Influencia de un programa de ejercicio físico realizado en el ámbito municipal sobre la fragilidad y capacidad funcional del adulto mayor no dependiente

Resum

Aging involves a series of changes at the biological and functional level that will have a direct impact on all the spheres that surround the person. These changes can lead to a geriatric syndrome. Frailty syndrome entails a deterioration in the physical capacity of the elderly, which increases their vulnerability and the risk of suffering adverse events. Sarcopenia is considered an intermediate step towards frailty and and both share disgnostic criteria, such as the evaluation of muscular strength and physical performance. The early detection of the deterioration of these capacities would be useful as a predictor of states of frailty. Some of the risk factors related to the appearance of these syndromes are modifiable, and physical exercise is the most effective intervention to prevent and reverse them. The aim of this work was to analyze the degree of fragility and functional capacity in a group of older adults participating in a municipal geronto-gymnastics program, as well as the presence of factors that could influence them. We also set out to identify the functional assessment tests with greater sensitivity and their relationship with stabilometric parameters. We also value the influence of a physical exercise program designed specifically for them that was carried out for 15 weeks. 74 subjects (age = 72.34 ± 6.15) participated in the study, who were assessed before and after performing the intervention program. An anthropometric and functional assessment was performed using the tests indicated for the determination of frailty by the SNS (SPPB, TUG and gait speed) in addition to other proposals by the EWGSOP to establish the existence and degree of sarcopenia (SCPT, PEF, grip strength and walk 400 m). In addition, a stabilometric assessment was carried out. The incidence of frailty was higher with age, there was no difference between the sexes and it accounted for 13.51% of the initial population. A high relationship was found between frailty and deterioration in lower limb strength and grip strength. Those people who had been practicing the longest physical exercise registered better marks in the TUG and the SPPB. Both the number of diseases and the percentages of total, relative and visceral fat were associated with a lower functional capacity of women. Among all the assessment tools used, the SPPB showed greater sensitivity when determining frailty states and it showed a high correlation with the rest of the functional assessment tests with the exception of PEF and grip strenght. The stabilometric assessment allowed identifying deficiencies in postural control not detected by the functional tests, and showed a relationship between the surface, mean X, VFY and mean speed parameters with the static and dynamic balance functional tests. After completing the program, 87.5% of the frail people who completed it left that state. The exercise program reported improvements in lower limb strength, balance, and fine postural control. The women also improved their resistance and grip strength. Better stabilometric values were also recorded that reflected better stability and invested energy expenditure to maintain it. Stabilometry was a valid tool for evaluating postural control and sensitive to the evolution of the interventions, since it reflected changes after treatment compatible with the results of functional tests. Keywords: elderly, frailty, sarcopenia, functional capacity, functional impairment, physical exercise.