A s quedas, definidas como escorregamento ou tropeçamento que resulta em ferimentos, não são acontecimentos ao acaso. 1-2 A população idosa portuguesa, seguindo a tendência mundial, tem vindo a aumentar. 3 Com o envelhecimento surgem inúmeras mudanças físicas, sensoriais e cognitivas que diminuem a eficiência, a aptidão para se adaptar e a funcionalidade, algo inevitável, manifes-Objectives: Falls are defined as events in which a person comes to rest inadvertently on the ground or floor or other lower level. They do not happen by chance, but can be predicted through the assessment of risk factors. The elderly population is more vulnerable. It is estimated that 30% of people aged 65 or more fall at least once a year. This represents a potentially preventable cause of disability and high health care costs. The aim of this study is to determine the benefits of physical exercise (PE) in the prevention of falls in the elderly. Data sources: MEDLINE and evidence-based medicine databases. Review methods: Research of clinical guidelines, meta-analyses (MA), systematic reviews (SR) and randomized controlled clinical trials, published between January 2010 and September 2014, using the MeSH terms: ACCIDENTAL FALLS, ACCIDENT PRE-VENTION, AGED and EXERCISE. Strength of Recommendation Taxonomy (SORT) was utilized for the assignment of levels of evidence and strength of recommendations. Results: We found 203 articles. Five met the inclusion criteria, including three MA and two SR. There is evidence that exercise programs to prevent falls in older people not only reduce the incidence of falls but also prevent injuries arising from falls. Many of the risk factors for falls are correctable by well-designed exercise programs. These are equally effective if practiced at home. The most effective type of PE in the prevention of falls in the elderly is balance training. PE programs are more effective if prolonged in time and of greater intensity (a greater number of hours and at least twice a week). Conclusions: PE programs should be recommended because they are effective in decreasing the number and risk of falls in the elderly (Strength of Recommendation A).
Highlights
Children with altered auditory processing exhibit a specific cognitive profile.
Lower verbal and spatial reasoning performance are associated with altered auditory processing.
Children with specific learning disorder should undergo a complete multimodal examination.
A atuação do Federal Reserve System - Fed - durante a formação e estouro da bolha imobiliária mostra as dificuldades de um banco central em processos financeiros de grande magnitude. O Fed foi leniente com o desenvolvimento da bolha, por considerar que a alta do preço dos imóveis ajudava a reduzir os riscos de instabilidade financeira gerados pelas crises de 2000-2002. Quando a crise do mercado subprime se tornou aguda, em setembro de 2008, o Fed atuou agressivamente como emprestador de última instância, expandindo a base monetária para conter os riscos de inadimplência generalizada no mercado interbancário. Nos dois momentos, o Fed agiu com pragmatismo e discricionariedade, contrariando as teses dominantes do "Novo Consenso", mas foi "prisioneiro" dessas teses e dos interesses do mercado financeiro: a tese de que a desregulamentação dos mercados favorece a sociedade inibiu iniciativas intervencionistas para restringir as inovações financeiras no mercado imobiliário; a tese de que o mandato da Autoridade Monetária deve ser a estabilidade de preços contribuiu para a leniência com os riscos crescentes nos mercados financeiros.
A autora agradece os valiosos comentários de Persio Arida, José Márcio Rego e Paulo Gala. Os erros e omissões são de inteira responsabilidade da autora.
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