Capacidade Funcional: estudo prospectivo em idosos residentes em uma instituição de longa permanência

The Short Physical Performance Balance - SPPB has been largely used in researches related to the effects of aging, as a practical and efficient instrument to estimate the physical conditions and screening of elderly people with future disability risk. The SPPB estimates the performance of lower limbs in three aspects: muscle strength, gait and balance, all recognized as fundamental to achieve good quality of life, being accepted as universal indicators to value the health conditions of the elderly. PURPOSE: Analyze the SPPB effectiveness to detect functional capacity changes among institutionalized elderly patients and how it is influenced by cognitive, clinical and global functional variables. METHODS: a prospective study, involving 30 residents of a philanthropic long-term care facility in São Paulo (17 women and 13 men), with ages above 60 years old (43% older than 80 years old) and an average of seven years of residence. After 18 months, these old people were reevaluated and data were compared. RESULTS: Considering the evaluated elderly who had good performance (17%), all of them showed up loss of strength during the research. It was observed that there was an improvement of 16% and 1%, respectively, in the balance and in gait, respectively. There was one or more falls in 47% of them. Comparing the Katz's Index of Independency in the Daily Living, the SPPB was more sensitive to the functional decline, indicating 39%, as compared to the 14% of the loss indentified by Katz. CONCLUSIONS: the data confirm the previous studies, which indicate the functional capacity decline of institutionalized elderly and for the SPPB applicability in the routine of functional attendance of this population.A Short Physical Performance Balance - SPPB vem sendo utilizada largamente em pesquisas sobre o envelhecimento, como instrumento prático e eficaz na avaliação do desempenho físico e rastreamento de idosos com riscos futuros de incapacidades. Ela avalia o desempenho de membros inferiores em três aspectos: força muscular, marcha e equilíbrio, reconhecidos como componentes fundamentais para a qualidade de vida, sendo aceitos como indicadores universais do estado de saúde em idosos. OBJETIVO: Analisar a eficácia da SPPB em detectar alterações na capacidade funcional do idoso institucionalizado e como esta é influenciada pelas variáveis cognitivas, clínicas e funcionais globais. METODOLOGIA: estudo prospectivo do qual participaram 30 residentes de uma instituição de longa permanência, filantrópica, em São Paulo (17 mulheres e 13 homens), com idades acima de 60 anos ou mais (43% maiores de 80 anos) e média de sete anos de residência. Após 18 meses, estes idosos foram reavaliados e os dados, comparados. RESULTADOS: Dos idosos avaliados que obtiveram bom desempenho (17%), todos apresentaram perda de força ao longo do seguimento. Quanto ao equilíbrio e marcha, notou-se melhora de 16% e 1%, respectivamente. Apresentaram uma ou mais quedas, 47% dos sujeitos. Quando comparada com o Índex de Independência nas Atividades de Vida Diária de Katz, a SPPB se mostrou mais sensível em relação ao declínio funcional, apontando 39% em comparação aos 14% de perda identificada pelo Katz. CONCLUSÃO: os dados corroboram estudos anteriores, que apontam para o declínio da capacidade funcional de idosos institucionalizados e para a aplicabilidade da SPPB na rotina de acompanhamento funcional dessa população.Universidade Federal de São Paulo (UNIFESP) Curso de Especialização em Reabilitação GerontológicaLar Escola São Francisco Centro de Reabilitação Setor de Reabilitação GerontológicaUniversidade de São Paulo Faculdade de Medicina Hospital das ClínicasUNIFESP, Curso de Especialização em Reabilitação GerontológicaSciEL

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