Physical therapy treatment on frailty syndrome: systematic review

Objective: To carry out a systematic review of the literature on physical therapy interventions and their effect on frail community-dwelling elders. Methods: Systematic review of studies published until June 2008 in the databases Medline, Embase, PEDro, SciELO, LILACS and Cochrane Library. We excluded studies with samples composed of institutionalized, hospitalized and non-frail participants, studies not aimed at treating frailty, and studies that were not specifically related to physical therapy. Results: In accordance with the exclusion criteria, out of the 152 Medline articles, only 15 were considered for analysis, out of the 71 PEDro articles only one was considered as the other ten had already been selected in Medline, and out of the 461 Embase articles only two that had not been selected in others databases were included in this study. A total of seven different types of interventions were verified: 1) muscle strengthening; 2) exercises for muscle strengthening, balance, coordination, flexibility, reaction time and aerobic training; 3) functional training; 4) physical therapy; 5) at-home physical therapy; 6) environment adaptation and prescription of assistive device; 7) water exercise. The results of some studies were contradictory even with similar interventions. The analyzed studies had different definitions for fragility, which made it difficult to compare the results. Conclusion: There is little evidence of the effect of physical therapy intervention on frail community-dwelling elders; thus, it is not possible to reach a consensus or conclusion on the effectiveness of the therapeutic regimens proposed for this complex syndrome.