La lengua de Martí

Available online at http://www.journalijdr.com ISSN: 2230-9926 International Journal of Development Research Vol. 11, Issue, 06, pp. 47886-47889, June, 2021 https://doi.org/10.37118/ijdr.22132.06.2021 RESEARCH ARTICLE OPEN ACCESS RELATION BETWEEN FUNCTIONAL MOBILITY AND MUSCLE STRENGTH OF THE ELDERLY IN A PUBLIC PHYSICAL ACTIVITIES PROGRAM *1Cristianne Confessor Castilho Lopes, 2Marilda Morais da Costa, 2Ana Letícia Ferreira Vilela, 2Mauren da Silva Salin, 3Daniela dos Santos, 4Paulo Sérgio Silva, 5Tulio Gamio Dias, 3Eduardo Barbosa Lopes, 6Alessandra Novak, 3Laísa Zanatta, 3Vanessa da Silva Barros, 3Talitta Padilha Machado, 3Liamara Basso Dala Costa, 3Heliude de Quadros e Silva and 7Youssef Elias Ammar 1Universidade da Região de Joinville - Joinville – SC; 2Associação Educacional Luterana - Faculdade IELUSC - Joinville – SC; 3Universidade Alto Vale do Rio do Peixe - Caçador – SC; 4UniSociesc/Joinville – SC; 5Escola de Artes, Ciências e Humanidades da USP – São Paulo – SP; 6University of the Region of Joinville - Joinville – SC; 7Universidade do Sul de Santa Catarina/Tubarão – SC ARTICLE INFO Article History: Received 28th March, 2021 Received in revised form 16th April, 2021 Accepted 18th May, 2021 Published online 26th June, 2021 Key Words: Elderly; Muscle Strength; Functional Mobility; Physical Activity. *Corresponding author: Cristianne Confessor Castilho Lopes ABSTRACT Objective: to verify the relationship between functional mobility and muscle strength in a group of elderly people participating in a public program of physical activities, called “Programa Mexase”, in the Joinville/SC city. Methods: This was a quantitative, correlational descriptive study, carried out in a non-probabilistic, intentional type. Included a random sample of 42 elderly people (27 women and 15 men), aged between 60 and 75 years, to whom two balance tests were applied: the Sit and Stand Test (TSL) and the Timed Up and Go Test (TUGT). The elderly also answered a questionnaire about sociodemographic factors, health and physical activity. Results: Statistically significant (p<0.05) relationships were found for TUGT, evidencing that there is astatistically significant correlation between TUGT and TSL (p <0.022). Regarding the values obtained for TSL with TVM, it also observeda significant correlation (p <0.000), as well as toTUGT and TVM (p <0.003). Conclusion: This study showeda correlation between the functional mobility of the elderly through TSL and TVM tests result. Alsodemonstrated that the group participating in the program had positive resultsregarding the level of physical activity practiced. This results indicates the importance of optimization in the prevention and rehabilitation programs for the elderly, to maintain the functional mobility of elderly community members and reduce the body mass index. Copyright © 2021, Cristianne Confessor Castilho Lopes et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Citation: Cristianne Confessor Castilho Lopes, Marilda Morais da Costa, Ana Letícia Ferreira Vilela et al. 2021. “Relation between functional mobility and muscle strength of the elderly in a public physical activities program”, International Journal of Development Research, 11, (06), 47886-47889. INTRODUCTION Aging is a natural process for humans and, as a result of time, changes and deterioration, such as: deficits in functional capacity and physiological alterations, start to occur in the entirehuman body system. These changes occur in an idiosyncratic way, evolving progressively (BRASIL, 2014). In this sense, Motta (2004) emphasizes that chronological aging begins in childhood, and is easily measurable, while biological changes associated with age are difficult to measure. Fechine and Tompieri (2012), observing the aging process and the main changes that happen to the elderly over the years, highlight thatit is possible to noticethat the primary aging is genetically defined or pre-programmed, andit is present in all the people of the world. On the other hand, the secondary aging is the resultof external influences, that is, the variable between individuals in different environments, influenced by characteristics resulting from cultural, geographical and chronological factors. Estimates project that the number of elderly people by 2025 will exceed 30 million in Brazil, and old age may be accompanied by high levels of chronic diseases, reducing the health and well-being (DEBERT, 1999; LIMA, 2003; LIMA; SILVA; GALHARDONI, 2008). This increase in the elderly portion of the population pyramid bringing more notoriety to the demands of the group, such as the diseases that affect them. Thus, challenges for health professionals involved in the care of the elderly become more frequentas the group increases. It is noteworthy that the aging process compromises the ability of the central nervous system to process vestibular, visual and proprioceptive signals, that are responsible for maintaining body balance, as well as reducing the ability to modify reflexes (BARIN, 2011). It is also interesting to note that, with aging, chronic-degenerative disordersbecome more frequent. These diseases affect their autonomy and independence to perform daily tasks, therefore, affect the life quality of this population (CARDOSO et al., 2012). In the search for actions to improve the elderly life quality, studies have shown that the regular practice of physical activities is essential to improve and maintain their functional capacity.Making the elderly maintain and improve their 47887 Cristianne Confessor Castilho Lopes et al., Relation between functional mobility and muscle strength of the elderly in a public physical ACTIVITIES PROGRAM independence and autonomy, in addition to reducing the risk of noncommunicable diseases, depression and cognitive decline (WHO, 2006; 2015).According to Maciel (2010), the practice of physical activity, such as aerobic, associated with muscle strength and enduranceexercises, is a factor in preventing and monitoring illnesses caused by old age. Lins and Corbucci (2007) report in their study the reasons that lead individuals aged 60 years and over to exercise regularly. The main reason identified was for pleasure, followed by the intention to improve health. This shows that information about thehealth benefits of physical activity as a form of prevention to the bio psychosocialpsychosocial problems of the elderly is widespread (MACIEL, 2010). The present research aimed to verify the relationship between functional mobility and muscle strength in a group of elderly people who participated in a public physical activity program “Programa Mexa-se” in the Joinville city. METHODS This is a quantitative comparative descriptive study, part of a larger one. The research project was approved by the “Comitê de Ética em Pesquisas em Seres Humanos da Faculdade IELUSC” under the numbernº. 3.275654/2019. All participants signed an Informed Consent Form. Study Participants: From a total of 42 elderly people who participated in the “Programa Mexa-se”, held at Arena, Bucarein neighborhood of Joinville-SCcity, 27 elderly women and 15 men aged 68 years or more, randomly selected, were evaluated. One participant over the age of 84 years was excluded. All participants had been attending the “Programa Mexa-se” for more than three months, carried out by the “Secretaria de Esportes de Joinville” (SESPORTE). TheSESPORTE, concerned with the health, leisure, well-being andpopulation’slife quality, implemented in august 2014 the “Programa Mexa-se”. it is a programthat performs systematic physical activities in groups for free, involving: gymnastics, dances, monitored walking, postural and breathing exercises, stretching and relaxation.There is always a professional from the physical education area who supervises the actions, in addition the program has the participation of physical education monitors, who teach the practices of physical activities. The activities offered take place from march to November with two (2) weekly classes with an average duration of one (1) hour. The “Programa Mexa-se”, which is configured as a continuous activity, proposes an action aimed at the practice of regular physical activity, the incorporation of healthy habits, social inclusion and serves the community in adulthood. It works in four axes:“Mexa-se RUN”, “Mexa-se Funcional”, “Mexa-se Esportes Adaptados” and “Mexa-se ginásticas e ritmos”. The last one was evaluated and is part of this study. According to the American College of Sports Medicine (ACMS) and American Heart Association (AHA) guidelines the recommendation for older adults is similar to the updated ACSM/AHA adult recommendation, but has several important differences.Amongst them: the recommended intensity of aerobic activity takes into account the aerobic fitness of the adult; activities that maintain or increase flexibility are recommended; and balance exercises are recommended for seniors at risk of falling. In addition, seniors must have an activity plan to achieve the recommended physical activity that integrates preventive and therapeutic recommendations. The promotion of physical activity in the elderly should emphasize aerobic activity of moderate intensity, muscle-strengthening activity, reduction of sedentary behavior and risk management (NELSON et al, 2007). According to Malafaia et al. (2019), during the aging process, physical and metabolic changes are observed. The reduction in aerobic capacity, changes in body constitution and the emergence of complications resulting from chronic diseases can lead to reduced independence and a significant increase in morbidity and mortality. Therefore, the importance of a structured plan with exercise prescription is based on four fundamental points that must be addressed in an integrated and continuous way: aerobic exercises, flexibility, balance and muscle strength (NELSON et al., 2007). It is worth noting that only the group of gymnastics from the Núcleo da Arena participated in this study, and that they participate in the gymnastics program (with coordination exercises, agility, balance muscle strength and fundamentally with rhythms, this happens for female elderly and for the male elderly the activities performed are: functional conditioning, upper and lower limb strength exercises, coordination, balance and walking. Measuring Instruments: The assessments were initiated through a questionnaire, in an interview form,covering sociodemographic, health and physical activity aspects. The following study instruments were also used to assess the functional mobility of the elderly: The Timed Up and Go Test (TUGT) by Schoene et al. (2013), which is part of Rikli's Senior Fitness Test (SFT) battery; and Jones (2008) to assess lower limb strength. To classify the participants physical activity level(low, moderate orhigh), the International Physical Activity Questionnaire - short version form (VALIM-ROGATTO; CANDOLO, 2011) and (NAHAS, 2013) was used. To assess muscle mass, a predictive equation was used (SOARES; MARCELINO; MAIA, 2017) establishing the Total Muscle Mass Index ranging from 5.9 to 9.5 kg.m2, calculated by equation (1), where the Index of Total Muscle Mass is expressed as IMMT (kg.m2) = MMT / E2. Total Muscle Mass (MMT) = 0.244 PC + 7, 80.E1 - 0.098.I + 6, 6.S + Et 3.3. Where PC is the body weight, in kg; E1 is the height, in meters; I age, in years; S is the sex (male = 0 and male =1); Ethnic ethnicity (Cauasians = 0, Asians = -1.2 and Afro-descendants = 1.4). It was also used a digital scale, with a resolution of 50g, to measure the body mass (Model OMRON), with a capacity of 150 kg, a Stadiometer with a resolution of 1 mm to measure the height (Model ES2020 Brand Sanny®, BR). After determining the Body Mass Index (BMI), the participants were classified into three groups: Low weight <22 kg/m2; Eutrophic 22 to 27 kg/m2; and Overweight >27 kg/m2. This classification of nutritional status based on BMI was proposed by the Nutrition Screening Initiative. These cutoff points were adopted for the elderly in Brazil according to recommendations of “Sistema de Vigilância Alimentar e Nutricional” (SISVAN). Data Analysis Data tabulation and analysis was performed using the GraphPad Prism 6® software. Descriptive statistics data were obtained. To verify the relationship between functional mobility and the other variables (BMI, age, TGUT, TSL and TVM), the Pearson Correlation Test was used, with a significance level of 95% (p<0.05). RESULTS All study participants were classified as having a good level of physical activity, only the maximum age grouppresented an overweight classification in the anthropometric assessment, as shown in Table 1 with the descriptive statistics data (means and standard deviations) for each controlled variable. As the BMI was used as a reference to classify the participants involved in the study, a correlation analysis was also performed between this variable and the others, as shown in Table 1. Table 1. Results of the variables Age, BMI TSL x TUGT and TSL x TVM M DP Min Max AGE 68.0 5.08 60 79 BMI 28.9 3.41 20 35.8 TUG 6.43 0.9 5.08 10.2 TVM 1.79 0.24 1.19 2.43 TSL 19.7 4.4 11 29 Caption: BMI, Body Mass Index (kg/m2); Age, in year; Total Muscle Mass Index (5.9 to 9.5 kg.m². TUGT (TimedUpandGo Test); TVM (Gait Speed Tests); TSL (Sit and Stand Test). All variables have mean M and deviation standard (SD) * significant difference (p<0.05). Table 2 shows that there was a correlation between TUGT and TSL, TUGT and TVM the values obtained TSL with TVM. 47888 International Journal of Development Research, Vol. 11, Issue, 06, pp. 47886-47889, June, 2021 Table 2. Relationship between functional mobility and variables (TGUT, TSL and TVM) r value p value TUGT X TSL r -0.35 p 0.022* TUGT x TVM 0.45 p 0.003* TSL x TVM r 0.68 p 0.00* * Pearson Correlation Test Caption: BMI, Body Mass Index (kg/m2); Age, in year; Total Muscle Mass Index (5.9 to 9.5 kg.m². TUGT (TimedUpandGo Test); TVM (Gait speed tests); TSL (Sit and Stand Test). All variables have mean M and deviation standard (SD).* Significant correlation coefficients (p<0.05). During the test, the elderly person was instructed to get up, walk a linear course of three meters, make a 180º turn and return and sit down again, supporting arms and back in the same chair, the entire test period has been timed. The timing starts when the elderly person takes the column from the chair and ends when it leans back. A digital stopwatch was used and the exact location of the chair, as well as the return point, three meters ahead, were clearly marked with yellow gold adhesive tape. All seniors belonging to the program were evaluated in a single month, in a large sports training room at Arena Joinville. According to the results indicated by PODSIADLO and RICHARDSON(1991): (1) TUGT up to ten seconds - elderly with no change in balance and with low risk of falls; (2) TUGT between 11 and 20 seconds - elderly without significant change in balance, but with some frailty and medium risk of falls; (3) TUGT greater than 20 seconds and less than 30 seconds - elderly in need of intervention; (4) TUGT greater than 30 seconds - elderly at high risk of falls and dependent individuals in activities of daily living (ADLs) and with altered mobility. In this study, parameters of muscle strength and functional mobility of the lower muscle limbs were investigated. In the analysis of Pearson's correlation, it is possible to notice a high correlation between the tests TUGT (r>0.35),for TSL and TUGT (r>0.45) above all, and for TVM; TSL(r>0.68) TVM as the value (p 0.003), respectively, in which it presents a sign of significant validity (p<0.05) (GARCIA, 2007). To assess the degree of functional mobility, the timed stand up and walk test (TUGT) was used. In its result, no statistical difference was detected between the TUGT means presented by genders, both in the community (p>0.05) and in the LSIE (p>0.05). Men and women living in the LSIE had a significantly higher mean TUG than men and women in the community (p<0.01). A significant difference was detected between the TUG means, when compared in terms of age group (p=0.003). Functional mobility is greater among the elderly living in the community, and that men and women have a similar level of performance in functional mobility, which decreases with age, in all age groups. In comparison with this study, although (n <) the participants obtained a very expressive result in the TUG Test (p 0.0022), thus attributing that the practice has brought benefits in the muscle strengthening of the elderly. In the study carried out by Souza et al. (2013) the aim is to evaluate and compare a measure of functional mobility in elderly people living in the community and in a long-term care institution for the elderly (ILPI), and verifying its relationship with age and gender in different locations. A total of 413 elderly people participated in this study, 72 of whom were institutionalized (80.9 ± 8.1 years; 53 women) and 341 from the community (69.8 ± 7.5 years; 269 women). DISCUSSION As age advances, structures related to locomotion are also altered. Bones become more fragile and thus there is a greater risk of fractures.There is a loss of muscle mass and strength, with difficulties in maintaining balance and, as a consequence, the elderly may show decreased agility, walk slower and dragged (SANTOS, 2010). The present study observed that functional mobility presents a correlation withTUGT, age and other variables. Although the literature shows that aging can cause several structural and functional changes in the elderly for this study, the particularities of the individuals and socioeconomic data were not taken into account. The group has a good level of physical activity. In the present study, the TUGT, TSL and TVM tests were correlated with each other and with BMI and Age. Lemos et al. (2006) highlight that the loss of functional independence, resulting from the inability to walk in the elderly, whether due to functional limitation or fear of falling,has been the main cause of the occurrence of hip fractures. Another factor is physical inactivity, which worsens osteoporosis and thus increases the risk of falls and, consequently, new fractures. Based on studiesperformed by MACIEL et al. (2005), SIQUEIRA et. al. (2007) and ALVARES et al. (2010), regarding a higher prevalence of falls in the elderly, they concluded that: the older the person gets, the greater it is the risk of falling. This is due to the reduction in the quality and quantity of information necessary for efficient postural control. Groisman (2002) explains that the rate of decline of physiological functions is exponential, that is, during the aging process, there are functional losses that are accelerated with increasing age. In this sense, there is a cumulative effect of functional changes, with progressive degeneration of the mechanisms that regulate the responses of cellular and organic phases. Associated with it, external aggressions lead to a functional imbalance in the body, in general, showingthe importance of actions aimed at evaluation and prevention inthe elderly health (BRASIL, 2009). During the stages of life, the individual undergoes the main biological changes: decreased muscle mass and bone density; loss of muscle strength; impaired agility, motor coordination and balance; impaired joint mobility, greater rigidity of cartilage, tendons and ligaments; decreased thermoregulatory capacity; greater ventilatory work on exertion; impaired liver and kidney function; smaller number and size of neurons; decreased reaction time and nerve conduction (LIMA, 2014). Moura et al. (2012) analyzed the effects of strength, balance and stretching training on the functional mobility of the elderly and observed benefits in elderly women with low bone mass in both the control and trained groups. Kemmler et al. (2003; 2007) mention, regarding the prevention of bone loss, high impact exercises proved to be more efficient, as this type of exercise requires greater bone strength.Thus, exposing these bones to episodes of stress can have positive effects on the rigidity of these bones, althoughmay cause fractures, when they are exposed to extreme stress. Based on the data obtained in the study carried out by Santos et al. (2010),it is possible to state that physical exercise is considered an important factor in both the prevention and treatment of osteoporosis. It was possible to verify that the exercises have specificities. Those most used in the treatment of osteoporosis were characterized as low and medium intensity since the bones of the elderly affected by osteoporosis can be fractured if exercises that produce great impacts are used. It is also noteworthy that the exercises that act to improve balance and coordination are efficient in the treatment, as they can reduce the risk of falls that could cause fractures for those affected by the disease. It was also observed that the exercises used to prevent osteoporosis were characterized as high intensity, as they significantly increase bone mineral density and because, as in prevention, the person does not have osteoporosis, the risk of fractures is lower (SANTOS et al., 2010). Therefore, pointing out the aspects of functional mobility and muscle strength in the elderly, it is correct to state that, as the mechanical properties of the muscle-tendon complex and the muscle capacity to produce strength leading the elderly to a predisposition to fall and possible bone fractures, studies point out that stretching exercises, sometimes associated with other types of activities, allow for the increase and maintenance of a joint range of motion, as they alter the viscoelastic characteristics of the musculature and modify its behavior in dynamic activities. According to the proposed objective of this study, which was to verify if there is a relationship between strength and functional mobility, thus contribute to the planning of physical activity actions in the program. it was possible to realize that strength training is one of the therapeutic conductsto alleviate muscle weakness with advancing age. A sport that is capable of providing very expressive gains in muscle strength, which can be performed with the help of some materials, such as dumbbells, rings, bars, elastic devices, in rehabilitation clinics and physical activity gyms (MEDEIROS, 2010). 47889 Cristianne Confessor Castilho Lopes et al., Relation between functional mobility and muscle strength of the elderly in a public physical ACTIVITIES PROGRAM Final Considerations This study found a correlation between functional mobility in muscle function of the elderly's lower limbs, through TSL and TVM,and demonstrated that the group participating in the program had positive results. This indicates the importance of optimizing prevention and rehabilitation programs for the elderly, including activities such as strength, coordination, and balance exercises, besidesmaintaining the functional mobility of community elderly people. We also highlight that the participating group is overweight, it is suggested to intensify activities to reduce the BMI. REFERENCES ÁLVARES L, LIMA R, SILVA R. Ocorrência de quedas em idosos residentes em instituições de longa permanência em Pelotas, Rio Grande do Sul, Brasil. Cad Saúde Pública. p. 26:31-40, 2010. BARIN K, Dodson EE. Dizziness in the elderly. Otolaryngol Clin North Am 2011; 44(2): 437-54. BRASIL, Agência Nacional de Saúde Suplementar. Manual técnico de promoção da saúde e prevenção de riscos e doenças na saúde suplementar / Agência Nacional de Saúde Suplementar (Brasil). – 3. ed. rev. e atual. – Rio de Janeiro : ANS, p. 244, 2009. BRASIL, MINISTÉRIO DA SAÚDE, SECRETARIA DE VIGILÂNCIA EM Vigitel Brasil 2013: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. 1ª ed. Brasília: Ministério da Saúde, 2014. CARDOSO, M. S. et. al. A prática de exércícios físicos nas academias da terceira idade, prática de atividade físia para idosos. Estação Científica Online, v. 4, p. 1-13, 2012. DEBERT, G. G. Velhice e sociedade. Campinas: Papirus, p.227, 1999. FECHINE, Basílio Rommel TROMPIERI, Nicolino. O processo de envelhecimento: as principais alterações que acontecem com o idoso com o passar dos anos. Revista Científica Internacional. 20 ed. v. 1, 2012. Disponível em: <http://www.fonovim.com.br/arquivos/534ca4b0b3855f1a4003d 09b77ee4138-Modifica----es-fisiol--gicas-normais-no-sistemanervoso-do-idoso.pdf>. Acesso em: 16 jun. 2020. GARCIA. Anthropometric measures and nutritional status in a healthy elderly population. BMC Public Health.; p. 7 (2):1-9. 2007 GROISMAN, E.A., KAYSER, J., AND SONCINI, F.C. (2002) REGULATION OF POLYMYXIN RESISTANCE AND ADAPTATION TO LOW‐MG2+ ENVIRONMENTS. J BACTERIOL. p. 179: 7040– 7045. KEMMLER Georg, Weiss, Elisabeth M; Stadelmann, Edith; Kohler, Christian G; Brensinger, Colleen M; Nolan, Karen A; et al. Journal of the International Neuropsychological Society : JINS; Cambridge. Vol. 13, Ed. 5, p. 881-7, out/2003. KEMMLER W, ENGELKE K, VON STENGEL S, WEINECK J, LAUBER D, KALENDER WA. Long-term four-year exercise has a positive effect on menopausal risk factors: the Erlangen Fitness Osteoporosis Prevention Study. J Strength Cond Res.; p. 21(1):232-9, 2007. KEMMLER W, ENGELKE K, WEINECK J, HENSEN J, KALENDER WA. The Erlangen Fitness Osteoporosis Prevention Study: a controlled exercise trial in early postmenopausal women with low bone density-first-year results. Arch Phys Med Rehabil. p. 84(5):673-82, 2003. LEMOS, MCD, MIYAMOTO, S.T, VALIM, V, NATOUR J. Qualidade de vida em pacientes com osteoporose: correlação entre OPAQ e SF-36. Rev Bras Reumatol. p. 46(5):323-8, 2006. LIMA, A.C Os benefícios do Pilates no processo de envelhecimento. 2014. LIMA, A.M.M.; SILVA, H.S.; GALHARDONI, R. Envelhecimento bem-sucedido: trajetórias de um constructo e novas fronteiras. Interface – Comunic., Saude, Educ.., v.12, n.27, p.795-807, 2008. LIMA, L.C. A Escola como Organização Educativa: Uma Abordagem Sociológica. São Paulo, Cortez. p. 189, 2003. LINS, Raquel Guimarães e CORBUCCI, Paulo Roberto. A importânc ia da motivação na prática de atividade física para idosos. Estaçã o Científica Online. Juiz de Fora, n. 04, abr/ mai 2007. MACIEL A, GUERRA R. Prevalência e fatores associados de equilíbrio em idosos. Rev Bras Ciênc Mov. p. 13:37-44, 2005. MACIEL, Marcos Gonçalves. Atividade Física e funcionalidade do idoso. Motriz, v. 16, n. 4, p. 1024-1032, 2010. MALAFAIA, Felipe Lopes; BUGLIA, Susimeire. Prescrição de atividade física em idosos: Nunca é tarde demias para combater o sedentarismo. Rev DERC,v. 25, n. 1: p.14-18, 2019. MEDEIROS, James Fernandes. Efeitos do treinamento de força na saúde do idoso. Buenos Aires: EFDeportes.com, Revista Digital, Buenos Aires, a.15, n 148, sept. 2010. Disponível em: Disponível em: <https://www.efdeportes.com/efd148/efeitos-dotreinamento-de-forca-do-idoso.htm>. Acesso em: 14 jun. 2020. MOTTA, L.B. Processo de envelhecimento. In: A.L. Saldanha e C.P. Caldas (Ed.), Saúde do Idoso: a arte de cuidar. 2 ed. Rio de janeiro: Interciência. p.115- 124, 2004. NAHAS, Markus Vinícius. Atividade física, saúde e qualidade de vida: conceitos e sugestoes para um estilo de vida ativo. 6 ed. Londrina: Midiograf, 2013. NELSON, ME, REJESKI, WJ, BLAIR SN, DUNCAN PW, JUDGE JO, KING AC, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation; p.116:1094–105, ago 2007. PODSIADLO D, RICHARDSON S. The Timed "Up and Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc.; p. 39:142-8, 1991. RIKLI, Roberta; JONES, Jessie. Teste de Aptidão Física para Idosos. São Paulo: Manole, 2008. SANTOS, Marcelo Lasmar dos; BORGES, Grasiely Faccin. Exercício físico no tratamento e prevenção de idosos com osteoporose: uma revisão sistemática. Fisioter. mov. (Impr.), Curitiba, v. 23, n. 2, p. 289-299, June 2010. Available from <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103 51502010000200012&lng=en&nrm=iso>. Access on 13 July 2020. SCHOENE, D.; WU, S.M.; MIKOLAIZAK, A. S.; MENANT, J. C.; SMITH, S. T.; DELBAERE, K.; LORD, S. R. Discriminative Ability and Predictive Validity of the Time Up and Go Test in Identifying Older People Who Fall: Systematic Review and Meta-Analysis, Journal American Geriatrics Society, v.61, p.202- 208, 2013. SIQUEIRA, F, FACCHINI LA, PICCINIi RX, TOMASI E, THUMÉ E, SILVEIRA DS et al. Prevalência de quedas em idosos e fatores associados. Rev Saúde Pública. p.41:749-56, 2007. SOARES, A. V.; MARCELINO, E.; MAIA, K. Relação entre mobilidade funcional e dinapenia em idosos com fragilidade. Revista Einstein, São Paulo, v. 15, n. 47, p. 278 - 282, 2017. SOUZA, Cibele Cardenaz de et al . Mobilidade funcional em idosos institucionalizados e não institucionalizados. Rev. bras. geriatr. gerontol., Rio de Janeiro, v. 16, n. 2, p. 285-293, 2013. Available from: <http://www.scielo.br/scielo.php?script =sci_arttext&pid=S1809-98232013000200008&lng=en &nrm=iso>. access on 13 July 2020>. TRIBESS S. Prescrição de exercícios físicos para idosos. Saúde.com [periódicos na Internet]. 2005 Dez [acesso em 06 ago 2020]; 1(2):163-72. Disponível em: http:// periodicos2.uesb.br/ index.php/rsc/article/view/58 VALIM-ROGATTO, P. C.; CANDOLO, C. Nível de Atividade Física e sua Relação com Quedas Acidentais e Fatores Psicossociais em Idosos de Centro de Convivência. Revista Brasileira de Geriatria e Gerontologia, Rio de Janeiro, v. 14, n. 3, maio, 2011. WHO (World Health Organization) World report on ageing and health. Luxembourg: WHO; 2015. [acesso em 06 ago 2020]. Disponível em: http://apps.who.int/iris/ bitstream/handle/10665/ 186463/9789240694811_eng. pdf?sequence=1 WHO. Multicentre Growth Reference Study Group. WHO child growth standards based on length/height, weight and age. Acta Paediatr Suppl. 450:76–85, 2006. *******