Catarina Pereira

Role of physical activity in the prevention of falls and their consequences in the elderly

This work aims to provide an inventory of the risk factors and consequences of falling in the elderly, namely fractures, and to identify strategies to prevent falls and minimise their effects. Falls in elderly people are a major cause of injuries, leading to a general fear of falling, poorer quality of life and even death. The increase in life expectancy brought by developments in the medical and health sciences has not always brought enhanced quality of life. More elderly people live with reduced functional capacities resulting in a higher prevalence of falls and associated problems for themselves and for society. Risk factors for falling, commonly resulting from normal aging processes, have already been identified through multiple studies. Exercise may play an important role in fall prevention and their consequences. Although, effective strategies are usually multi-disciplinary and focus simultaneously on several risk factors. However, only large-scale prevention programmes can have significant effective social impact. To minimise occurrence and consequences of falls, policies to systematically implement prevention programmes should be established.

Physical activity patterns in adults who are blind as assessed by accelerometry.

The main purpose of our study was to quantify, by using accelerometry, daily physical activity (PA) in adults with visual impairments. Sixty-three adults (34.9% women) who are blind (18-65 years) wore an accelerometer for at least 3 days (minimum of 10 hr per day), including 1 weekend day. Nineteen participants (~30%) reached the recommendation of 30 min per day of PA, when counting every minute of moderate or greater intensity. No one achieved that goal when considering bouts of at least 10 min. No differences were found between genders in PA measures. Chronological age, age of blindness onset, and body mass index were not associated with PA. We conclude that adults who are blind have low levels of PA and are considerably less active compared with the general population. Health promotion strategies should be implemented to increase daily PA for people with visual impairments.

Role of physical activity in the occurrence of falls and fall-related injuries in community-dwelling adults over 50 years old

Abstract Purpose: This study examined the effect of the type, level and amount of physical activity in falls and fall-related injuries. Method: Participants were 506 community-dwelling adults aged >50 years (390 women: 67.7 ± 6.8 years and 116 men: 69.6 ± 6.6 years). Falls, fall-related injuries (slight and severe), and physical activity (type, level and energy expenditure) were evaluated by questionnaires. Confounders included co-morbidities, fear of falling, environmental hazards and physical fitness. Results: After adjustment for confounders, logistic analysis revealed that the likelihood of falling decreased by 2% for each 100 metabolic expenditure (MET-min/week) of total physical activity and increased by 5% for each 100 MET-min/week of vigorous-intensity physical activity; total physical activity >1125 MET-min/week and vigorous physical activity <500 MET-min/week were identified as cut-off values discriminating non-fallers from fallers. Compared to the low physical activity level, increased physical activity levels diminished the likelihood of the occurrence of severe fall-related injuries by 76% (moderate) and 58% (high; p < 0.05) in fallers. Conclusions: Being active, especially sufficiently active, reduces fall-related injuries by decreasing falls and by safeguarding against severe injuries when falls occur. At least 1125 MET-min/week of total physical activity including >500 MET-min/week of vigorous intensity seems to prevent falls and, therefore, fall-related injuries. Implications for Rehabilitation Being sufficiently active reduces fall-related injuries by reducing falls and by safeguarding against severe injury when falls occur For each additional amount of total physical activity there is a corresponding direct (due to the effect of isolated physical actvivity) and indirect (due to the subject gaining in fitness) decrease in the risk of falling and thus injury. Vigorous physical activity leads to an increase in total physical activity; however, it also leads to an increase in the risk of falling and injury Total physical activity of at least 1125 MET-min/week with equal or lower than 500 MET-min/week (i.e. less than ∼1 h/week, according IPAQ criteria) of vigorous intensity significantly reduces falls and therefore injury

Role of physical activity, physical fitness, and chronic health conditions on the physical independence of community-dwelling older adults over a 5-year period.

The variability in the individual characteristics and habits could help determine how older adults maintain independence. The impact of the variability in physical activity, physical fitness, body composition, and chronic health conditions (co-morbidities) on the independence of older adults, especially over time, is seldom examined. This study aims to analyze quantitatively the impact of baseline values and changes in physical activity, physical fitness, body composition, and co-morbidities on the physical independence of community-dwelling, older adults over a 5-year period. Data from 106 and 85 community-dwelling adults (≥60 years) were collected at baseline and after five years, respectively. Linear regression selected the main predictors of changes in physical independence as follows: the baseline physical independence (β=0.032, R(2)=9.9%) and co-morbidities (β=-0.191, R(2)=6.3%) and the changes in co-morbidities (β=-0.244, R(2)=10.8%), agility (β=-0.288, R(2)=6.7%), aerobic endurance (β=0.007, R(2)=3.2%), and walking expenditure (β=0.001, R(2)=5.1%) (p<0.05). In conclusion, baseline physical independence, baseline co-morbidities, and changes in co-morbidities, walking, agility, and aerobic endurance predicted physical independence over five years regardless of age and gender. Gains of up to 8.3% in physical independence were associated with improvements in these variables, which corresponds to regaining independence for performing one or two activities of daily living.

Effects of a 10-week multimodal exercise program on physical and cognitive function of nursing home residents: a psychomotor intervention pilot study

BackgroundNursing home institutionalization tends to exacerbate loss of functioning.AimsExamine the feasibility and the effect of a psychomotor intervention—a multimodal exercise program promoting simultaneous cognitive and motor stimulation—on the executive (planning ability and selective attention) and physical function of nursing home residents.MethodsSeventeen participants engaged in a 10-week multimodal exercise program and 17 maintained usual activities.ResultsExercise group improved planning ability (25–32%), selective attention (19–67%), and physical function [aerobic endurance, lower body strength, agility, balance, gait, and mobility (19–41%)], corresponding to an effect size ranging from 0.29 (small) to 1.11 (high), p < 0.05.DiscussionThe multimodal exercise program was feasible and well tolerated. The program improved executive and physical functions of the nursing home residents, reverting the usual loss of both cognitive and motor functioning in older adult institutionalized.ConclusionsMultimodal exercise programs may help to maintain or improve nursing home residents’ functioning.