Background: The COVID-19 pandemic hit Brazil in a scenario of substantial socioeconomic and health inequalities. It is unknown the immediate impact of social restriction recommendations (i.e., lockdown, stay-at-home) on the life-space mobility of older people.Objective: To investigate the immediate impact of COVID-19 pandemic on life-space mobility of community-dwelling Brazilian older adults and examine the social determinants of health associated with change in life-space mobility.Design: Baseline data from a prospective cohort study (REMOBILIZE Study).Setting: Community.Subject: A convenience snowball sample of participants aged 60 and older (n = 1,482) living in 22 states in Brazil.Methods: We conducted an online and phone survey using an adapted version of the Life-Space Assessment (LSA). Linear regression models were used to investigate social determinants of health on the change in LSA score.Results: Regardless of their gender and social determinants of health, participants showed a significant reduction in life-space mobility since COVID-19 pandemic outbreak. Life-space mobility reduction was higher among black individuals, those living alone and aged between 70 and 79. Other variables associated with change in life-space mobility, to a lesser extent, were sex, education and income.Conclusion: Social restriction measures due to pandemic caused substantial reduction in older adults' life-space mobility in Brazil. Social inequalities strongly affected vulnerable groups. Concerted actions should be put in place to overcome the deterioration in life-pace mobility amongst these groups. Failure in minimizing health inequalities amplified by the pandemic may jeopardize the desired achievements of the Decade of Healthy Aging.
Virtual reality therapy (VRT) has clinical indications in rehabilitation programs for the elderly; however, there is still no consensus on the recovery of body balance. The objective of this review was to summarize the effects of physical therapy interventions with VRT in the rehabilitation of balance in the elderly. The studies were identified via a systematic search in the databases PubMed, SciELO, LILACS and PEDro from 2010 onward. Clinical trials with interventions that involved VRT in the elderly were included in the study and were subjected to methodological quality analysis using the PEDro scale. A random effects meta-analysis of the studies that analyzed balance using the Berg Balance Scale and the Timed Up and Go (TUG) test was performed. Ten articles met the inclusion criteria, which presented variability in relation to the types of interventions used (70%) and the outcomes analyzed (60%). The mean duration of the interventions was 13.90 (± 5.08) weeks, with at least two weekly sessions (± 0.73). There were positive results in relation to improvements in both dynamic and static balance (70% of the studies), mobility (80%), flexibility (30%), gait (20%) and fall prevention (20%). A summary of the meta-analysis showed mean effects on the Berg scale (standardized mean difference [SMD]: -0.848; 95% CI: -1.161; − 0.535) and the TUG test (SMD: 0. 894; 95% CI: 0.341; 1.447). Individually, virtual reality is promising in rehabilitation programs for the elderly. The overall measures were sufficient to show beneficial effects of the therapy on balance in the elderly.
This study was reported as a protective mechanism against depression, disability and fragility, maintaining the well-being, good cognitive function and autonomy in daily activities. Increased investments in the health care of this population are needed regarding musculoskeletal and cardiorespiratory capacity. Physical activity must be encouraged by policies to foster health promotion.
INTRODUÇÃO: A dor lombar modifica e limita aspectos tanto físicos quanto psicossociais da vida do idoso, impondo muitas vezes mudanças que causam transtornos pessoais, familiares e redução da capacidade funcional. OBJETIVO: Verificar a prevalência de dor lombar (DL) não específica em uma amostra de idosos da comunidade e determinar a correlação existente entre as variáveis: sexo, índice de massa corpórea (IMC), incapacidade funcional e sintomas depressivos. MATERIAIS E MÉTODOS: Participaram deste estudo 54 idosos da comunidade (72 ± 5,2 anos). As características clínicas e sociodemográficas foram avaliadas por meio de questionário semiestruturado e a DL, por meio do Questionário de McGill. Para a medida de incapacidade em indivíduos com disfunções na coluna foi usado o Questionário de Roland Morris - Brasil (RM-BR). Sintomas depressivos e o nível geral de atividade física foram avaliados, respectivamente, por meio da versão reduzida da Escala de Depressão Geriátrica (GDS-15) e pelo Perfil de Atividade Humana. RESULTADOS: Evidenciou-se correlação alta e positiva entre a presença de DL, incapacidade funcional (RM-BR) (rs = 0,774; p = 0,00) e presença de sintomas depressivos (GDS-15) (rs = 0,271; p = 0,048). Nenhuma correlação foi evidenciada entre IMC (rs = 0,178; p = 0,197), sexo (rs = -0,073; p = 0,599) e DL. CONCLUSÃO: Observou-se prevalência alta de DL não específica na amostra de idosos estudada. Incapacidade funcional e depressão são condições fortemente associadas com DL em idosos da comunidade; cabe, portanto, desenvolver outras abordagens a fim de alcançar melhor efetividade das propostas terapêuticas.
Background: Low back pain (LBP) and urinary incontinence (UI) are highly prevalent among elderly individuals. In young adults, changes in trunk muscle recruitment, as assessed via ultrasound imaging, may be associated with lumbar spine stability. Objective:To assess the associations between LBP, UI, and the pattern of transversus abdominis (TrA), internal (IO), and external oblique (EO) muscle recruitment in the elderly as evaluated by ultrasound imaging. Method:Fifty-four elderly individuals (mean age: 72±5.2 years) who complained of LBP and/or UI as assessed by the McGill Pain Questionnaire, Incontinence Questionnaire-Short Form, and ultrasound imaging were included in the study. The statistical analysis comprised a multiple linear regression model, and a p-value <0.05 was considered significant. Results:The regression models for the TrA, IO, and EO muscle thickness levels explained 2.0% (R2=0.02; F=0.47; p=0.628), 10.6% (R2=0.106; F=3.03; p=0.057), and 10.1% (R2=0.101; F=2.70; p=0.077) of the variability, respectively. None of the regression models developed for the abdominal muscles exhibited statistical significance. A significant and negative association (p=0.018; β=-0.0343) was observed only between UI and IO recruitment. Conclusion:These results suggest that age-related factors may have interfered with the findings of the study, thus emphasizing the need to perform ultrasound imaging-based studies to measure abdominal muscle recruitment in the elderly.
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