Learning needs in healthy and active aging according to key stakeholders: a multinational survey.

Healthy and active aging and age-friendly society frameworks attempt to address the well-documented challenges and opportunities of population aging. To meet the needs of an increasingly older society, there is a demand for professionals with appropriate age-related knowledge and skills. To this end, a master's in active aging is in development. This study reports on the consultation with prospective students, employers, older people and academics on the knowledge areas to be included in the course. An anonymous online survey gathered data from stakeholders in Ireland, Slovenia, Austria, Portugal, Finland, and Greece. Participants ranked the importance of 14 broad knowledge areas and linked topics. The influence of participant characteristics on decisions was examined using multivariate regression modeling. Across all stakeholder groups (total sample N = 757), health promotion was most often deemed very important (80%), followed by psychology (73%), and social inclusion and engagement (71%). Potential students from healthcare backgrounds were more interested than others in aging physiology, social aspects, and the physical environment. More western-located European countries overall showed more enthusiasm for the topics presented, additional to regional variations between topics. This learning needs analysis provides multi-stakeholder insights into priorities regarding learning in healthy and active aging and age-friendly society.

The European Portuguese Version of the Composite Physical Function Scale: Cross-Cultural Adaptation and Validation in Community-Dwelling Older Adults.

This study aims to perform the cross-cultural adaptation to European Portuguese of the Composite Physical Function Scale and to assess its validity and reliability in a sample of community-dwelling older adults. The scale was translated into European Portuguese, back translated, and piloted in a sample of 16 representative individuals. Its validity and reliability were tested in an independent sample of 114 community-dwelling older adults (52 were tested twice to assess test-retest reliability). The results showed that the scale had good internal consistency (α = .90), construct validity (ρ = .71) and measurement error (78.8% agreement), and excellent test-retest reliability (κ = .98). However, a ceiling effect was found as 28% of the participants achieved the highest possible score. Although the scale has good measurement properties, the presence of ceiling effects is indicative that this tool is not able to distinguish higher levels of intrinsic capacity within community-dwelling older adults.

Knee osteoarthritis pre-screening questionnaire (KOPS): cross-cultural adaptation and measurement properties of the brazilian version-KOPS Brazilian version.

BACKGROUND: Despite the criteria already established for the classification of knee osteoarthritis (OA), a radiographic and/or clinical knee OA diagnosis usually occurs in cases of fully manifest or more advanced disease, which can make health promotion, prevention, and functional rehabilitation in more advanced stages of the disease less effective. In addition, radiographic knee OA can generate more financial costs for health services. Therefore, developing and validating screening instruments to assess the probability of development and progression of knee OA would be of great value for both clinical practice and science. OBJECTIVE: To cross-culturally adapt and investigate the measurement properties of the Knee OA Pre-screening Questionnaire Brazilian version. METHODS: A total of 250 individuals of both sexes aged between 35 and 92 years [(mean (standard deviation): 63 (11) years old; 74.1 (15.1) kg; 1.59 (0.09) m; 29.38 (5.44) kg/m2] participated in this study. The cross-cultural adaptation and analyses of the measurement properties of the KOPS Brazilian version included: (1) assessment of conceptual and item equivalence; (2) assessment of semantic equivalence; (3) assessment of operational equivalence; and (4) assessment of measurement equivalence, reliability, and validity. RESULTS: Cronbach's alpha for the internal consistency among the six components of the KOPS Brazilian version was 0.71. The test-retest 72 h apart for each component resulted in a coefficient correlation intraclass ranging from 0.74 to 1.00. The probability of an individual randomly chosen from the population having KL ≥ 1 and KOPS Brazilian version ≥ 21 points was 0.74 (area under the curve of the Receiver Operating Characteristic - AUC of ROC); furthermore, the AUC for KL ≥ 2 and the KOPS Brazilian version ≥ 23 points was 0.77. CONCLUSION: The KOPS Brazilian version is a reliable and valid instrument for early screening of knee OA in individuals aged 35 years and over in the Brazilian context.

Users' Perspective on the AI-Based Smartphone PROTEIN App for Personalized Nutrition and Healthy Living: A Modified Technology Acceptance Model (mTAM) Approach.

The ubiquitous nature of smartphone ownership, its broad application and usage, along with its interactive delivery of timely feedback are appealing for health-related behavior change interventions via mobile apps. However, users' perspectives about such apps are vital in better bridging the gap between their design intention and effective practical usage. In this vein, a modified technology acceptance model (mTAM) is proposed here, to explain the relationship between users' perspectives when using an AI-based smartphone app for personalized nutrition and healthy living, namely, PROTEIN, and the mTAM constructs toward behavior change in their nutrition and physical activity habits. In particular, online survey data from 85 users of the PROTEIN app within a period of 2 months were subjected to confirmatory factor analysis (CFA) and regression analysis (RA) to reveal the relationship of the mTAM constructs, i.e., perceived usefulness (PU), perceived ease of use (PEoU), perceived novelty (PN), perceived personalization (PP), usage attitude (UA), and usage intention (UI) with the users' behavior change (BC), as expressed via the acceptance/rejection of six related hypotheses (H1-H6), respectively. The resulted CFA-related parameters, i.e., factor loading (FL) with the related p-value, average variance extracted (AVE), and composite reliability (CR), along with the RA results, have shown that all hypotheses H1-H6 can be accepted (p < 0.001). In particular, it was found that, in all cases, FL > 0.5, CR > 0.7, AVE > 0.5, indicating that the items/constructs within the mTAM framework have good convergent validity. Moreover, the adjusted coefficient of determination (R 2) was found within the range of 0.224-0.732, justifying the positive effect of PU, PEoU, PN, and PP on the UA, that in turn positively affects the UI, leading to the BC. Additionally, using a hierarchical RA, a significant change in the prediction of BC from UA when the UI is used as a mediating variable was identified. The explored mTAM framework provides the means for explaining the role of each construct in the functionality of the PROTEIN app as a supportive tool for the users to improve their healthy living by adopting behavior change in their dietary and physical activity habits. The findings herein offer insights and references for formulating new strategies and policies to improve the collaboration among app designers, developers, behavior scientists, nutritionists, physical activity/exercise physiology experts, and marketing experts for app design/development toward behavior change.

The role of work conditions on the functional decline in senior workers in the automotive industry.

BACKGROUND: The aging of the workforce is changing, but working conditions have not changed at the same exponential growth rate for senior workers. Such a situation can compromise the worker's physical and cognitive capability, reducing the ability to perform work activities. OBJECTIVES: This study aims to understand the main functional capacity changes in senior workers in the automotive industry and to determine the contribution of working conditions on the decline of the functional capacity in senior workers. METHODS: To achieve the objectives of the study, a set of questionnaires (Sociodemographic Data, COPSOQ, Nordic Questionnaire, and Par-Q) and a battery of 4 functional capacity tests were used. RESULTS: Work conditions, namely awkward postures, force demands and manual material handling, and age, were statistically associated to the functional decline in workers. Additionally, multiple linear regression showed that height, weight, seniority, and strength have predictive value to the handgrip decline (both positions HG2 and HG5). CONCLUSION: These results suggest that workers' handgrip assessment should be considered as a future measure as an indicator of strength ability in the occupational field.

A genetic algorithm approach to design job rotation schedules ensuring homogeneity and diversity of exposure in the automotive industry.

Job rotation is a work organization strategy with increasing popularity, given its benefits for workers and companies, especially those working with manufacturing. This study proposes a formulation to help the team leader in an assembly line of the automotive industry to achieve job rotation schedules based on three major criteria: improve diversity, ensure homogeneity, and thus reduce exposure level. The formulation relied on a genetic algorithm, that took into consideration the biomechanical risk factors (EAWS), workers' qualifications, and the organizational aspects of the assembly line. Moreover, the job rotation plan formulated by the genetic algorithm formulation was compared with the solution provided by the team leader in a real life-environment. The formulation proved to be a reliable solution to design job rotation plans for increasing diversity, decreasing exposure, and balancing homogeneity within workers, achieving better results in all of the outcomes when compared with the job rotation schedules created by the team leader. Additionally, this solution was less time-consuming for the team leader than a manual implementation. This study provides a much-needed solution to the job rotation issue in the manufacturing industry, with the genetic algorithm taking less time and showing better results than the job rotations created by the team leaders.

Biomechanical Performance Factors in the Track and Field Sprint Start: A Systematic Review.

In athletics sprint events, the block start performance can be fundamental to the outcome of a race. This Systematic Review aims to identify biomechanical factors of critical importance to the block start and subsequent first two steps performance. A systematic search of relevant English-language articles was performed on three scientific databases (PubMed, SPORTDiscus, and Web of Science) to identify peer-reviewed articles published until June 2021. The keywords "Block Start", "Track and Field", "Sprint Running", and "Kinetics and Kinematics" were paired with all possible combinations. Studies reporting biomechanical analysis of the block start and/or first two steps, with track and field sprinters and reporting PB100m were sought for inclusion and analysis. Thirty-six full-text articles were reviewed. Several biomechanical determinants of sprinters have been identified. In the "Set" position, an anthropometry-driven block setting facilitating the hip extension and a rear leg contribution should be encouraged. At the push-off, a rapid extension of both hips and greater force production seems to be important. After block exiting, shorter flight times and greater propulsive forces are the main features of best sprinters. This systematic review emphasizes important findings and recommendations that may be relevant for researchers and coaches. Future research should focus on upper limbs behavior and on the analysis of the training drills used to improve starting performance.

Postmatch Recovery Practices Carried Out in Professional Football: A Survey of 56 Portuguese Professional Football Teams.

BACKGROUND: In football (ie, soccer), the effectiveness of recovery practices is critical to maintain high levels of performance, prevent residual fatigue, and reduce injury risk. However, the recovery methods that professional football teams put in place up to 72 hours postmatch are widely unknown. PURPOSE: This study aimed to characterize the postmatch recovery practices in Portuguese football teams in different postmatch periods and match locations. METHODS: Portuguese football teams (total, N = 56; male: first league [n = 17], second league [n = 16], under-23 league [n = 12]; female: first league, n = 11) participated in the study. The practitioners in charge of recovery strategies in each team filled out the online questionnaire in the middle of the 2019-20 season. The questions focused on the type of recovery methods to be used at different times after home and away matches. RESULTS: After home matches, stretching, electrostimulation, active recovery, and massage were used with higher frequency (P < .017) in later postmatch periods (ie, 12-24, and 24-72 h) compared with immediately postmatch. After away matches, several differences were found (P < .017) for the stretching, electrostimulation, active recovery, cold-water immersion, massage, nutrition, and sleep between postmatch periods. Regarding match location, stretching (r = .19), active recovery (r = .39), cold-water immersion (r = .46), and massage (r = .29) showed a higher frequency of use immediately after home matches. Conversely, the use of compression garments (r = .27) was higher immediately after away matches. CONCLUSIONS: It was concluded that in professional football, recovery methods are not applied uniformly along postmatch periods and differ depending on the match location.

Knee osteoarthritis pre-screening questionnaire (KOPS): cross-cultural adaptation and measurement properties of the brazilian version—KOPS Brazilian version

Abstract Background: Despite the criteria already established for the classification of knee osteoarthritis (OA), a radiographic and/or clinical knee OA diagnosis usually occurs in cases of fully manifest or more advanced disease, which can make health promotion, prevention, and functional rehabilitation in more advanced stages of the disease less effective. In addition, radiographic knee OA can generate more financial costs for health services. Therefore, developing and validating screening instruments to assess the probability of development and progression of knee OA would be of great value for both clinical practice and science. Objective: To cross-culturally adapt and investigate the measurement properties of the Knee OA Pre-screening Questionnaire Brazilian version. Methods: A total of 250 individuals of both sexes aged between 35 and 92 years [(mean (standard deviation): 63 (11) years old; 74.1 (15.1) kg; 1.59 (0.09) m; 29.38 (5.44) kg/m2] participated in this study. The cross-cultural adaptation and analyses of the measurement properties of the KOPS Brazilian version included: (1) assessment of conceptual and item equivalence; (2) assessment of semantic equivalence; (3) assessment of operational equivalence; and (4) assessment of measurement equivalence, reliability, and validity. Results: Cronbach's alpha for the internal consistency among the six components of the KOPS Brazilian version was 0.71. The test-retest 72 h apart for each component resulted in a coefficient correlation intraclass ranging from 0.74 to 1.00. The probability of an individual randomly chosen from the population having KL ≥ 1 and KOPS Brazilian version ≥ 21 points was 0.74 (area under the curve of the Receiver Operating Characteristic - AUC of ROC); furthermore, the AUC for KL ≥ 2 and the KOPS Brazilian version ≥ 23 points was 0.77. Conclusion: The KOPS Brazilian version is a reliable and valid instrument for early screening of knee OA in individuals aged 35 years and over in the Brazilian context.

Predictive Factors of Short-Term Related Musculoskeletal Pain in the Automotive Industry.

To determine the short-term associations between biomechanical risk factors and musculoskeletal symptoms in the upper limbs and low back in an automotive company, a longitudinal study with a follow-up of 4 days was conducted in a sample of 228 workers of the assembly and paint areas. Data were analyzed using generalized estimating equations, calculating the crude and adjusted model for age, sex, seniority, and intensity of pain at baseline. The interactions found were the same for both models. Workers were divided in low-risk and high-risk group for posture, force, exposure, percentage of cycle time with the arm at/above shoulder level, and with the trunk flexed or/and strongly flexed. The predictive factors showed by time × group effect were found between pain intensity on the left shoulder for posture (ß = 0.221, p < 0.001), percentage of time with the trunk flexed (ß = 0.136, p = 0.030) and overall exposure (ß = 0.140, p = 0.013). A time × group interactions were observed, namely between neck pain and posture (ß = 0.218, p = 0.005) and right wrist and force (ß = 0.107, p = 0.044). Workers in the high-risk group were more prone to report unfavorable effects on their self-reported musculoskeletal pain, across a workweek when exposed to specific risk factor, being posture important to neck, right wrist and left shoulder pain.

Effects of Ankle Foot Orthoses on the Gait Patterns in Children with Spastic Bilateral Cerebral Palsy: A Scoping Review.

BACKGROUND: Cerebral palsy (CP) is the most common cause of motor disability in children and can cause severe gait deviations. The sagittal gait patterns classification for children with bilateral CP is an important guideline for the planning of the rehabilitation process. Ankle foot orthoses should improve the biomechanical parameters of pathological gait in the sagittal plane. METHODS: A systematic search of the literature was conducted to identify randomized controlled trials (RCT) and controlled clinical trials (CCT) which measured the effect of ankle foot orthoses (AFO) on the gait of children with spastic bilateral CP, with kinetic, kinematic, and functional outcomes. Five databases (Pubmed, Scopus, ISI Web of SCIENCE, SciELO, and Cochrane Library) were searched before February 2020. The PEDro Score was used to assess the methodological quality of the selected studies and alignment with the Cochrane approach was also reviewed. Prospero registration number: CRD42018102670. RESULTS: We included 10 studies considering a total of 285 children with spastic bilateral CP. None of the studies had a PEDro score below 4/10, including five RCTs. We identified five different types of AFO (solid; dynamic; hinged; ground reaction; posterior leaf spring) used across all studies. Only two studies referred to a classification for gait patterns. Across the different outcomes, significant differences were found in walking speed, stride length and cadence, range of motion, ground force reaction and joint moments, as well as functional scores, while wearing AFO. CONCLUSIONS: Overall, the use of AFO in children with spastic bilateral CP minimizes the impact of pathological gait, consistently improving some kinematic, kinetic, and spatial-temporal parameters, and making their gait closer to that of typically developing children. Creating a standardized protocol for future studies involving AFO would facilitate the reporting of new scientific data and help clinicians use their clinical reasoning skills to recommend the best AFO for their patients.

Post-match Recovery Practices in Professional Football: Design, Validity, and Reliability of a New Questionnaire.

Introduction: Although several approaches have been proposed to mitigate post-match fatigue, few studies have been conducted in team sports to understand the types of recovery methods and the underlying reasons for the choices of medical and technical staff. This study aimed to develop a valid and reliable online questionnaire to assess the recovery practices implemented by football clubs within 72 h post-match. Methods: Two research members developed the original questionnaire proposal, and two experts in sports science and sports medicine confirmed the content and face validities. Then, 20 football coaches (age: 39.4 ± 6.8 years) with a minimum of 5 years of experience in professional football (9.1 ± 4.9 years) and with an academic background participated in determining the ecological validity and reliability of the questionnaire. The acceptability and relevance of the questionnaire were determined using descriptive statistics. Results: After confirming the content and face validities, one questionnaire section with two questions was excluded due to lack of relevance, seven open-ended questions were removed due to the adherence of small participants (i.e., 45.4%), and one section was divided into three to facilitate clearness in reading. The remaining sections were considered acceptable and relevant (>94.1%). About 91.8% of nominal and ordinal items derived from the questionnaire questions showed good to very good reliability outcomes (average k classification: 0.73 ± 0.13; min-max: 0.22-1.00, p < 0.05; average wk classification: 0.82 ± 0.15; min-max: 0.22-1.00, p < 0.05). Conclusions: This study provided a novel, valid, reliable, and easy-to-use tool to examine the post-match recovery practices in professional football contexts.

Translation, cultural adaptation and validation of the self-efficacy to manage chronic disease 6-item scale for european Portuguese.

OBJECTIVES: Self-efficacy is an important factor in the acquisition of self-management skills in patients with chronic diseases. The present study provides a translation and cultural adaptation for the Portuguese population, as well as psychometric properties, of the Self-Efficacy for Managing Chronic Disease 6-Item Scale. MATERIALS AND METHODS: This is a cross-sectional study. As a first stage, a translation and cultural adaptation were conducted. After preparation, a final version was applied initially to a sample of 30 participants with chronic disease in two phases, with a one-week gap between phases, to assess teste retest reliability. Subsequently, a sample of 217 participants with chronic disease, mean age 42.8 (10.7) years, participated in the study. Participants were supposed to be over the age of 18 and with at least one clinically diagnosed chronic disease. The questionnaire was applied electronically. RESULTS: The results showed a good test retest reliability (ICC of 0.83, 95% CI: 0.65 - 0.92). Internal consistency met the criterion for a reliable measure (global Cronbach's alpha of 0.95). Item-total correlations of all items were above 0.30. A correlation matrix was considered favorable (KMO = 0.90; Bartlett's sphericity test = 1399.090, p < 0.01). The results confirmed the permanence of the 6 items, as in the original scale. CONCLUSIONS: A Self-Efficacy for Managing Chronic Disease 6-Item Scale is a reliable and valid instrument to assess the patients' self-efficacy for managing chronic diseases in Portuguese, enabling its use in clinical practice and in future studies.

Postgraduate education in healthy and active ageing: learning needs, curriculum and expected outcomes: a scoping review protocol.

Background: As the European population ages, it becomes increasingly important to promote and facilitate healthy and active ageing and age-friendly societies. Professionals across a range of disciplines and sectors need knowledge and skills to support both. Objective: This scoping review aims to identify and map the literature on learning needs, learning outcomes and respective curricula in healthy and active ageing and age-friendly society concepts. Inclusion criteria: Studies focused on the teaching/learning process in healthy and active ageing and/or age-friendly society, of any design type, are eligible. Included studies may focus on undergraduate, postgraduate or continuing education and on any aspect of the educational process, such as needs analysis, content delivery, learner satisfaction/acceptability, or education outcome. Methods: This review will follow the Joanna Briggs Institute (JBI) methodology for conducting scoping reviews. Four electronic databases, PubMed, EBSCO (Academic Search Complete), Scopus and Applied Social Sciences Index and Abstracts (ASSIA), will be searched, limited to studies published from 1 st January 2000. Text language will be limited to English, German, Greek, Portuguese, Finnish, and Slovenian. Google Scholar and Research Gate will be searched for grey literature, limited to the first 50 results of each. Title and abstract screening, followed by full-text screening will be undertaken independently by at least two reviewers. The JBI extraction tool will be adapted for data extraction. Quality assessment will be conducted using a tool developed by Hawker and colleagues. A narrative synthesis will outline the data in relation to the aims and objectives outlined.

Normative reference values of the handgrip strength for the Portuguese workers.

INTRODUCTION: The active workforce is increasingly aging. However workload, as well as working time and intensity, sometimes remains unchanged. This can be an even more critical situation in older people, since occupational exposure associated with aging, will further reduce the muscle's ability to generate energy, which in turn facilitates the development of these age-related syndromes. This study aims to identify the normative values of handgrip strength for Portuguese workers in the automotive industry. METHODS: About 1225 employees were invited to participate in the study. The final sample consisted of 656 employees in the assembly area. The handgrip strength was measured in kilograms (kg) using the Jamar digital dynamometer. Sex-specific profiles of handgrip strength were designed by the Ordinary Least Square regression (OLS) analysis, where height, age, age squared, and height squared are entered into the models as determining factors of the maximum grip strength in both female and male groups. RESULTS: The peak mean values of handgrip strength in the group of women was 34 kg in the age group of 35-39 years, and in the group of men the peak mean was 52 kg in the age group of 25-34 years. The most pronounced decline in the female group appears in the age of 30-34 years of about 4 kg and the male group the decline occurs at 2kg below the peak force, in the age group of 40-57 year-olds. This study used a cut-off at 2 SD below by the sex-specific peak mean. CONCLUSION: Normative values can help delineate the career path of workers because they portray risk values according to age, height, and gender. The normative values assist health and engineering professionals and ergonomists in adjusting task demands to the morphological and strength characteristics of the workers.

Responsiveness of the Calf-Raise Senior test in community-dwelling older adults undergoing an exercise intervention program.

INTRODUCTION: Mobility significantly depends on the ankle muscles' strength which is particularly relevant for the performance of daily activities. Few tools are available, to assess ankle strength with all of the measurement properties tested. The purpose of this study is to test the responsiveness of Calf-Raise Senior Test (CRS) in a sample of elderly participants undergoing a 24-week community exercise program. METHODS: 82 older adults participated in an exercise program and were assessed with CRS Test and 30-second chair stand test (CS) at baseline and at follow-up. Effect size (ES), standardized response mean (SRM) and minimal detectable change (MDC) measures were calculated for the CRS and CS tests scores. ROC curves analysis was used to define a cut-off representing the minimally important difference of Calf-Raise Senior test. RESULTS: Results revealed a small (ES = 0.42) to moderate (SRM = 0.51) responsiveness in plantar-flexion strength and power across time, which was lower than that of CS test (ES = 0.64, SRM = 0.67). The responsiveness of CRS test was more evident in groups of subjects with lower initial scores. A minimal important difference (MID) of 3.5 repetitions and a minimal detectable change (MDC) of 4.6 was found for the CRS. CONCLUSION: Calf-Raise Senior Test is a useful field test to assess elderly ankle function, with moderate responsiveness properties. The cutoff scores of MDC and MID presented in this study can be useful in determining the success of interventions aiming at improving mobility in senior participants.

Can the calf-raise senior test predict functional fitness in elderly people? A validation study using electromyography, kinematics and strength tests.

The assessment of the plantar-flexors muscle strength in older adults (OA) is of the utmost importance since they are strongly associated with the performance of fundamental tasks of daily life. The objective was to strengthen the validity of the Calf-Raise-Senior (CRS) test by assessing the biomechanical movement pattern of calf muscles in OA with different levels of functional fitness (FF) and physical activity (PA). Twenty-six OA were assessed with CRS, a FF battery, accelerometry, strength tests, kinematics and electromyography (EMG). OA with the best and worst CRS scores were compared. The association between the scores and EMG pattern of ankle muscles was determined. OA with the best CRS scores presented higher levels of FF, PA, strength, power, speed and range of movement, and a more efficient movement pattern during the test. Subjects who scored more at the CRS test demonstrated the possibility to use a stretch-shortening cycle type of action in the PF muscles to increase power during the movements. OA with different levels of FF can be stratified by the muscular activation pattern of the calf muscles and the scores in CRS test. This study reinforced the validity of CRS for evaluating ankle strength and power in OA.

Effect of 6-month community-based exercise interventions on gait and functional fitness of an older population: a quasi-experimental study.

BACKGROUND: Gait ability in older adults has been associated with independent living, increased survival rates, fall prevention, and quality of life. There are inconsistent findings regarding the effects of exercise interventions in the maintenance of gait parameters. OBJECTIVES: The aim of the study was to analyze the effects of a community-based periodized exercise intervention on the improvement of gait parameters and functional fitness in an older adult group compared with a non-periodized program. METHODS: A quasi-experimental study with follow-up was performed in a periodized exercise group (N=15) and in a non-periodized exercise group (N=13). The primary outcomes were plantar pressure gait parameters, and the secondary outcomes were physical activity, aerobic endurance, lower limb strength, agility, and balance. These variables were recorded at baseline and after 6 months of intervention. RESULTS: Both programs were tailored to older adults' functional fitness level and proved to be effective in reducing the age-related decline regarding functional fitness and gait parameters. Gait parameters were sensitive to both the exercise interventions. CONCLUSION: These exercise protocols can be used by exercise professionals in prescribing community exercise programs, as well as by health professionals in promoting active aging.

Community-Based Exercise Intervention for Gait and Functional Fitness Improvement in an Older Population: Study Protocol.

Functional fitness (FF) and gait ability in older populations have been associated with increased survival rates, fall prevention, and quality of life. One possible intervention for the improvement of FF is well-structured exercise programs. However, there are inconsistent findings regarding the effects of exercise interventions in the maintenance of gait parameters. The aim of this protocol is to develop a community-based exercise intervention targeting an older population. The intervention aim is the improvement of gait parameters and FF. A control trial with follow-up will be performed. The primary outcome variables will be plantar pressure gait parameters. The secondary outcome variables will be aerobic endurance, lower limb strength, agility, and balance. These variables will be recorded at baseline and after 12, 24, and 36 weeks, in the intervention and control groups. If effective, this protocol can be used by exercise professionals in improving community exercise programs.

Intergenerational educational trajectories and lower back pain in young women and men.

We examined the association between intergenerational educational trajectories and lower back pain (LBP) outcomes in young women and men from the general population. Participants were part of the 21 years old follow-up of the EPITeen cohort study, which was set up during the 2003/2004 school year and recruited subjects born in 1990 attending schools in Porto, Portugal (n=1657, 51.6% women). Parental and individual educational levels were used to define intergenerational educational trajectories as stable-high, upward, stable-low, and downward. Data on the presence, severity and chronicity of LBP were also assessed. Gender-specific adjusted odds ratios (OR) with 95% confidence intervals (95% CI) were computed to estimate the associations between educational trajectories and LBP outcomes. When compared to women with stable-high educational trajectories, those with stable-low educational trajectories were significantly more likely to report moderate/severe (adjusted OR=1.76, 95% CI: 1.21-2.57) and chronic (adjusted OR=1.82, 95% CI: 1.02-3.22) LBP. The magnitude of these associations was even stronger among females with downward educational trajectories (moderate/severe: adjusted OR=2.58, 95% CI: 1.49-4.46; chronic: adjusted OR=2.42, 95% CI: 1.12-5.27). Educational trajectories were not significantly associated to LBP outcomes among men. In conclusion, intergenerational educational trajectories may contribute to LBP as reported in early adulthood, particularly in women.