Influência do treinamento de força e de multicomponentes na funcionalidade de idosos: revisão sistemática e metanálise

Lemos, Estele Caroline Welter Meereis; Guadagnin, Eliane Celina; Mota, Carlos Bolli

doi:10.1590/1980-0037.2020v22e6070

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original article • Rev. bras. cineantropom. desempenho hum 22 • 2020 • https://doi.org/10.1590/1980-0037.2020v22e6070 linkcopiar

Influência do treinamento de força e de multicomponentes na funcionalidade de idosos: revisão sistemática e metanálise

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

O exercício físico é uma opção importante para a manutenção da independência funcional nos idosos, porém, não está claro qual tipo de exercício pode ser mais benéfico. Diante disso, buscou-se verificar o efeito de intervenções com treinamento de força e do treino com multicomponentes na funcionalidade em idosos saudáveis, através de uma revisão sistemática com metanálise. Número de registro: CRD42017071887. Foram realizadas buscas nas bases de dados Pubmed, Web of Science, PEDro, Cochrane e Lilacs. Dos 1434 estudos encontrados, 32 ensaios clínicos que realizaram treino de força e/ou combinado com outras modalidades (multicomponentes) em idosos e avaliaram os desfechos Timed up and Go (TUG), sentar-e-levantar (STS) e/ou Escala de Equilíbrio de Berg (EEB) foram incluídos. A qualidade metodológica foi avaliada pela escala Downs & Black. A análise dos dados foi realizada no Software Rewiew Manager. Verificou-se que os resultados favoreceram o treino multicomponentes em comparação aos grupos controle nos desfechos TUG, STS e EEB. Já para o treino de força isso ocorreu somente para o STS. Quando os dois treinamentos foram comparados, não houve favorecimento para nenhum deles. O escore médio não alto na avaliação da qualidade metodológica dos estudos incluídos é uma limitação do presente estudo. Conclui-se que ambos os treinos se mostraram efetivos para a funcionalidade e são boas estratégias de treinamento para idosos. Porém, como a comparação entre os dois tipos de treinamento foi realizada em poucos estudos, não é possível afirmar qual é mais efetivo para a funcionalidade, sugerindo-se a realização de novos ensaios clínicos.

Palavras-chave Envelhecimento; Terapia por exercício; Metanálise; Treinamento de resistência

Study	Subjects			Training							PeDro
Study	Age	Gender/ Race	Health condition/ Medication	Type of training	Performed activities	Weekly frequency (week)	Session duration (min)	Total duration (week)	Tests	Effect	PeDro
Egaña et al.,²⁰	E: 69 ± 5 C: 64 ± 4	E: F C: F Race NI	Sedentary, nonsmokers, normotensive no apparent cardiovascular disease/None hormone replacement therapy nether other medication that could affect cardiovascular function	ST	Warming up, ST with elastic bands for lower limbs, upper limbs and stretching	3	60	12	30STS	+ p<0.05	6
Granacher et al.,²¹	E: 70.8± 4.1 C: 70.2 ± 4.5	E: F/M C: F/M Race NI	None had any history of musculoskeletal, neurological or orthopedic disorders, all participants were classified as non-pathological in the Clock Drawing Test (CDT)/Medication NI	ST	ST for core	2	60	9	TUG	+ p<0.05	7
Kalapotha-rakos et al.,²²	E: 83.4± 2.8 C: 82.5 ± 2	E: M C: M Race NI	Independent according to the functional questionnaire for BDL/IADL scale, without cognitive impairment or unstable cardiovascular, metabolic, neuromuscular or other chronic disease that might limit training or testing/Medication NI	ST	ST for lower limbs and upper limbs	2	60	14	TUG; 5STS	TUG: + p<0.001 5STS: NS	6
Lee e Park,²³	E: 73.1± 3.6 C: 69.5 ± 3.6	E: F/M C: F/M Race NI	Normal cognition, no cardiac or muscular problems, no severe cardiac disease or orthopedic or neurological disorders/Medication NI	ST	ST for lower limbs	NI	NI	12	30STS	NS	6
Locks et al.,²⁴	E: 69.0± 5.0 C: 66.0 ± 6.0	E: F/M C: F/M Race NI	Stable condition, without joint injury or surgery, cardiac disease, cancer, neuropathies, no use of prostheses, without contraindications for exercise in accordance with the Brazilian Hypertension Guidelines or severe functional limitations as significant cognitive impairment/Medication NI	ST	ST for lower limbs	2	± 55	24	5STS	NS	6
Lustosa et al.,²⁵	E + C: 72.0±4.0	E: F C: F Race NI	Prefrail older women without cognitive impairment, orthopedic and neurologic diseases that limited physical activity, no acute inﬂammatory disease or cancer/without use of medications with known immunologic effects.	ST	Warming up, strength training for lower limbs, stretching e relaxation	3	60	10	TUG	+ p<0.05	8
Raj et al.,²⁶	E: 68 ± 5 C: 67 ± 5	E: F/M C: F/M Race NI	No relevant cardiovascular or orthopedic problems/ Medication NI	ST	Linear strength training for lower limbs and upper limbs	2	NI	16	TUG	+ p<0.01	6
Ramírez-Campillo et al.,²⁷	E: 68.7 ± 6.4 C: 66.7 ± 4.9	E: F C: F Race NI	Healthy by self-report, without heart disease, osteoarthritis, severe visual impairment, neurological and pulmonary disease, uncontrolled hypertension, lower extremity joint fracture/Medication NI	ST	Warming up, Strength training for lower limbs, upper limbs and core	3	± 70	12	30STS	+ p<0.05	6
Smolarek et al.,²⁸	NI	E: F C: F	Patients that not exhibiting any Alzheimer’s symptoms or any other neurodegenerative disease previously diagnosed by a doctor/Medication NI	ST	ST for lower limbs and upper limbs	3	NI	12	30STS	NS	7
Sundstrup et al.,¹	E: 69.1± 3.1 C: 67.4 ± 2.7	E: M C: M Race NI	Healthy, nonsmokers/No Medication	ST	ST for lower limbs and upper limbs	3	70	48	30STS	+ p=0.025	8
Canuto Wanderley et al.,²⁹	E: 70.8± 4.1 C: 70.2 ± 4.5	E: F/M C: F/M Race NI	Without acute or terminal illness, severe or uncontrolled hypertension, severe or uncontrolled diabetes, cardiovascular and/or respiratory disorders, any neurological, skeletal-muscle, or joint disorder or disturbance that precluded participation in exercise and testing/Without medication that could reduce safety during exercise	ST	Warming up, Strength training for lower limbs and upper limbs, relaxation	3	50	32	5STS	+ p=0.03	10
Andersen et al.,³⁰	E: 69.1± 3.1 C: 67.4 ± 2.7	E: M C: M Race NI	Healthy, nonsmokers/No medication	ST	ST for lower limbs, upper limbs and core	2	60	16	30STS	+ p<0.01	5
Bento et al.,³¹	E: 69.1± 3.1 C: 67.4 ± 2.7	E: F/M C: F/M Race NI	Health/Medication NI	MT	Water training: warming up, aerobic and strength training and stretching	3	60	12	30STS	+ p=0.89	5
Foley et al.,⁹	E: 78.3 ± 6.5 C: 79.9 ± 8.4	E: F/M C: F/M Race: NI	Cognitively intact, the reason for referral no involved spinal or lower limb musculoskeletal impairment, disability or surgery, reduced functional mobility or falls no neurological disorder/Medication NI	MT	Aerobic, strength and balance training and stretching	2	60	12	TUG, EBB, 30STS	NS	9
Jacobson et al.,³²	E: 79.7±5.55 C: 78.7±4.85	E: F/M C: F/M Race NI	Health/Medication NI	MT	Strength training with motorized exercise apparatus for lower limbs, upper limbs and core	2	30	12	30STS	+ p=0.006	6
Kim et al.,³³	E: 81.0 ± 2.6 C: 80.2 ± 5.6	E: F C: F Race: Japanese	Sarcopenic, no severe knee or back pain; no severely impaired mobility and cognition; stable cardiac conditions/Medication NI	MT	Stretching, strength training with elastic bands, balance and gait training	2	60	12	TUG	+ p<0.001	9
Kim et al.,³⁴	E: 81.1± 2.8 C: 80.3 ± 3.3	E: F C: F Race Japanese	Frail women/Medication NI	MT	Warming up, stretching, strength training with elastic bands, balance and gait training	2	60	12	TUG	+ p<0.01	10
Lacroix et al.,³⁵	E: 72.7± 4.0 C: 72.7 ± 3.8	E: F/M C: F/M Race NI	Health, all participants were classified as nonpathological on CDT/Medication NI	MT	Balance training, strength training for lower limbs and core	3	45	12	TUG; 5STS	+ p<0.05	6
Magistro et al.,³⁶	E: 72 ± 4.5 C: 74.1 ± 6.0	E: F/M C: F/M Race NI	Health without myocardial infarction and or coronary bypass surgery, uncontrolled diabetes or hypertension, orthopedic impairment, or upper or lower extremity fracture/Medication NI	MT	Strength training for lower limbs, balance and gait training	2	75	16	TUG; 30STS	+ p<0.0001	6
Pereira et al.,³⁷	E: 62.5 ± 5.4 C: 62.2 ± 4.3	E: F C: F Race: Caucasian	Health condition: NI/ Medication: NI	MT	Warming up, strength training for lower limbs and upper limbs, balance training and stretching	3	60	12	30STS	+ p<0.05	6
Silva et al.,³⁸	E: 69.3 ± 6.55 C: 70.5 ± 6.03	E: F C: F Race NI	With low density mineral bone or with osteopenic or osteoporosis, no impaired cognition; musculoskeletal, and/or neurologic without pain during the walk/No medication with corticosteroids, anticonvulsants or metotrexato	MT	Strength training, gait and balance training and stretching	3	60	10	TUG	+ p=0.004	4
Sousa et al.,³⁹	NI	E: M C: M Race NI	No smoking; without diabetes; severe obesity; severe hypertension; history of falls, and those with neurological, mental or cognitive disorders, and orthopedic, pulmonary or cardiac problems that could restrict their activity/None of the participants was using any medications that would alter vascular function	MT	Aerobic and circuit strength training for lower limbs and upper limbs	3	60	32	30STS	NS	6
Vaughan et al.,⁴⁰	E: 73.1± 3.6 C: 69.5 ± 3.6	E: F C: F Race NI	Health, inability to obtain written clearance from a general practitioner; without a diagnosis of dementia or Parkinson’s disease; ability to walk 20 meters unaided and head injury within the previous 12 months/Medication: NI	MT	Strength training, coordination and aerobic and balance training	2	60	16	TUG	+ p<0.001	10
Zhuang et al.,⁴¹	E: 70.8± 4.1 C: 70.2 ± 4.5	E: F/M C: F/M Race NI	Health, able to walk without a cane or other assistive device, without medical conditions and musculoskeletal problems limiting safe participation in an exercise program/Medication: NI	MT	ST for lower limbs and upper limbs, balance and Tai chi chuan exercise	3	60	12	TUG; 30STS	TUG: + p<0.001 30STS: NS	8
Swanen-burg et al.,⁴²	E: 71.8± 5.4 C: 70.7 ± 8.1	E: F C: F Race NI	Older adult with osteopenia or osteoporosis, patients without any severe peripheral or central neurological disease known to inﬂuence gait, balance or muscle strength/Without medical contraindications for exercise	MT	ST for lower limbs and upper limbs, coordination, aerobic and balance training	2	60	12	EBB	+ p=0.008	9
Beling and Roller⁴³	E: 79.1± 6.5 C: 81 ± 5	E: F/M C: F/M Race NI	No history of cardiac conditions, musculoskeletal, and/or neurologic limitations that could account for possible imbalance and falls such as cerebrovascular accident, spinal cord injury, Parkinson disease, transient ischemic attacks, lower-extremity joint replacements/ fusions/ amputations (could use a cane or walker), or fracture within past year/Medication NI	MT	Balance training, circuits and functional stations	3	60	12	TUG; EBB	TUG: NS EEB:+ p≤0.05	6
Fahlman et al.,⁸	E: 69.1± 3.1 C: 67.4 ± 2.7	E: F/M C: F/M Race NI	Health, without uncontrolled angina, any health problem that prohibited moderate resistance or aerobic training/Medication: NI	ST e MT	SG: ST MG: aerobic and ST with elastic bands	3	NI	16	30STS	+ p<0.05	5
Ansai et al.,⁴³	E: 82.2 ± 2.8 C: 82.6 ± 2.6	E: F/M C: F/M Race NI	Health, without injury listed in the absolute contraindications of the Physical Activity, without relative cognition, neurological or skeletal muscle contraindications /Medication: NI	ST e MT	SG: Strength training for lower limbs, upper limbs and core; MG: warming up, aerobic, strength and balance training and stretching	3	60	16	5STS	+ p<0.001	8

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[1] Subtitle: QA: Quality evaluation; ST: Strength training; MT: Multicomponent training; SG: Strength Group; MG: Multicomponent Group; E: Experimental Group; C: Control Group; M: Male; F: Female; NI: Not informed; 30STS: Sit to stand 30 seconds; 5STS: Sit to stand 5 repetitions; TUG: Timed-up-and-go; BBE: Berg Balance Escale; +: positive results; NS: Not significant.