A Controlled Clinical Trial on the Effects of Aquatic Exercise on Cognitive Functions in Community-Dwelling Older Adults.

Several therapies have been developed to reduce cognitive decline associated with aging. Aquatic exercises, which are widely used to enhance functional capacity, may play a role in stimulating cognitive functions. This study investigated the effects of a 3-month aquatic exercise program on cognitive functions in community-dwelling older adults. In this prospective, single-blinded, controlled clinical trial, 31 participants were allocated to either the experimental (aquatic exercises) or control (no-exercise) group. The intervention program consisted of exercises conducted twice a week in a 1.2 m deep indoor pool. The main outcome measures were cognitive functions, assessed using Raven's Progressive Matrices test and the Wisconsin Card Sorting Test. A repeated-measures analysis of variance was used to assess the impact of the exercise program. The effect sizes (η2p) were reported when a level of significance was achieved (p < 0.05). Compared with the control group, the participants who underwent aquatic exercises showed positive outcomes in Raven's Progressive Matrices test (p = 0.046; η2p = 0.131) and the Wisconsin Card Sorting Test (p = 0.001, η2p = 0.589). Complementary analyses of the Wisconsin Card Sorting Test indicated that the benefits of the aquatic exercise were observed in terms of the number of trials (p = 0.001, η2p = 0.478), number of errors (p = 0.001, η2p = 0.458), and number of non-perseverative errors (p = 0.001, η2p = 0.302). The results indicate that a period of three months of aquatic exercise was beneficial for stimulating specific aspects of the cognitive function of community-dwelling older individuals. Aquatic exercise should be prescribed to this population.

Impact of the COVID-19 Pandemic on the Scientific Production of Physical Education Researchers: A Five-Year Follow-Up Study.

The COVID-19 pandemic caused significant changes in society's dynamics, particularly affecting the landscape of education. Research in several areas may have been affected during periods of social restrictions. This study analyzed the curricula of 558 researchers across 27 graduate programs in physical education in Brazil to investigate the potential impact of the COVID-19 pandemic on scientific publications. Researchers' production from 2018 to 2022 underwent a comprehensive analysis, considering the total number of publications, Qualis rank, and journal impact factor. Data were analyzed using chi-squared and Kruskal-Wallis tests. Significance was set at 5%. Overall, the analyzed researchers published a total of 17,932 manuscripts from 2018 to 2022. During the COVID-19 pandemic, there was a decline of 16.4% in the number of articles published (p = 0.001). This decline was similar between men and women (p = 0.603) and was associated with a worsening in Qualis rank (p = 0.001). The number of studies published in journals with impact factors was also affected (p = 0.001). The findings suggest a potential impact of the COVID-19 pandemic on the scientific production of Brazilian researchers in the field of physical education. Funding agencies should consider the challenges associated with the COVID-19 pandemic before evaluating researchers and programs.

Effects of Intracerebral Aminophylline Dosing on Catalepsy and Gait in an Animal Model of Parkinson's Disease.

Parkinson's disease (PD) is a progressive disorder characterized by the apoptosis of dopaminergic neurons in the basal ganglia. This study explored the potential effects of aminophylline, a non-selective adenosine A1 and A2A receptor antagonist, on catalepsy and gait in a haloperidol-induced PD model. Sixty adult male Swiss mice were surgically implanted with guide cannulas that targeted the basal ganglia. After seven days, the mice received intraperitoneal injections of either haloperidol (experimental group, PD-induced model) or saline solution (control group, non-PD-induced model), followed by intracerebral infusions of aminophylline. The assessments included catalepsy testing on the bar and gait analysis using the Open Field Maze. A two-way repeated-measures analysis of variance (ANOVA), followed by Tukey's post hoc tests, was employed to evaluate the impact of groups (experimental × control), aminophylline (60 nM × 120 nM × saline/placebo), and interactions. Significance was set at 5%. The results revealed that the systemic administration of haloperidol in the experimental group increased catalepsy and dysfunction of gait that paralleled the observations in PD. Co-treatment with aminophylline at 60 nM and 120 nM reversed catalepsy in the experimental group but did not restore the normal gait pattern of the animals. In the non-PD induced group, which did not present any signs of catalepsy or motor dysfunctions, the intracerebral dose of aminophylline did not exert any interference on reaction time for catalepsy but increased walking distance in the Open Field Maze. Considering the results, this study highlights important adenosine interactions in the basal ganglia of animals with and without signs comparable to those of PD. These findings offer valuable insights into the neurobiology of PD and emphasize the importance of exploring novel therapeutic strategies to improve patient's catalepsy and gait.

Benefits of a Dual-Task Training on Motor and Cognitive Functions in Community-Dwelling Older Adults: A Controlled Clinical Trial.

OBJECTIVE: The aim of the study is to verify the effects of a 3-mo dual-task training on motor and cognitive functions in community-dwelling older adults. DESIGN: In this prospective, single-blinded, controlled clinical trial, a total of 40 participants were allocated to either the experimental or the control (no-exercise) group. The intervention program consisted of a combination of motor and cognitive exercises conducted twice a week on nonconsecutive days. The main outcome measures were postural stability, mobility, fear of falling, and cognitive functions. Multiple analyses of variance were used to assess the impact of the dual-task training. Effect sizes (η 2 p) were reported. Significance was set at 5%. RESULTS: Compared with the control group, participants who underwent the dual-task training showed positive outcomes in terms of postural stability (η 2 p = 0.298, P = 0.020), mobility (η 2 p = 0.285, P = 0.003), and cognitive functions (η 2 p = 0.536, P = 0.001). No significant differences were observed between the groups in terms of the fear of falling ( P = 0.566). CONCLUSIONS: Three-month dual-task training was beneficial for postural control, mobility, and cognitive functions in community-dwelling older adults. Based on the present findings, healthcare professionals should consider incorporating dual-task training into clinical practice.

Impacto da pandemia da covid-19 na produção de artigos com idosos: como a área da educação física foi afetada? / Impact of the covid-19 pandemic on the production of articles with older individuals: how was the field of physical education affected? / Impacto de la pandemia de la covid-19 en la producción de artículos con adultos mayores: ¿cómo se vio afectado el campo de la educación física?

O objetivo desse estudo foi avaliar o impacto da pandemia da COVID-19 na produção de artigos de Educação Física com idosos. Nesse estudo bibliométrico, 558 pesquisadores de programas de pós-graduação do Brasil na área da Educação Física tiveram sua produção científica avaliada entre os anos 2018 e 2022. Foram incluídos apenas artigos cujo público-alvo era idoso. Os artigos foram analisados segundo os estratos Qualis e o fator de impacto das revistas. De um total de 17.932 artigos, 969 eram estudos com idosos. Durante a pandemia, houve uma queda na quantidade de artigos publicados sobre idosos (P = 0,001), com piora nos estratos Qualis (P = 0,001). O fator de impacto das revistas não foi afetado pela pandemia (P = 0,426). Os resultados apontam impacto da pandemia da COVID-19 na produção de artigos sobre idosos, fato que deve ser considerado por agências de fomento antes de avaliar pesquisadores e programas.(AU)

This study aimed to assess the impact of the COVID-19 pandemic on the production of Physical Education articles involving older individuals. In this bibliometric study, 558 researchers of Physical Education graduate programs in Brazil were evaluated between 2018 and 2022. Only articles targeting older individuals were included. The articles were analyzed based on Qualis ranking and the journals' impact factors. Out of a total of 17,932 manuscripts, 969 involved older individuals. During the COVID-19 pandemic, there was a decline in the number of articles published with older adults (P = 0.001), accompanied by a worsening of Qualis ranking (P = 0.001). The COVID-19 pandemic, differently, did not affect the impact factor of the journals (P = 0.426). The findings highlight the impact of the COVID-19 pandemic on the production of articles with older individuals, reinforcing the need for funding agencies to consider this aspect before evaluating researchers and programs.(AU)

Este estudio tuvo como objetivo evaluar el impacto de la pandemia de COVID-19 en la producción de artículos de Educación Física que involucran a adultos mayores. En este estudio bibliométrico, se evaluaron 558 investigadores de programas de posgrado en Educación Física de Brasil entre 2018 y 2022. Solo fueron incluidos artículos con adultos mayores. Los artículos fueron analizados según el Qualis y el factor de impacto de las revistas. De un total de 17,932 manuscritos, 969 envolvieran adultos mayores. Durante la pandemia, hubo una disminución en el número de artículos publicados (P = 0.001), acompañada por un empeoramiento del Qualis (P = 0.001). La pandemia no afectó el factor de impacto de los periodicos (P = 0.426). Los resultados resaltan el impacto de la pandemia en la producción de artículos con adultos mayores, subrayando la necesidad de que las agencias de financiamiento consideren este aspecto antes de evaluar investigadores y programas.(AU)

Efficacy of Transcranial Direct Current Stimulation (tDCS) on Cognition, Anxiety, and Mobility in Community-Dwelling Older Individuals: A Controlled Clinical Trial.

Transcranial direct current stimulation (tDCS) has gained popularity as a method of modulating cortical excitability in people with physical and mental disabilities. However, there is a lack of consensus on its effectiveness in older individuals. This study aimed to assess the efficacy of a 2-month tDCS program for improving physical and mental performance in community-dwelling older individuals. In this single-blinded, controlled clinical trial, forty-two participants were allocated to one of three groups: (1) the tDCS group, which received, twice a week, 20 min sessions of 2 mA electric current through electrodes placed on the dorsolateral prefrontal cortex; (2) the tDCS-placebo group, which underwent the same electrode placement as the tDCS group but without actual electric stimulation; and (3) the cognitive-control group, which completed crossword puzzles. Main outcome measures were cognition, mobility, and anxiety. Multivariate analyses of variance were employed. Significance was set at 5% (p < 0.05). Regarding the results, no significant benefits were observed in the tDCS group compared with the tDCS-placebo or cognitive-control groups for cognition (p = 0.557), mobility (p = 0.871), or anxiety (p = 0.356). Cognition exhibited positive oscillations during the assessments (main effect of time: p = 0.001). However, given that all groups showed similar variations in cognitive scores (main effect of group: p = 0.101; group × time effect: p = 0.557), it is more likely that the improvement reflects the learning response of the participants to the cognitive tests rather than the effect of tDCS. In conclusion, a 2-month tDCS program with two sessions per week appears to be ineffective in improving physical and mental performance in community-dwelling older individuals. Further studies are necessary to establish whether or not tDCS is effective in healthy older individuals.

Impact of Using Smartphone While Walking or Standing: A Study Focused on Age and Cognition.

BACKGROUND: Using smartphones during a task that requires upright posture is suggested to be detrimental for the overall motor performance. The aim of this study was to determine the role of age and specific aspects of cognitive function on walking and standing tasks in the presence of smartphone use. METHODS: 51 older (36 women) and 50 young (35 women), mean age: 66.5 ± 6.3 and 22.3 ± 1.7 years, respectively, were enrolled in this study. The impact of using a smartphone was assessed during a dynamic (timed up and go, TUG) and a static balance test (performed on a force platform). Multivariate analyses of variance were applied to verify main effects of age, task, estimates of cognitive function and interactions. RESULTS: Compared to young, older individuals exhibited a poorer performance on the dynamic and on the static test (age effect: p = 0.001 for both variables). Dual-tasking with a smartphone had a negative impact on both groups (task effect: p = 0.001 for both variables). The negative impact, however, was greater in the older group (age × task effect: p = 0.001 for both variables). Executive function and verbal fluency partially explained results of the dynamic and static tests, respectively. CONCLUSIONS: The negative impact of using a smartphone while performing tasks similar to daily activities is higher in older compared to young people. Subclinical deficits in distinct aspects of cognitive function partially explain the decreased performance when dual-tasking.

Using the cell phone while standing or walking affects balance and mobility in people with Parkinson's disease.

BACKGROUND: Cell phones are part of peoples' lives. The literature indicates risks when cell phones are used during a secondary motor task. Studies addressing this topic in people with Parkinson's disease are still scarce. OBJECTIVE: To investigate the impact of daily dual tasks with cell phone on balance and mobility in people with Parkinson's disease, compared to healthy control peers. METHODS: Participants with Parkinson's disease and controls underwent three motor tasks: (1) Standing and walking without using a cell phone; (2) Standing and walking while talking on the phone; and (3) Standing and walking while texting messages on the phone. Assessments involved balance and mobility tests. Statistical analysis was performed with multivariate analysis of variance, comparing main effect for group (Parkinson's disease × control), task (using × not using cell phone) and interactions (group × task). Significance was set at 5%. Effect sizes are reported. RESULTS: Participants with Parkinson's disease showed worse balance (p = 0.001, effect size of 0.471) and mobility (p = 0.001, effect size of 0.472) than control peers. The use of cell phone while performing a secondary motor task affected both groups (p = 0.005, effect size of 0.673 for balance and p = 0.001, effect size of 0.549 for mobility). The dual task impact, however, was higher in the Parkinson's disease group (p = 0.009, effect size of 0.407 for mobility). CONCLUSION: Daily dual tasks with cell phones increase imbalance and mobility risks in Parkinson's disease. People should be careful when using their cell phone while standing or walking.

ANTECEDENTES: Aparelhos celulares fazem parte da vida das pessoas. A literatura aponta riscos quando o uso do celular está associado a uma tarefa motora. Estudos abordando esse tema na doença de Parkinson são escassos. OBJETIVO: Investigar o impacto de tarefas-duplas com o celular sobre equilíbrio e mobilidade de pessoas com doença de Parkinson, na comparação com controles saudáveis. MéTODOS: Participantes com e sem doença de Parkinson foram submetidos a três tarefas: (1) Ficar em pé e caminhar sem o celular; (2) Ficar em pé e caminhar enquanto conversa ao celular; e (3) Ficar em pé e caminhar enquanto digita mensagens. As avaliações envolveram testes de equilíbrio e mobilidade. Os procedimentos estatísticos envolveram testes de análise múltipla de variâncias, com análise de efeito principal para os fatores grupo (doença de Parkinson × controle), tarefa (com celular × sem celular) e interação (grupo × tarefa). Significância foi estipulada em 5%. Tamanhos de efeito foram reportados. RESULTADOS: Participantes com doença de Parkinson apresentaram pior equilíbrio (p = 0,001; tamanho do efeito: 0,471) e mobilidade (p = 0,001; tamanho do efeito: 0,472) que controles. O uso do celular afetou ambos os grupos (p = 0,005, tamanho do efeito de 0,673 para equilíbrio e p = 0,001, tamanho do efeito de 0,549 para mobilidade). O impacto da tarefa-dupla, contudo, foi maior no grupo Parkinson (p = 0,009; tamanho do efeito de 0,407 para mobilidade). CONCLUSãO: Tarefas simultâneas com o celular causam desequilíbrio e problemas de mobilidade na doença de Parkinson. As pessoas devem ter cuidado ao utilizar celulares durante atividades em pé e ao caminhar.

Using the cell phone while standing or walking affects balance and mobility in people with Parkinson's disease / O uso do celular em pé ou durante a caminhada afeta o equilíbrio e a mobilidade de pessoas com doença de Parkinson

Abstract Background Cell phones are part of peoples' lives. The literature indicates risks when cell phones are used during a secondary motor task. Studies addressing this topic in people with Parkinson's disease are still scarce. Objective To investigate the impact of daily dual tasks with cell phone on balance and mobility in people with Parkinson's disease, compared to healthy control peers. Methods Participants with Parkinson's disease and controls underwent three motor tasks: (1) Standing and walking without using a cell phone; (2) Standing and walking while talking on the phone; and (3) Standing and walking while texting messages on the phone. Assessments involved balance and mobility tests. Statistical analysis was performed with multivariate analysis of variance, comparing main effect for group (Parkinson's disease × control), task (using × not using cell phone) and interactions (group × task). Significance was set at 5%. Effect sizes are reported. Results Participants with Parkinson's disease showed worse balance (p = 0.001, effect size of 0.471) and mobility (p = 0.001, effect size of 0.472) than control peers. The use of cell phone while performing a secondary motor task affected both groups (p = 0.005, effect size of 0.673 for balance and p = 0.001, effect size of 0.549 for mobility). The dual task impact, however, was higher in the Parkinson's disease group (p = 0.009, effect size of 0.407 for mobility). Conclusion Daily dual tasks with cell phones increase imbalance and mobility risks in Parkinson's disease. People should be careful when using their cell phone while standing or walking.

Resumo Antecedentes Aparelhos celulares fazem parte da vida das pessoas. A literatura aponta riscos quando o uso do celular está associado a uma tarefa motora. Estudos abordando esse tema na doença de Parkinson são escassos. Objetivo Investigar o impacto de tarefas-duplas com o celular sobre equilíbrio e mobilidade de pessoas com doença de Parkinson, na comparação com controles saudáveis. Métodos Participantes com e sem doença de Parkinson foram submetidos a três tarefas: (1) Ficar em pé e caminhar sem o celular; (2) Ficar em pé e caminhar enquanto conversa ao celular; e (3) Ficar em pé e caminhar enquanto digita mensagens. As avaliações envolveram testes de equilíbrio e mobilidade. Os procedimentos estatísticos envolveram testes de análise múltipla de variâncias, com análise de efeito principal para os fatores grupo (doença de Parkinson x controle), tarefa (com celular × sem celular) e interação (grupo × tarefa). Significância foi estipulada em 5%. Tamanhos de efeito foram reportados. Resultados Participantes com doença de Parkinson apresentaram pior equilíbrio (p = 0,001; tamanho do efeito: 0,471) e mobilidade (p = 0,001; tamanho do efeito: 0,472) que controles. O uso do celular afetou ambos os grupos (p = 0,005, tamanho do efeito de 0,673 para equilíbrio e p = 0,001, tamanho do efeito de 0,549 para mobilidade). O impacto da tarefa-dupla, contudo, foi maior no grupo Parkinson (p = 0,009; tamanho do efeito de 0,407 para mobilidade). Conclusão Tarefas simultâneas com o celular causam desequilíbrio e problemas de mobilidade na doença de Parkinson. As pessoas devem ter cuidado ao utilizar celulares durante atividades em pé e ao caminhar.

Impact of lower urinary tract symptoms in women with multiple sclerosis: an observational cross-sectional study.

BACKGROUND: Lower urinary tract symptoms (LUTS) are common in women with multiple sclerosis. OBJECTIVE: To investigate the impact of LUTS on pelvic floor muscle contraction, sexual function, and quality of life in women with multiple sclerosis. METHODS: Thirty-nine women with relapsing-remitting multiple sclerosis were enrolled in this study. Participants were divided into the presence or not of LUTS. Assessments involved the Expanded Disability Status Scale score, the NEW PERFECT scheme, the Female Sexual Function Index, and the Qualiveen Questionnaire. Statistical procedures involved Student t-tests, chi-squared, and regression analyses (R2). RESULTS: Nineteen women (48.7%) presented LUTS. Women with LUTS were in a more advanced stage of multiple sclerosis (p = .029), presented weaker pelvic muscle contraction (p = .009), less sexual function satisfaction (p = .018), and more limitations in the quality of life (p = .001) than women without LUTS. Regression analyses pointed out that the quality of life and sexual function of women with multiple sclerosis are affected by intercourse pain (R2 = 12.9) and perineal contraction force (R2 = 19.2). CONCLUSION: LUTS affects pelvic floor muscle contraction, sexual function, and quality of life in women with multiple sclerosis. A multi-professional rehabilitation team should assist women with multiple sclerosis, taking special care of LUTS.

Motor and respiratory functions are main challenges to patients with multiple sclerosis / Funções motoras e respiratórias representam desafios importantes para pacientes com esclerose múltipla

Abstract Introduction People with multiple sclerosis (MS) present wide and varied symptoms. Objective To investigate the impact of MS on subjects' motor and respiratory functions. Methods One hundred one participants were enrolled in this study. The subjects had previous diagnosis of relapsing-remittent MS (n = 48) or presented no neurologic diseases (n = 53, control group). Assess-ments involved mobility (Timed Get Up and Go) and balance (Berg Balance Scale) tests. A force platform was used to evaluate postural stabilometry. Respiratory functions were assessed with a portable spirometer and a digital manovacuometer. Data analyses were carried out with Student´s t-tests, chi-square, and Pearson correlation index. Significance was set at 5%. Results Compared to control peers, participants with MS showed higher motor dysfunctions affecting mobility, balance, and postural stability. Spirometry indicated normal parameters for pulmonary flows and lung capacities in both groups. The manovacuometer, differently, pointed to a respiratory muscle weakness in 48% of participants with MS. Correlation analyses highlighted that respiratory functions are more associated to dynamic than to static motor tests. Conclusion Pathological changes in MS lead to motor dysfunction on mobility, balance and postural stability. Respiratory tests showed normal pulmonary flows and lung capacities in patients with MS, but with commitment of respiratory muscle strength. Respiratory functions were more impacted by dynamic tasks rather than static motor tasks.

Resumo Introdução Pessoas com esclerose múltipla (EM) apresentam sintomas amplos e variados. Objetivo Investigar o impacto cau-sado pela EM nas funções motoras e respiratórias. Métodos Cento e um participantes foram incluídos neste estudo. Os sujeitos tinham diagnóstico prévio de EM remitente-recorrente (n = 48) ou não apresentavam doenças neurológicas (n = 53, grupo controle). As avaliações envolveram testes de mobilidade (Timed Get Up and Go) e equilíbrio (Berg Balance Scale). Uma plataforma de força foi utilizada para avaliar a estabilometria postural dos sujeitos. As funções respiratórias foram avaliadas com um espirômetro portátil e um manovacuômetro digital. A análise dos dados foi realizada pelos testes t de Student, qui-quadrado e pelo índice de correlação de Pearson. Nível de significância foi estipulado em 5%. Resultados Comparados com controles saudáveis, participantes com EM apresentaram maiores disfunções motoras que afetam mobilidade, equilíbrio e estabilidade postural. A espirometria indicou parâmetros nor-mais para fluxos pulmonares e capacidades pulmonares em ambos os grupos. A manovacuômetria, diferentemente, apontou fraqueza dos músculos respiratórios em 48% dos participantes com EM. Análises de correlação destacaram que as funções respiratórias estão mais associadas a testes motores dinâmicos do que a testes estáticos. Conclusão As alterações patológicas na EM levam à disfunção motora na mobilidade, no equilíbrio e na estabilidade postural. Os testes respiratórios mostraram padrões normais para fluxos pulmonares e capacidades pul-monares em pacientes com EM, mas com comprometimento da força muscular respiratória. As funções respiratórias foram mais afetadas por tarefas motoras dinâmicas do que por tarefas estáticas.

Pulmonary function and medication effect in mild-stage subjects with Parkinson's disease.

BACKGROUND: Parkinson's disease (PD) causes a series of movement disorders, many of them starting in the early stage. OBJECTIVE: To analyze the pulmonary function of mild-stage subjects with PD and to investigate the effects of levodopa on it. METHODS: We included 21 patients with idiopathic PD and 20 healthy control subjects. The participants were submitted to spirometry and impulse oscillometry assessments. The PD patients were evaluated during the "off" and "on" phases of their anti-PD medication, which was was converted to levodopa in an equivalent daily dose. A statistical analysis was performed with cross-sectional (PD patients "off" medication versus controls) and paired (PD patients "off" medication versus PD patients "on" medication) tests. The effect of levodopa was calculated with partial Eta-squared (η2 ρ). Significance was set at 5%. RESULTS: The PD patients presented normal values in the impulse oscillometry. Regarding spirometry, the results indicated an incipient obstructive ventilatory disorder in the PD group - confirmed by patients' flow-volume curves. The PD patients received a daily dose of 354.7 ± 148.2 mg of levodopa. The paired analyses showed a small effect of anti-PD medication on pulmonary parameters (η2 ρ = 0.197 for spirometry and η2 ρ= 0.043 for impulse oscillometry). CONCLUSION: Patients with PD in the mild stage of the disease present pulmonary compliance and resistance compatible with normal parameters. The differences regarding the spirometric results indicate an incipient obstructive ventilatory disorder in patients with PD. Levodopa had small effect on pulmonary function in the mild stage of the disease.

ANTECEDENTES: A doença de Parkinson (DP) causa uma série de distúrbios do movimento, muitos deles se desenvolvendo na fase inicial. OBJETIVO: Analisar função pulmonar de pessoas com DP em estágio leve e investigar o efeito da levodopa nesse processo. MéTODOS: Vinte e um participantes com DP idiopática e vinte controles saudáveis foram incluídos na pesquisa. Todos os sujeitos foram submetidos a avaliações de espirometria e oscilometria de impulso. Participantes com DP foram avaliados nas fases 'on' e 'off' de medicação anti-parkinsoniana. A medicação dos pacientes foi convertida em dose diária de levodopa. A análise estatística foi realizada com testes transversais (Parkinson na fase 'off' da medicação vs controles) e pareados (Parkinson nas fases 'off' vs 'on' da medicação). O efeito da levodopa foi calculado pelo eta ao quadrado parcial (η2 ρ). Significância foi estipulada em 5%. RESULTADOS: Pacientes com DP apresentaram valores normais na oscilometria de impulso. Na espirometria, os resultados indicaram uma desordem ventilatória obstrutiva incipiente no grupo DP ­ confirmada pelas curvas fluxo-volume dos pacientes. Pacientes com DP receberam uma dose diária de 354,7 ± 148,2 miligramas de levodopa. Análises pareadas mostraram baixo impacto da medicação anti-parkinsoniana nos parâmetros pulmonares (η2 ρ = 0,197 na espirometria e η2 ρ = 0,043 na oscilometria de impulso). CONCLUSãO: Pacientes com DP na fase leve apresentam complacência e resistência pulmonares compatíveis com parâmetros normais. Diferenças espirométricas indicam distúrbio ventilatório obstrutivo incipiente em pacientes com DP. A administração de levodopa apresentou baixo efeito na função pulmonar na fase leve da doença.

Pulmonary function and medication effect in mild-stage subjects with Parkinson's disease / Função pulmonar e efeitos da medicação em pessoas com doença de Parkinson em estágio leve

Abstract Background Parkinson's disease (PD) causes a series of movement disorders, many of them starting in the early stage. Objective To analyze the pulmonary function of mild-stage subjects with PD and to investigate the effects of levodopa on it. Methods We included 21 patients with idiopathic PD and 20 healthy control subjects. The participants were submitted to spirometry and impulse oscillometry assessments. The PD patients were evaluated during the "off" and "on" phases of their anti-PD medication, which was was converted to levodopa in an equivalent daily dose. A statistical analysis was performed with cross-sectional (PD patients "off" medication versus controls) and paired (PD patients "off" medication versus PD patients "on" medication) tests. The effect of levodopa was calculated with partial Eta-squared (η2ρ). Significance was set at 5%. Results The PD patients presented normal values in the impulse oscillometry. Regarding spirometry, the results indicated an incipient obstructive ventilatory disorder in the PD group - confirmed by patients' flow-volume curves. The PD patients received a daily dose of 354.7 ± 148.2 mg of levodopa. The paired analyses showed a small effect of anti-PD medication on pulmonary parameters (η2ρ = 0.197 for spirometry and η2ρ = 0.043 for impulse oscillometry). Conclusion Patients with PD in the mild stage of the disease present pulmonary compliance and resistance compatible with normal parameters. The differences regarding the spirometric results indicate an incipient obstructive ventilatory disorder in patients with PD. Levodopa had small effect on pulmonary function in the mild stage of the disease.

Resumo Antecedentes A doença de Parkinson (DP) causa uma série de distúrbios do movimento, muitos deles se desenvolvendo na fase inicial. Objetivo Analisar função pulmonar de pessoas com DP em estágio leve e investigar o efeito da levodopa nesse processo. Métodos Vinte e um participantes com DP idiopática e vinte controles saudáveis foram incluídos na pesquisa. Todos os sujeitos foram submetidos a avaliações de espirometria e oscilometria de impulso. Participantes com DP foram avaliados nas fases 'on' e 'off' de medicação anti-parkinsoniana. A medicação dos pacientes foi convertida em dose diária de levodopa. A análise estatística foi realizada com testes transversais (Parkinson na fase 'off' da medicação vs controles) e pareados (Parkinson nas fases 'off' vs 'on' da medicação). O efeito da levodopa foi calculado pelo eta ao quadrado parcial (η2ρ). Significância foi estipulada em 5%. Resultados Pacientes com DP apresentaram valores normais na oscilometria de impulso. Na espirometria, os resultados indicaram uma desordem ventilatória obstrutiva incipiente no grupo DP - confirmada pelas curvas fluxo-volume dos pacientes. Pacientes com DP receberam uma dose diária de 354,7 ± 148,2 miligramas de levodopa. Análises pareadas mostraram baixo impacto da medicação anti-parkinsoniana nos parâmetros pulmonares (η2ρ = 0,197 na espirometria e η2ρ = 0,043 na oscilometria de impulso). Conclusão Pacientes com DP na fase leve apresentam complacência e resistência pulmonares compatíveis com parâmetros normais. Diferenças espirométricas indicam distúrbio ventilatório obstrutivo incipiente em pacientes com DP. A administração de levodopa apresentou baixo efeito na função pulmonar na fase leve da doença.

Effects of Aquatic Physical Exercise on Motor Risk Factors for Falls in Older People During the COVID-19 Pandemic: A Randomized Controlled Trial.

OBJECTIVE: The aim of this study was to assess the effects of aquatic training on motor risk factors for falls in older people during the COVID-19 pandemic. METHODS: A randomized controlled trial was carried out with older people, divided into an aquatic training group (ATG) (n = 24) and a control group (CG) (n = 25). Muscle strength was assessed by the 5-Times Sit-to-Stand Test, mobility by the simple and dual-task Timed Up and Go Test, and postural stability through stabilometric data (force platform). The CG received monthly calls to monitor general health. The ATG carried out training lasting 16 weeks, with two 1-hour sessions per week. RESULTS: Both groups improved muscular strength and cognitive-motor tasks, and they performed a dual task with fewer errors in the secondary task after 16 weeks regardless of the pandemic and COVID-19 diagnosis. There was a significant decrease in the area of center of pressure displacement in the tandem posture with eyes closed in the CG. When analyzing participants who adhered at least 50% to the intervention, the ATG significantly reduced the number of steps on the Timed Up and Go Test performance. Both groups improved muscular strength and cognitive-motor tasks and increased the cognitive task cost. In the CG, there was a significant decrease in the mean amplitude of the anteroposterior center of pressure displacement in the feet together with eyes open. CONCLUSION: We found that aquatic physical exercise presented positive effects on some potentially modifiable motor risk factors for falls (mobility and muscle strength) regardless of the COVID-19 pandemic and COVID-19 diagnosis, especially among people who adhered to the intervention.

Risks of Accidents Caused by the Use of Smartphone by Pedestrians Are Task- and Environment-Dependent.

Using smartphones during a task that requires an upright posture can be detrimental for the overall motor performance. The aim of this study was to determine the risks of accidents caused by the use of smartphones by pedestrians while walking in a controlled (laboratory) and a non-controlled (public street) environment. Two hundred and one participants, 100 men and 101 women, all young adults, were submitted to walking activities while texting messages and talking on the phone. The risk of accident was measured by the time and the number of steps necessary to walk a 20 ft distance. Assessments were performed with no external distractors (laboratory) and on a public street with vehicles, pedestrians, lights, and noises. Multivariate analysis of variance tests provided the main effect of task (using × not using smartphone), environment (laboratory × street), sex (men × women), and interactions. Significance was set at 5%. The results showed that using a smartphone while walking demanded a greater number of steps and time to perform the task (main effect of task: 0.84; p = 0.001). The risk of accident was higher on the streets where, due to traffic hazards, pedestrians performed the task faster and with a lower number of steps (the main effect of environment: 0.82; p = 0.001). There was no difference of risks between men and women (main effect of sex: 0.01; p = 0.225), whether in the laboratory or on the street (main effect of sex × environment: 0.01; p = 0.905). The task × environment interaction showed that using a smartphone on the street potentiates risks of accidents of pedestrians (main effect of task × environment: 0.41; p = 0.001). In conclusion, using a smartphone while walking can be risky for pedestrians, especially in a traffic environment. People should avoid using their smartphone while crossing streets.

Impact of Social Isolation on the Physical and Mental Health of Older Adults: A Follow-Up Study at the Apex of the COVID-19 Pandemic in Brazil.

INTRODUCTION: The COVID-19 pandemic has affected people's lives and caused changes in habits. The World Health Organization recommends social isolation as a way of minimizing the risk of contagion of the disease. OBJECTIVE: The aim of the study was to assess the impact of social isolation due to COVID-19 pandemic on the physical and mental health of older adults and to investigate how anthropometric, functional, and clinical aspects are associated with this process. METHODS: Fifty healthy older adults were followed-up during 5 months. The subjects had their physical and mental health assessed during social isolation (pre-vaccine situation) and after the opening of stores and activities in the municipality (post-vaccine situation). Physical evaluation was performed using the 30-s sit and stand test. Participants' mental health was assessed with the Geriatric Depression Scale and the Loneliness Index. In this methodological design, muscle strength, depressive symptoms, and loneliness index were subject to pre-post analyses. In addition, these variables were included as outcomes in linear regression models. Participants' anthropometric, functional, and clinical factors were included as predictors of the statistical model. RESULTS: Participants' scores at baseline were consistent with mild depressive symptoms and low loneliness. The muscle strength of the subjects was appropriate to their ages. After 5 months of social isolation, all variables declined, but with statistical significance only for depressive symptoms (p = 0.017, effect size of 0.11). Anthropometric, functional, and clinical factors explained 42.8% of depressive symptoms, 22.3% of loneliness, and 30.2% of muscle strength in the elderly. DISCUSSION/CONCLUSION: Older adults presented baseline scores consistent with mild depressive symptoms and low loneliness. The muscular strength of the subjects was appropriate for their ages. After 5 months of social isolation, all variables declined. Anthropometric, functional, and clinical factors explained a substantial part of the depressive symptoms, loneliness, and muscular strength in the elderly. Health care professionals should be aware of performing a wide assessment in subjects' lives to ensure better health status.

Accuracy and Sensitivity of Clinical Parameters in Predicting Successful Extubation in Patients with Acute Brain Injury.

BACKGROUND: Brain injuries are frequent causes of intubation and mechanical ventilation. The aim of this study was to investigate the accuracy and sensitivity of clinical parameters in predicting successful extubation in patients with acute brain injury. METHODS: Six hundred and forty-four patients assisted at a high-complexity hospital were recruited. Patients were divided as for successful or failed extubation. The VISAGE score, maximum inspiratory and expiratory pressures, peak cough flow, and airway occlusion pressure at 0.1 s were used as predictors. Logistic regression analyses using ROC-curve identified values of accuracy and sensitivity. The Hosmer-Lemeshow test and the stepwise method calibrated the statistical model. RESULTS: VISAGE score (odds ratio of 1.975), maximum inspiratory pressure (odds ratio of 1.024), and peak cough flow (odds ratio of 0.981) are factors consistent in distinguishing success from failure extubation. The ROC curve presented an accuracy of 79.7% and a sensitivity of 95.8%. CONCLUSIONS: VISAGE score, maximum inspiratory pressure and peak cough flow showed good accuracy and sensitivity in predicting successful extubation in patients with acute brain injury. The greater impact of VISAGE score indicates that patients' neurological profile should be considered in association with ventilatory parameters in the decision of extubation.

Age, motor dysfunction and neuropsychiatric symptoms impact quality of life in multiple sclerosis.

OBJECTIVES: to investigate the impact of age, motor dysfunction and neuropsychiatric symptoms on the quality of life of people with multiple sclerosis in comparison to healthy peers. METHODS: a total of 141 participants were tested in a single session. The assessments were composed by general questionnaires applied in both groups and by specific instruments restricted to multiple sclerosis. Multiple regression models were applied to assess relationships between predictors and outcome. RESULTS: age, motor dysfunction and neuropsychiatric symptoms explained 56.6% of quality of life of the multiple sclerosis group. Age and neuropsychiatric symptoms explained 36.6% of quality of life in the control group. Age impacted more the multiple sclerosis group than the control group. Neuropsychiatric symptoms affected both groups similarly. Motor dysfunction impacted 21.9% of the quality of life in multiple sclerosis. CONCLUSIONS: the predictors explained considerable variance of quality of life in multiple sclerosis, which should guide public health policies.

Impacto da pandemia da covid-19 nas funções cognitivas e motoras de pessoas idosas: um estudo coorte de 3 anos / Impact of the COVID-19 pandemic on the cognitive and motor functions of older people: a 3-year cohort study

Resumo Objetivo Analisar o impacto da pandemia da covid-19 sobre as funções cognitivas e motoras de pessoas idosas. Método Neste estudo coorte, 90 idosos foram submetidos a testes cognitivos (Mini Exame do Estado Mental e Bateria de Avaliação Frontal) e motores (teste Timed Up and Go e Questionário Internacional de Queda) em dois momentos: antes do primeiro caso da pandemia ser identificado no Brasil e após o fim do estado de emergência em saúde pública. O teste de análise múltipla de variâncias para medidas repetidas foi aplicado junto ao teste lambda de Wilk para verificar o impacto da covid-19 sobre os fatores "momento" (pré × pós-pandemia), "grupo" (sexo, estado civil e escolaridade) e "interação" (momento × grupo). Tamanho do efeito e poder estatístico foram reportados. Significância foi admitida em 5%. Resultados Pessoas idosas sofreram declínio cognitivo durante a pandemia da covid-19 (tamanho do efeito: 0,43; poder estatístico: 99,8%; p=0,001). O declínio foi semelhante segundo sexo (p=0,864), estado civil (p=0,910) e escolaridade (p=0,969). Os participantes sofreram ainda declínio das funções motoras durante a pandemia (tamanho do efeito: 0,74; poder estatístico: 99,9%; p=0,001). O declínio foi semelhante segundo sexo (p=0,542) e estado civil (p=0,260). Participantes com menor escolaridade sofreram maior declínio físico do que pessoas com maiores níveis escolares (tamanho do efeito: 0,38; poder estatístico: 97,6%; p=0,004). Conclusão A pandemia da covid-19 afetou as funções cognitivas e motoras de pessoas idosas. Participantes com baixa escolaridade sofreram maior impacto da pandemia sobre sua saúde física, fato que deve incentivar novos estudos a explorar essa temática.

Abstract Objective To analyze the impact of the COVID-19 pandemic on the cognitive and motor functions in older people. Method In this cohort study, 90 older persons underwent cognitive (Mini-Mental State Examination and Frontal Assessment Battery) and motor (Timed Up and Go test and International Fall Questionnaire) tests in two moments: before the first case of the COVID-19 pandemic have been identified in Brazil and after the end of the state of public health emergency. The multiple analysis of variance was applied with the Wilk's lambda test to verify the impact of the COVID-19 pandemic on the factors "time" (pre × post-pandemic), "group" (sex, marital status and education) and "interaction" (time × group). Effect size and statistical power are reported. Significance was set at 5%. Results Older persons presented cognitive decline during the COVID-19 pandemic (effect size: 0.43; statistical power: 99.8%; p=0.001). The decline was similar according to sex ( p=0.864), marital status ( p=0.910) and schooling ( p=0.969). The participants also suffered a motor decline during COVID-19 pandemic (effect size: 0.74; statistical power: 99.9%; p=0.001). The decline was similar according to sex ( p=0.542) and marital status ( p=0.260). Participants with lower educational level suffered greater physical decline than persons with higher schooling (effect size: 0.38; statistical power: 97.6%; p=0.004). Conclusion The COVID-19 pandemic affected the cognitive and motor functions of older persons. Participants with low schooling suffered a greater decline of their physical health during the pandemic, a fact that should encourage further studies on this thematic.

Age, motor dysfunction and neuropsychiatric symptoms impact quality of life in multiple sclerosis / Idade, disfunção motora e sintomas neuropsiquiátricos impactam a qualidade de vida na esclerose múltipla / La edad, la disfunción motora y los síntomas neuropsiquiátricos impactan en la calidad de vida en la esclerosis múltiple

ABSTRACT Objectives: to investigate the impact of age, motor dysfunction and neuropsychiatric symptoms on the quality of life of people with multiple sclerosis in comparison to healthy peers. Methods: a total of 141 participants were tested in a single session. The assessments were composed by general questionnaires applied in both groups and by specific instruments restricted to multiple sclerosis. Multiple regression models were applied to assess relationships between predictors and outcome. Results: age, motor dysfunction and neuropsychiatric symptoms explained 56.6% of quality of life of the multiple sclerosis group. Age and neuropsychiatric symptoms explained 36.6% of quality of life in the control group. Age impacted more the multiple sclerosis group than the control group. Neuropsychiatric symptoms affected both groups similarly. Motor dysfunction impacted 21.9% of the quality of life in multiple sclerosis. Conclusions: the predictors explained considerable variance of quality of life in multiple sclerosis, which should guide public health policies.

RESUMO Objetivos: investigar o impacto da idade, da disfunção motora e dos sintomas neuropsiquiátricos sobre a qualidade de vida de pessoas com esclerose múltipla na comparação com controles saudáveis. Métodos: 141 participantes foram testados em uma única sessão. As avaliações foram compostas por questionários gerais aplicados em ambos os grupos e por instrumentos específicos à esclerose múltipla. Modelos de regressão múltipla foram usados para avaliar relações entre preditores e desfecho. Resultados: idade, disfunção motora e sintomas neuropsiquiátricos explicaram 56,6% da qualidade de vida do grupo esclerose múltipla. Idade e sintomas neuropsiquiátricos corresponderam a 36,6% da qualidade de vida do grupo-controle. Idade impactou mais o grupo esclerose múltipla do que o grupo-controle. Sintomas neuropsiquiátricos afetaram os grupos semelhantemente. A disfunção motora impactou 21,9% da qualidade de vida na esclerose múltipla. Conclusões: os preditores explicaram considerável variação da qualidade de vida na esclerose múltipla, o que deve nortear políticas públicas de saúde.

RESUMEN Objetivos: investigar el impacto de edad, disfunción motora y síntomas neuropsiquiátricos en la calidad de vida de personas con esclerosis múltiple en comparación con controles saludables. Métodos: 141 participantes fueron evaluados en una sesión. Las evaluaciones fueron compuestas por cuestionarios generales aplicados en ambos grupos y por instrumentos específicos a la esclerosis múltiple. Modelos de regresión múltiple fueron utilizados para evaluar relaciones entre predictores y resultado. Resultados: edad, disfunción motora y síntomas neuropsiquiátricos explicaron 56,6% de la calidad de vida en la esclerosis múltiple. Edad y síntomas neuropsiquiátricos explicaron 36,6% de la calidad de vida del grupo control. Edad afectó más la esclerosis múltiple que al grupo de control. Síntomas neuropsiquiátricos afectaron los grupos similarmente. La disfunción motora impactó 21,9% de la calidad de vida en la esclerosis múltiple. Conclusiones: los predictores explicaron una considerable variación de la calidad de vida en la esclerosis múltiple, lo que debe guiar políticas de salud pública.