Palabras clave
balance
older adults
Ejercicio aeróbico
balance
adultos mayores
Resumen
El efecto específico del ejercicio aeróbico sobre el equilibrio en personas adultas mayores no es claro. Este meta-análisis examinó el efecto del ejercicio aeróbico sobre el equilibrio en personas adultas mayores. Se realizó la búsqueda sistemática en bases de datos científicas académicas: Academic Search Complete, ProQuest, PubMed, Science Direct y Sport Discuss, utilizando la frase booleana: (aerobic exercise OR aerobic training) AND (adult* OR aging* OR senior* OR older adult*) AND (balanc*) NOT (diet OR nutrition) NOT (Animal) AND random*. Los criterios de inclusión fueron: publicaciones en idioma inglés o español, texto completo, persona adulta mayor (hombres y mujeres), personas mayores de 50 años, estudios experimentales y cuasi-experimentales, tratamiento enfocado en ejercicio aeróbico y se evaluó equilibrio dinámico o estático indistintamente del tipo de prueba. Se analizaron 4496 estudios y solamente 11 investigaciones cumplieron con los criterios de inclusión, generando 56 tamaños de efecto (TE) basados en un total de 590 sujetos. Las variables moderadoras fueron edad, sexo, nivel de actividad física, condición de salud, N por estudio, duración de la sesión y modalidad del ejercicio. El Tamaño de Efecto Global, para las condiciones experimentales fue de TE= 1.083, (p ≤ 0.05) (IC 95%: 0.63 – 1.53; Q= 679.07, p= 0.00, I2= 99.55); el Tamaño de Efecto del grupo control fue TE= 0.056, (p= 0.685) (IC 95%: -0.14, .25; Q= 11.48, p= 0.009, I2= 73.88). No se encontraron diferencias significativas entre los TE de
los grupos control (n=16) y grupo experimental (n=40) (F=2.73; p=.104). El ejercicio aeróbico (EA) ejerce un efecto positivo sobre el equilibrio de las personas adultas mayores, por lo que, el entrenamiento de EA es una estrategia válida para contrarrestar la pérdida del equilibrio en este grupo poblacional.
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ACSM. (2013). ACSM’s Guidelines for Exercise Testing and Prescription. Lippincott Williams & Wilkins.
Baydal-Bertomeu, J.M., Barberà I Guillem, R., Soler-Gracia, C., Peydro De Moya, M.F., Prat, J.M., Barona De Guzmán, R. (2004). Determinación de los patrones de comportamiento postural en población sana española. Acta Otorrinolaringológica Española 55, 260–269. https://doi.org/10.1016/S0001- 6519(04)78520-9
Borenstein, M., Hedges, L.H., Higgins, J.P.T., Rothstein, H.R. (2009). Introduction to Meta-Analysis. WILEY.
Carmeli, Eli, Kessel, S., Coleman, R., Ayalon, M. (2002). Effects of a treadmill walking program on muscle strength and balance in elderly people with Down syndrome. Journals of Gerontology - Series A Biological Sciences and Medical Sciences 57, M106-110. https://doi.org/10.1093/ gerona/57.2.M106
Donath, L., Faude, O., Roth, R., Zahner, L., (2014a). Effects of stair-climbing on balance, gait, strength, resting heart rate, and submaximal endurance in healthy seniors. Scand J Med Sci Sports 24, e93-101. https://doi.org/10.1111/sms.12113
Donath, L., Faude, O., Roth, R., Zahner, L., (2014b). Effects of stair-climbing on balance, gait, strength, resting heart rate, and submaximal endurance in healthy seniors. Scand J Med Sci Sports 24, e93-101. https://doi.org/10.1111/sms.12113
Egger, M., Davey Smith, G., Schneider, M., Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ 315, 629–634.
Eyigor, S., Karapolat, H., Durmaz, B., Ibisoglu, U., Cakir, S. (2009). A randomized controlled trial of Turkish folklore dance on the physical performance, balance, depression and quality of life in older women. Archives of Gerontology and Geriatrics 48, 84–88. https://doi.org/10.1016/j. archger.2007.10.008
Frankel, J.E., Bean, J.F., Frontera, W.R. (2006). Exercise in the elderly: research and clinical practice. Clin. Geriatr. Med. 22, 239–256; vii. https://doi. org/10.1016/j.cger.2005.12.002
Harber, M.P., Konopka, A.R., Douglass, M.D., Minchev, K., Kaminsky, L.A., Trappe, T.A., Trappe, S. (2009). Aerobic exercise training improves whole muscle and single myofiber size and function in older women. Am. J. Physiol. Regul. Integr. Comp. Physiol. 297, R1452-1459. https://doi.org/10.1152/ ajpregu.00354.2009
Hedges, L.V. (1981). Distribution Theory for Glass’s Estimator of Effect Size and Related Estimators. Journal of Educational Statistics 6, 107–128. https://doi.org/10.2307/1164588
Howe, T.E., Rochester, L., Neil, F., Skelton, D.A., Ballinger, C. (2011). Exercise for improving balance in older people. Cochrane Database Syst Rev CD004963. https://doi.org/10.1002/14651858.CD004963.pub3
INEC. (2011). Estimaciones y Proyecciones de población | INSTITUTO NACIONAL DE ESTADISTICA Y CENSOS [WWW Document]. URL http:// www.inec.go.cr/poblacion/estimaciones-y-proyecciones-de-poblacion (accessed 2.25.19).
Konopka, A.R., Douglass, M.D., Kaminsky, L.A., Jemiolo, B., Trappe, T.A., Trappe, S., Harber, M.P. (2010). Molecular Adaptations to Aerobic Exercise Training in Skeletal Muscle of Older Women. J Gerontol A Biol Sci Med Sci 65A, 1201–1207. https://doi.org/10.1093/gerona/glq109
Liberati, A., Altman, D.G., Tetzlaff, J., Mulrow, C., Gøtzsche, P.C., Ioannidis, J.P.A., Clarke, M., Devereaux, P.J., Kleijnen, J., Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339, b2700.
Lichtenstein, M.J., Shields, S.L., Shiavi, R.G., Burger, M.C. (1989). Exercise and balance in aged women: A pilot controlled clinical trial. Archives of Physical Medicine and Rehabilitation 70, 138–143. https:// doi.org/10.5555/uri:pii:0003999389901330
Lord, S. (1994). Effect of exercise on balance, strength and reaction time in older people. Australian Journal of Physiotherapy 40, 83–88. https://doi. org/10.1016/S0004-9514(14)60454-2
Lord, S., Castell, S. (1994). Effect of exercise on balance, strength and reaction time in older people. Aust J Physiother 40, 83–88. https://doi.org/10.1016/ S0004-9514(14)60454-2
Lord, S.R., Clark, R.D., Webster, I.W. (1991). Physiological Factors Associated with Falls in an Elderly Population. Journal of the American Geriatrics Society 39, 1194–1200. https://doi. org/10.1111/j.1532-5415.1991.tb03574.x
Marques, E.A., Figueiredo, P., Harris, T.B., Wanderley, F.A., Carvalho, J. (2017). Are resistance and aerobic exercise training equally effective at improving knee muscle strength and balance in older women? Arch Gerontol Geriatr 68, 106–112. https://doi.org/10.1016/j.archger.2016.10.002
Morrison, S., Colberg, S.R., Parson, H.K., Vinik, A.I. (2014). Exercise improves gait, reaction time and postural stability in older adults with type 2 diabetes and neuropathy. J. Diabetes Complicat. 28, 715–722. https://doi.org/10.1016/j.jdiacomp.2014.04.007
Nichols, J.F., Omizo, D.K., Peterson, K.K., Nelson, K.P. (1993). Efficacy of heavy-resistance training for active women over sixty: muscular strength, body composition, and program adherence. J Am Geriatr Soc 41, 205–210.
OMS. (2018). Organización Mundial de la Salud | 10 datos sobre el envejecimiento y la salud. [WWW Document]. OMS. URL http://www.who.int/ features/factfiles/ageing/es/ (accessed 6.17.18).
Thomas, J. R. & French, K. E. (1986). The use of meta analysis in exercise and sport: A tutorial. Research Quarterly for Exercise and Sport, 57, 196 204. [WWW Document], n.d. ResearchGate. URL https://www.researchgate. net/publication/235977261_Thomas_ J_R_ French_K_E_1986_The_use_of_meta_analysis_ in_exercise_and_sport_A_tutorial_Research_ Quarterly_for_Exercise_and_Sport_57_196_204 (accessed 2.23.19).
Powers, S.K., Howley, E.T., Cotter, J., Pumpa, K., Leicht, A., Rattray, B., Muendel, T., Jong, X.J.D. (2014). Exercise Physiology: Australia New Zealand. McGraw-Hill Education (Australia) Pty Limited.
Shigematsu, R., Chang, M., Yabushita, N., Sakai, T., Nakagaichi, M., Nho, H., Tanaka, K. (2002a). Dance-based aerobic exercise may improve indices of falling risk in older women. Age Ageing 31, 261–266.
Shigematsu, R., Okura, T. (2006). A novel exercise for improving lower-extremity functional fitness in the elderly. Aging Clin Exp Res 18, 242–248.
Shkuratova, N., Morris, M.E., Huxham, F. (2004). Effects of age on balance control during walking. Arch Phys Med Rehabil 85, 582–588.
Smart, N.A., Waldron, M., Ismail, H., Giallauria, F., Vigorito, C., Cornelissen, V., Dieberg, G. (2015). Validation of a new tool for the assessment of study quality and reporting in exercise training studies: TESTEX. Int J Evid Based Healthc 13, 9–18. https://doi.org/10.1097/XEB.0000000000000020
Sturnieks, D.L., St George, R., Lord, S.R. (2008). Balance disorders in the elderly. Neurophysiol Clin 38, 467–478. https://doi.org/10.1016/j. neucli.2008.09.001
Whipple, R.H., Wolfson, L.I., Amerman, P.M. (1987). The relationship of knee and ankle weakness to falls in nursing home residents: an isokinetic study. J Am Geriatr Soc 35, 13–20.
WHO. (2018). World Health Organization | Global recommendations on physical activity for health [WWW Document]. Global recommendations on physical activity for health. URL http:// www.who.int/dietphysicalactivity/factsheet_ recommendations/en/ (accessed 7.6.18).