Correlation between concern about falling and functional muscle fitness in community-dwelling elderly

Introduction: To establish a correlation between concern about falling and a more comprehensive functional parameter, functional muscle fitness, a variable that encompasses functional components such as balance, muscle strength, power, flexibility and motor coordination in an integrated way. Functional muscle fitness is measured using the sitting-rising (from the floor) test (SRT), a simple, safe, fast and ecological test. Objective: The aim of our study was to determine the correlation between concern about falling and functional muscle fitness in the elderly. Methods: A cross-sectional observational study was conducted. The sample consisted of 53 elderly people of both sexes (86.8% women; 65.6 ± 4.7 years old; body mass index 28.5 ± 3.8 kg/m 2 ), who were assessed for concern about falling (through Falls Efficacy Scale International, FES-I-Brazil) and functional muscle fitness (through SRT). Correlation analysis was performed using the Spearman test. For all analyses, a significance level of 5% (p < 0.05) was established. Results: Concern about falling showed a negative correlation with functional muscle fitness (rho = -0.229; p = 0.015). Conclusion: Elderly people with lower levels of functional muscle fitness have a higher level of concern about falling.


Introduction
According to the projection of the United Nations, it is estimated that in 2050 about 30% of the population will be composed of elderly people. 1 Faced with the increase in the elderly population, the literature has pointed to the importance of increasingly studying the entire process of senescence and its changes.  Brazil. 6,7 Senescence also brings with it some psychological damage, 8 such as the concern about falling, characterized by the feeling of insecurity during daily activities. 9 Schepens et al. 10 conducted a meta-analysis pointing out that the concern about falling appears as a protective factor against falls, increasing attention in the performance of daily activities; however, these increases end up developing an excessive restriction of movements, decreasing the levels of physical activity, which can aggravate the loss of functionality in the elderly. 9,10 The literature demonstrates a correlation between the level of concern about falling and some functional components alone, such as balance, 11 Considering that previous studies have already demonstrated a correlation between the concern about falling and other isolated functional components in the elderly, [11][12][13][14][15][16] it is likely that there may also be a negative correlation with functional muscle fitness. In this sense, it would be possible to previously identify possible psychological damage associated with the concern about falling, through a single test capable of predicting the functional status of the elderly. Therefore, the objective of the present study was to correlate the levels of concern about falling with functional muscle fitness in community-dwelling elderly. 17

Procedures
Assessment of concern about falling -International

Fall Efficacy Scale (FES-I-Brazil)
Concern about falling was assessed using the FES-I-Brazil, which represents the degree of concern about the possibility of falling when performing activities of daily living (basic and instrumental), socialization and postural control. 19 The scale contains 16 questions with scores ranging from 1 to 4 points per question, where 1 point is the minimum score (not at all concerned) and 4 is the maximum score (extremely concerned).

Evaluation of functional muscle fitness (SRT)
The measurement of functional muscle fitness was performed using the SRT. 17,20 The test consists of quantifying the supports that the individual uses to sit and get up from the floor, which can be hands and/or knees, or even the hands on the knees and legs. Independent grades are assigned for each of the two acts, sitting and rising. The maximum grade is 5 for each of the two.
You also lose half a point for any noticeable imbalance.
The best result of two attempts for each of the two acts

Results
The      between concern about falling with force, through handgrip strength and strength in knee extension, and in both methods significant associations with concern about falling were found.
Regarding muscle power and concern about falling, in the only study found that brought this relationship,

Discussion
Confirming the initial hypothesis, the present study revealed a negative correlation between functional muscle fitness (SRT) and concern about falling (FES-I- Brazil), indicating that functional impairments are related to increased levels of concern about falling. Although the relationship between concern about falling and functional aspects has already been pointed out in the concern about falling in the elderly, the SRT evaluates all these components in an integrated way. Thus, it is possible to relate functional muscle fitness with concern about falling in the elderly.
Another important finding is that the SRT, according  (Table 2) and confirmed the results that the lower the functional muscle fitness, the greater the concern about falling among the elderly.
The present study showed as strengths the use of a validated, reliable and sensitive instrument for the elderly population, capable of quick, safe, practical and costless determination of functional parameters in an integrated manner. In addition, it is also an instrument capable of offering an overview of another important aspect in the context of the elderly, which is the level of concern about falling, especially useful in times of a pandemic, in which the elderly, classified as a risk group, need to avoid exposures. On the other hand, the sample size, derived from a non-probabilistic sample size, was considered a