Musculoskeletal Pain, Mood, and Sports Injury in Wheelchair Power Soccer Players.

CONTEXT: Wheelchair Power Soccer (WPS) is the only team sport that allows the participation of people with severe physical disabilities who require the daily use of motorized wheelchairs. These individuals may live with chronic pain due to the characteristics of the disabilities and treatments, interfering with their health and limiting their participation in sports. OBJECTIVES: To investigate the prevalence of musculoskeletal pain and its relationship with mood in WPS players and to analyze the incidence of traumatic injuries during a championship. METHODS: A prospective, longitudinal study was carried out on 30 WPS athletes (93.33% male) with a mean (SD) (range) age of 22.37 (9.79) (47) years. Data collection was performed during a South American WPS Championship lasting 3 days, with: investigation of the presence of musculoskeletal pain and mood through a questionnaire; investigation of the occurrence of traumatic injuries through match observation; and confirmation of the occurrence of traumatic injuries through access to medical department records. RESULTS: About 30% (n = 9/30) of the sample presented some pain on the day of evaluation, with an intensity of 5.67 (3.35) (10) points on the visual analog scale. The most common regions of pain were the lower back (13.3%, n = 4/30), thoracic (10%; n = 3/30), and cervical (10%; n = 3/30) areas of the spine. A total of 46.7% (n = 14/30) reported pain in the month before data collection but of less intensity (2.56 [4] [10] points), the most common regions being the lower limbs (20%; n = 6/30) and cervical spine (20%; n = 6/30). Among the between-group comparisons (ie, participants with pain vs without pain), no relationship was observed between mood state and pain. No traumatic injuries were identified during the competition. CONCLUSION: The presence of musculoskeletal pain was common in WPS players, but it was not related to mood. As no traumatic injuries were observed during the championship, this modality seems to be safe for people with physical disabilities in general.

Acute Hormone Responses Subsequent to Agonist-Antagonist Paired Set vs. Traditional Straight Set Resistance Training.

Miranda, H, de Souza, JAAA, Scudese, E, Paz, GA, Salerno, VP, Vigário, PdS, and Willardson, JM. Acute hormone responses subsequent to agonist-antagonist paired set vs. traditional straight set resistance training. J Strength Cond Res 34(6): 1591-1599, 2020-The purpose of this study was to compare acute hormone responses and rating of perceived exertion (OMNI-Res) subsequent to the agonist-antagonist paired set (PS) vs. the traditional straight set (TS) resistance training method. Twelve recreationally trained men (25.7 ± 4.7 years, 173 ± 6.3 cm and 71.5 ± 6.6 kg) participated in the current study. After 10 repetition maximum (RM) load determination, each subject performed the following 2 experimental sessions in random order: TS session-3 sets of 10 repetitions at 85% of 10RM for the machine seated row and barbell bench press with 2-minute rest intervals between sets; and PS-3 sets of 10 repetitions with 85% of 10RM alternating machine seated row and barbell bench press for the total of 6 PSs with 2-minute rest intervals between sets. Total testosterone (TT), free testosterone (FT), cortisol, TT/cortisol ratio, growth hormone (GH), and blood lactate concentrations were measured before workout and immediately after workout and 15 and 30 minutes after workout. The OMNI-RES was recorded at the end of each set for both exercises within each session. Under the TS session, TT significantly increased immediately post-workout vs. the pre-workout time point. For the PS session, TT significantly decreased at 30-minute post-workout vs. the immediate post-workout time point, whereas, FT significantly increased immediately post-workout and 15-minute post-workout vs. the pre-workout time point. For the TS session, GH significantly increased immediately post-workout, and at the 15- and 30-minute post-workout time points vs. the pre-workout time point, respectively. For the PS session, GH was significantly increased immediately post-workout vs. the pre-workout time point. Blood lactate significantly increased at all post-workout time points vs. the pre-workout time point under both sessions. The cortisol and TT/cortisol ratio showed no differences between sessions. In conclusion, from an acute standpoint, the TS approach showed a tendency to cause greater disruption in hormone levels, despite the lack of significant differences vs. the PS approach at all time points. However, both strategies may promote similar acute hormone responses.

Does low-normal serum TSH level adversely impact cognition in elderly adults and might methimazole therapy improve outcomes?

Serum thyroid stimulating hormone (TSH) levels increase with age. This elevation has been associated with better outcomes in very elderly subjects; however, little is known about the relationship between TSH below the lower limit of the reference range and health-related outcomes. Here, we investigated the association between cognitive impairment or depressive symptoms and low-normal serum TSH (<1.0 µIU/mL, in the reference range) in elderly subjects and whether the use of methimazole in subjects without dementia but with low-normal TSH could affect cognition or depressive symptoms. From 293 healthy adults ≥65 years old with normal TSH included in the sectional phase, only subjects without dementia were prospectively analyzed: 1) TSH ≥1.0 µIU/mL (observation; untreated); 2) TSH <1.0 µIU/mL (observation; untreated); and 3) TSH <1.0 µIU/mL (methimazole therapy). Cognition was assessed, using the Mini Mental State Examination (MMSE) and depressive symptoms (at MMSE ≥ 13) by the Geriatric Depression Scale (GDS). Age >80 years was the sole independent factor associated with dementia (OR=2.89; confidence interval [CI] 1.72-4.86; p<0.01). Prospectively, 93 completed follow-up, with 7.5% (7) receiving methimazole intervention. Untreated subjects with lower TSH showed the greatest declines in MMSE scores during follow-up that was not observed in those with serum TSH ≥1.0 µIU/mL. Lower MMSE score reductions were associated with elderly subjects receiving methimazole. There were no significant changes in depressive symptoms and GDS scores among those with serum TSH <1.0 µIU/mL. In this study, low-normal TSH was not associated with higher prevalence of dementia. However, in elderly subjects without dementia, low TSH was associated with worsening cognition.

Functional Capacity of Oldest Old Living in a Long-stay Institution in Rio De Janeiro, Brazil.

[Purpose] A significant increase in the number of oldest old has occurred worldwide. The aim of this study was to characterize the functional capacity of the oldest old residents in a long-stay institution in Rio de Janeiro, Brazil. [Subjects and Methods] All participants were evaluated according to the following metrics: anthropometry, body composition (bioelectrical impedance), handgrip strength, balance (Berg scale and stabilometry), ankle mobility (electrogoniometry), physical capacity (six-minute walk test), quality of life (WHOQOL-OLD), and dietary habits (questionnaire). [Results] Twenty elderly subjects with a mean age of 85.75 ± 5.22 years and a mean fat percentage of 39.02 ± 5.49% participated in the study. The group at risk of falls (n = 8) had a lower handgrip strength and walked a shorter distance over the course of six minutes compared with the group not at risk of falls. The obese group (n = 15) had higher values for stabilometric variables than the nonobese group. There was a positive and significant correlation between ankle joint mobility and physical capacity (r = 0.47). [Conclusion] High values for obesity and low values for handgrip strength and physical capacity were associated with worse body balance. Low values for ankle mobility were also associated with worse physical capacity in this population.

The Perception of Nursing Professionals Working in a Central Sterile Supplies Department regarding Health Conditions, Workload, Ergonomic Risks, and Functional Readaptation.

Background: The central sterile supply department (CSSD) is wrongly seen as a place in the hospital environment that does not require skills and physical effort, being commonly a hospital sector for the relocation of functionally-readapted professionals. However, CSSD is a work environment that demands professional experience and presents itself as a sector that does not have a healthy work environment. This study aims to evaluate the frequency of comorbidities and functionally-readapted people among nursing professionals allocated to a CSSD and, also, to seek the perception of these professionals about the ergonomic risks and the degree of difficulty to perform activities within a CSSD. Methods: This is a cross-sectional study that analyzed the opinions of nursing professionals who work in the CSSD of public hospitals in Rio de Janeiro, Brazil. Nurses, nursing technicians and nursing assistants aged ≥18 years were included. Results: Seventy-two nursing professionals were consecutively evaluated. It was observed that 43 of them (59.7%) had never worked in a CSSD. The most prevalent comorbidity in the present study was chronic rhinosinusitis, observed in more than half of the sample, although it is interesting to note the high frequency of participants with work-related musculoskeletal disorders (WMSD) and repetitive strain injuries (RSI). There is a relationship between previous work in a CSSD and the ability to identify surgical tweezers by visual recognition (p=0.031). There is a relationship between the time the participant had previously worked in the hospital and the skill regarding the information contained in the conference folders for preparing the tray surgical procedures (τb = -0.34, p=0.001). Conclusion: Almost a third of nursing professionals working in a CSSD are rehabilitated, with a high prevalence of WMSD and RSI. The commitment of managers to an internal health policy aimed at workers is necessary for health promotion.

Effects of A Short-term Cardio Tai Chi Program on Cardiorespiratory Fitness and Hemodynamic Parameters in Sedentary Adults: A Pilot Study.

This study evaluates the effects of a short-term Cardio Tai Chi program on the cardiorespiratory fitness and hemodynamic parameters in sedentary adults. Thirty-one sedentary participants (age: 58 ± 9 years, body mass: 63 ± 12 kg) were subjected to an exercise program during 10 sessions over a 10-day period within 2 weeks. The Cardio Tai Chi program consisted in a series of three to five intervals lasting 90 s each at ∼70% maximal heart rate separated by 2-min of low-intensity recovery. Primary outcome measures were cardiorespiratory fitness (peak oxygen uptake, V˙O2peak) assessed by the Rockport walking test and resting hemodynamic parameters (systolic, diastolic, mean, and pulse pressures). We observed a significant difference of means on post-pre V˙O2peak [4.5 ml/kg/min, 95% confidence interval (CI): 3.1 to 5.8, p = 0.004], systolic blood pressure (-5.5 mmHg, 95% CI:-7.3 to -3.8, p = 0.010) and pulse pressure (-3.7 mmHg, 95% CI: -5.2 to -2.3, p = 0.028). No significant differences were observed for diastolic pressure (-1.8 mmHg, 95% CI: -2.6 to -1.0, p = 0.226), mean blood pressure (2.5 mmHg, 95% CI: 1.4 to 3.6, p = 0.302), or resting heart rate (-0.9 beat/min, 95% CI: -2.0 to 0.1, p = 0.631). Our findings suggest that engaging in a short-term Cardio Tai Chi program can improve cardiorespiratory fitness and hemodynamic parameters in sedentary adults.

Electromyographic activity of the quadriceps and gluteus medius muscles during/different straight leg raise and squat exercises in women with patellofemoral pain syndrome.

Patellofemoral pain syndrome (PPS) is characterized by anterior knee pain and affects young female adults. Physiotherapy is the most indicated treatment. The objective of the study was to analyze electromyographic activity of the quadriceps and gluteus medius muscles during different open and closed kinetic chain exercises in women with PPS. Twenty-two clinically healthy women and 24 women with symptomatic PPS were assessed through surface electromyography of the quadriceps and gluteus medius during the following exercises: straight leg raise with and without lateral hip rotation; squats; squats with adduction and hip abduction; and squats combined with lateral hip rotation. When comparing the groups, only the quadriceps muscle showed higher activity in the PPS group. In the comparisons between the exercises, in relation to gluteus medius and quadriceps muscle activity, the straight leg raise and straight leg raise with lateral hip rotation exercises showed more activity than squats in both groups. Among the squats, squats with adduction generated more gluteus medius activity in both groups, and no difference was noted among the squats for the quadriceps muscle. Therefore, rehabilitation programs that include exercises such as straight leg raises, straight leg raises with lateral hip rotation, and squats with adduction may be used for PPS patients.

Heart rate response to graded exercise test of elderly subjects in different ranges of TSH levels.

OBJECTIVE: Life expectancy is increasing worldwide and studies have been demonstrating that elevated serum thyroid stimulating hormone (TSH) concentration in elderly is associated with some better health outcomes. This elevation is somewhat physiological as aging. The aim of this study was to investigate the heart rate (HR) response during a graded exercise test and its recovery in healthy elderly, comparing subjects within serum TSH in the lower limit of reference range to those within the TSH in the upper limit. SUBJECTS AND METHODS: A cross-sectional study was conducted with 86 healthy elderly aged 71.5 ± 5.1 years, with serum TSH between 0.4 - 4.0 mUl/mL. The participants were divided into two groups according to TSH level: < 1.0 mUl/mL (n = 13) and ≥ 1.0 µUI/mL (n = 73). All participants performed an ergometric test on a treadmill. The HR was recorded and analyzed at rest, during exercise and during the three minutes immediately after exercise. RESULTS: No differences were observed in relation to HR at peak of exercise (TSH < 1.0 µUI/mL: 133.9 ± 22.5 bpm vs. TSH ≥ 1.0 µUI/mL: 132.4 ± 21.3 bpm; p = 0.70) and during the first minute of recovery phase (TSH < 1.0 µUI/mL: 122.3 ± 23.1 bpm vs. TSH ≥ 1.0 µUI/mL: 115.7 ± 18.4 bpm p = 0.33). The groups also presented similar chronotropic index (TSH < 1.0 µUI/mL: 78.1 ± 30.6 vs. TSH ≥ 1.0 µUI/mL: 79.5 ± 26.4; p = 0.74). CONCLUSION: In this sample studied, there were no difference between lower and upper TSH level concerning HR response during rest, peak of exercise and exercise recovery.

Exercise training improves quality of life in women with subclinical hypothyroidism: a randomized clinical trial.

OBJECTIVE: The aim was to evaluate the quality of life (HRQoL) in women with subclinical hypothyroidism (sHT) after 16 weeks of endurance training. SUBJECTS AND METHODS: In the first phase, a cross-sectional study was conducted in which 22 women with sHT (median age: 41.5 (interquartile range: 175) years, body mass index: 26.2 (8.7) kg/m2, thyroid stimulating hormone > 4.94 mIU/L and free thyroxine between 0.8 and 1.3 ng/dL were compared to a group of 33 euthyroid women concerned to HRQoL. In the second phase, a randomized clinical trial was conducted where only women with sHT were randomly divided into two groups: sHT-Tr (n = 10) - participants that performed an exercise program - and sHT-Sed (n = 10) - controls. Exercise training consisted of 60 minutes of aerobic activities (bike and treadmill), three times a week, for 16 weeks. The HRQoL was assessed by the SF-36 questionnaire in the early and at the end of four months. RESULTS: Women with sHT had lower scores on functional capacity domain in relation to the euthyroid ones (770 ± 23.0 vs. 88.8 ± 14.6; p = 0.020). The sHT-Tr group improved functional capacity, general health, emotional aspects, mental and physical component of HRQoL after training period, while the sHT-Sed group showed no significant changes. CONCLUSION: After 16 weeks of aerobic exercise training, there were remarkable improvements in HRQoL in women with sHT.

Validity of the Polar V800 heart rate monitor for assessing cardiac autonomic control in individuals with spinal cord injury

Abstract Aim: Spinal cord injury (SCI) is associated with changes in cardiac autonomic control, that can be evaluated by heart rate variability (HRV), for which the electrocardiogram (ECG) is the gold standard. However, the use of ECG is limited to laboratory environments, and new tools are needed for this purpose and that can be applied in the routine monitoring of individuals with SCI. The present study aimed to investigate the validity of the Polar V800 heart rate monitor in assessing the cardiac autonomic control of individuals with SCI. Methods: Nineteen adult men with SCI (paraplegia n = 10; 44.5 ± 8.5 years and tetraplegia n = 9; 34.4 ± 7.5 years) participated in this cross-sectional study. The participants remained in the sitting position at rest for 10 min for the acquisition of the ECG and Polar V800 signals. The last 5-min window was used to count the beat-by-beat R-R interval series and then calculate the HRV indices (linear methods in the time and frequency domains). The study subgroups were compared, and the validity of the measurements generated with a heart rate monitor was determined using the intraclass correlation coefficient (ICC2,1) and Bland-Altman graphs. Results: Agreement analyses for the R-R intervals, SDNN, rMSSD, PNN50, SD1, LF, HF, and LF: HF ratio tended to show reliability ranging from acceptable to excellent (ICC = 0.579-0.990; P = 0.043-0.001) and acceptably narrow limits of agreement within both the group with tetraplegia and the group with paraplegia. Conclusion: The Polar V800 heart rate monitor is a valid instrument for assessing HRV in individuals with paraplegia and tetraplegia.

Association Between Hemodynamic Profile, Physical Capacity and Quality of Life in Pulmonary Hypertension.

BACKGROUND: No studies have described and evaluated the association between hemodynamics, physical limitations and quality of life in patients with pulmonary hypertension (PH) without concomitant cardiovascular or respiratory disease. OBJECTIVE: To describe the hemodynamic profile, quality of life and physical capacity of patients with PH from groups I and IV and to study the association between these outcomes. METHODS: Cross-sectional study of patients with PH from clinical groups I and IV and functional classes II and III undergoing the following assessments: hemodynamics, exercise tolerance and quality of life. RESULTS: This study assessed 20 patients with a mean age of 46.8 ± 14.3 years. They had pulmonary capillary wedge pressure of 10.5 ± 3.7 mm Hg, 6-minute walk distance test (6MWDT) of 463 ± 78 m, oxygen consumption at peak exercise of 12.9 ± 4.3 mLO2.kg-1.min-1 and scores of quality of life domains < 60%. There were associations between cardiac index (CI) and ventilatory equivalent for CO2 (r=-0.59, p <0.01), IC and ventilatory equivalent for oxygen (r=-0.49, p<0.05), right atrial pressure (RAP) and 'general health perception' domain (r=-0.61, p<0.01), RAP and 6MWTD (r=-0.49, p<0.05), pulmonary vascular resistance (PVR) and 'physical functioning' domain (r=-0.56, p<0.01), PVR and 6MWTD (r=-0.49, p<0.05) and PVR index and physical capacity (r=-0.51, p<0.01). CONCLUSION: Patients with PH from groups I and IV and functional classes II and III exhibit a reduction in physical capacity and in the physical and mental components of quality of life. The hemodynamic variables CI, diastolic pulmonary arterial pressure, RAP, PVR and PVR index are associated with exercise tolerance and quality of life domains.

Does low serum TSH within the normal range have negative impact on physical exercise capacity and quality of life of healthy elderly people?

OBJECTIVE: Investigate the differences in cardiopulmonary (CP) capacity and Quality of Life (QOL) between healthy elderly (≥ 65 years) with different TSH levels (< 1.0 and ≥ 1.0 µIU/mL) both within the normal range. Also, evaluate the effects of TSH elevation on CP test and QOL, by administering methimazole to subjects with initial lower-normal TSH, in order to elevate it to superior-normal limit. MATERIALS AND METHODS: Initially, a cross-sectional study was performed to compare CP capacity at peak exercise and QOL (using WHOQOL-OLD questionnaire) between healthy seniors (age ≥ 65 years) with TSH < 1.0 µIU/mL vs. TSH ≥1.0 µIU/mL. In the second phase, participants with TSH < 1.0 µIU/mL were included in a non-controlled-prospective-interventional study to investigate the effect of TSH elevation, using methimazole, on QOL and CP capacity at peak exercise. RESULTS: From 89 elderly evaluated, 75 had TSH ≥ 1 µIU/mL and 14 TSH < 1 µIU/mL. The two groups had similar basal clinical characteristics. No difference in WHOQOL-OLD scores was observed between groups and they did not differ in terms of CP function at peak exercise. QOL and CP variables were not correlated with TSH levels. Twelve of 14 participants with TSH < 1.0 µIU/mL entered in the prospective study. After one year, no significant differences in clinical caracteristics, QOL, and CP variables were detected in paired analysis before and after methimazole intervention. CONCLUSIONS: We found no differences in CP capacity and QOL between health elderly with different TSH levels within normal range and no impact after one year of methimazole treatment. More prospective-controlled-randomized studies are necessary to confirm or not the possible harm effect in normal low TSH.

Dissimilaridade entre o estado de humor, humor deprimido e qualidade de vida em atletas com deficiência visual / Disimilitud entre el estado de ánimo, el humor deprimido y la calidad de vida en atletas con discapacidad visual / Dissimilarity among mood stat e, depressed humor and quality of life in athletes with visual impairment

O objetivo foi avaliar o estado de humor, o humor deprimido e a qualidade de vida de atletas de rendimento com deficiência visual, assim como a dissimilaridade entre estes constructos e a prática esportiva. Foi realizado um estudo seccional com 44 atletas com baixa visão ou cegueira total (26,8 ± 6,0 anos de idade; 72,7% homens), sendo 11 atletas de futebol de cinco, 14 de goalball, 2 de atletismo e 17 de judo. Os seguintes instrumentos na sua versão em portugues foram utilizados: (I) Profile of Mood States (POMS); (II) Beck Depression Inventory (BDI) e (III) Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). Os participantes apresentaram o perfil de iceberg desejável para a POMS, 81,8% apresentou "nenhum risco" de transtorno depressivo e todos os escores dos domínios do SF-36 estavam acima da média. Foi encontrada correlação positiva entre a duração da sessão de treino e o fator "vigor" da POMS, dentre outras. Os participantes do estudo apresentaram perfil positivo nos estados de humor, baixo risco de ocorrência de transtorno depressivo e uma percepção positiva de qualidade de vida. Parece haver proximidade de elementos da prática esportiva com os estados de humor e domínios da qualidade de vida, e portanto devem ser acompanhados

El objetivo fue evaluar el estado de ánimo, el estado de ánimo deprimido y lacalidad de vida de los atletas com discapacidad visual, así como la disparidad entre estos constructos y la práctica deportiva. Se realiz o um estudio transversal con 44 atletas con baja visión o ceguera total (26.8 ± 6.0 años de edad, 72.7% hombres): 11 jugadores de fútbol de 5, 14 jugadores de goalball, 2 atletas de atletismo y 17 atletas de judo. Se utilizaron las versions brasileñas de l os siguientes instrumentos: (I) Profile of Mood States (POMS); (II) Beck Depression Inventory (BDI) y (III) Medical Outcomes Study 36 - Item Short Form Health Survey (SF - 36). Los participantes presentaron el deseable perfil de iceberg para POMS, el 81.8% presen tó "sin riesgo" de transtorno depresivo y todos los puntajes de los dominios SF - 36 estuvieron por encima del promedio. Se encontró una correlación positiva entre la duración de la sesión de entrenamiento y el factor "vigor" del POMS, entre otros. Los parti cipantes del estúdio presentaron un perfil positivo en los estados de ánimo, un bajo riesgo de transtorno depresivo y una percepción positiva de la calidad de vida. Parece haber una cercanía entre los elementos de la práctica deportiva con los estados de h umor y los dominios de la calidad de vida, y por lo tanto deben acompañarse

The aim was to evaluate mood, depressed mood and quality of life of athletes wit h visual impairment, as well as the dissimilarity between these constructs and sports practice. A cross - sectional study was carried out with 44 athletes with low vision or total blindness (26.8 ± 6.0 years of age, 72.7% men): 11 five - a - side football player s, 14 goalball players, 2 athletics and 17 judo athletes. The Portuguese Brazilian versions of the following instruments were used: (I) Profile of Mood States (POMS); (II) Beck Depression Inventory (BDI) and (III) Medical Outcomes Study 36 - Item Short Form Health Survey (SF - 36). Participants presented the desirable iceberg profile for POMS, 81.8% presented "no risk" of depressive disorder and all scores of SF - 36 domains were above average. Positive correlation was found between the duration of the training s ession and the "vigor" factor of the POMS, among others. The study participants presented a positive profile in mood states, a low risk of depressive disorder and a positive perception of quality of life. There seems to be closeness of elements of sports p ractice with states of humor and domains of quality of life, and therefore must be accompanied

Exercise is associated with better quality of life in patients on TSH-suppressive therapy with levothyroxine for differentiated thyroid carcinoma.

OBJECTIVE: To evaluate if a supervised exercise training program improves the quality of life (QoL) of differentiated thyroid carcinoma (DTC) patients on TSH-suppressive therapy with levothyroxine (L-T4). SUBJECTS AND METHODS: Initially, a cross-sectional study was performed to compare the QoL and the health-related quality of life (HRQoL) between subclinical hyperthyroidism (SCH) patients (n = 33) and euthyroid subjects (EU; n = 49). In the prospective phase of the study, SCH patients were randomized in a non-blinded fashion to either participate (SCH-Tr = trained patients; n = 16) or not (SCH-Sed = untrained patients; n = 17) in a supervised exercise training program. The exercise program consisted of 60 minutes of aerobic and stretching exercises, twice a week, during twelve weeks. The QoL was assessed by the application of the WHOQOL-Bref, and the SF-36 was used to assess the HRQoL. RESULTS: SCH patients had statistically lower scores than EU on the "physical" domain of WHOQOL-Bref, besides "physical function", "role-physical", "bodily pain", "general health", "vitality", "role-emotional", and "mental-health" domains of SF-36. After three months, SCH-Tr patients showed improvement in the "physical" and "psychological" domains of WHOQOL-Bref (p < 0.05), and in the "physical function", "role-physical", "bodily pain", "vitality" and "mental health" domains of SF-36. CONCLUSION: Patients on TSH-suppressive therapy with L-T4 for DTC had impaired QoL and HRQoL compared to EU, but it was improved after 3-months of an exercise training program. Exercise seems to play an important role in the follow-up of DTC patients, since it seems to minimize the adverse effects of the treatment on QoL and HRQoL.

[Analysis of elderly outpatients in relation to nutritional status, sarcopenia, renal function, and bone density]. / Análise de idosos ambulatoriais quanto ao estado nutricional, sarcopenia, função renal e densidade óssea.

OBJECTIVES: To evaluate relationships between nutritional status, sarcopenia and osteoporosis in older women. SUBJECTS AND METHODS: We studied 44 women, 67-94 years, by mini-nutritional assessment (MAN), glomerular filtration corr. 1.73 m(2), body mass index (BMI), arm circumference and calf (CP and CB), bone mineral density and body composition, DXA (fat mass MG; lean MM). We gauge sarcopenia: IMM MM = MSS + MIS/height(2). We used the Pearson correlation coefficient, p < 0.05 as significant. RESULTS: MNA and IMM were positively correlated with BMI, CP, CB and MG. Age influenced negatively FG corr., BMI, FM, IMM and CP. Fourteen had a history of osteoporotic fractures. The lowest T-score was directly related to MAN and MG. CONCLUSIONS The aging caused the decline of FG, fat mass and muscle; the calf circumference, and brachial reflected nutritional status and body composition; and major influences on BMD were nutritional status and fat mass.

Inadequate levothyroxine replacement for primary hypothyroidism is associated with poor health-related quality of life-a Brazilian multicentre study.

This study aimed to verify the impact of levothyroxine replacement on health-related quality of life (HRQoL) in a Brazilian sample of primary hypothyroidism patients. A cross-sectional study was performed with 2,057 consecutive primary hypothyroidism patients on levothyroxine (LT4) replacement at four referral centers in Brazil (median age = 53; 25th percentile = 43; 75th percentile = 61 years). Patient biochemical data were acquired from medical records, and patients completed a questionnaire on socioeconomic issues and clinical signs and symptoms of hypothyroidism. HRQoL was assessed using the SF-36v2. Patients were divided into three groups according to TSH levels: overtreated (OvT; TSH < 0.4 mU/L), appropriately treated (AT; TSH between 0.4 and 4.0 mU/L), and undertreated (UnT; TSH > 4.0 mU/L). Patients were also analyzed by TSH and FT4 serum levels: overt hyperthyroidism (OHyper; TSH < 0.4 mU/L and FT4 > 1.9 ng/dL), subclinical hyperthyroidism (SHyper; TSH < 0.4 mU/L and FT4 0.8-1.9 ng/dL), subclinical hypothyroidism (SHypo; TSH > 4.0 mU/L and FT4 0.8-1.9 ng/dL), and overt hypothyroidism (OHypo; TSH > 4.0 mU/L and FT4 < 0.8 ng/dL). A total of 14.4 % of patients were OvT, with 13.0 % SHyper and 1.4 % OHyper. The prevalence of UnT was 25.9 %, with 21.5 % SHypo and 4.4 % OHypo. Overtreatment was not associated with HRQoL impairment. UnT patients had worse HRQoL than AT patients, especially for physical and emotional aspects, independent of SHypo or OHypo status. Hypothyroidism undertreatment is associated with poor patient HRQoL. Therefore, adequate LT4 therapy should be given to maintain serum TSH within the reference range.

Postural control in athletes with different degrees of visual impairment / Controle postural de atletas com diferentes graus de deficiência visual

ABSTRACT The aim of this study was to describe postural control in athletes with different degrees of visual impairment in erect semi-static position and verify whether it differs with sport modalities. Twenty-two athletes with total loss of vision (functional classification B1) and 17 with partial loss of vision (functional classification B2 and B3) were included in this cross-sectional study. Their sport modalities were judo (n = 17), goalball (n = 12) and five-a-side football (n=10). Postural control was investigated on a force platform with athletes in bipedal stance with eyes closed and blindfolded. The elliptical area of 95% confidence interval (mm2) and the mean displacement velocity (mm/s) were calculated. Athletes with total loss of vision presented smaller oscillation area values (p = 0.02) when compared to athletes with partial loss of vision. Considering sport modality, five-a-side athletes were found to present the best postural control. Moreover, goalball athletes oscillated less and presented a lower mean displacement velocity in relation to judoists. The differences found in postural control in visually impaired athletes seem to be associated with the degree of loss of vision and specificities of each sport modality.

RESUMO O objetivo do estudo foi descrever o controle postural na posição ereta semiestática de atletas com diferentes graus de deficiência visual e verificar se existem diferenças de acordo com a modalidade esportiva praticada. Participaram deste estudo seccional 22 atletas com perda total da visão (classificação funcional B1) e 17 com baixa visão (classificação funcional B2 e B3) das modalidades judô (n=17), goalball (n=12) e futebol de cinco (n=10). O controle postural foi investigado utilizando uma plataforma de força, sendo calculadas a área da elipse de 95% de intervalo de confiança (mm2) e a velocidade média de deslocamento (mm/s). A tarefa postural foi realizada com os pés unidos e olhos fechados e vendados. Atletas com perda total da visão apresentaram menores valores para área de oscilação (p=0,02) em relação aos atletas com baixa visão. Na comparação quanto à modalidade esportiva, foi possível observar que os atletas de goalball oscilaram menos e apresentaram menor velocidade de deslocamento que os atletas de judô. Em paralelo, os jogadores de futebol de cinco foram aqueles que apresentaram melhor controle postural. As diferenças encontradas no controle postural de atletas com deficiência visual parecem estar associadas ao grau de perda visual e às especificidades das modalidades esportivas.

Heart rate response to graded exercise test of elderly subjects in different ranges of TSH levels

ABSTRACT Objective: Life expectancy is increasing worldwide and studies have been demonstrating that elevated serum thyroid stimulating hormone (TSH) concentration in elderly is associated with some better health outcomes. This elevation is somewhat physiological as aging. The aim of this study was to investigate the heart rate (HR) response during a graded exercise test and its recovery in healthy elderly, comparing subjects within serum TSH in the lower limit of reference range to those within the TSH in the upper limit. Subjects and methods: A cross-sectional study was conducted with 86 healthy elderly aged 71.5 ± 5.1 years, with serum TSH between 0.4 - 4.0 mUl/mL. The participants were divided into two groups according to TSH level: < 1.0 mUl/mL (n = 13) and ≥ 1.0 µUI/mL (n = 73). All participants performed an ergometric test on a treadmill. The HR was recorded and analyzed at rest, during exercise and during the three minutes immediately after exercise. Results: No differences were observed in relation to HR at peak of exercise (TSH < 1.0 µUI/mL: 133.9 ± 22.5 bpm vs. TSH ≥ 1.0 µUI/mL: 132.4 ± 21.3 bpm; p = 0.70) and during the first minute of recovery phase (TSH < 1.0 µUI/mL: 122.3 ± 23.1 bpm vs. TSH ≥ 1.0 µUI/mL: 115.7 ± 18.4 bpm p = 0.33). The groups also presented similar chronotropic index (TSH < 1.0 µUI/mL: 78.1 ± 30.6 vs. TSH ≥ 1.0 µUI/mL: 79.5 ± 26.4; p = 0.74). Conclusion: In this sample studied, there were no difference between lower and upper TSH level concerning HR response during rest, peak of exercise and exercise recovery.

Exercise training improves quality of life in women with subclinical hypothyroidism: a randomized clinical trial

ABSTRACT Objective: The aim was to evaluate the quality of life (HRQoL) in women with subclinical hypothyroidism (sHT) after 16 weeks of endurance training. Subjects and methods: In the first phase, a cross-sectional study was conducted in which 22 women with sHT (median age: 41.5 (interquartile range: 175) years, body mass index: 26.2 (8.7) kg/m2, thyroid stimulating hormone > 4.94 mIU/L and free thyroxine between 0.8 and 1.3 ng/dL were compared to a group of 33 euthyroid women concerned to HRQoL. In the second phase, a randomized clinical trial was conducted where only women with sHT were randomly divided into two groups: sHT-Tr (n = 10) - participants that performed an exercise program - and sHT-Sed (n = 10) - controls. Exercise training consisted of 60 minutes of aerobic activities (bike and treadmill), three times a week, for 16 weeks. The HRQoL was assessed by the SF-36 questionnaire in the early and at the end of four months. Results: Women with sHT had lower scores on functional capacity domain in relation to the euthyroid ones (770 ± 23.0 vs. 88.8 ± 14.6; p = 0.020). The sHT-Tr group improved functional capacity, general health, emotional aspects, mental and physical component of HRQoL after training period, while the sHT-Sed group showed no significant changes. Conclusion: After 16 weeks of aerobic exercise training, there were remarkable improvements in HRQoL in women with sHT.

Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life.

OBJECTIVES: To evaluate the impact of subclinical hypothyroidism (sHT) treatment on health-related quality of life (QoL), psychiatric symptoms, clinical score, and muscle function. MATERIALS AND METHODS: In this randomized double-blind study, patients were assigned either to treatment (n = 35) or placebo (n = 36). Clinical and psychiatric symptoms were assessed by the Zulewski, Hamilton and Beck scales. QoL was assessed by the SF-36 questionnaire. Assessments of quadriceps (QS) and inspiratory muscle (IS) strength were performed by a chair dynamometer and a manuvacuometer. RESULTS: Treatment improved IS (+11.5 ± 17.2; p = 0.041), as did QoL domains "Pain" and "Role Physical" (+19.7 ± 15.2, 0.039 and +22.1 ± 47.5, p = 0.054; respectively). Clinical and psychiatric symptoms showed similar responses to both interventions. CONCLUSIONS: sHT treatment improved IS and physical aspects of QoL, despite no impact in other muscle parameters. Clinical score, psychiatric symptoms, and SF-36 domains, based on mental dimensions of QoL may be more susceptible to "placebo effect" in patients with sHT.