Qual teste tem melhor acurácia para rastrear quedas em idosos comunitários: força de preensão manual ou o teste de sentar e levantar da cadeira?
DOI:
https://doi.org/10.1590/Palavras-chave:
Acidentes por Quedas, Força da MãoResumo
Diversos instrumentos podem ser utilizados para o rastreio de quedas em idosos, dentre os quais destacam-se a força de preensão manual (FPM) e o teste de sentar e levantar da cadeira de 5 repetições (TSLC5rep). No entanto, não se sabe qual dos dois testes teria maior capacidade preditiva para identificar associação com o histórico de quedas. Esse conhecimento poderá identificar idosos com maior risco de cair e permitir a proposição e o estabelecimento de estratégias de prevenção e reabilitação precoce. Busca-se, portanto, determinar qual teste de força tem melhor acurácia para rastrear quedas em idosos comunitários: a FPM ou o TSLC5rep. Tratouse de um estudo transversal, com amostra probabilística de 308 idosos comunitários. A variável dependente foi o histórico de quedas relatadas nos últimos 12 meses, e as variáveis analisadas foram o desempenho nos testes FPM e TSLC5rep. A análise estatística foi realizada por meio da receiver operating characteristic curves (ROC). A FPM obteve melhor acurácia para rastrear quedas em idosas comunitárias do sexo feminino. Idosas com FPM≤16,05kgF [AUC: 0,69 (95%IC:0,54-0,81)] têm maiores chances de apresentarem histórico de quedas. Não foram encontrados valores preditos para a FPM em homens, nem para o TSLC5rep em homens e mulheres.
Downloads
Referências
1. Pereira SEM, Buksman S, Perracini M, Py L, Barreto KML,
et al. Quedas em idosos [Internet]. Brasília, DF: Sociedade
Brasileira de Geriatria e Gerontologia; 2008 [cited 2026 Mar
5]. Available from: http://www.bibliomed.com.br/diretrizes/
pdf/quedas_idosos.pdf
2. Elias Filho J, Borel WP, Diz JBM, Barbosa AWC, Britto
RR, et al. Prevalence of falls and associated factors in
community-dwelling older Brazilians: a systematic review
and meta-analysis. Cad Saúde Pública. 2019;35(8). doi:
10.1590/0102-311X00115718
3. Abey-Nesbit R, Schluter PJ, Wilkinson TJ, Thwaites JH, Berry
SD, et al. Risk factors for injuries in New Zealand older adults
with complex needs: a national population retrospective study.
BMC Geriatr. 2021;21(1):630. doi: 10.1186 / s12877-021-02576-1
4. Lavedán A, Viladrosa M, Jürschik P, Botigué T, Nuín C, et al.
Fear of falling in community-dwelling older adults: a cause
of falls, a consequence, or both? PLoS One. 2018;13(3). doi:
10.1371/journal.pone.0194967
5. Mikos M, Trybulska A, Czerw A. Falls: the socio-economic and
medical aspects important for developing prevention and
treatment strategies. Ann Agric Environ Med. 2021;28(3):391-6.
doi: 10.26444/aaem/122409
6. Abreu DROM, Novaes ES, Oliveira RR, Mathias TAF, Marcon SS.
Fall-related admission and mortality in older adults in Brazil:
trend analysis. Cienc Saúde Coletiva. 2018;23(4):1131-41. doi:
10.1590/1413-81232018234.09962016
7. Wu CY, Lee HS, Tsai CF, Hsu YH, Yang HY. Secular trends in
the incidence of fracture hospitalization between 2000 and
2015 among the middle-aged and elderly persons in Taiwan: a
nationwide register-based cohort study. Bone. 2021;154:116250.
doi: 10.1016/j.bone.2021.116250
8. Pereira CB, Kanashiro AMK. Falls in older adults: a practical
approach. Arq Neuropsiquiatr. 2022;80(5 suppl 1):313-23. doi:
10.1590/0004-282X-ANP-2022-S107
9. Toosizadeh N, Ehsani H, Miramonte M, Mohler J. Proprioceptive
impairments in high fall risk older adults: the effect of
mechanical calf vibration on postural balance. Biomed Eng
Online. 2018;1-14. doi: 10.1186/s12938-018-0482-8
10. Saftari LN, Kwon OS. Ageing vision and falls: a review. J Physiol
Anthropol. 2018;37(1):1-14. doi: 10.1186/s40101-018-0170-1
11. Osoba MY, Rao AK, Agrawal SK, Lalwani AK. Balance and gait
in the elderly: a contemporary review. Otol Neurotol Neurosc.
2019;1:143-53. doi: 10.1002/lio2.252
12. Bobowik P, Wiszomirska I. Diagnostic dependence of
muscle strength measurements and the risk of falls in the
elderly. Int J Rehabil Res. 2020;43(4):330-6. doi: 10.1097/
MRR.0000000000000430
13. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, et
al. Sarcopenia: revised European consensus on definition
and diagnosis. Age Ageing. 2019;48(1):16-31. doi: 10.1093/
envelhecimento/afy169
14. Bohannon RW. Hand-grip dynamometry provides a valid
indication of upper extremity strength impairment in home
care patients. J Hand Ther. 1998;11(4):258-60. doi: 10.1016/
s0894-1130(98)80021-5
15. Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, et
al. Clinical measurement of sit-to-stand performance in people
with balance disorders: validity of data for the Five-Times-Sitto-
Stand Test. Phys Ther. 2005;85(10):1034-45. doi: 10.1093/
ptj/85.10.1034
16. Lopes PB, Rodacki ALF, Wolf R, Fisher K, Bento PCB, et al.
Can age influence functional tests differently to predict falls in
nursing home and community-dwelling older adults? Exp Aging
Res. 2021;47(2):192-202. doi: 10.1080/0361073X.2020.1871277
17. Zhang F, Ferrucci L, Culham E, Metter EJ, Guralnik J, et al.
Performance on five times sit-to-stand task as a predictor of
subsequent falls and disability in older persons. J Aging Health.
2013;25(3):478-92. doi: 10.1177/0898264313475813
18. Buatois S, Miljkovic D, Manckoundia P, Gueguen R, Miget P, et al.
Five times sit to stand test is a predictor of recurrent falls in healthy
community-living subjects aged 65 and older. J Am Geriatr
Soc. 2008;56(8):1575-7. doi: 10.1111/j.1532-5415.2008.01777.x
19. Yang NP, Hsu NW, Lin CH, Chen HC, Tsao HM, et al. Relationship
between muscle strength and fall episodes among the elderly:
the Yilan study, Taiwan. BMC Geriatr. 2018;18(1). doi: 10.1186/
s12877-018-0779-2
20 Bohannon RW. Grip strength: an indispensable biomarker for
older adults. Clin Intervent Aging. 2019;14:1681-91. doi: 10.2147/
CIA.S194543
21. Gafner SC, Allet L, Hilfiker R, Bastiaenen CHG. Reliability and
diagnostic accuracy of commonly used performance tests
Relative to fall history in older persons: a systematic review.
Clin Interv Aging. 2021;16:1591-616. doi: 10.2147/CIA.S322506
22. Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. O Miniexame
do estado mental em uma população geral: impacto da
escolaridade. Arq Neuropsiquiatr. 1994;52(1):1-7. doi: 10.1590/
S0004-282X1994000100001
23. Casanova JS, editor. Clinical assessment recommendations. 2nd
ed. Chicago: Am Society of Hand Therapists; 1992. Chapter 1,
Grip strength; p. 41-5.
24. Wang RH, Hsu HC, Chen SY, Lee CM, Lee YJ, et al. Risk factors
of falls and the gender differences in older adults with diabetes
at outpatient clinics. J Adv Nurs. 2021;77(6):2718-27. doi: 10.1111/
jan.14795
25. Shimada H, Suzukawa M, Tiedemann A, Kobayashi K,
Yoshida H, et al. Which neuromuscular or cognitive test is
the optimal screening tool to predict falls in frail communitydwelling
older people? Gerontology. 2009;55(5):532-8.
doi: 10.1159/000236364
26. Pijnappels M, van der Burg PJCE, Reeves ND, van Dieën JH.
Identification of elderly fallers by muscle strength measures.
Eur J Appl Physiol. 2008;102(5):585-92. doi: 10.1007/
s00421-007-0613-6
27. Porto JM, Nakaishi APM, Cangussu-Oliveira LM, Freire Júnior
RC, Spilla SB, et al. Relationship between grip strength
and global muscle strength in community-dwelling older
people. Arch Gerontol Geriatr. 2019;82:273-8. doi: 10.1016/j.
archger.2019.03.005
28. Bai HJ, Sun JQ, Chen M, Xu DF, Xie H, et al. Age-related decline
in skeletal muscle mass and function among elderly men and
women in Shanghai, China: a cross sectional study. Asia Pac
J Clin Nutr. 2016;25(2):326-32. doi: 10.6133/apjcn.2016.25.2.14
29. Tavares GMS, Müller DVK, Fão RN, Manfredini V, Piccoli JCE.
Análise da força de preensão palmar e ocorrência de quedas em
idosas. Rev Bras Ciênc Mov. 2016;24(3):19-25. doi: 10.18511/0103-
1716/rbcm.v24n3p19-25
30. Neri SGR, Lima RM, Ribeiro HS, Vainshelboim B. Poor handgrip
strength determined clinically is associated with falls in older women.
J Frailty, Sarcopenia Falls. 2021;6(2):43. doi: 10.22540/JFSF-06-043
31. Ditroilo M, Forte R, Benelli P, Gambarara D, de Vito G. Effects
of age and limb dominance on upper and lower limb muscle
function in healthy males and females aged 40-80 years. J
Sports Sci. 2010;28(6):667-77. doi: 10.1080/02640411003642098
32. Porto JM, Cangussu-Oliveira LM, Freire Júnior RC, Vieira
FT, Capato LL, et al. Relationship between lower limb
muscle strength and future falls among communitydwelling
older adults with no history of falls: a prospective
1-year study. J Appl Gerontol. 2021;40(3):339-46. doi:
10.1177/0733464820932778
33. Valenzuela PL, Maffiuletti NA, Saner H, Schütz N, Rudin B, et
al. Isometric strength measures are superior to the timed up
and go test for fall prediction in older adults: results from a
prospective cohort. Clin Interv Aging. 2020;15:2001-8. doi:
10.2147/CIA.S276828
Downloads
Publicado
Edição
Seção
Licença
Direitos autorais (c) 2026 Letícia Silvano Guimarães, Adriana Neto Parentoni, Vanessa Amaral Mendonça, Ana Cristina Rodrigues Lacerda, Ana Lúcia Danielewicz, Núbia Carelli Pereira de Avelar
Este trabalho está licenciado sob uma licença Creative Commons Attribution-ShareAlike 4.0 International License.
