Efeitos dos exergames no equilíbrio corporal de idosos diabéticos: ensaio clínico randomizado

Abstract

Introduction: The presence of type 2 Diabetes Mellitus is directly related to functional deficit, low physical performance and even risk of falls in the elderly. One of the most important complications for this audience is body imbalance. Physical exercise is one of the most indicated treatments. Among the most used techniques, training based on strengthening, stretching, flexibility and relaxation induces an improvement in the postural balance of the diabetic elderly. Another strategy is the use of exergames, used for functional recovery of postural balance. Objective: to investigate the influence of an exergames protocol on the body balance of elderly people with type 2 Diabetes Mellitus. Methodology: This is a randomized clinical trial with RBR-67y6cz registration at REBEC. Individuals aged between 65 and 79 years, diabetics, with complaints of imbalance, risk of falling, without cognitive deficit and with mild or moderate peripheral neuropathy were included. The sessions lasted 40 minutes, twice a week, for 12 weeks. For both groups, in all sections, a protocol for strengthening the lower limbs was initially performed (10 min). Individuals in the control group (CG) performed a kinesiotherapy protocol (40min) focused on balance; those in the experimental group (EG) used games (40min) that simulate the GC protocol (free run, soccer heading, penguin slide, island cycling, tilt table, free steps and balance bubble). They were evaluated before and after treatment and at the 3-month follow-up period. Functional balance data (MiniBesTest), functional performance (Short Physical Performance Battery), functional capacity (Brazilian OARS Multidimensional Functional Assessment Questionnaire), hand grip strength by hand dynamometer and balance confidence (ABC scale) were evaluated. A 2x3 mixed ANOVA was used to compare the outcomes between the two groups and in the three evaluation moments. Results: in total, 34 individuals composed the study, randomized into 17 in the CG and 17 in the EG. For the control group, there was a statistical difference between T1 and T2 for SPPB (p=0,001), FPP (p=0,003) and BOMFAQ (p=0,035); between T1 and T3 only for SPPB (p=0,02) and FPP (p=0,01). For the experimental group, there was a statistical difference in the 3 times for the MBT (p<0,001; p=0,04; p=0,05), between T1 and T2 for the SPPB (p<0,001) and ABC scale (p=0,04); and between T2 and T3 for SPPB (p=0,02). Conclusion: the exergames protocol was effective to promote improvement in the body balance of elderly diabetics, however, the protocol in question was not effective to promote improvement in hand grip strength and independence for activities of daily living in this population.