Changes in HRQoL after 12 months of exercise linked to primary care are associated with fitness effects in older adults.

PURPOSE: To analyse the effects of 1 year of participation in a physical activity (PA) program linked to a health-care setting on physical fitness (PF) and health-related quality of life (HRQoL) and to determine the relationships between PA, PF and HRQoL in middle-aged and older adults. METHODS: In total, 3214 participants were recruited from a health-care setting. Sociodemographic data, HRQoL questionnaires and PF tests were applied by 37 employees at baseline and 1 year later. The participants were placed in an exercise group (EG) (n = 2614) and the remaining participants (n = 600) were placed in the control group (CG). EG performed the program 3 days/week for 50-60 minutes per session involving brisk walking with intermittent flexibility, strength and balance activities/exercises.CG participants were asked to continue with their usual activities. Data analysis included repeated measures analysis of variance, linear regression and contingency analysis. RESULTS: EG showed significant mild-moderate improvement in all PF and HRQoL outcomes, especially in adjusted models. Changes in several PF variables were predictive of HRQoL changes. EG exhibited either improvements or no change in HRQoL dimensions. CG exhibited no change or declines in all dimensions. CONCLUSIONS: PF is positively related with HRQoL. PA significantly improved PF, especially the PF components more impaired at baseline.

Applicability and test-retest reliability of isokinetic shoulder abduction and adduction in women fibromyalgia patients.

OBJECTIVE: To investigate the applicability and reliability of isokinetic strength measurements during concentric and eccentric actions of the shoulder muscles in fibromyalgia (FM) patients. DESIGN: Test-retest reliability study. SETTING: University laboratory. PARTICIPANTS: Women with FM (N=25) aged 37 to 69. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Two isokinetic tests of the shoulder were repeated after an interval of 7 days. Each test involved 3 repetitions of abduction and adduction performed at a rate of 60°/s. The first test involved 2 concentric muscle actions (concentric/concentric test). The second test involved concentric abduction followed by eccentric adduction (concentric/eccentric test). Unilateral peak torque (Nm) and average work (J) were measured. Applicability was calculated as the proportion of participants who were able to complete every test. Reliability was analyzed by intraclass coefficient (ICC), standard error of measurement, and smallest real difference (SRD). RESULTS: Applicability was 84% for the concentric/concentric test and 52% for the concentric/eccentric test. The main factor influencing applicability was age. In the concentric/eccentric test, measurement of peak torque showed high reliability for the abduction (ICC=.88; standard error of measurement=1.82; SRD=5.05) and adduction (ICC=.89; standard error of measurement=3.83; SRD=10.62) phases. In the concentric/concentric test, measurement of peak torque showed low reliability in the abduction phase (ICC=.29; standard error of measurement=6.45; SRD=17.87) and excellent reliability in the adduction phase (ICC=.92; standard error of measurement=5.95; SRD=16.50). CONCLUSIONS: The applicability of shoulder isokinetic tests in FM patients who are women may be affected by age. In comparison, the concentric/concentric test was more applicable and less reliable than the concentric/eccentric test during abduction and adduction. These findings will facilitate the clinical interpretation of changes in isometric and isokinetic shoulder adduction and abduction tests in women with FM.

The effects of whole-body muscle stimulation on body composition and strength parameters: A PRISMA systematic review and meta-analysis.

BACKGROUND: This systematic review and meta-analysis set out to determine the efficacy of whole-body muscle electrostimulation on body composition, strength, and muscle power in active and non-active adults (aged ≥18 years). METHOD: This review was reported in accordance with the Protocol Statement of Preferred Reporting Element Guidelines for Systematic Reviews and Meta-Analysis included controlled trials; whole-body electromyostimulation trials with at least 1 exercise and control group; participants >18 years old. Outcome measures were defined as standardized mean differences for muscle mass, body fat mass, strength, and power. Studies were searched in the following electronic databases: PubMed, Web of Science, Scopus, SPORTDiscus, and EMBASE for all articles published up to July 30, 2021. The risk of bias was assessed by 2 independent researchers using the Physiotherapy Evidence Database scale and Grading of Recommendations, Assessment, Development and Evaluations approach. Analyses were performed using the metafor package of the statistical software R (version 4.0.3; R Core Team, 2020). Random effects models, forest, and funnel plots to quantify the asymmetry associated with publication bias were fitted using the metafor library in R. Statistical heterogeneity was assessed using I2 statistics. RESULTS: In total, 26 studies representing 1183 participants were included (WB-electromyostimulation: n = 586 and control group: n = 597). The mean age of the participants ranged from a minimum of 20.4 to a maximum of 77.4 years old. Interventions lasted a minimum of 4 and a maximum of 54 weeks. Standardized mean difference was 0.36 (95% confidence interval [CI]: 0.16-0.57) for muscle mass, -0.38 (95% CI: -0.62-0.15) for body fat, 0.54 (95% CI: 0.35-0.72) for strength, and 0.36 (95% CI: 0.02-0.71) for power with significant differences between groups (all P < .04). I2 revealed low heterogeneity of muscle mass (15%) and power (0%) between trials and medium heterogeneity of body fat (45%) and strength (55%). CONCLUSION: We concluded that WB-electromyostimulation has significant positive effects on muscle mass, body fat, strength, and power.

Association between Agility, Health-Related Quality of Life, Depression, and Anthropometric Variables in Physically Active Older Adult Women with Depression.

INTRODUCTION: Depressive disorders are mental disorders that last over time, and seriously affect the lives of the people who suffer from them, diminishing their quality of life, reducing their motor capacity, and incapacitating them in their daily lives. It is a major problem worldwide. OBJECTIVE: To study the association between agility, health-related quality of life (hrqol), anthropometric status, and depression status in older adult women with depression. DESIGN: Data collected from 685 physically active older women with depression were analyzed. RESULT: A moderate inverse correlation (r = -0.34) is shown between Time Up & Go (TUG) and EuroQol Five-Dimensional Three-Level Version (EQ-5D-3L). Between TUG and Geriatric Depression Scale (GDS), there is a small direct correlation (r = 0.14) between them. Between TUG and anthropometric data, all observed correlations are significant. CONCLUSIONS: There is a significant association between agility, health-related quality of life, depression, and anthropometric data in physically active older women with depression.

Increased Odds for Depression and Antidepressant Use in the Inactive Spanish Population.

Introduction: Depression is a disabling mental illness and therefore also a serious public health problem. It affects 5% of the adult population in the world and is the leading cause of disability, with an annual cost of USD one trillion. In Spain, its prevalence is 13.4%, costing EUR 6000 million a year. Physical inactivity has been linked to an increase in depressive symptoms, with physical activity associated with an improvement in health-related quality of life. Objective: To calculate the odds ratio (OR) and relative risk (RR) of suffering from depression and taking antidepressants in the inactive Spanish population compared to groups with a higher level of physical activity. Method: 17,141 individuals aged 18−69 years residing in Spain and interviewed in the 2017 Spanish National Health Survey were included in this cross-sectional investigation. Results: Dependence relationships were found between the level of physical activity and the prevalence of depression and taking antidepressants (p < 0.001). We found elevated ORs and RRs for depression and antidepressant use in inactive people compared to those with a high/very high level of physical activity (Depression: OR: 4.32. CI95%: 3.35−5.57. RR: 1.59. 95% CI: 1.51−1.68; Antidepressants: OR: 4.95. CI95%: 3.59−6.82. RR: 1.61. CI95%: 1.52−1.71). Conclusions: Belonging to an inactive population group increases the risk of suffering from depression and of taking antidepressants.

Physical Activity and Prevalence of Depression and Antidepressants in the Spanish Population.

INTRODUCTION: Depression is a mental disorder that affects more than 250 million people in the world, limiting their functional capacities. The work of public health policies is aimed at reducing its prevalence as well as its pharmaceutical cost. Physical activity (PA) programs are interventions with a high potential for effectiveness. OBJECTIVES: To establish the relationships between physical activity and the prevalence of depression and antidepressant intake in the Spanish population. DESIGN: We performed a correlational study that was based on data from the European Health Survey Spain 2020 with 20,287 participants, aged 18-84 years, living in Spain. RESULTS: Dependency relationships were found between the prevalence of depression, and: the frequency of PA, the number of days of PA per week, and the number of days of muscle strengthening in the population, in both sexes, and in all age groups (p < 0.001). Dependency relationships were found between the three PA variables and the prevalence of taking antidepressants (p < 0.001). An elevated prevalence of depression and antidepressant taking were found in the inactive groups compared to those who performed PA (p < 0.05). CONCLUSIONS: There is an inverse relationship between physical activity and the probability of suffering from depression and the intake of antidepressants. Performing PA 3-4 days/week, including 1-2 days of strength work, could be the best proposal to reduce the prevalence of depression in the Spanish population.

Association between Lower-Body Strength, Health-Related Quality of Life, Depression Status and BMI in the Elderly Women with Depression.

INTRODUCTION: Depression is currently the most prevalent mental illness in the world. It is a very frequent geriatric syndrome that causes a high degree of disability and increases mortality in the elderly population. This mental disorder is a social and public health problem that alters the quality of life (Qol) of the patient. Physical strength work has been reported to improve the clinical picture of people with depression. OBJECTIVE: To determine the relationship between lower body strength, health-related quality of life (HRQoL), depression status and body mass index (BMI) in older women with depression. DESIGN: A cross-sectional descriptive study with 685 elder women with depression. RESULTS: A mild direct correlation (Rho = -0.29; p ≤ 0.001) between stand-ip test and EQ-5D-3L test was shown. There is a mild inverse correlation between stand-up test and six of fifteen items of the Geriatric Depression Scale (GDS) (Rho item 1 = -0.24; p ≤ 0.001; item 4 = 0.11; p ≤ 0.001; item 5 = -0.20; p ≤ 0.001; item 7 = -0.15; p ≤ 0.001; item 11 = -0.19; p ≤ 0.001; item 13 = -0.21; p ≤ 0.001). Between Stand-Up test and BMI, the correlation is weak inverse (Rho = -0.20; p ≤ 0.001). CONCLUSIONS: There is a significant association of lower body strength with HRQoL, and BMI, as well as some variables of depression status in elder women with depression. Better scores in the stand-up test lead to an improvement in HRQoL and BMI. Therefore, stand-up test could be a complementary tool in public health for improve HRQoL in the elderly women with depression.

Fitness and health-related quality of life dimensions in community-dwelling middle aged and older adults.

BACKGROUND: The aim of the present study was to identify the physical fitness (PF) tests of a multi-component battery more related to the perception of problems in each dimension of the health-related quality of life (HRQoL) assessed by the EuroQol 5 dimensions 3 level questionnaire (EQ-5D-3L) in community-dwelling middle-aged and older adults METHODS: A cross-sectional study was conducted with 7104 participants (6243 females and 861 males aged 50-99 years) who were recruited in the framework of the Exercise Looks After You Program, which is a public health program designed to promote physical activity (PA) in community-dwelling middle-aged and older adults. Participants were assessed by the EQ-5D-3L questionnaire and a battery of fitness tests. The responses to each EQ-5D-3L dimension were collapsed into a two-tier variable consisting of «perceive problems¼ and «do not perceive problems¼. Correlation coefficients for the relationships between the HRQoL variables, between the PF variables, and between the HRQoL and PF variables were obtained. Two logistic regression models, one adjusted and one unadjusted, were developed for each EQ-5D-3L dimension. RESULTS: There were significant correlations between all variables except anxiety/depression and the back scratch test. The PF tests that correlated best with the HRQoL dimensions were the Timed Up-and-Go Test (TUG) and the 6-min walk; pain/discomfort and anxiety/depression correlated less well. All PF tests correlated, especially the TUG and 6-min walk tests. Unadjusted logistic models showed significant goodness of fit for the mobility and pain/discomfort dimensions only. Adjusted logistic models showed significant goodness of fit for all dimensions when the following potential confounding variables were included: age, gender, weekly level of PA, smoking and alcohol habits, body mass index, and educational level. For all dimensions, the highest odds ratios for the association with PF tests were with the TUG; this was observed with both the unadjusted and adjusted models. CONCLUSIONS: The perception of problems, as measured by the EQ-5D-3L dimensions, was associated with a lower level of fitness, particularly for those dimensions that relate more closely to physical components. The PF tests that associated most closely with the perception of problems in the HRQoL dimensions were the TUG and the 6-min walk. This information will aid the design and assessment of PA programs that aim to improve HRQoL.

Validation of the iPhone app using the force platform to estimate vertical jump height.

BACKGROUND: Vertical jump performance has been evaluated with several devices: force platforms, contact mats, Vertec, accelerometers, infrared cameras and high-velocity cameras; however, the force platform is considered the gold standard for measuring vertical jump height. The purpose of this study was to validate an iPhone app called My Jump, that measures vertical jump height by comparing it with other methods that use the force platform to estimate vertical jump height, namely, vertical velocity at take-off and time in the air. METHODS: A total of 40 sport sciences students (age 21.4±1.9 years) completed five countermovement jumps (CMJs) over a force platform. Thus, 200 CMJ heights were evaluated from the vertical velocity at take-off and the time in the air using the force platform, and from the time in the air with the My Jump mobile application. The height obtained was compared using the intraclass correlation coefficient (ICC). RESULTS: Correlation between APP and force platform using the time in the air was perfect (ICC=1.000, P<0.001). Correlation between APP and force platform using the vertical velocity at take-off was also very high (ICC=0.996, P<0.001), with an error margin of 0.78%. CONCLUSIONS: Therefore, these results showed that application, My Jump, is an appropriate method to evaluate the vertical jump performance; however, vertical jump height is slightly overestimated compared with that of the force platform.

Cost-effectiveness of a follow-up program for older patients with heart failure: a randomized controlled trial.

PURPOSE: To assess the cost-utility of adding a disease management program (DMP) delivered by geriatric day hospital (GDH) for older patients with heart failure (HF) after hospital discharge. METHODS: 117 older HF patients discharged by a geriatric service were randomly assigned to DMP (n = 59) and usual care (UC) (n = 58) groups. The DMP group received health education, therapeutic control and monitoring through both telephone contacts and face-to-face visits at the GDH for 12 months. The UC group received standard health care. The main outcome measures were the costs from the health-care system and societal perspectives and quality-adjusted life-years (QALYs) using EuroQol (EQ-5D-3L). The cost-effectiveness analysis used the package ICEinfer in R 2.13.0. RESULTS: The mean age was 85 years, and 73% of the patients were women. The mean values of QALYs after 12 months were - 0.083 in DMP and - 0.154 in UC. Each extra QALY gained by the DMP relative to usual care cost was €38,274 and €25,390 from health-care or societal perspective, respectively. An investment of €44,000/QALY (Spanish Health System Threshold) showed a 91 and 85% of probability to be cost-effective from health-care and societal perspectives. CONCLUSION: The intervention was moderately cost-effective in delaying deaths and preserving the loss of health-related quality of life in older patients with HF. The study was internationally registered with the ISRCTN10823032.

Effects of whole body vibration therapy on main outcome measures for chronic non-specific low back pain: a single-blind randomized controlled trial.

OBJECTIVE: The aim of this study was to determine whether a 12-week course of low-frequency vibrating board therapy is a feasible therapy for non-specific chronic low back pain, and whether it improves the main outcome measures. DESIGN: Randomized controlled trial. PATIENTS: A total of 50 patients with non-specific low back pain were included. They were randomly assigned to either a vibrating plate via reciprocation therapy group (n = 25) or a control group (n = 25). METHODS: The 12-week vibration therapy programme consisted of a total of 24 training sessions (2 times/week, with 1 day of rest between sessions). Assessments of the main outcome measures for non-specific low back pain were performed at baseline and at 12 weeks. RESULTS: In the vibration therapy group there was a statistically significant improvement, of 20.37% (p = 0.031) in the Postural Stability Index (anterior-posterior); 25.15% (p = 0.013) in the Oswestry Index; 9.31% in the Roland Morris Index (p = 0.001); 8.57% (p = 0.042) in EuroQol 5D-3L; 20.29% (p = 0.002) in the Sens test; 24.13% (p = 0.006) in visual analogue scale back; and 16.58% (p = 0.008) in the Progressive Isoinertial Lifting Evaluation test. CONCLUSION: A 12-week course of low-frequency vibrating board therapy is feasible and may represent a novel physical therapy for patients with non-specific low back pain.