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Previous issue date: 2013-12-16 / Introduction: Loss of balance limits the life of the elderly as it is related to falls. The balance is maintained by the action of four Balance-Maintenance-Systems (BMS): vestibular, visual, somatosensory, and visual preference whose information is organized by the central nervous system (CNS). The CNS receives and organizes sensory information and plans the actions of effector organs responsible for maintaining body balance. The oldest-old (80 years or older) is the age group with the highest prevalence of falls and least studied. Objective: To study the involvement of mechanisms to maintain body balance, the risk of falls and fear of falling in elderly and oldest old. Methods: The participation of BMS was conducted in two groups: 32 elderly (60-69 years) and 30 oldest-old (80 years or more) performing cognitive screening (Mini Mental State Examination - MMSE), assessment of risk of falls (Timed Up and Go - TUG), fear of falling (Falls Efficacy Scale - FES) and Sensory Organization Test (SOT) by foam-laser dynamic posturography. This research project was approved by the Scientific Committee of the Institute of Geriatrics and Gerontology - PUCRS and by the Ethics Committee in Research of PUCRS. Results: The oldest-old performed worse in all SOT, significantly in those with somatosensory conflict. Significant differences were observed between elderly and oldest-old in the systems: visual (91.1?6.1 and 54.8?43.7), vestibular (76.5?9.8 and 38.3?33.3) and visual preference (78.9?17.8 and 64.2?23.3), with similar performance in somatosensory (86.8?7.9 and 83.8?17.3). TUG and FES differ significantly between the groups and associated with scores of SME. The association between TUG and the visual system was affected by the MMSE and FES. Physical activity and education were associated with scores of SME. Conclusions: We conclude that SME most affected were the vestibular and visual. Differences between elderly and oldest-old were higher than expected for the visual and vestibular systems, but smaller in the somatosensory system. Dynamic posturography may be efficient to guide rehabilitation programs encouraging the use of more appropriate strategies for each elderly or oldest-old. / Introdu??o: A perda de equil?brio limita a vida dos idosos por ser relacionado ?s quedas. O equil?brio ? mantido pela a??o de quatro Sistemas de Manuten??o do Equil?brio (SME): vestibular, visual, prefer?ncia visual e somatossensorial, cujas informa??es s?o organizadas pelo sistema nervoso central. Este recebe e organiza as informa??es sensoriais e planeja as a??es dos ?rg?os efetores respons?veis pela manuten??o do equil?brio corporal. Os longevos (80 anos ou mais de idade) s?o o grupo et?rio com maior preval?ncia de quedas e pouco estudado. Objetivo: Estudar a participa??o dos mecanismos de manuten??o do equil?brio corporal, o risco de quedas e o medo de cair em idosos e longevos. Metodologia: Foi realizada a participa??o dos SME em dois grupos: 32 idosos (60 a 69 anos) e 30 longevos (80 anos ou mais), por meio de rastreio cognitivo (Mini Exame do Estado Mental MEEM), avalia??o do risco de quedas (Timed Up and Go TUG), do medo de cair (Falls Efficacy Scale-International-Brasil FES-I-Brasil) e Teste de Organiza??o Sensorial (TOS) pela Posturografia Din?mica Foam-Laser. O projeto desta pesquisa foi aprovado pela Comiss?o Cient?fica do Instituto de Geriatria e Gerontologia da PUCRS e pelo Comit? de ?tica em Pesquisa da PUCRS. Resultados: Os longevos desempenharam pior em todas as condi??es do TOS, significativamente aquelas com conflito somatossensorial. Observaram-se diferen?as significativas entre idosos e longevos nos sistemas visual (91,1?6,1 e 54,8?43,7), vestibular (76,5?9,8 e 38,3?33,3) e prefer?ncia visual (78,9?17,8 e 64,2?23,3), tendo desempenho similar no somatossensorial (86,8?7,9 e 83,8?17,3). TUG e FES diferiram significativamente entre os grupos e foram associados com escores dos SME. A associa??o entre TUG e o sistema visual foi afetada pelo MEEM e FES. Atividade f?sica e escolaridade foram associados com escores dos SME. Conclus?es: Os SME mais afetados foram o vestibular e visual. Diferen?as entre idosos e longevos foram maiores que o esperado para os sistemas visual e vestibular, mas menores no sistema somatossensorial. A Posturografia Din?mica pode ser eficiente para orientar programas de reabilita??o estimulando a utiliza??o de estrat?gias mais apropriadas para cada idoso ou longevo.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/2717 |
| Date | 16 December 2013 |
| Creators | Soldera, Cristina Loureiro Chaves |
| Contributors | B?s, ?ngelo Jos? Gon?alves |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, BR, Instituto de Geriatria e Gerontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 500, 600, 2296420844541114010 |
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