Resistance training as a tool for changing muscle mass and frailty status in sarcopenic older women: a quasi-experimental study / Exercícios resistidos modificam a massa muscular e a classificação de fragilidade em idosas sarcopênicas: estudo quase-experimental / Los ejercicios de fuerza provocan cambios en la masa muscular y la clasificación de la fragilidad en ancianas con sarcopenia: un estudio cuasiexperimental

ABSTRACT Frailty and sarcopenia are geriatric syndromes highly prevalent, complex, and hard to diagnose and treat. The literature still lacks a consensus on which resistance training program is better for older people, especially when considering frailty status and sarcopenia. We aimed to evaluate the effectiveness of a progressive resistance training program on muscle mass and frailty status in older sarcopenic women. This study included 18 community-dwelling sarcopenic women aged 65 or older enrolled in the progressive resistance training program. The intervention was based on 75% of each subject's maximum repetition test (3 times/week, for 12 weeks). Before the intervention, 16.7% were frail, and 61.1% were pre-frail; after the intervention, 5.6% were frail, and 50% were pre-frail. The result shows that the intervention reduced frailty status and increased muscle mass (p=0.01). Hence, after the intervention, we observed both a decrease in frailty and a positive change in function, since the percentage of robust women increased twice (p=0.01). We conclude that the progressive resistance training program might be the best strategy to prevent frailty and sarcopenia. Therefore, we suggest using weight resistance training in daily clinical practice to improve muscle mass and decrease frailty status in sarcopenic women.

RESUMO Fragilidade e sarcopenia são consideradas síndromes geriátricas que apresentam grande prevalência e complexidade e são de difícil diagnóstico e tratamento. Ainda não existe consenso quanto ao melhor programa de exercícios resistidos, especialmente quando se considera a fragilidade e a sarcopenia. O objetivo deste estudo foi avaliar a efetividade de um programa de carga na massa muscular e na classificação de fragilidade em idosas sarcopênicas. Participaram 18 idosas sarcopênicas, com idade a partir de 65 anos, que completaram um programa de carga progressiva. A intervenção utilizou o cálculo de 75% de uma repetição máxima (1RM) para cada participante (3 vezes/semana, por 12 semanas). Antes da intervenção, 16,7% foram consideradas frágeis e 61,1% pré-frágeis; após, 5,6% passaram a ser consideradas frágeis e 50% pré-frágeis. Os resultados mostraram que a intervenção alterou a classificação de fragilidade e aumentou a massa muscular das idosas (p=0,01). Observou-se diminuição nos itens de classificação da fragilidade e consequente melhora no perfil funcional, havendo o aumento da porcentagem daquelas consideradas não frágeis após a intervenção (p=0,01). Conclui-se que o programa de exercício resistido progressivo é provavelmente uma das melhores estratégias para prevenir a fragilidade e a sarcopenia. Desta forma, recomenda-se o seu uso na prática clínica diária para melhorar a massa muscular e diminuir o status de fragilidade em mulheres sarcopênicas.

RESUMEN La fragilidad y la sarcopenia son síndromes geriátricos de alta prevalencia y complejidad, además de ser de difícil diagnóstico y tratamiento. Todavía no hay un consenso sobre el programa de ejercicios de fuerza más indicado, especialmente teniendo en cuenta la fragilidad y la sarcopenia. El objetivo de este estudio fue evaluar la efectividad de un programa de carga sobre la masa muscular y la clasificación de la fragilidad en ancianas con sarcopenia. Participaron 18 ancianas con sarcopenia, de más de 65 años y que completaron un programa de carga progresiva. La intervención utilizó el cálculo del 75% de repetición máxima (1RM) para cada participante (3 veces/semana, durante 12 semanas). Antes de la intervención, el 16,7% de las participantes se consideraban frágiles y el 61,1% prefrágiles; después de la intervención, el 5,6% se consideraban frágiles y el 50% prefrágiles. Los resultados mostraron que la intervención produjo cambios en la clasificación de la fragilidad y aumentó la masa muscular de las ancianas (p=0,01). Hubo una reducción en los ítems de clasificación de la fragilidad y una mejora en el perfil funcional, con un aumento del porcentaje de aquellas consideradas no frágiles después de la intervención (p=0,01). Se concluye que el programa de ejercicios de fuerza progresiva se mostró una de las mejores estrategias para prevenir la fragilidad y la sarcopenia. Por tanto, se recomienda aplicarlo en la práctica clínica cotidiana para mejorar la masa muscular y disminuir el estado de fragilidad de mujeres con sarcopenia.

Attitudes and beliefs of older adults with acute low back pain: 12-month results from the Brazilian cohort back complaints in the elders.

BACKGROUND: Psychosocial factors have been identified as important predictors of onset, course and persistence of low back pain (LBP) in the general population. OBJECTIVE: To identify factors associated with attitudes/beliefs in older adults with LBP throughout a 12-month follow-up. METHODS: A longitudinal investigation was conducted with 500 participants aged ≥60 years reporting a new (acute) episode of nonspecific LBP. Data were obtained at baseline, 6-week, 3-, 6-, 9-, and 12-month interviews. The study variables were: [dependent] LBP-related attitudes/beliefs that were assessed by the Back Beliefs Questionnaire (BBQ); [independent] age; sex; LBP intensity 'at-the-present-time' of interview and 'over-the-past-week' before interview; LBP frequency; LBP-related treatments; disability; mobility; depressive symptoms; self-perceived recovery; expectation of pain improvement; and expectation for returning to activities. Data were analysed by multiple linear regression analysis. RESULTS: At baseline, 85.7% of the participants were female, had mean age of 69.0 (6.3) years, mean BBQ score of 24.5 (6.5), and 79.6% reported pain complaints after an acute episode of LBP. After 12 months, participants maintained a mean BBQ score of 24.6 (6.6) and 63.3% still reported pain complaints after an acute episode of LBP at baseline. Multivariate analysis showed that disability, advancing age, poor expectation of pain improvement in 3 months, and mobility decline were significantly associated with worse BBQ scores during all follow-ups. CONCLUSION: Ageing, hopelessness, and physical and functional impairment impact pain-related behaviours among older patients seeking healthcare due to acute LBP complaints. Their screening may assist in strategies to manage symptoms and prevent the persistence of pain.

Do Older Brazilian Women Who Participate in a Regular Physical Exercise Program Have Higher Habitual Physical Activity Levels? A Cross-Sectional Study Based on Accelerometer Data.

A cross-sectional study was conducted to compare the habitual physical activity level, measured by accelerometry, gait performance, assessed by the GAITRite® system, handgrip strength, and static balance between older Brazilian women who participate (n = 50; 70.7 ± 5.5 years) and do not participate (n = 50; 70.1 ± 5.6 years) in a regular physical exercise program, and to investigate whether participation in a regular exercise program ensures compliance with physical activity recommendations. Older women who participated in a regular physical exercise program had significantly shorter sedentary activity time (effect size [ES] = 0.54), longer moderate activity time (ES = 0.85), and higher energy expenditure (ES = 0.64), number of steps (ES = 0.82), gait speed (ES = 0.49), and step length (ES = 0.45). However, regular participation in an exercise program did not guarantee compliance with physical activity recommendations. Behavioral changes to increase physical activity levels among older women who do and do not participate in a regular exercise program are necessary.

Cross-cultural adaptation, validity and reproducibility of the Back Beliefs Questionnaire among older Brazilians with acute low back pain. A cross-sectional study.

BACKGROUND: Low back pain (LBP) has emerging as an epidemic, multifactorial and multidimensional condition in older age. Assessment of attitudes and beliefs of patients with back pain is necessary for understanding the impact of psychosocial factors on pain perception and management. OBJECTIVES: To cross-culturally adapt and examine the validity and reproducibility (intra and interrater reliability and agreement) of the Back Beliefs Questionnaire (BBQ) in older Brazilians with acute LBP. DESIGN AND SETTING: Cross-sectional methodological report conducted at the Department of Physical Therapy of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. METHODS: The present study was conducted for translating, adapting, and examining the psychometric properties of a questionnaire. Participants aged ≥ 60 years experiencing an acute episode of LBP were recruited. Coefficients of internal consistency, reliability and agreement were obtained using Cronbach's α, intraclass correlations, and standard error of measurement and the smallest detectable change, respectively. RESULTS: Twenty-six participants aged between 60-84 years and reporting a mean of 9.8 (4.3) years of schooling completed the study. The Brazilian Portuguese-language version of the BBQ (BBQ-Brazil) was proposed and presented with adequate conceptual, semantic, operational, and measurement equivalence from the original version. Intra and interrater evaluations showed moderate (0.74) and excellent (0.91) intraclass correlation coefficients, respectively, with small standard error of measurement for both evaluations. Internal consistency was considered adequate (0.70). CONCLUSION: BBQ-Brazil had consistent measurements of validity and reproducibility, and proved to be a valuable tool in clinical practice for addressing attitudes and beliefs of older patients with acute LBP.

Energy Expenditure in Older Adults Who Are Frail: A Doubly Labeled Water Study.

BACKGROUND AND PURPOSE: Frailty is a common and important geriatric syndrome, distinct from any single chronic disease, and an independent predictor of mortality. It is characterized by age-associated decline in physiological reserve and function across multiple systems, culminating in a vicious cycle of altered energy expenditure. The total energy expenditure (TEE) of an individual includes the resting metabolic rate (RMR), the thermic effect of feeding, and the energy expenditure in physical activity (PAEE). The investigation of the energy expenditure of older adults who are frail is essential for better understanding the syndrome. Therefore, we compared the RMR, the PAEE, the physical activity level (PAL), and the TEE of older adults who were frail with those who were not frail. METHODS: A cross-sectional study was conducted with 26 community-dwelling older adults (66-86 years of age). Older adults in the frail and nonfrail groups were matched for age and gender, and the matched pairs were randomly selected to continue the study. The RMR was measured by indirect calorimetry. The TEE was obtained by the multipoint, doubly labeled water method. After collecting a baseline urine sample, each participant received an oral dose of doubly labeled water composed of deuterium oxide and oxygen-18 (H2O). Subsequently, urine samples were collected on the 1st, 2nd, 3rd, 7th, 12th, 13th, and 14th days after the baseline collection and analyzed by mass spectrometry. RESULTS AND DISCUSSION: The older adults who were frail presented significantly lower PAEE (1453.7 [1561.9] vs 3336.1 [1829.3] kj/d, P < .01), PAL (1.4 [0.3] vs 1.9 [0.6], P = .04), and TEE (7919.0 [2151.9] vs 10442.4 [2148.0] kj/d, P < .01) than the older adults who were nonfrail. There was no difference in their RMRs (5673.3 [1569.2] vs 6062.0 [1891.7] kj/d, P = .57). Frailty has been associated with a smaller lean body mass and with a disease-related hypermetabolic state, which might explain the lack of difference in the RMR. The PAL of the older adults who were frail was below the recommended level for older adults and determined a lower PAEE and TEE when compared with older adults who were not frail. CONCLUSION: This study showed that low energy expenditure in physical activity is a main component of frailty. The PAL of the older adults who were frail was far below the recommended level for older adults.

Prevalência e transição para a fragilidade em idosos com alteração cognitiva em uma coorte de um ano / Prevalence and transition to frailty in older adults with cognitive impairment: a 1-year cohort study

Alteração cognitiva e fragilidade são frequentemente encontradas em idosos e parece haver uma relação entre elas. Entretanto, pouco se sabe sobre a prevalência e a transição para a fragilidade nos idosos com alteração cognitiva, principalmente para a população brasileira. O objetivo do estudo foi avaliar a prevalência e a transição entre os estados de fragilidade em um grupo de idosos com alteração cognitiva em uma coorte prospectiva de um ano. Neste estudo de coorte foram avaliados 59 idosos comunitários com alteração cognitiva (≥ 65 anos). O indivíduo frágil foi identificado por apresentar pelo menos três dos seguintes critérios: perda de peso não intencional, fraqueza da força de preensão palmar, exaustão, lentidão na marcha e baixo nível de atividade física. Quando o indivíduo apresentou um ou dois critérios, foi considerado pré-frágil; quando não apresentou nenhum critério, foi considerado não frágil. A função cognitiva foi avaliada pelo Mini Exame do Estado Mental e a gravidade, pela Clinical Dementia Rating Scale. Do total de 59 idosos avaliados na linha de base, 28 (47,5%) eram frágeis, a mesma quantidade era de pré-frágeis e apenas 3 idosos eram não frágeis. Em 12 meses, verificou-se uma transição para fragilidade de 33,3%. Este estudo mostrou que a prevalência de fragilidade é alta entre os idosos com alteração cognitiva e, em um período de 12 meses, novos casos de fragilidade ocorreram entre os idosos com alteração cognitiva. Entretanto, mais estudos são necessários para investigar com melhor precisão uma relação existente entre o declínio cognitivo e a fragilidade

Cognitive impairment and frailty are often found in older people, and they appear to be related to each other. However, little is known about the prevalence and transition to frailty in older adults with cognitive impairment, especially in the Brazilian population. The present study aimed to determine the prevalence and transitions between frailty states in a cohort of older adults with cognitive impairment followed prospectively for 1 year. A cohort of 59 community-dwelling older adults (aged ≥ 65 years) with cognitive impairment was evaluated. Individuals were classified as frail by the presence of 3 or more of the following criteria: unintentional weight loss; reduced grip strength; exhaustion; slowness; and low physical activity level. Individuals meeting 1 or 2 criteria were classified as prefrail, and those meeting 0 criteria as nonfrail. Cognitive function was assessed by the Mini-Mental State Examination, and severity, by the Clinical Dementia Rating scale. Of 59 older adults evaluated at baseline, 28 (47.5%) were classified as frail, 28 (47.5%) as prefrail, and only 3 (5%) as nonfrail. Over 12 months, 33.3% of participants transitioned from prefrail to frail. The present study showed a high prevalence of frailty in older adults with cognitive impairment and, within 12 months, new cases of frailty were identified in this population. Therefore, more research is needed to further investigate the relationship between cognitive decline and frailty.

Pontos de corte alternativos para massa muscular apendicular para verificação da sarcopenia em idosos brasileiros: dados da Rede Fibra - Belo Horizonte/Brasil / Puntos de corte alternativos para la masa muscular apendicular para la certificación de la sarcopenia en ancianos brasileños: datos de Red Fibra - Belo Horizonte/Brasil / Alternative appendicular muscle mass cut-off points for verification of sarcopenia in older Brazilians: data from Rede Fibra - Belo Horizonte/Brazil

RESUMO Estabeleceram-se pontos de corte alternativos para o cálculo da massa muscular apendicular (MMA) em idosos brasileiros para classificar a sarcopenia. Foram analisados dados de 562 idosos participantes do estudo Fibra (Fragilidade em Idosos Brasileiros), no polo Belo Horizonte. Por meio da equação de Lee, determinaram-se pontos de corte para MMA baseado na percentil 20 de sua distribuição na população estudada. Em seguida, os sujeitos foram classificados para sarcopenia de acordo com os critérios do Consenso Europeu sobre Definição e Diagnóstico da Sarcopenia em Idosos, além de avaliadas as possíveis associações desta com a capacidade funcional e comorbidades. A maioria da amostra foi composta por mulheres (65,5%) com idade média de 74,1 (±6,4) e média de 1,5 (±1,4) comorbidades. Os pontos de corte para MMA foram <6.47kg/m2 para mulheres e <8.76kg/m2 para homens. A prevalência de sarcopenia foi de 14,9%, sendo 13,5% da população parcialmente dependente para atividades básicas de vida diária (ABVD), 30,6% para atividades instrumentais de vida diária (AIVD) e 66,7% para atividades avançadas de aida diária (AAVD). A sarcopenia se correlacionou apenas com AIVD (r=0,081, p= 0.05), e encontrou-se uma correlação negativa entre sarcopenia e comorbidades (r= −0,103, p=0,014). Foram propostos pontos de corte específicos para MMA para a população de idosos brasileiros e não foram encontradas correlações entre as variáveis do estudo, exceto para AIVD e comorbidades.

RESUMEN Se establecieron puntos de corte alternativos para el cálculo de la masa muscular apendicular (MMA) en ancianos brasileños para clasificar la sarcopenia. Fueron analizados datos de 562 ancianos participantes del estudio Fibra (Debilidad en Ancianos Brasileños), en el polo Belo Horizonte. Por medio de la ecuación de Lee, se determinaron puntos de corte para MMA basado en la percentil 20 de su distribución en la población estudiada. Luego, los sujetos fueron clasificados para sarcopenia de acuerdo con los criterios del Consenso Europeo sobre Definición y Diagnóstico de la Sarcopenia en Ancianos, además de evaluadas las posibles asociaciones de esta con la capacidad funcional y comorbidades. La gran parte de la muestra fue compuesta por mujeres (el 65,5%) con edad media de 74,1 (±6,4) y promedio de 1,5 (±1,4) comorbidades. Los puntos de corte para MMA fueron <6.47kg/m2 para mujeres y <8.76kg/m2 para hombres. La prevalencia de sarcopenia fue del 14,9%, siendo el 13,5% de la población parcialmente dependiente para actividades básicas de vida diaria (ABVD), el 30,6% para actividades instrumentales de vida diaria (AIVD) y el 66,7% para actividades avanzadas de vida diaria (AAVD). La sarcopenia se correlacionó solamente con AIVD (r=0,081, p= 0.05), y se encontró una correlación negativa entre sarcopenia y comorbidades (r= −0,103, p=0,014). Fueron propuestos los puntos de corte específicos para MMA para la población de ancianos brasileños y no fueron encontradas correlaciones entre las variables del estudio, excepto para AIVD y comorbidades.

ABSTRACT Alternative cut-off points for the calculation of appendicular muscle mass (AMM) in older Brazilians were established to classify sarcopenia. Data from 562 older adults from Belo Horizonte who participated in the Fibra study (Fragilidade em Idosos Brasileiros [Fragility in Older Brazilians) were analyzed. Through Lee's equation, cut-off points for AMM were determined based on the 20th percentile of their distribution in the studied population. Then, the subjects were classified for sarcopenia according to the criteria of the European Consensus on Definition and Diagnosis of Sarcopenia in Older Adults, and its possible associations with functional capacity and comorbidities were evaluated. Most of the sample was composed by women (65.5%) with 74.1 years of age (±6.4) and 1.5 (±1.4) comorbidities on average. The cut-off points for AMM were <6.47kg/m2 for women and <8.76kg/m2 for men. The prevalence of sarcopenia was 14.9%, 13.5% of the population being partially dependent for basic activities of daily living (BADL), 30.6% for instrumental activities of daily living (IADL) and 66.7% for advanced activities of daily living (AADL). Sarcopenia was correlated with IADL only (r=0.081, p=0.05), and a negative correlation was found between sarcopenia and comorbidities (r=−0.103, p=0.014). Cut-off points specific to AAM for the population of older Brazilians were proposed, and no correlations between the variables of the study were found, except for IADL and comorbidities.

Factor analysis of the minnesota leisure time activities questionnaire - brazilian portuguese / Análise fatorial do minnesota leisure time activities questionnaire - português-brasil / Análisis factorial del minnesota leisure time activities questionnaire - portugués-brasil

ABSTRACT Introduction: Accurate measures of physical activity to establish dose-response relationship in health outcomes are still controversial. Scales that estimate caloric expenditure are proposed with a view to categorizing the phenomenon globally. Objective: To carry out a factor analysis of the structure of the Minnesota Leisure Time Activities Questionnaire - Brazilian Portuguese, and propose a new adapted version for the Brazilian elderly community. Methods: Participants were elderly female members of the community, without any distinction in terms of ethnic group and/or social class, who frequented extension projects of two higher education institutions. Those with cognitive impairments; dependence on walking aids; musculoskeletal pain in the last two weeks and neurological diseases were excluded from the study. All participants answered the questionnaire with sociodemographic and clinical data and the Minnesota Leisure Time Activities Questionnaire - Brazilian Portuguese version. We determined whether each activity had been undertaken by the participants and the average number of times it was performed over the last two weeks, considering average time, in minutes, on each occasion. Each activity was considered a single item and energy expenditure was calculated according to the authors' instructions. We used factor analysis with Varimax orthogonal rotation, excluding items whose variance was equal to zero. Correlation between items was determined using the Pearson correlation matrix. Internal consistency between items, before and after the factor analysis, was verified using Cronbach's α coefficient. 5% significance level. Results: Participants were 220 women (70.8 ± 5.9 years). The factor analysis resulted in 10 components, which explained, in total, 61.87% of the variance of the total score on the scale. Each component was composed of one, two or three aggregate items. Internal consistency by Cronbach's α coefficient was 0.30. Conclusion: The factor analysis of the structure of the Minnesota Leisure Time Activities Questionnaire - Brazilian Portuguese- has shown a new range with 10 components, which explained, in total, more than 60% of the variance of the total score on the scale, yet with low internal consistency. Level of Evidence III; Study of nonconsecutive patients; without consistently applied reference ''gold'' standard.

RESUMO Introdução: Medidas acuradas de atividade física para estabelecer relação dose-resposta em desfechos de saúde ainda são controversas. Escalas que estimam o gasto calórico são propostas visando categorizar o fenômeno de forma global. Objetivo: Realizar a análise fatorial da estrutura do Minnesota Leisure Time Activities Questionnaire - português-Brasil e propor uma nova versão adaptada aos idosos comunitários brasileiros. Métodos: Participaram idosas, residentes da comunidade, sem distinção de raça e/ou classe social e frequentadoras de projetos de extensão de duas escolas de ensino superior. Excluíram-se aquelas com alterações cognitivas, marcha dependente, dores musculoesqueléticas nas últimas duas semanas e doenças neurológicas. Todas responderam ao questionário com dados sócio-clínico-demográficos e ao Minnesota Leisure Time Activities Questionnaire - versão português-Brasil. Foi identificado se cada atividade tinha sido realizada e o número médio de vezes nas últimas duas semanas, considerando tempo médio, em minutos, em cada ocasião. Cada atividade foi considerada como um item e o gasto energético foi calculado de acordo com as instruções dos autores. Utilizou-se a análise fatorial com rotação ortogonal Varimax excluindo os itens cuja variância era igual a zero. A correlação entre os itens foi realizada pela matriz de correlação de Pearson. A consistência interna entre os itens, antes e depois da análise fatorial foi realizada através do coeficiente α de Cronbach. Nível de significância de 5%. Resultados: Participaram 220 mulheres (70,8 ± 5,9 anos). A análise fatorial resultou em 10 componentes que explicaram no total 61,87% da variância da pontuação total na escala. Cada componente era composto por um, dois ou três itens agregados. A consistência interna pelo coeficiente α de Cronbach foi de 0,30. Conclusão: A análise fatorial da estrutura do Minnesota Leisure Time Activities Questionnaire - português-Brasil apresentou uma nova escala com 10 componentes que explicou no total mais de 60% da variância da pontuação total na escala, porém com uma baixa consistência interna. Nível de Evidência Nível III; Estudo de pacientes não consecutivos; sem padrão de referência "ouro" aplicado uniformemente.

RESUMEN Introducción: Las medidas precisas de actividad física para establecer relación dosis-respuesta en los resultados de salud aún son controvertidas. Las escalas que estiman el gasto calórico son propuestas buscando categorizar el fenómeno de forma global. Objetivo: Realizar el análisis factorial de la estructura del Minnesota Leisure Time Activities Questionnaire - Portugués-Brasil y proponer una nueva versión adaptada a los individuos de tercera edad comunitarios brasileños. Métodos: Participaron mujeres de tercera edad, residentes en comunidad, sin distinción de raza y/o clase social y frecuentadoras de proyectos de extensión de dos escuelas de enseñanza superior. Se excluyeron aquellas con alteraciones cognitivas, marcha dependiente, dolores musculoesqueléticos en las últimas dos semanas y enfermedades neurológicas. Todas respondieron el cuestionario con datos socio-clínico-demográficos y el Minnesota Leisure Time Activities Questionnaire - versión en portugués de Brasil. Se identificó si cada actividad había sido realizada y el número promedio de veces en las últimas dos semanas, considerando tiempo promedio, en minutos, en cada ocasión. Cada actividad fue considerada como un ítem y se calculó el gasto energético de acuerdo con las instrucciones de los autores. Se utilizó análisis factorial con rotación ortogonal Varimax excluyendo los ítems cuya varianza fue igual a cero. La correlación entre los elementos fue realizada por la matriz de correlación de Pearson. La consistencia interna entre los elementos, antes y después del análisis factorial fue realizada a través del coeficiente α de Cronbach. Nivel de significancia de 5%. Resultados: Participaron 220 mujeres (70,8 ± 5,9 años). El análisis factorial resultó en 10 componentes que explicaron en total 61,87% de la varianza de puntuación total en la escala. Cada componente era compuesto por uno, dos o tres elementos agregados. La consistencia interna por el coeficiente α de Cronbach fue de 0,30. Conclusión: El análisis factorial de la estructura del Minnesota Leisure Time Activities Questionnaire - Portugués-Brasil presentó una nueva escala con 10 componentes que explicó en total más de 60% de la varianza de la puntuación total de la escala, aunque con una baja consistencia interna. Nivel de Evidencia Nivel III; Estudio de pacientes no consecutivos; sin estándar de referencia "oro" aplicado uniformemente.

Effect of a resistance exercise program for sarcopenic elderly women: quasi-experimental study / Efeito de um programa de exercícios resistidos para idosas sarcopênicas: estudo quase-experimental / Efecto de un programa de ejercicios resistidos para ancianas sarcopénicas: estudio cuasiexperimental

Abstract Introduction: Resistance training is quoted as one of the best pathways to manage sarcopenia and progressive resistance training is supposed to improve muscle mass, strength and performance in older adults. Objective: The aim was to examine the impact of a progressive resistance exercise program (PREP) on muscle and function performance in sarcopenic community-dwelling elder women. Methods: Quasi-experimental study (pre - post intervention). Participated 18 sarcopenic community-dwelling elder women (65 years or older). PREP based on 75% of the participant's maximum load (12/wk, 3 times/wk). Main outcome measures: muscle strength of knee extensors (isokinetic dynamometry), muscle mass (dual-x ray absorptiometry - DXA), functional performance (Short Physical Performance Battery - SPPB). Paired t-test was used to evaluate differences pre and post intervention. Results: Improvements on power (p = 0.01) and peak torque (p = 0.01) were observed when measured by the isokinetic dynamometer at low speed (60º/s). Improvements on DXA (pre PREP: 5.49 kg/m2 vs. post PREP: 6.01 kg/m2; p = 0.03) and SPPB scores (pre PREP: 9.06 vs. post PREP: 10.28; p = 0.01) were also observed. Conclusion: The PREP was able to improve muscle and functional performance in sarcopenic community-dwelling elder women. This program should be considered in clinical practice.

Resumo Introdução: Exercícios com carga são uma das boas indicações de tratamento no caso da sarcopenia e o treinamento com carga progressiva pode aumentar a massa muscular, força e desempenho em idosos. Objetivo: Avaliar o impacto de um programa de exercícios com carga progressiva (PECP) no desempenho muscular e funcional de idosas sarcopênicas da comunidade. Métodos: Estudo quasi-experimental (pré-pós intervenção). Participaram 18 idosas sarcopênicas, da comunidade (65 anos e mais). PECP foi baseado em 75% de uma resistência máxima (12/semanas, 3 x/ semana). Medidas de desfecho: força muscular dos extensores de joelho (dinamômetro isocinético), massa muscular (dual-x ray absorptiometry - DXA), desempenho funcional (Short Physical Performance Battery - SPPB). Comparações pré-pós intervenção foi por meio do teste t-test pareado. Resultados: Houve aumento na potência (p = 0,01) e no torque (p = 0,01), observados nas medidas do isocinético em baixa velocidade (60º/s). Observou-se também aumento no DXA (5,49 kg/m2 vs. 6,01 kg/m2; p = 0,03) e melhora nos escores do SPPB (9,06 vs. 10,28; p = 0,01). Conclusão: O PECP aumentou o desempenho funcional e muscular das idosas sarcopênicas comunitárias. Este programa deve ser considerado para a prática clínica.

Resumen Introducción: Ejercicios con carga es una de las buenas indicaciones de tratamiento en el caso de la sarcopenia y el entrenamiento con carga progresiva puede aumentar la masa muscular, fuerza y desempeño en ancianos. Objetivo: Evaluar el impacto de un programa de ejercicios con carga progresiva (PECP) en el desempeño muscular y funcional de ancianas sarcopénicas de la comunidad. Métodos: Estudio cuasiexperimental (pre-pos intervención). Participaron 18 ancianas sarcopénicas, de La comunidad (65 años y más). PECP se basó en 75% de una resistencia máxima (12/semanas, 3 x/semana). Las medidas de desenlace: fuerza muscular de los extensores de rodilla (dinamómetro isocinético), masa muscular (dual-x ray absorptiometry - DXA), desempeño funcional (Short Physical Performance Battery - SPPB). Las comparaciones pre-post-intervención fueron a través de La prueba t-test pareado. Resultados: Hubo aumento en la potencia (p = 0,01) y en el par de apriete - torque (p= 0,01), observados en las medidas del isocinético a baja velocidad (60º/s). Se observo también un aumento en el DXA (5,49 kg/m² vs. 6,01 kg/m², p = 0,03) y mejora en los escores del SPPB (9,06 vs. 10,28, p = 0,01. Conclusión: El PECP aumento el desempeño funcional y muscular de las ancianas sarcopénicas comunitarias. Este programa debe ser considerado para la práctica clínica.

Prevalence of obesity, sarcopenic obesity and associated factors: A FIBRA Network study / Prevalência da obesidade, obesidade sarcopênica e fatores associados: um estudo da Rede FIBRA

Abstract Introduction: Sarcopenic obesity in older adults may lead to an inability to use muscles efficiently and has been associated with functional deficits and disabilities. Objective: To identify the prevalence of obesity and sarcopenic obesity (SO) among community-dwelling older adults, and to characterize associated sociodemographics, health conditions and functional performance. Methods: Study data are from the FIBRA Network database of the Federal University of Minas Gerais. There were 1,373 older adult participants, subdivided into three groups: 1) non-obese; 2) non-sarcopenic obese; and 3) sarcopenic obese (SO). The latter is defined as a BMI ≥30 kg/m2 and weak palmar grip strength (PGS). Results: The overall prevalence of obesity and SO among older adults was 25.85% and 4.44%, respectively, with levels of frailty and pre-frailty among at 36.1% and 59%, respectively. Gait speed (GS) was lower in the SO group as well, compared to the other groups. An average increase in GS of 0.1 m/sec reduced the likelihood of SO by 85.1%, in average. Sarcopenic obese older adults were 14.2 times more likely to be pre-fragile and 112.9 times more likely to be fragile than the other groups. Conclusion: The prevalence of obesity found in this study was higher than that in the general population, but similar to national statistics for the sample's mean age and gender. SO was directly associated with frailty in advanced and instrumental activities of daily living as well as gait speed and significantly increased the likelihood of being pre-frail and frail. GS may be an extremely useful tool for monitoring the progress of SO in older adults.

Resumo Introdução: A obesidade sarcopênica é uma condição de saúde que em idosos, pode resultar na incapacidade de utilizar os músculos de forma eficiente e tem sido associada a déficits funcionais e incapacidades. Objetivo: Identificar a prevalência da obesidade e obesidade sarcopênica (OS) e os fatores sociodemográficos, condições de saúde e medidas de desempenho funcional, associadas à OS em idosos comunitários. Métodos: Recorte do banco de dados do polo UFMG da Rede FIBRA. Participaram do estudo 1373 idosos divididos em três grupos 1) Não obesos; 2) Obesos não sarcopênicos; 3) Obesos sarcopênicos. OS foi definida por IMC ≥30 kg/m2 e baixa força de preensão palmar (FPP). Resultados: A prevalência de obesidade foi 25,85% e de OS foi 4,44%. Entre os obesos sarcopênicos a prevalência de fragilidade foi 36,1% e 59% de pré-frágilidade. A velocidade de marcha (VM) no grupo obeso sarcopênico, foi menor quando comparada aos outros grupos. Um aumento médio de 0,1m/seg na VM reduziu em média 85,1% a chance de se ter OS na amostra. Ser obeso sarcopênico aumentou em 14,2 vezes a chance de ser pré-frágil e 112,9 vezes a chance de ser frágil. Conclusão: A prevalência de obesidade foi maior que as taxas gerais, porém semelhante aos dados nacionais para a média de idade e sexo da amostra. OS se associou ao perfil de fragilidade, às atividades instrumentais e avançadas de vida diária e à velocidade de marcha. OS aumentou expressivamente a chance de o idoso ser pré-frágil e frágil e a VM pode ser uma ferramenta útil de acompanhamento da progressão da OS.

Electromyographic normalization of vastus lateralis and biceps femoris co-contraction during gait of elderly females / Normalização eletromiográfica da co-contração do vasto lateral e bíceps femoral durante a marcha de idosas

Abstract Introduction: Analyze muscle co-contraction using electromyographic signals, which are normalized to compare individuals, muscles and studies. Maximum voluntary isometric contraction (MVIC) and peak electrical activity (PEA) during movement are the most widely used forms of normalization. Objective: Compare inter-subject variability and investigate the association between the co-contraction indices of the vastus lateralis and biceps femoris during gait, normalized by MVIC and PEA. Methods: Thirty elderly women, aged 70.33 ± 3.69 years took part. Electrical muscle activity during MVIC and gait was recorded using a Biopac MP100 electromyograph. MVIC was performed in a Biodex isokinetic dynamometer. For normalization, the signals were divided by the Root Mean Square values of MVIC and PEA of gait. Results: The coefficient of variation of non-normalized data was 69.3%, and those normalized by PEA and MVIC were 30.4% and 48.9% respectively. Linear regression analysis resulted in a prediction model: PEA = 0.04 + 0.16 x MVIC. The goodness of fit of the regression model was statistically significant (p=0.02). The confidence interval (95% CI) for the intercept was between 0.02 and 0.29 and for MVIC between 0.03 and 0.06. Conclusions: The data normalized by PEA showed less variation than those normalized by MVIC. A 100% variation in data normalized by MVIC resulted in a 16% variation in data normalized by PEA, while variation in normalization by MVIC accounts for 17% of the variation in normalization by PEA and vice versa.

Resumo Introdução: Analisa-se co-contração muscular através dos sinais eletromiográficos, os quais são normalizados para permitir comparação entre indivíduos, músculos e estudos. A contração voluntária máxima isométrica (CVMi) e o pico da atividade elétrica (PAE) durante o ato motor são as formas de normalização mais utilizadas. Objetivos: Comparar a variabilidade inter-sujeitos e investigar a associação entre os índices de co-contração, do vasto lateral e bíceps femoral durante a marcha, normalizados pela CVMi e PAE. Métodos: Participaram 30 idosas, idade 70,33 ± 3,69 anos. A atividade elétrica dos músculos durante a CVMi e na marcha foi registrada pelo eletromiógrafo Biopac MP100. A CVMi foi realizada no dinamômetro isocinético Biodex. Para normalização, os sinais foram divididos pelos valores do Root Mean Square da CVMi e pelo PAE da marcha. Resultados: O coeficiente de variação dos dados não normalizados foi 69,3%, e dos normalizados pelo PAE e CVMi foram 30,4% e 48,9% respectivamente. A análise de regressão linear produziu o modelo de predição: PAE = 0,04 + 0,16 x CVMi. O ajuste do modelo de regressão foi estatisticamente significante (p=0,02). O intervalo de confiança (IC95%) para o intercepto foi de 0,02 a 0,29 e para a CVMi foi de 0,03 a 0,06. Conclusão: Os dados normalizados pelo PAE apresentaram menor variação que os normalizados pela CVMi. Uma variação de 100% nos dados normalizados pela CVMi resulta em 16% de variação nos dados normalizados pelo PAE, enquanto a variação da normalização pela CVMi é responsável por 17% de variação da normalização pelo PAE e vice-versa.

Multifactorial assessment of the risk of falls in low bone density older women / Avaliação multifatorial do risco de quedas em idosas com baixa densidade óssea

Abstract Introduction: Identifying effective assessment instruments for predicting falls, specifically in older women with low bone mineral density (BMD) that are more susceptible to fractures remains a challenge. Objective: To evaluate risk factors for falls at baseline, to identify the falls occurrence over six months of follow-up and to investigate the predictive validity of the Quickscreen Clinical Falls Risk Assessment for predicting multiple falls among low BMD older women. Methods: A methodological study with 110 older women with diagnosis of osteoporosis or osteopenia (70.26 ± 6.24 years). The presence of two or more of the eight risk factors assessed by the QuickScreen characterized the risk of falling (baseline) and monthly phone calls identified the occurrence of falls during the six months of follow-up. Results: The most prevalent falls risk factors were self-reported previous falls, polypharmacy and impairment in shifting weight and lateral instability. Most of the older women (67.3%) had two or more risk factors, 24.5% reported a single fall and 13.6% reported multiple falls over the six months. The QuickScreen (cutoff ≥ 2 risk factors) showed good sensitivity (73.3%) and high negative predictive value (88.89%) for predicting multiple falls among low BMD older women. Conclusions: The results indicated a high frequency of falls among low BMD older women. Additionally, the results highlighted that the QuickScreen instrument was able to predict multiple falls in the six months of follow-up among these older women.

Resumo Introdução: A identificação de instrumentos de avaliação eficazes na predição de quedas, especificamente em idosas com baixa densidade mineral óssea (DMO) e mais susceptíveis a fraturas, permanece um desafio. Objetivo: Avaliar os fatores de risco para quedas na linha de base, identificar a ocorrência de quedas em seis meses de acompanhamento e investigar a validade preditiva do teste Quickscreen Clinical Falls Risk Assessment para predizer quedas múltiplas em idosas com baixa DMO. Métodos: Estudo metodológico com 110 idosas com diagnóstico de osteoporose ou osteopenia (70,26 ± 6,24 anos). O risco de queda (linha de base) foi caracterizado pela presença de dois ou mais dos oito fatores de risco avaliados no QuickScreen e a ocorrência de quedas nos seis meses posteriores identificada por meio de telefonemas mensais. Resultados: Os fatores de risco para quedas mais frequentes foram o autorrelato de quedas prévias, a polifarmácia e o déficit de deslocamento de peso e instabilidade lateral. A maioria das idosas (67,3%) apresentou dois ou mais fatores de risco, 24,5% relataram uma queda e 13,6% quedas múltiplas nos seis meses. O QuickScreen (ponto de corte ≥ 2 fatores de risco) apresentou boa sensibilidade (73,3%) e alto valor preditivo negativo (88,89%) para predizer quedas múltiplas em idosas com baixa DMO. Conclusão: Os resultados indicaram alta frequência de quedas entre idosas com baixa DMO e apontaram que o instrumento QuickScreen foi capaz de prever quedas múltiplas em seis meses de acompanhamento nessas idosas.

Association Between the Plasma Levels of Mediators of Inflammation With Pain and Disability in the Elderly With Acute Low Back Pain: Data From the Back Complaints in the Elders (BACE)-Brazil Study.

STUDY DESIGN: Cross-sectional study with subsample of elderly women with acute low back pain (LBP), from Back Complaints in the Elders-Brazil (BACE-Brazil) OBJECTIVE: To investigate the association between plasma levels of mediators of inflammation (interleukin-1 beta (IL-1ß), IL-6, tumor necrosis factor alpha (TNF-α), and soluble TNF receptor 1 (sTNF-R1)) with pain and disability experienced by elderly women with acute LBP. SUMMARY OF BACKGROUND DATA: Among the elderly, LBP is a complaint of great importance and can lead to disability. Inflammatory cytokines are elevated in painful conditions, and may promote pain. METHODS: We included 155 community-dwelling elderly women (age ≥ 65 yr), who presented with a new (acute) episode of LBP. Enzyme-linked immunosorbent assays were used to measure TNF-α, sTNF-R1, IL-1ß, and IL-6. Disability was assessed using the Roland Morris Disability Questionnaire; pain was assessed using the McGill Pain Questionnaire. Linear regression models were fit with each pain and disability outcome as dependent variables: Present Pain Intensity; Qualities of pain; Severity of pain in the last week; LBP frequency and disability. RESULTS: Depressive symptoms and IL-6 were associated and explained 20.9% of "qualities of pain" variability. TNF-α, sTNFR1, education, body mass index, and depressive symptoms explained 8.4% of "Severity of pain in the past week" variability. TNF-α, education, BMI, depressive symptoms, present pain intensity, qualities of pain, and LBP frequency explained 48.6% of "disability." No associations between inflammatory cytokines and "present pain intensity" and "LBP frequency" were found. CONCLUSION: Our results demonstrate associations between inflammatory markers (TNF-α and sTNFR1) and pain severity, IL-6 was associated with the qualities of pain, and TNF-α was also associated with disability. These inflammatory mediators represent new markers to be considered in the assessment and treatment of elderly patients with LBP. LEVEL OF EVIDENCE: 5.

Is the Veterans Specific Activity Questionnaire Valid to Assess Older Adults Aerobic Fitness?

BACKGROUND: Aerobic fitness in older adults is related to health status, incident disability, nursing home admission, and all-cause mortality. The most accurate quantification of aerobic fitness, expressed as peak oxygen consumption in mL·kg·min, is the cardiorespiratory exercise test; however, it is not feasible in all settings and might offer risk to patients. The Veterans Specific Activity Questionnaire (VSAQ) is a 13-item self-administered symptom questionnaire that estimates aerobic fitness expressed in metabolic equivalents (METs) and has been validated to cardiovascular patients. PURPOSE: The purpose of this study was to assess the validity and reliability of the VSAQ in older adults without specific health conditions. METHODS: A methodological study with a cross-sectional design was conducted with 28 older adults (66-86 years). The VSAQ was administered on 3 occasions by 2 evaluators. Aerobic capacity in METs as measured by the VSAQ was compared with the METs found in an incremental shuttle walk test (ISWT) performed with a portable metabolic measurement system and with accelerometer data. RESULTS: The validity of the VSAQ was found to be moderate-to-good when compared with the METs and distance measured by the ISWT and with the moderate activity per day and steps per day obtained by accelerometry. The Bland-Altman graph analysis showed no values outside the limits of agreement, suggesting good precision between the METs estimated by questionnaire and the METs measured by the ISWT. Also, the intrarater and interrater reliabilities of the instrument were good. CONCLUSIONS: The results showed that the VSAQ is a valuable tool to assess the aerobic fitness of older adults.

Relação da capacidade funcional, força e massa muscular de idosas com osteopenia e osteoporose / Relación entre la capacidad funcional, la fuerza y la masa muscular en personas mayores con osteopenia y osteoporosis / Relation of functional capacity, strength and muscle mass in elderly women with osteopenia and osteoporosis

Este estudo buscou analisar a associação entre testes de capacidade funcional, desempenho dos músculos do joelho e composição corporal de idosas com baixa densidade óssea. Foi desenvolvido um estudo transversal com 48 idosas (70,62±5,95 anos). Avaliou-se a capacidade funcional (testes Timed Up and Go - TUG e levantar e sentar na cadeira - TLS), desempenho muscular de joelho (dinamômetro isocinético), massa muscular (índice muscular esquelético com BIA) e massa magra (dobras cutâneas). A maioria da amostra era ativa ou moderadamente ativa (95,8%), apresentou sobrepeso (68,75%), ausência de sarcopenia (62,5%) e desempenho médio de 7,7 segundos no TUG e de 11,21 segundos no TLS. Observaram-se correlações negativas moderadas e baixas da capacidade funcional com as variáveis de desempenho muscular de joelho. A massa muscular apresentou correlação positiva baixa com potência de extensores de joelho e não apresentou correlação com a capacidade funcional, a qual apresentou associação somente com o desempenho muscular, reforçando a fragilidade do uso da massa muscular como medida única na identificação de sarcopenia.

En este estudio se analizó la relación entre pruebas de capacidad funcional, el rendimiento de los músculos de la rodilla y la composición corporal de adultos mayores con baja densidad ósea. Se desarrolló un estudio transversal con 48 adultos mayores (70,62±5,95 años) para que se evalúe la capacidad funcional (test de Timed Up and Go - TUG y el de Levantarse y Sentarse en la silla - TLS), el rendimiento muscular de la rodilla (dinamómetro isocinético), la masa muscular (índice del músculo esquelético con BIA) y la masa magra (pliegues cutáneos). La mayoría de la muestra era activa o moderadamente activa (un 95,8%), presentaba sobrepeso (un 68,75%) ausencia de sarcopenia (un 62,5%) y un rendimiento medio de 7,7 segundos en el TUG y de 11,21 segundos en el TLS. Se observó moderadas y bajas correlaciones negativas en cuanto a la capacidad funcional con las variables de rendimiento muscular de la rodilla. La masa muscular mostró una baja correlación positiva con la potencia de extensores de rodilla, en cambio, no señaló una correlación con la capacidad funcional, que había demostrado relación solamente con el rendimiento muscular, lo que refuerza la fragilidad de utilización de la masa muscular como única medida para que se identifique la sarcopenia.

This study aimed at analyzing the association among functional ability tests, performance of knee muscles, and body composition of elderly women with low bone densities. A transverse study with 48 elderly women (aged 70.62±5.95 years) was developed, and their functional abilities were evaluated (Timed Up and Go - TUG - and Chair Stand - CST - tests), as well as their knee muscle performance (isokinetic dynamometer), their muscle mass (skeletal muscle index with BIA), and their lean mass (skin folds). The majority of the sample was active or moderately active (95.8%), was found to be overweight (68.75%), was not found to have sarcopenia (62.5%), and had average performances of 7.7 seconds in TUG and 11.21 seconds in CST. The functional ability was found to have moderate and low negative correlations with the knee muscle performance variables. Their muscle mass was found to have a low positive correlation with the power of knee extensor muscles and it was found to have no correlation with the functional ability, which was only found to have an association with the muscle performance, which reinforces how unreliable it is to use muscle mass as the single measurement for the identification of sarcopenia.

Psychometric properties of the Brazilian version of the Pain Catastrophizing Scale for acute low back pain.

Measurement instruments of pain catastrophizing for middle-aged and elderly individuals are needed to understand its impact on low back pain. The goals were to cross-culturally adapt the Pain Catastrophizing Scale, assess the construct validity through Rasch analysis, and verify reliability and convergent validity of pain catastrophizing with psychosocial factors. 131 individuals aged 55 years and older with acute low back pain were interviewed . The intra-rater reliability was Kp = 0.80 and interrater Kp = 0.75. The Rasch analysis found adequate reliability coefficients (0.95 for items and 0.90 for individuals ). The separation index for the elderly was 2.95 and 4.59 items. Of the 13 items, one did not fit the model, which was justified in the sample evaluated. The pain catastrophizing correlated with most psychosocial factors. The instrument proved to be clinically useful. Subsequent studies should carry out the same analysis in different populations.

Psychometric properties of the Brazilian version of the Pain Catastrophizing Scale for acute low back pain / Propriedades psicométricas da versão brasileira da Escala de Catastrofização da Dor para dor lombar aguda

Measurement instruments of pain catastrophizing for middle-aged and elderly individuals are needed to understand its impact on low back pain. The goals were to cross-culturally adapt the Pain Catastrophizing Scale, assess the construct validity through Rasch analysis, and verify reliability and convergent validity of pain catastrophizing with psychosocial factors. 131 individuals aged 55 years and older with acute low back pain were interviewed . The intra-rater reliability was Kp = 0.80 and interrater Kp = 0.75. The Rasch analysis found adequate reliability coefficients (0.95 for items and 0.90 for individuals ). The separation index for the elderly was 2.95 and 4.59 items. Of the 13 items, one did not fit the model, which was justified in the sample evaluated. The pain catastrophizing correlated with most psychosocial factors. The instrument proved to be clinically useful. Subsequent studies should carry out the same analysis in different populations.

Instrumentos de medida da catastrofização da dor para indivíduos de meia-idade e idosos são necessários para compreensão do impacto na dor lombar nessa população. Os objetivos foram adaptar transculturalmente a Escala de Catastrofização da Dor, avaliar a validade de construto pela análise Rasch, verificar a confiabilidade e a validade convergente da catastrofização da dor com fatores psicossociais. Participaram 131 indivíduos comunitários com 55 anos e mais com dor lombar aguda. A confiabilidade intra-examinadores foi de Kp = 0,80 e inter-examinadores Kp = 0,75. A análise Rasch, detectou adequados coeficientes de confiabilidade (0,95 para itens e 0,90 para indivíduos). O índice de separação dos idosos foi de 2,95 e dos itens 4,59. Dos 13 itens, um não se enquadrou no modelo, o que se justificou na amostra avaliada. A catastrofização da dor se correlacionou com a maioria dos fatores psicossociais. O instrumento mostrou-se clinicamente útil. Estudos subsequentes devem proceder às mesmas análises em diferentes populações.

Functional performance and plasma cytokine levels in elderly women with and without low back pain.

BACKGROUND AND OBJECTIVES: Low back pain (LBP) is a complaint of great importance among the elderly due to its significant impact on function. LBP could contribute to changes in the regulatory process of inflammatory mediators observed in elders. The aim of this study was to compare plasma levels of interleukin(IL)-6, soluble tumor necrosis factor receptor 1(sTNF-R1), and functionality among 3 groups of elderly women: GI, with LBP; GII, without LBP but reports of other pain; and GIII, without any reported pain. MATERIAL AND METHOD: This was an observational study of a subsample of the international Back Complaints in the Elders cohort study. IL-6 and sTNF-R1 were measured using the enzyme-linked immunosorbent assay. Functionality was assessed using the Timed Up and Go, gait speed and Roland Morris Disability Questionnaire; and pain, using the numerical pain scale. RESULTS: Two hundred and thirteen women aged 71.35 ± 4.76 years were included. GI presented the highest sTNF-R1 levels (p=0.016), worst TUG performance (p< 0.001) and slowest gait speed (p< 0.01) compared to GII and GIII, which were similar (p > 0.05). No difference was found between the IL-6 plasma levels in any of the groups. CONCLUSION: Elderly women with LBP had the highest sTNF-R1 plasma levels and the worst functional performance compared to elderly women with reports of other pain (not LBP) or no pain.

Aerobic Fitness and Habitual Physical Activity in Frail and Nonfrail Community-Dwelling Elderly.

BACKGROUND: Self-reported measures of decreased aerobic fitness and low physical activity are criteria of frailty. However, research assessing aerobic fitness and physical activity levels associated with frailty is limited. Therefore, the aims of this study were to objectively assess the aerobic fitness and the physical activity level of frail and nonfrail elderly, and to examine the association between frailty, aerobic fitness and habitual physical activity. METHODS: This study included 26 elderly (66 to 86 years), randomly selected. The groups (frail/nonfrail) were age and sex paired. Peak oxygen consumption, maximal walking distance and speed were assessed during the incremental shuttle walk test (ISWT). Average daily time spent in sedentary, light, moderate and hard activity, counts, number of steps and energy expenditure were measured by accelerometry. RESULTS: All variables measured by the ISWT and accelerometer differed significantly between the groups (P < .02). All aerobic fitness and physical activity variables were significantly associated with frailty, independent of the number of chronic health conditions (P < .05). CONCLUSIONS: Frailty is associated with low peak oxygen consumption and low physical activity level. These findings could guide future clinical trials designed to evaluate the efficacy of aerobic exercises in the prevention and treatment of frailty.

Impact of clinical and functional conditions on quality of life in old women with obesity / Impacto de las condiciones clínicas y funcionales en la cualidad de vida de ancianas con obesidad / Impacto das condições clínicas e funcionais na qualidade de vida de idosas com obesidade

Obesity is associated with functional disabilities and impairments of quality of life, and many factors affect this relationship. This study aimed at characterizing and identifying the impact of clinical and functional conditions on health-related quality of life (HRQoL) in obese old women. The HRQoL was assessed by the questionnaires "Outcomes Study Short Form-36 Health Survey" (SF-36) and "Impact of Weight on Quality of Life - Lite" (IWQOL - Lite), which were applied to 63 women with body mass index ≥30 kg/m2. Regression models were developed for general (SF-36) and specific (IWQOL-Lite) HRQoL. The associated factors investigated were: age, number of medicines, number of diseases, depressive symptoms, body mass index, grip strength, level of physical activity, and functional performance. The old women had a low level of strength and physical activity. Their functional performance was good to moderate, but a third of the sample presented deficit of mobility. The level of physical activity and functional performance had a positive impact on the general HRQoL and number of drugs had a negative one (R2=0.44). Depressive symptoms and body mass index negatively affected the specific HRQoL (R2=0.57). The study concluded that obese old women with depressive symptoms, low levels of physical activity, and functional performance, making use of a great number of drugs, are more vulnerable to experiencing poor HRQoL. All the factors associated with the HRQoL in this study are potentially modifiable with interventions of health prevention and promotion.

La obesidad está asociada a incapacidades funcionales y prejuicios a la cualidad de vida, y muchos factores interfieren en esa asociación. Eso estudio tuvo por objetivo caracterizar e identificar el impacto de las condiciones clínicas y funcionales en la cualidad de vida relacionada a la salud (CVRS) en ancianas obesas. La CVRS fue evaluada por los cuestionarios "Outcomes Study Short Form-36 Health Survey" (SF-36) e "Impact of Weight on Quality of Life - Lite" (IWQOL-Lite), aplicados a 63 mujeres con índice de masa corporal ≥30 kg/m2. Fueron desarrollados modelos de regresión para la CVRS general (SF-36) y específica (IWQOL-Lite). Los factores asociados investigados fueron: edad, número de medicamentos, número de enfermedades, síntomas depresivos, índice de masa corporal, fuerza de preensión, nivel de actividad física y desempeño funcional. Las ancianas presentaron un bajo nivel de fuerza y actividad física. El desempeño funcional varió del bueno al moderado, pero un tercio de la muestra presentó déficit de movilidad. Lo nivel de actividad física y desempeño funcional tuvieron un impacto positivo en la CVRS general y el número de medicamentos, negativo (R2=0,44). Síntomas depresivos e índice de masa corporal impactaron negativamente en la CVRS específica (R2=0,57). El estudio concluso que ancianas obesas con síntomas depresivos, bajos niveles de actividad física y desempeño funcional, utilizando una gran cuantía de medicamentos, son más vulnerables a presentaren baja CVRS. Todos los factores asociados a la CVRS son potencialmente modificables con medidas de prevención y promoción a la salud.

A obesidade está associada a incapacidades funcionais e aos prejuízos à qualidade de vida, e muitos fatores interferem nesta associação. Este estudo teve por objetivo caracterizar e identificar o impacto de condições clínicas e funcionais na qualidade de vida relacionada à saúde (QVRS) em idosas obesas. A QVRS foi avaliada pelos questionários "Outcomes Study Short Form-36 Health Survey" (SF-36) e "Impact of Weight on Quality of Life - Lite" (IWQOL-Lite), aplicados a 63 mulheres com índice de massa corporal ≥30 kg/m2. Foram desenvolvidos modelos de regressão para QVRS geral (SF-36) e específica (IWQOL-Lite). Os fatores associados investigados foram: idade, número de medicamentos, número de doenças, sintomas depressivos, índice de massa corporal, força de preensão, nível de atividade física e desempenho funcional. As idosas apresentaram baixo nível de força e atividade física. O desempenho funcional foi de bom a moderado, mas um terço da amostra apresentou déficit de mobilidade. Nível de atividade física e desempenho funcional impactaram de maneira positiva a QVRS geral e número de medicamentos, negativa (R2=0,44). Sintomas depressivos e índice de massa corporal impactaram negativamente a QVRS específica (R2=0,57). O estudo concluiu que idosas obesas com sintomas depressivos, baixos níveis de atividade física e desempenho funcional, fazendo uso de grande número de medicamentos, são mais vulneráveis a apresentarem baixa QVRS. Todos os fatores associados à QVRS são potencialmente modificáveis com medidas de prevenção e promoção de saúde.