of knowledge. Regarding to scientific production, two RG had highlighted in relation to articles production. The most part of the articles were published in journals classified with B1 and B2 Qualis strata, and the RG leaders were present as co-authors in most of them. The results showed a low number of RG in some regions of the country. Furthermore, the scientific production was concentrated in few RG, and knowledge produced has been published, mainly, in journals with low impact factor.