It is essential to identify people suffering from chronic degenerative diseases early on and to register them at health centers (HCs) to successfully control risk factors for these diseases. Physical exercise is an important tool for the promotion, prevention, and rehabilitation in healthcare, reducing morbidity, mortality, and costs. Therefore, the objective of the Floripativa program is to implement rehabilitation, prevention, and health promotion at the HCs in Florianopolis, SC, Brazil.
This program is the fruit of a partnership between the Health and Social Services Departments and the city’s universities’ (UFSC and UDESC) unifying existing programs, in an intervention linked to the Global Strategy for an Elderly Citizen’s Social Protection Network. To unify the programs already in existence, a single program was created (Floripativa), designed to act through rehabilitation, prevention and promotion in healthcare using physical exercise programs that are part of the Elderly Capital project.
The program consists of a number of stages divided into 3 phases. Stage 1 of phase A is to identify patients with nontransmissible diseases and conditions (NTDC) and refer them for stages 2 and 3, which are cardiopulmonary and metabolic rehabilitation (CPMR) carried out by physiotherapists. When patients have finished phase A, they are referred for phase B in which they are offered secondary and tertiary prevention, i.e., stages 4 and 5, in addition to referring patients with specific conditions such as depression, Parkinson’s and Alzheimer’s to specialists. Stages 4 and 5 are carried out by physical education professionals. Once patients have completed phase B, they are referred for C: primary prevention and secondary and health promotion, once more carried out by physical education professionals. Only patients whose diseases are under control are referred for phase C. Phases A and B have been implemented in 4 HCs and are being extended to another 8 HCs in the city with the expectation that they will be implemented in all of the health authority’s administrative regions (53 HCs). There are 25 groups currently on phase C and this too will be extended.
The physical activities in the program are aerobics and walking, 3 times a week, for a duration of 60 min. These activities emphasize aerobic fitness, strength, and balance. There are currently 70 elderly people in phase A, 125 in phase B and 600 in phase C. The results of a pilot study have demonstrated that elderly participants reduced their consumption of medication, were admitted to hospital less often and attended fewer medical consultations and also improved their overall physical fitness, functional capacity, and self-esteem.