Treinamento com realidade virtual não imersiva é efetivo na melhora da funcionalidade de idosos institucionalizados e uma opção de atividade física segura nos momentos de restrição: um estudo piloto / Non-immersive Virtual Reality training is effective in improving the functionality of institutionalized elderly and an option for safe physical activity in times of restriction: a pilot study

O envelhecimento é um processo dinâmico e progressivo que proporciona a diminuição gradual da capacidade funcional, aumentando a dependência dos idosos e culminando, muitas vezes, na sua institucionalização. Neste contexto, a Realidade Virtual Não Imersiva (RVNI) vem se mostrando uma ferramenta segura e efetiva para estimular a funcionalidade em idosos, inclusive diante da situação de distanciamento social que vivemos atualmente. Objetivo: Avaliar, preliminarmente, o efeito do treinamento com jogos de RVNI sobre a funcionalidade de idosos institucionalizados. Método: Estudo intervencional randomizado, com amostra composta por 17 idosos de quaisquer gêneros (idade 87 anos ±5,4 anos), residentes em uma instituição de Porto Alegre, divididos em dois grupos: Grupo Treinamento (GT) e Grupo Controle (GC). Foram avaliadas a escala de independência funcional (MIF) e a circunferência da panturrilha e do braço, bem como foram realizados o teste de Força de Preensão Palmar (FPP) e o Timed Get Up and Go (TUG). O protocolo de intervenção teve duração de 8 semanas, com duas sessões semanais de 30 minutos. Resultados: Os grupos demostraram ser homogêneos em relação ao gênero e idade. O GT apresentou melhora significante em 4 das 5 variáveis analisadas, já o GC apenas no teste de FPP. O GT no FPP apresentou uma diferença estatisticamente significativa de 21,1 ± 12,60 kg para 23,8 ± 13,51 kg (p<0,003). Conclusão: O presente estudo sugere que o treinamento com RVNI é efetivo na melhora da funcionalidade de idosos institucionalizados e pode ser uma opção de intervenção física segura, especialmente em momentos de restrição.

Aging is a dynamic and progressive process leading to reduction in functional capacity, dependence, and institutionalization in many cases. In this context, Non-Immersive Virtual Reality (RVNI) has been proposed as a safe and effective tool to stimulate functionality in the older adults, even in situations of social distance, similarly we are currently experiencing. Objective: To evaluate, preliminally, the effect of RVNI training on functional outcomes of institutionalized older adults. Method: Randomized interventional study, with a sample composed of 17 participants of any gender (age 87 ± 5.4 years), living in a home-institution for the aged in Porto Alegre, divided into two groups: Training Group (TG) and Control Group (CG). The functional independence scale (FIM) and the circumference of the calf and arm were evaluated, as well as the Palmar Grip Strength test (FPP) and the Timed Get Up and Go (TUG). The intervention protocol lasted 8 weeks, with two weekly sessions of 30 minutes. Results: Both groups were homogeneous in relation to gender and age. The TG showed a significant improvement in 4 of the 5 variables analyzed, whereas the CG only in the FPP test. The FPP showed a statistically significant difference from 21.1 ± 12.60 kg to 23.8 ± 13.51 kg (p <0.003) in the TG. Conclusion: The present study suggests RVNI training may be effective in improving functional outcomes in institutionalized older adults and should be considered as a safe physical intervention, especially in times of restriction.

Alternative Physical Therapy Protocol Using a Cycle Ergometer During Hospital Rehabilitation of Coronary Artery Bypass Grafting: a Clinical Trial

ABSTRACT OBJECTIVE: To compare the efficacy of a cycle ergometer-based exercise program to a standard protocol on the increment of the maximum distance walked during the six-minute walk test in the postoperative rehabilitation of patients submitted to coronary artery bypass grafting. METHODS: A controlled clinical trial pilot, blinded to the outcome, enrolled subjects who underwent coronary artery bypass grafting in a hospital from Southern Brazil. Subjects were designated for the standard physical rehabilitation protocol or to an alternative cycle ergometer-based protocol through simple random sampling. The primary outcome was the difference in the maximum distance walked in the six-minute walk test before and after the allocated intervention. RESULTS: Twenty-four patients were included in the analysis, 10 in the standard protocol and 14 in the alternative protocol group. There was an increment in the maximum distance walked in both groups, and borderline superiority in the intervention group comparing to the control group (312.2vs. 249.7; P=0.06). CONCLUSION: There was an increase in the maximum distance walked in the alternative protocol compared to the standard protocol. Thus, it is postulated that the use of a cycle ergometer can be included in physical rehabilitation in the hospital phase of postoperative coronary artery bypass grafting. However, randomized studies with larger sample size should be conducted to assess the significance of these findings.

[Clinical characteristics and social determinants in a sample of non-homebound elderly]. / Características clínicas e sociais determinantes para o idoso sair de casa.

This study aimed to assess social and clinical factors associated with the fact that older adults (≥ 60 years) go out of their homes. The study interviewed 5,898 older adults identified through home visits, randomly selected in 59 cities in the State of Rio Grande do Sul, Brazil. Multivariate logistic regression was used to assess the association between the outcome and independent variables. Factors associated with going out were being men, younger and married, presence of arthrosis, ease in performing specific activities, and good self-rated health. Heart disease was a negative factor for going out. Given the importance of social activity for quality of life and the World Health Organization policy for active aging, it is extremely important to consider clinical conditions that allow the older adults to remain active in the community. Studies like this can help to adjust public policies for the elderly, especially acting on modifiable clinical and functional conditions.

Características clínicas e sociais determinantes para o idoso sair de casa / Clinical characteristics and social determinants in a sample of non-homebound elderly / Características clínicas y sociales determinantes para que el anciano salga de casa

O estudo objetivou avaliar fatores sociais e de saúde envolvidos no fato de o idoso (60 anos ou mais) sair de casa. Foram entrevistados 5.898 idosos identificados por visita domiciliar, aleatoriamente selecionados em 59 cidades do Rio Grande de Sul, Brasil. A associação entre o desfecho e as variáveis independentes foi analisada de forma múltipla por meio de regressão logística. Fatores favorecedores à saída de idosos de casa: ser do sexo masculino, ser de faixa etária mais jovem, ser casado, ter artrose, realizar atividades específicas com facilidade e ter boa autopercepção de saúde. A presença de cardiopatias foi um fator negativo para sair de casa. Em face da importância da vida social na qualidade de vida e na política de envelhecimento ativo da Organização Mundial da Saúde, é fundamental considerar condições clínicas que permitem aos idosos manterem-se ativos em comunidade. Estudos como este podem auxiliar na adequação das políticas públicas para idosos, principalmente atuando em condições modificáveis, como as clínicas e funcionais.

This study aimed to assess social and clinical factors associated with the fact that older adults (≥ 60 years) go out of their homes. The study interviewed 5,898 older adults identified through home visits, randomly selected in 59 cities in the State of Rio Grande do Sul, Brazil. Multivariate logistic regression was used to assess the association between the outcome and independent variables. Factors associated with going out were being men, younger and married, presence of arthrosis, ease in performing specific activities, and good self-rated health. Heart disease was a negative factor for going out. Given the importance of social activity for quality of life and the World Health Organization policy for active aging, it is extremely important to consider clinical conditions that allow the older adults to remain active in the community. Studies like this can help to adjust public policies for the elderly, especially acting on modifiable clinical and functional conditions.

El estudio tuvo como objetivo evaluar factores (de salud y sociales) involucrados en el hecho de que las personas mayores (60 años o más) salgan de casa. Se encuestaron a 5.898 ancianos, identificados mediante visitas domiciliarias, seleccionados al azar en 59 ciudades del estado de Río Grande do Sul, Brasil. La asociación entre el desenlace y las variables independientes fue analizada mediante regresión logística. Los factores que favorecieron la salida de casa fueron: sexo masculino, edad más joven, estar casado, historia de osteoartritis, facilidad en realizar actividades específicas y buena percepción de salud. La presencia de enfermedades cardiacas fue un factor negativo para salir de casa. Conociendo la importancia de la vida social en la calidad de vida, y en la política de envejecimiento activo propuesta por la Oraganización Mundial de la Salud, es muy importante tener en cuenta las condiciones clínicas que permiten a los ancianos mantenerse activos en la comunidad; estudios como éste pueden ayudar en la adaptación de las políticas públicas para las personas mayores, trabajando principalmente en condiciones cambiantes, tales como la clínica y funcional.

Alternative Physical Therapy Protocol Using a Cycle Ergometer During Hospital Rehabilitation of Coronary Artery Bypass Grafting: a Clinical Trial.

OBJECTIVE: To compare the efficacy of a cycle ergometer-based exercise program to a standard protocol on the increment of the maximum distance walked during the six-minute walk test in the postoperative rehabilitation of patients submitted to coronary artery bypass grafting. METHODS: A controlled clinical trial pilot, blinded to the outcome, enrolled subjects who underwent coronary artery bypass grafting in a hospital from Southern Brazil. Subjects were designated for the standard physical rehabilitation protocol or to an alternative cycle ergometer-based protocol through simple random sampling. The primary outcome was the difference in the maximum distance walked in the six-minute walk test before and after the allocated intervention. RESULTS: Twenty-four patients were included in the analysis, 10 in the standard protocol and 14 in the alternative protocol group. There was an increment in the maximum distance walked in both groups, and borderline superiority in the intervention group comparing to the control group (312.2 vs. 249.7; P=0.06). CONCLUSION: There was an increase in the maximum distance walked in the alternative protocol compared to the standard protocol. Thus, it is postulated that the use of a cycle ergometer can be included in physical rehabilitation in the hospital phase of postoperative coronary artery bypass grafting. However, randomized studies with larger sample size should be conducted to assess the significance of these findings.

Fatores socioambientais associados à ocorrência de quedas em idosos / Social and environmental factors associated with the occurrence of falls in the elderly

O objetivo deste artigo é investigar aspectos socioambientais associados às quedas em idosos residentes no estado do Rio Grande do Sul. Estudo descritivo, transversal, populacional, de base domiciliar, com coleta de dados primários, pertencente a um inquérito epidemiológico realizado no período de 2010 a 2011, com 6751 idosos de 59 cidades do estado do Rio Grande do Sul, Brasil, denominado Perfil dos Idosos do RS. A associação entre o desfecho quedas e as variáveis independentes foram analisadas de forma univariada e múltipla, através de regressão logística, calculando desta forma a chance associada à queda, ajustando por sexo e idade. A frequência de quedas foi de 10,7%. Observamos serem fatores protetores: sexo masculino, maior escolaridade, percepção de insegurança e falta de bancos em locais públicos, participação em atividades sociais e cívicas. Foram considerados fatores de risco: faixa etária mais elevada, uso de órtese e participação em atividades comunitárias. Os resultados mantiveram-se significativos nas análises ajustadas. As quedas são comumente associadas a aspectos físicos e comportamentais, no entanto, as variáveis socioambientais também demonstram ser significativas nesse processo.

This article seeks to investigate environmental aspects that may be associated with falls among elderly residents in the state of Rio Grande do Sul. It is a population-based, descriptive, cross-sectional study, with primary data collection taken from an epidemiological study entitled A Profile of the Elderly in the state of Rio Grande do Sul. The study was conducted between the years of 2010 and 2011 with 6751 elderly individuals in 59 cities in the state of Rio Grande do Sul. The association between falling and the independent variables was verified by univariate and multivariate analysis, to estimate chances of falling, adjusted for sex and age. The frequency of falls was 10.7%. Factors detected to be effective against falling: being male, having higher education, perception of insecurity, placing of seats in public places and participation in social and civic activities. The following were considered risk factors: old age, use of walking aids and participation in community activities. The results remained significant after adjustment for demographic factors. Falling is commonly associated with physical and behavioral aspects, though social and environmental factors also prove significant in this respect.

[Social and environmental factors associated with the occurrence of falls in the elderly]. / Fatores socioambientais associados à ocorrência de quedas em idosos.

This article seeks to investigate environmental aspects that may be associated with falls among elderly residents in the state of Rio Grande do Sul. It is a population-based, descriptive, cross-sectional study, with primary data collection taken from an epidemiological study entitled A Profile of the Elderly in the state of Rio Grande do Sul. The study was conducted between the years of 2010 and 2011 with 6751 elderly individuals in 59 cities in the state of Rio Grande do Sul. The association between falling and the independent variables was verified by univariate and multivariate analysis, to estimate chances of falling, adjusted for sex and age. The frequency of falls was 10.7%. Factors detected to be effective against falling: being male, having higher education, perception of insecurity, placing of seats in public places and participation in social and civic activities. The following were considered risk factors: old age, use of walking aids and participation in community activities. The results remained significant after adjustment for demographic factors. Falling is commonly associated with physical and behavioral aspects, though social and environmental factors also prove significant in this respect.