Combined Aerobic and Strength Training Improves Dynamic Stability and can Prevent against Static Stability Decline in Postmenopausal Women: A Randomized Clinical Trial.

OBJECTIVE: To analyze the effect of combined training (CT) in postural control and gait parameters in postmenopausal women. METHODS: A parallel-group, randomized, control study was conducted with 16 weeks of combined training (n = 16) versus a non-training control group (n = 12) in postmenopausal women (aged 59.3 ± 8.0). Pre and postintervention assessments included postural control (using an AMTI force platform - Advanced Mechanical Technology, Inc., Watertown, MA, USA) and gait impairments (using baropodometry). In addition, the upper limb strength and abdominal tests, as well as aerobic capacity, assessed functional indicators. RESULTS: The CT intervention in postmenopausal women resulted in improved gait (stride length (p = 0.006); speed (p = 0.013); double support time (p = 0.045); and improved postural control (displacement area of postural sway in a normal base of support with eyes open (p = 0.006). Combined training increased functional indicators (abdominal - p = 0.031; aerobic capacity - p = 0.002). CONCLUSION: In conclusion, combined aerobic plus strength training effectively improved gait and balance control in older women. The postmenopausal women from the CT group walked faster and with bigger steps after the intervention than the control group. In addition, they presented decreased postural sway in standing and decreased the percentage of double support time while walking, which means improved static and dynamic balance control and functional indicators.

OBJETIVO: Analisar o efeito do treinamento combinado (TC) no controle postural e nos parâmetros da marcha em mulheres na pós-menopausa. MéTODOS: Foi realizado um estudo controlado randomizado de grupos paralelos com 16 semanas de treinamento combinado (n = 16) versus um grupo controle sem treinamento (n = 12) em mulheres na pós-menopausa (59,3 ± 8,0 anos). As avaliações pré e pós-intervenção incluíram controle postural (usando a plataforma de força AMTI) e deficiências da marcha (usando baropodometria). Além disso, os testes de força de membros superiors e abdominal, bem como a capacidade aeróbica, avaliaram indicadores funcionais. RESULTADOS: A intervenção do TC em mulheres na pós-menopausa resultou em melhora da marcha (comprimento da passada (p = 0,006), velocidade (p = 0,013), tempo de apoio duplo (p = 0,045) e controle postural aprimorado (área de deslocamento da oscilação postural em base de apoio normal com olhos abertos (p = 0,006). O TC aumentou os indicadores funcionais (abdominal - p = 0,031; capacidade aeróbia - p = 0,002). CONCLUSãO: Em conclusão, o TC de força e aeróbico melhorou efetivamente o controle da marcha e do equilíbrio em mulheres idosas. As mulheres na pós-menopausa do grupo CT caminharam mais rápido e com passos maiores após a intervenção do que o grupo controle. Além disso, elas apresentaram redução da oscilação postural em pé e do percentual de tempo de apoio duplo durante a caminhada, o que significa melhora no controle do equilíbrio estático e dinâmico e dos indicadores funcionais.

Effect of Combined Training on Body Image, Body Composition and Functional Capacity in Patients with Breast Cancer: Controlled Clinical Trial.

OBJECTIVE: Evaluate the effect of combined training on body image (BI), body composition and functional capacity in patients with breast cancer. As also the relationship of BI with body composition and functional capacity. METHODS: This was a Controlled Clinical Trial study, this study including 26 patients with breast cancer (30 to 59 years). The training group (n = 13) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20s. The Control Group (n = 13) received only the standard hospital treatment. Participants were evaluated at baseline and after 12 weeks. BI (primary outcomes) was assessed using the Body Image After Breast Cancer Questionnaire; Body composition was estimated with the indicators: Body mass index; Weight, Waist hip Ratio; Waist height ratio; Conicity index; Reciprocal ponderal index; Percentage of fat; Circumference of the abdomen and waist; Functional capacity by cardiorespiratory fitness (cycle ergometer) and strength (manual dynamometer). The statistic was performed in the Biostatistics and Stata 14.0 (α = 5%). RESULTS: The patients in the training group showed a reduction in the limitation dimension (p = 0.036) on BI, However, an increase in waist circumference was observed in both groups. In addition an increase in VO2max (p < 0.001) and strength in the right (p = 0.005) and left arms (p = 0.033). CONCLUSION: Combined training demonstrates to be an effective and non-pharmacological strategy to patients with breast cancer, with improvement on BI and functional capacity, changing related variables negatively when there is no physical training.

OBJETIVO: Avaliar o efeito do treinamento combinado na imagem corporal (IB), composição corporal e capacidade funcional em pacientes com câncer de mama. Assim como a relação do IB com a composição corporal e capacidade funcional. MéTODOS:: Este foi um estudo de Ensaio Clínico Controlado, este estudo incluiu 26 pacientes com câncer de mama (30 a 59 anos). O grupo de treinamento (n = 13) foi submetido a 12 semanas de treinamento, incluindo três sessões de 60 min de exercício aeróbio e treinamento de resistência, e duas sessões de treinamento de flexibilidade por semana; cada exercício de flexibilidade durou 20s. O Grupo Controle (n = 13) recebeu apenas o tratamento hospitalar padrão. Os participantes foram avaliados no início e após 12 semanas. O IB (desfechos primários) foi avaliado por meio do Body Image After Breast Cancer Questionnaire; A composição corporal foi estimada com os indicadores: índice de massa corporal; Peso, relação cintura-quadril; Relação da altura da cintura; Índice de conicidade; Índice ponderal recíproco; Porcentagem de gordura; Circunferência do abdômen e cintura; Capacidade funcional por aptidão cardiorrespiratória (cicloergômetro) e força (dinamômetro manual). A estatística foi realizada na Bioestatística e no Stata 14.0 (α = 5%). RESULTADOS: Os pacientes do grupo de treinamento apresentaram redução da dimensão da limitação (p = 0,036) no IB, porém, foi observado aumento da circunferência da cintura em ambos os grupos. Além disso, um aumento do VO2máx (p <0,001) e da força nos braços direito (p = 0,005) e esquerdo (p = 0,033). CONCLUSãO:: O treinamento combinado demonstra ser uma estratégia eficaz e não farmacológica para pacientes com câncer de mama, com melhora do IB e da capacidade funcional, alterando variáveis relacionadas negativamente quando não há treinamento físico.

The influence of mat Pilates training adherence on strength and flexibility parameters in breast cancer survivors undergoing hormone therapy.

The aim of this study was to evaluate the influence of adherence to mat Pilates training on lower and upper body strength and flexibility in breast cancer survivors. Breast cancer survivors (≥40 years) with cancer stages 0-III undergoing hormone therapy participated in this study. For this secondary investigation only the intervention group was analyzed, divided into low and high training adherence. Participants performed a 60-min session of mat Pilates, 3 times/wk, for 24 weeks. Concentric, eccentric, and isometric hip flexor-extensor muscle peak torque, and isometric maximal strength parameters of the shoulder abductors, trunk extensors, and handgrip were assessed. Physical activity level was analyzed as a control variable. The results showed that high training adherence improved (P<0.05) left shoulder abductor strength parameters and lower and upper body flexibility compared to baseline. The low training adherence group improved (P<0.05) trunk extensors, right and left shoulder abductor strength parameters, handgrip strength, and extensor-flexor peak torque compared to baseline. There were no differences (P>0.05) between high and low adherence for physical activity level before and after the intervention. Therefore, it appears that higher training adherence most influences some strength parameters and flexibility, while fewer sessions enable the achievement of significant results for shoulder abductor and hip extensor-flexor muscle strength parameters.

Relationship of different intensities of physical activity and quality of life in postmenopausal women.

BACKGROUND: It is known that the elderly population remains most of the time in light activity. Physical activity plays a key role in the primary prevention of chronic diseases to mitigate various deleterious effects of aging and improve quality of life. The objective of the present study was to evaluate whether the time that postmenopausal women remain in light activities during the day are related to better quality of life and compare these results with the quality of life of those who remain longer in moderate intensity and vigorous activity. METHODS: This is a cross sectional study there were evaluated 102 women, aged 50 to 79 years, all postmenopausal. Physical activity was measured by triaxial accelerometers. The quality of life was assessed using a Brazilian validated version of the SF-36 questionnaire. The sample was divided in three groups (G1, G2 and G3) according to tercile of time spent per week on light, moderate and moderate+vigorous physical activity. The comparisons between groups were made by ANOVA One Way, and the relationship between variables were made through the Spearman's correlation coefficient, and the significance was set at 5%. RESULTS: We found that the amount of time of light physical activity shows a higher correlation values compared to the moderate and moderate+vigorous physical activity (p < 0,05) and presented significant correlation in all domains of quality of life. Vigorous physical activity did not presented significant correlation in all domains of quality of life. CONCLUSION: Our data suggests that light intensity physical activity presented influence on the quality of life of postmenopausal women. TRIAL REGISTRATION: (NCT02804308). Registered on 17 june 2016 (retrospectively registred).

Practice of physical activity and dysmobility syndrome in community-dwelling older adults.

The aim this study was to analyze the association between insufficient physical activity and dysmobility syndrome (DS) in community-dwelling older adults. In total, 375 subjects were evaluated aged ≥60 years. For the diagnosis of DS the presence of ≥3 clinical factors was considered: (a) low muscle mass; (b) low muscular strength; (c) low gait speed; (d) high body fat, and (e) osteoporosis. Information relating to the practice of habitual physical activity (HPA) was obtained using a questionnaire and accelerometry. The chi-square test was used to verify the association between HPA and DS and analysis of binary logistic regression to build multiple models. Insufficiently active older adults are approximately 2 times (95% confidence interval, 1.14-3.79) more likely to have DS, independent of body mass index, smoking and ethnicity. The insufficient practice of physical activity is associated with DS in older adults, mainly in women and older.

Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over.

OBJECTIVE: This study sought to analyze the relationship between the components and aggravations of body composition (obesity, sarcopenia, and sarcopenic obesity) and bone mineral density in elderly subjects aged ≥80 years. METHODS: A cross-sectional study design was utilized to assess 128 subjects aged between 80 and 95 years. Body composition and bone mineral density were measured by dual energy X-ray absorptiometry. Gait speed was assessment by walking test. The statistical analyses included Spearman's correlation, one-way analysis of variance, the chi-squared test, and binary logistic regression analysis. RESULTS: The elderly subjects with sarcopenia had lower bone mineral density compared to the obesity group, with higher risk for presence of osteopenia/osteoporosis in the spine (OR: 2.81; CI: 1.11-7.11) and femur (OR: 2.75; CI: 1.02-7.44). Obesity was shown to be a protective factor for osteopenia/osteoporosis in the spine (OR: 0.43; CI: 0.20-0.93) and femur (OR: 0.27; CI: 0.12-0.62). CONCLUSION: It was found that lean mass is more directly related to bone mineral density (total, femur, and spine) and sarcopenia is associated with osteopenia/osteoporosis. Obesity represents a possible protective factor for osteopenia/osteoporosis in elderly subjects aged 80 years and over.

OBJETIVO: O objetivo do presente estudo foi analisar a relação entre os componentes e agravos da composição corporal (obesidade, sarcopenia e obesidade sarcopênica) com a densidade mineral óssea em idosos com idade ≥ 80 anos. MÉTODOS: Estudo com delineamento transversal que avaliou 128 sujeitos com idade entre 80 e 95 anos. A composição corporal e densidade mineral óssea foram mensuradas por meio da técnica de absorciometria de raios X de dupla energia. A velocidade de caminhada foi avaliada pelo teste de caminhada usual. Para análise estatística foram realizados os testes de correlação de Spearman, análise de variância com um fator, teste qui-quadrado e análise de regressão logística binária. RESULTADOS: Os idosos com sarcopenia apresentaram valores menores de DMO quando comparados com o grupo obesidade com maior chance de risco para a presença de osteopenia/osteoporose na coluna (OR: 2,81; IC: 1,11-7,11) e fêmur (OR: 2,75 IC: 1,02-7,44). Obesidade apresentou fator de proteção para osteopenia/osteoporose na coluna (OR: 0,43; IC: 0,20-0,93) e fêmur (OR: 0,27; IC: 0,12-0,62). CONCLUSÃO: Observou-se que a massa magra está diretamente relacionada com a DMO (total, fêmur e coluna) e que a sarcopenia está associada à osteopenia/osteoporose em idosos com 80 anos ou mais.

Brazilian Photographic Figure Rating Scale: Development and Psychometric Investigation.

This study reports on the development, reliability, and validity of a new instrument for obtaining respondents' body image perception, the Brazilian Photographic Figure Rating Scale (BPFRS). This instrument consists of eight photographic images (seven distorted and one accurate) of respondents themselves in standardized poses, taken just prior to requesting respondents to make self-ratings on the instrument. Participants involved in developing and evaluating this instrument were 142 Brazilian women (age 21.8 ± 3.0 years). Ten experts assessed content validity and showed high agreement (defined by ratings of 4-5 on a 5-point scale) with items measuring underlying constructs and high (>70%) interrater agreement. A Pearson correlation demonstrated convergence between the BPFRS and other related scales; a positive correlation was also evident between actual and respondent-perceived body mass index. Both test-retest and Kappa confirmed temporal stability. These findings indicate that the BPFRS can accurately and reliably assess body image dissatisfaction and body perception in young women by deploying realistic, personalized images as stimuli for self-ratings. Implications for further research and treatment of body image problems are discussed.

Treinamento concorrente e o treinamento funcional promovem alterações benéficas na composição corporal e esteatose hepática não alcoólica de jovens obesos / Concurrent training and functional training promotes beneficial changes in body composition and nonalcoholic fatty liver of obese youth

Comparar efeito do treinamento concorrente e o treinamento funcional na composição corporal, perfil lipídico e esteatose hepática não alcoólica (EHNA) em adolescentes obesos. Estudo longitudinal/analítico por amostragem não aleatória. Amostra de 49 adolescentes obesos (treinamento concorrenteENT#091;n=36ENT#093;; treinamento funcionalENT#091;n=13ENT#093;). Nos dois tipos de treinamento físico 50% de atividade aeróbia, e 50% resistida (concorrente: musculação; funcional: peso do próprio corpo e/ou pesos livres). Para distribuição normal aplicou-se Teste t de Student para dados pareados. Treinamento concorrente apresentou redução para lipoproteína de baixa densidade (-16,45%), colesterol total (-11,55%), gordura corporal (-8,52%) e gordura de tronco (-9,95%) e aumento da massa muscular (5,05%). Treinamento funcional reduziu 76,9% a ocorrência da EHNA, gordura corporal (-4,97%), gordura intra-abdominal (-19,90%), e aumento na massa muscular (4,18%). Devido ao alto acometimento da EHNA neste grupo, futuras investigações se fazem necessárias. Para tanto, o treinamento concorrente parece ser uma ferramenta útil para o tratamento da EHNA em adolescentes obesos.

To compare the effect of concurrent and functional exercise training on body composition, lipid profile and non-alcoholic steatohepatitis in obese adolescents. Longitudinal/analytical study by non-random sampling carried out with 49 obese adolescents (n=36 in concurrent and n=13 in functional exercise training). Both protocols had 50% of the session designed to aerobic activities and the other half session to resistance and functional training (activities using self-body weight and dumbbells). Set data had normal distribution and the paired sample t test was applied. Concurrent exercise training decreased low density lipoprotein (-16.45%), total cholesterol (-11.55%), body fatness (-8.52%), trunk fatness (-9.95%) and increased fat free mass (5.05%). On the other hand, functional exercise training decrease body fatness (-4.97%), trunk fatness (-5.11%), intra-abdominal adiposity (-19,9%), increase fat free mass (4.18%) and occurrence of non-alcoholic steatohepatitis (reduction of 76.9%). Concurrent training seems a relevant tool to the treatment of non-alcoholic steatohepatitis in obese adolescents.

The relationship between visceral fat thickness and bone mineral density in sedentary obese children and adolescents.

BACKGROUND: Among adults, obesity has been positively related to bone mineral density. However, recent findings have pointed out that abdominal obesity could be negatively related to bone density. The above mentioned relationship is not clear among pediatric populations. Therefore, this cross-sectional study analyzed the relationship between thickness of abdominal adipose tissue and bone mineral variables in sedentary obese children and adolescents. METHODS: One hundred and seventy five obese children and adolescents (83 male and 92 female) with ages ranging from 6 to 16 years-old were analyzed. Bone mineral content and density were estimated by dual-energy X-ray absorptiometry and ultrasound equipment which estimated the thickness of the abdominal adipose tissue. Pubertal stage was self-reported by the participants. RESULTS: The mean age was 11.1 (SD=2.6). Thickness of the abdominal adipose tissue was negatively related to bone mineral density (r=-0.17 [r95%CI: -0.03;-0.32]), independent of gender, pubertal stage and other confounders (ß=-0.134±0.042 [ß95%CI: -0.217; -0.050]). CONCLUSIONS: In sedentary obese children and adolescents abdominal obesity is negatively related to bone mineral density, suggesting a potential link between abdominal obesity and osteoporosis.

Fractal correlation of heart rate variability in obese children.

BACKGROUND: The loss of variability and fractal properties in the heart rate is related to greater morbidity and mortality rates. OBJECTIVE: The aim of the present study was to analyze heart rate dynamics in obese children by measuring short and long-term fractal exponents and heart rate variability (HRV) indices. MATERIALS AND METHODS: 112 male and female children aged 8 to 12 years were divided into two groups based on body mass index: obese (n=51) and normal weight range (n=61). Heart rate was monitored beat-to-beat in the dorsal decubitus position for 20 min, analyzing the low frequency (LF) and high frequency (HF) spectral indices in normalized units and ms(2) as well as short and long-term fractal exponents (alpha-1 and alpha-2) of the detrended fluctuation analysis (DFA). The non-paired Student's t-test and Mann-Whitney test were used for the statistical analysis, with the level of significance set at P< or =0.05. RESULTS: The following were lower in the obese children: alpha-1 exponent value (0.930+/-0.14 vs. 0.992+/-0.11; P=0.012), LF index (219.0 vs. 361.0; P=0.001) and HF index (175.0 vs. 227.0; P=0.019) in ms(2). No significant differences between groups were found for the alpha-2 exponent, LF and HF indices in normalized units or LF/HF ratio. CONCLUSION: The obese children exhibited a reduction in short-term fractal correlation properties in heart frequency dynamics associated to a reduction in both sympathetic and parasympathetic activities, thereby demonstrating a need for early treatment for these children in order to avoid future complications.

Consumo máximo de oxigênio e fatores de risco cardiovascular em adultos jovens / Maximum uptake oxygen consumption and cardiovascular risk factors in young adults

Objetivos: Analisar a interação do consumo máximo de oxigênio com diferentes indicadores de risco cardiovascular entre adultos jovens do sexo masculino e sem histórico prévio de doenças. Métodos: Estudo transversal realizado com universitários. A amostra foi composta por 32 adultos jovens do sexo masculino e sem histórico prévio de doenças. Foram adotados como indicadores de risco: peso corporal, circunferência de cintura, percentual de gordura, glicemia em jejum, pressão arterial sistólica e diastólica. O consumo máximo de oxigênio foi avaliado de maneira direta em teste de esteira. A análise de variância e teste qui-quadrado analisaram os dados. Resultados: Menor consumo máximo de oxigênio associou-se com maior excesso de peso (p= 0,005), mas não com hipertensão (p= 0,059). Além disso, o mesmo associou-se com a menor ocorrência de riscos cardiovasculares. Conclusão: O consumo máximo de oxigênio é um indicador de risco mesmo entre adultos jovens sem diagnóstico prévio de doenças.

Objectives: To analyze the relationship between maximum oxygen uptake and cardiovascular risk factors among young male adults with no previously detected disease. Methods: Cross-sectional study with undergraduate subjects. The sample was composed by 32 young male adults without previously detected disease. Body weight, waist circumference, percentage body fat, fasting glucose, systolic and diastolic blood pressure were utilized as cardiovascular risk factors. Maximum oxygen uptake was assessed through treadmill test. Analysis of variance and chi-square test analyzed the data. Results: Lower maximum oxygen uptake was associated with higher overweight (p= 0,005), but not with arterial hypertension (p= 0,059). Moreover, the maximum oxygen uptake was also associated with lower occurrence of cardiovascular risk. Conclusion: The maximum oxygen uptake is an indicator of higher risk even among young adults without previously detected disease.

Association between regular participation in sports and leisure time behaviors in Brazilian adolescents: a cross-sectional study.

BACKGROUND: The belief that adolescents engaged in sports increase their overall physical activity level while simultaneously decreasing physical inactivity has been the foundation of many intervention programs in developing countries. The aim of this study was to analyze the association between regular participation in sports and both active behaviors and TV viewing during leisure time. METHODS: A total of 1752 Brazilian adolescents (812 = male and 940 = female) participated in this study. Regular participation in sports, as well as active behaviors (exemplified by walking or cycling) and TV viewing during leisure time were assessed by means of a questionnaire. The chi-square test analyzed the association between sports practice and leisure time behaviors, and the Poisson regression with robust variance indicated the magnitude of these associations. RESULTS: The prevalence of regular participation in sports was 14.8% (95% confidence interval 13.2% to 16.5%). After adjustment for all confounders, participation in sports was associated with, at the highest frequency, cycling (PR = 2.55 [1.80-3.60]) and walking (PR = 2.69 [1.98-3.64]) during leisure time. However, there was not an association between the participation in sports and frequency of TV viewing (PR = 1.28 [0.81-2.02]). CONCLUSION: This study presented data indicating that the regular participation in sports is positively associated with a higher frequency of physically active behaviors during leisure time. However, the results did not support the hypothesis that the engagement in sports necessarily decreases leisure time spent in TV viewing.