Validação Concorrente do Protocolo Normal Flex para Avaliação da Amplitude de Movimento Articular em Mulheres Idosas: Estudo Comparativo com Métodos Goniométricos
DOI:
https://doi.org/10.36557/2674-9432.2026v5n5p912-926Abstract
This study investigated the impacts of aging on flexibility in older women, with emphasis on the validation of the Normal Flex protocol as an instrument for assessing joint range of motion (ROM). A literature review was conducted addressing age-related physiological changes, the effects of sedentary lifestyle, and the benefits of regular physical activity.
The initial sample consisted of 50 older women (mean age between 60 and 75 years) living in the State of Rio de Janeiro, Brazil, divided into two groups: 30 physically active (Group 1) and 20 sedentary (Group 2). There was a loss of 9 participants. The Normal Flex protocol consists of seven movements organized into three body segments (upper limbs, trunk, and lower limbs), with three levels of difficulty and dichotomous scoring (success/failure).
The protocol was compared with analog, digital, and radiological goniometry, as well as toniciometry. Statistical analysis included Spearman and Pearson correlations, in addition to the application of Fuzzy Logic using FuzzyTech® software for combinatorial classification.
Main results: Moderate to high concurrent validity was observed between analog and digital goniometry in most movements (e.g., horizontal shoulder extension r ≈ 0.83; shoulder abduction r = 0.99; standing lumbar flexion r = 0.86; knee flexion r = 0.96; all with p < 0.05). Correlations with radiological goniometry and toniciometry were low or absent, indicating that these methods are not suitable as gold standards. Inter-rater reliability was good, with consistency in central tendency measures. Fuzzy Logic analysis confirmed the validity of the classificatory table, especially in Group 1, where active participants showed a high concentration of maximum scores. Correlations between lumbar flexion tests were moderate but showed no redundancy, justifying the retention of all items in the protocol.
Conclusion: The Normal Flex protocol proved to be reliable and valid for the functional assessment of flexibility in older women. Its use is recommended for monitoring functional autonomy during aging. Future studies with more heterogeneous samples are suggested to further strengthen its validation.
Keywords: Aging; Flexibility; Test validation; Joint range of motion; Older women; Normal Flex protocol; Fuzzy Logic.
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Copyright (c) 2026 Ronaldo Vivone Varejão, Karollyni Bastos Andrade Dantas, Claudia Valéria Silvestre Rêgo Lacerda, Carlos Soares Pernambuco, Estélio Henrique Martin Dantas
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