A simple medical device development according to normative values of calf circumference across ages: results from the Italian Longevity Check-up 7+ (Lookup 7+) project.

BACKGROUND: Wide consensus exists on the notion that low muscle mass is a predictor of negative health-related events, such as disability, morbidity, and mortality. Indeed, the European Working Group on Sarcopenia in Older People 2 had identified muscle mass as the key component to confirm the diagnosis of sarcopenia. However, the lack of normative values for muscle mass across ages hampers the practical assessment of this important parameter. The aim of the present study was to produce cross-sectional centile and normative values for calf circumference (a surrogate estimation of muscle mass) across a wide spectrum of ages using a large and unselected sample of community-dwellers enrolled in the Longevity Check-up 7+ (Lookup 7+) project. METHODS: This is a cross-sectional study using the data of Lookup 7+ project, an ongoing study started in June 2015 and conducted in unconventional settings (i.e., exhibitions, malls, and health promotion campaigns). Candidate participants were considered eligible for enrolment if they were at least 45 years of age and provided written informed consent. Calf circumference was measured using an inextensible but flexible plastic tape in a sitting position with the knee and ankle at a right angle and the feet resting on the floor. Normative values for calf circumference from ages 45 to 80 + years were generated. RESULTS: A total of 11 814 participants were enrolled from 1 June 2015 to 30 September 2022. The mean age of participants included in the analyses was 61.8 years (standard deviation; 10.2 years; range: 45-98 years), and 6686 (57%) were women. Normative values for calf circumference were obtained for men and women, stratified by age groups. Accordingly, a calf circumference tape, with colour bands that demarcate the centiles range into which the patient falls, was created and validated. CONCLUSIONS: Our study established age- and gender-specific centile reference values for calf circumference. The calf circumference tape can be used to easily interpret the assessment in every-day practice for the early detection of individuals with or at risk of sarcopenia and malnutrition.

Sex- and age-specific normative values of lower extremity muscle power in Italian community-dwellers.

BACKGROUND: Muscle power is associated with health-related parameters. Simple equations were validated to estimate lower extremity muscle power measures based on the time to complete the five-repetition sit-to-stand test. The present study was conducted to provide lower extremity muscle power estimates and produce centile values in a large and relatively unselected population across a wide age spectrum. METHODS: Data were from the Longevity Check-up 7+ (Lookup 7+) project, an ongoing initiative conducted in unconventional settings (e.g., exhibitions, shopping centres and health promotion campaigns) across Italy to foster adoption of healthy lifestyles. Absolute, relative, allometric and specific muscle power measures of the lower extremities were estimated using validated formulas. Cross-sectional centile and normative values for muscle power measures from 18 to 81+ years were produced for the two sexes. Smoothed normative curves for men and women were constructed using the lambda-mu-sigma method. RESULTS: From 1 June 2015 to 31 October 2021, 13 515 participants were enrolled of whom 12 864 were eligible for the present study. Mean age was 55.9 years (standard deviation: 14.8 years; range: 18-98 years), and 7217 (56.%) were women. Absolute, relative, allometric and specific muscle power declined significantly with age. Specific patterns of decline were observed according to sex and muscle power parameter. Absolute muscle power peaked at 41-50 and 31-40 years in men and women, respectively. Afterwards, a decline rate of approximately 12% per decade was observed, regardless of sex. Relative muscle power showed the largest reduction with age, such that it was 40.6% and 46.4% smaller in men and women older than 80, respectively, compared with those aged 18-30 years. Age-related changes in allometric and specific muscle power measures were similar between men and women. CONCLUSIONS: Data from the Lookup 7+ project indicate that lower extremity muscle power estimated using simple equations is significantly associated with age. Sex-specific patterns of decline in absolute and relative muscle power were observed with age. Allometric and specific muscle power declined at a similar rate in men and women.

The contribution of mitochondrial DNA alterations to aging, cancer, and neurodegeneration.

Mitochondrial DNA (mtDNA) is as a double-stranded molecule existing in hundreds to thousands copies in cells depending on cell metabolism and exposure to endogenous and/or environmental stressors. The coordination of mtDNA replication and transcription regulates the pace of mitochondrial biogenesis to guarantee the minimum number of organelles per cell. mtDNA inheritance follows a maternal lineage, although bi-parental inheritance has been reported in some species and in the case of mitochondrial diseases in humans. mtDNA mutations (e.g., point mutations, deletions, copy number variations) have been identified in the setting of several human diseases. For instance, sporadic and inherited rare disorders involving the nervous system as well higher risk of developing cancer and neurodegenerative conditions, including Parkinson's and Alzheimer's disease, have been associated with polymorphic mtDNA variants. An accrual of mtDNA mutations has also been identified in several tissues and organs, including heart and muscle, of old experimental animals and humans, which may contribute to the development of aging phenotypes. The role played by mtDNA homeostasis and mtDNA quality control pathways in human health is actively investigated for the possibility of developing targeted therapeutics for a wide range of conditions.

Amino Acid Profiles in Older Adults with Frailty: Secondary Analysis from MetaboFrail and BIOSPHERE Studies.

An altered amino acid metabolism has been described in frail older adults which may contribute to muscle loss and functional decline associated with frailty. In the present investigation, we compared circulating amino acid profiles of older adults with physical frailty and sarcopenia (PF&S, n = 94), frail/pre-frail older adults with type 2 diabetes mellitus (F-T2DM, n = 66), and robust non-diabetic controls (n = 40). Partial least squares discriminant analysis (PLS-DA) models were built to define the amino acid signatures associated with the different frailty phenotypes. PLS-DA allowed correct classification of participants with 78.2 ± 1.9% accuracy. Older adults with F-T2DM showed an amino acid profile characterized by higher levels of 3-methylhistidine, alanine, arginine, ethanolamine, and glutamic acid. PF&S and control participants were discriminated based on serum concentrations of aminoadipic acid, aspartate, citrulline, cystine, taurine, and tryptophan. These findings suggest that different types of frailty may be characterized by distinct metabolic perturbations. Amino acid profiling may therefore serve as a valuable tool for frailty biomarker discovery.

Circulating Inflammatory, Mitochondrial Dysfunction, and Senescence-Related Markers in Older Adults with Physical Frailty and Sarcopenia: A BIOSPHERE Exploratory Study.

Multisystem derangements encompassing musculoskeletal, stress, and metabolic response have been described in older adults with physical frailty and sarcopenia (PF&S). Whether PF&S is also associated with markers of cellular senescence has yet to be explored. To address this research question, we quantified the serum levels of selected inflammatory, mitochondrial, and senescence-associated secretory phenotype (SASP)-related factors in 22 older adults with PF&S (mean age 75.5 ± 4.7 years; 81.8% women) and 27 nonPF&S controls (mean age 75.0 ± 4.4 years; 62.9% women) and evaluated their association with PF&S. Markers of inflammation (interleukin (IL)1-ß, IL6, and tumor necrosis factor α (TNF-α)), matrix remodeling (Serpin E1, intercellular adhesion molecule 1 (ICAM-1), and tissue inhibitor of metalloproteinases 1 (TIMP-1)), mitochondrial dysfunction (growth/differentiation factor 15 (GDF15) and fibroblast growth factor 21 (FGF21)), Activin A, and glial fibrillary acidic protein (GFAP) were assayed. Serum levels of TNF-α and those of the SASP-related factors ICAM-1 and TIMP-1 were found to be higher, while IL1-ß and IL6 were lower in PF&S participants compared with controls. Partial least squares discriminant analysis allowed discrimination of PF&S from nonPF&S participants with 74.0 ± 3.4% accuracy. Markers that significantly contributed to the classification were ICAM-1, TIMP-1, TNF-α, GFAP, and IL6. Future studies are warranted to establish whether inflammatory and SASP-related pathways are causally linked to the development and progression of PF&S, and may represent new targets for interventions.

Biomarkers shared by frailty and sarcopenia in older adults: A systematic review and meta-analysis.

BACKGROUND: Physical frailty and sarcopenia show extensive clinical similarities. Whether biomarkers exist that are shared by the two conditions is presently unclear. METHODS: We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association of frailty and/or sarcopenia with biomarkers as a primary or secondary outcome in adults aged 60 years and older. Only studies published in English that defined frailty using a validated scale and/or questionnaire and diagnosed sarcopenia according to the presence of muscle atrophy plus dynapenia or low physical function were included. Studies were identified from a systematic search of MEDLINE and SCOPUS databases from inception through August 2020. The quality of reporting of each study was assessed by using the Quality Assessment Tool for Observational Cohort, Cross-Sectional and Case-Control studies of the National Institute of Health. A meta-analysis was conducted when at least three studies investigated the same biomarker in both frailty and sarcopenia. Pooled effect size was calculated based on standard mean differences and random-effect models. Sensitivity analysis was performed based on age and the setting where the study was conducted. RESULTS: Eighty studies (58 on frailty and 22 on sarcopenia) met the inclusion criteria and were included in the qualitative analysis. Studies on frailty included 33,160 community-dwellers, hospitalized, or institutionalized older adults (60-88 years) from 21 countries. Studies on sarcopenia involved 4904 community-living and institutionalized older adults (68-87.6 years) from 9 countries. Several metabolic, inflammatory, and hematologic markers were found to be shared between the two conditions. Albumin and hemoglobin were negatively associated with both frailty and sarcopenia. Interleukin 6 was associated with frailty and sarcopenia only in people aged < 75. Community-dwelling older adults with frailty and sarcopenia had higher levels of tumor necrosis factor alpha compared with their robust and non-sarcopenic counterparts. CONCLUSIONS: A set of metabolic, hematologic, and inflammatory biomarkers was found to be shared by frailty and sarcopenia. These findings fill a knowledge gap in the quest of biomarkers for these conditions and provide a rationale for biomarker selection in studies on frailty and sarcopenia.

Circulating extracellular vesicles: friends and foes in neurodegeneration.

Extracellular vesicles have been identified as pivotal mediators of intercellular communication with critical roles in physiological and pathological conditions. Via this route, several molecules (e.g., nucleic acids, proteins, metabolites) can be transferred to proximal and distant targets to convey specific information. Extracellular vesicle-associated cargo molecules have been proposed as markers of several disease conditions for their potential of tracking down the generating cell. Indeed, circulating extracellular vesicles may represent biomarkers of dysfunctional cellular quality control systems especially in conditions characterized by the accrual of intracellular misfolded proteins. Furthermore, the identification of extracellular vesicles as tools for the delivery of nucleic acids or other cargo molecules to diseased tissues makes these circulating shuttles possible targets for therapeutic development. The increasing interest in the study of extracellular vesicles as biomarkers resides mainly in the fact that the identification of peripheral levels of extracellular vesicle-associated proteins might reflect molecular events occurring in hardly accessible tissues, such as the brain, thereby serving as a "brain liquid biopsy". The exploitation of extracellular vesicles for diagnostic and therapeutic purposed might offer unprecedented opportunities to develop personalized approaches. Here, we discuss the bright and dark sides of extracellular vesicles in the setting of two main neurodegenerative diseases (i.e., Parkinson's and Alzheimer's diseases). A special focus will be placed on the possibility of using extracellular vesicles as biomarkers for the two conditions to enable disease tracking and treatment monitoring.

Cell Death and Inflammation: The Role of Mitochondria in Health and Disease.

Mitochondria serve as a hub for a multitude of vital cellular processes. To ensure an efficient deployment of mitochondrial tasks, organelle homeostasis needs to be preserved. Mitochondrial quality control (MQC) mechanisms (i.e., mitochondrial dynamics, biogenesis, proteostasis, and autophagy) are in place to safeguard organelle integrity and functionality. Defective MQC has been reported in several conditions characterized by chronic low-grade inflammation. In this context, the displacement of mitochondrial components, including mitochondrial DNA (mtDNA), into the extracellular compartment is a possible factor eliciting an innate immune response. The presence of bacterial-like CpG islands in mtDNA makes this molecule recognized as a damaged-associated molecular pattern by the innate immune system. Following cell death-triggering stressors, mtDNA can be released from the cell and ignite inflammation via several pathways. Crosstalk between autophagy and apoptosis has emerged as a pivotal factor for the regulation of mtDNA release, cell's fate, and inflammation. The repression of mtDNA-mediated interferon production, a powerful driver of immunological cell death, is also regulated by autophagy-apoptosis crosstalk. Interferon production during mtDNA-mediated inflammation may be exploited for the elimination of dying cells and their conversion into elements driving anti-tumor immunity.

Altered Expression of Mitoferrin and Frataxin, Larger Labile Iron Pool and Greater Mitochondrial DNA Damage in the Skeletal Muscle of Older Adults.

Mitochondrial dysfunction and iron (Fe) dyshomeostasis are invoked among the mechanisms contributing to muscle aging, possibly via a detrimental mitochondrial-iron feed-forward loop. We quantified the labile Fe pool, Fe isotopes, and the expression of mitochondrial Fe handling proteins in muscle biopsies obtained from young and older adults. The expression of key proteins of mitochondrial quality control (MQC) and the abundance of the mitochondrial DNA common deletion (mtDNA4977) were also assessed. An inverse association was found between total Fe and the heavier Fe isotope (56Fe), indicating an increase in labile Fe abundance in cells with greater Fe content. The highest levels of labile Fe were detected in old participants with a Short Physical Performance Battery (SPPB) score ≤ 7 (low-functioning, LF). Protein levels of mitoferrin and frataxin were, respectively, higher and lower in the LF group relative to young participants and older adults with SPPB scores ≥ 11 (high-functioning, HF). The mtDNA4977 relative abundance was greater in old than in young participants, regardless of SPPB category. Higher protein levels of Pink1 were detected in LF participants compared with young and HF groups. Finally, the ratio between lipidated and non-lipidated microtubule-associated protein 1A/1B-light chain 3 (i.e., LC3B II/I), as well as p62 protein expression was lower in old participants regardless of SPPB scores. Our findings indicate that cellular and mitochondrial Fe homeostasis is perturbed in the aged muscle (especially in LF older adults), as reflected by altered levels of mitoferrin and frataxin, which, together with MQC derangements, might contribute to loss of mtDNA stability.

Extracellular Vesicles and Damage-Associated Molecular Patterns: A Pandora's Box in Health and Disease.

Sterile inflammation develops as part of an innate immunity response to molecules released upon tissue injury and collectively indicated as damage-associated molecular patterns (DAMPs). While coordinating the clearance of potential harmful stimuli, promotion of tissue repair, and restoration of tissue homeostasis, a hyper-activation of such an inflammatory response may be detrimental. The complex regulatory pathways modulating DAMPs generation and trafficking are actively investigated for their potential to provide relevant insights into physiological and pathological conditions. Abnormal circulating extracellular vesicles (EVs) stemming from altered endosomal-lysosomal system have also been reported in several age-related conditions, including cancer and neurodegeneration, and indicated as a promising route for therapeutic purposes. Along this pathway, mitochondria may dispose altered components to preserve organelle homeostasis. However, whether a common thread exists between DAMPs and EVs generation is yet to be clarified. A deeper understanding of the highly complex, dynamic, and variable intracellular and extracellular trafficking of DAMPs and EVs, including those of mitochondrial origin, is needed to unveil relevant pathogenic pathways and novel targets for drug development. Herein, we describe the mechanisms of generation of EVs and mitochondrial-derived vesicles along the endocytic pathway and discuss the involvement of the endosomal-lysosomal in cancer and neurodegeneration (i.e., Alzheimer's and Parkinson's disease).

Normative values of muscle strength across ages in a 'real world' population: results from the longevity check-up 7+ project.

BACKGROUND: Low muscle strength is a powerful predictor of negative health-related events and a key component of sarcopenia. The lack of normative values for muscle strength across ages hampers the practical appraisal of this parameter. The aim of the present study was to produce normative values for upper and lower extremity muscle strength across a wide spectrum of ages, in a large sample of community-dwellers recruited in the Longevity check-up (Lookup) 7+ project. METHODS: Lookup 7+ is an ongoing project that started in June 2015 and conducted in unconventional settings (i.e. exhibitions, malls, and health promotion campaigns) across Italy with the aim of fostering the adoption of healthy lifestyles in the general population. Candidate participants are eligible for enrolment if they are 18+ years and provide written informed consent. Upper and lower extremity muscle strength is assessed by handgrip strength and five-repetition chair-stand [5 × sit-to-stand (STS)] tests, respectively. Cross-sectional centile and normative values for handgrip strength and 5 × STS tests from age 18 to 80+ years were generated for the two genders. Smoothed normative curves for the two tests were constructed for men and women using the lambda-mu-sigma method. RESULTS: From 1 June 2015 to 30 May 2019, 11 448 participants were enrolled. The mean age of participants was 55.6 years (standard deviation: 11.5 years; range: 18-98 years), and 6382 (56%) were women. Normative values for handgrip strength and the 5 × STS test, both absolute and normalized by body mass index, were obtained for men and women, stratified by age groups. Values of upper and lower extremity muscle strength across ages identified three periods in life: an increase to peak in young age and early adulthood (18-24 years), preservation through midlife (25-44 years), and a decline from midlife onwards (45+ years). CONCLUSIONS: Our study established age-specific and gender-specific percentile reference values for handgrip strength and the 5 × STS test. The normative curves generated can be used to interpret the assessment of muscle strength in everyday practice for the early detection of individuals with or at risk of sarcopenia.

Older Adults with Physical Frailty and Sarcopenia Show Increased Levels of Circulating Small Extracellular Vesicles with a Specific Mitochondrial Signature.

Mitochondrial dysfunction and systemic inflammation are major factors in the development of sarcopenia, but the molecular determinants linking the two mechanisms are only partially understood. The study of extracellular vesicle (EV) trafficking may provide insights into this relationship. Circulating small EVs (sEVs) from serum of 11 older adults with physical frailty and sarcopenia (PF&S) and 10 controls were purified and characterized. Protein levels of three tetraspanins (CD9, CD63, and CD81) and selected mitochondrial markers, including adenosine triphosphate 5A (ATP5A), mitochondrial cytochrome C oxidase subunit I (MTCOI), nicotinamide adenine dinucleotide reduced form (NADH):ubiquinone oxidoreductase subunit B8 (NDUFB8), NADH:ubiquinone oxidoreductase subunit S3 (NDUFS3), succinate dehydrogenase complex iron sulfur subunit B (SDHB), and ubiquinol-cytochrome C reductase core protein 2 (UQCRC2) were quantified by Western immunoblotting. Participants with PF&S showed higher levels of circulating sEVs relative to controls. Protein levels of CD9 and CD63 were lower in the sEV fraction of PF&S older adults, while CD81 was unvaried between groups. In addition, circulating sEVs from PF&S participants had lower amounts of ATP5A, NDUFS3, and SDHB. No signal was detected for MTCOI, NDUFB8, or UQCRC2 in either participant group. Our findings indicate that, in spite of increased sEV secretion, lower amounts of mitochondrial components are discarded through EV in older adults with PF&S. In-depth analysis of EV trafficking might open new venues for biomarker discovery and treatment development for PF&S.

The COVID-19 pandemic and physical activity.

The SARS-CoV-2-caused COVID-19 pandemic has resulted in a devastating threat to human society in terms of health, economy, and lifestyle. Although the virus usually first invades and infects the lung and respiratory track tissue, in extreme cases, almost all major organs in the body are now known to be negatively impacted often leading to severe systemic failure in some people. Unfortunately, there is currently no effective treatment for this disease. Pre-existing pathological conditions or comorbidities such as age are a major reason for premature death and increased morbidity and mortality. The immobilization due to hospitalization and bed rest and the physical inactivity due to sustained quarantine and social distancing can downregulate the ability of organs systems to resist to viral infection and increase the risk of damage to the immune, respiratory, cardiovascular, musculoskeletal systems and the brain. The cellular mechanisms and danger of this "second wave" effect of COVID-19 to the human body, along with the effects of aging, proper nutrition, and regular physical activity, are reviewed in this article.

Moderate-Intensity Walking Training Improves Depressive Symptoms and Pain in Older Adults with Good Quality of Life: A Controlled Randomized Trial

Abstract Background: Walking training can be an adequate choice to improve physical and psychological conditions in the elderly. Studies have reported positive changes in the quality of life, depressive symptoms and pain. However, baseline characteristics of volunteers have been controlled, and some of previous studies have not investigated these parameters concomitantly. Objectives: To assess the effects of moderate-intensity walking on quality of life, depressive symptoms and physical pain in physically active elderly individuals. Methods: Sixty-nine subjects were recruited and allocated into two groups: training group (n = 40) and control group (n = 29). All were evaluated for quality of life, depressive symptoms and pain. Training group underwent 40 minutes of walking (50-70% of maximum heart rate), 3 days a week for 12 weeks. For statistical analysis, we used the Kolmogorov-Smirnov test, Student's t-test and Split-Plot ANOVA with Bonferroni post hoc, Pearson correlation. Significance level was set at 5%. Results: After 12 weeks of training, depressive symptoms and physical pain significantly reduced in the training group (2.7 ± 2.4 to 1.9 ± 1.8 and 4.3 ± 3.1 to 2.8 ± 2.9, respectively) compared with baseline values, and remained unchanged in the control group. There was a positive, moderate correlation between depressive symptoms and pain (r = 0.30). Conclusion: physically active elderly individuals with good quality of life show improved depressive symptoms after a short-term moderate-intensity walking training program.

Exercício com intensidade autosselecionada para idosos: implicações do afeto em aulas comunitárias / Self-selected intensity exercise for the elderly: implications of affect in community classes

A prescrição da intensidade do exercício de forma autosselecionada em função de maior afeto positivo é uma estratégia utilizada para promover aderência da população na prática de exercícios. Entre-tanto, ainda não foram investigadas as implicações que essa estratégia pode gerar na valência afetiva de idosos em ambientes não laboratoriais e em aulas em grupos. O objetivo desse estudo foi analisar se o exercício com intensidade autosselecionada realizado em grupos de idosos pode influenciar na valência afetiva. A amostra foi composta por 176 idosos, sendo 42 homens, com média de idade 70,70 ± 10,10 anos e 134 mulheres, com média de idade 71,00 ± 6,60 anos. Os idosos vinculados a um centro comunitário reportaram a valência afetiva e percepção subjetiva de esforço após uma caminhada de 30 minutos com intensidade autosselecionada. Os participantes foram alocados em três grupos segundo os tercis de percepção subjetiva de esforço: grupo com baixa (GBPE), média (GMPE) e alta (GAPE) percepção de esforço. Foi identificado que todos grupos se diferenciam entre si na valência afetiva [c² (2) = 50,860; p < 0,05]. A magnitude das diferenças pelo tamanho de efeito foi moderada na análise global (*ES = 0,331) e entre GBPE e GAPE (ES = 0,329). Conclui-se existe uma implicação negativa na valência afetiva em exercício com autosseleção da intensidade rea-lizados por idosos em grupos comunitários, possivelmente causado por fatores psicossociais capazes de influenciar na variabilidade de respostas perceptivas

The self-selected exercise intensity prescription due to greater positive affect is a strategy used to promote adherence of the population to exercise. However, the implications that this strategy may have on the affective valence of the elderly in non-laboratory environments and in group classes have not still investigated. The purpose of this study was to analyze whether self-selected intensity exercise performed in elderly groups can influence affective valence. The sample consisted of 176 elderly, 42 men, with a mean age of 70.70 ± 10.10 years and 134 women, with a mean age of 71.00 ± 6.60 years. The elderly linked to a community center reported affective valence and rating perceived exertion after a 30-minute walk with self-selected intensity. Participants were allocated to three groups according to the terciles of rating perceived exertion: group with low (GBPE), medium (GMPE) and high (GAPE) perceived exertion. It was identified that all groups differ in affective valence [c² (2) = 50,860; p <0.05]. The magnitude of the differences by effect size was moderate in the overall analysis (*ES = 0.331) and between GBPE and GAPE (ES = 0.329). In conclusion, there is a negative implication in affective valence in self-selected exercise intensity performed by the elderly in community groups, possibly caused by psychosocial factors capable of influencing the variability of perceptual responses

Protective effects of accumulated aerobic exercise in infarcted old rats / Efeitos protetores do exercício aeróbio acumulado em ratos idosos infartados

Background: Aerobic exercise exerts cardioprotective effects on myocardial infarction. However, there is lack of information about the possible protective effects of continuous or accumulated aerobic exercise performed prior to myocardial infarction in aging. Objective: To evaluate the preventive effects of continuous or accumulated aerobic exercise on physical capacity, pulmonary congestion and ventricular weight in rats submitted to myocardial infarction. Methods: Old male Wistar rats were divided into four groups: sham control, sedentary infarcted, continuous aerobic exercise submitted to myocardial infarction, and accumulated aerobic exercise submitted to myocardial infarction. Body weight and maximum speed were evaluated at the beginning and at the end of the protocol. Trained groups performed continuous (1 h a day) or accumulated (30 minutes in the morning and 30 minutes in the afternoon) exercise. All groups, except the sham control, were submitted to myocardial infarction surgery at the end of the protocol. Heart, skeletal muscles, as well as wet and dry lung were weighed. The significance level in statistical analysis was established at p < 0.05. Results: Both continuous and accumulated exercise caused an increase in physical capacity in rats, as well as prevented its further impairment after myocardial infarction, and in the accumulated exercise group this prevention was greater. The continuous exercise group demonstrated an increase in lung water content, while the accumulated exercise group presented a reduction in body weight and an increase in left ventricle relative weight. Conclusion: In conclusion, the data of the present study indicate that accumulated aerobic exercise present a better protective effect than continuous aerobic training in the context of myocardial infarction and aging

Multicomponent exercise decreases blood pressure, heart rate and double product in normotensive and hypertensive older patients with high blood pressure / El ejercicio multicomponente disminuye los parámetros hemodinámicos en pacientes ancianos normotensos e hipertensos no controlados

Abstract Objective: The present study aimed to investigate the effects of a 6-month multicomponent exercise program on blood pressure, heart rate, and double product of uncontrolled and controlled normotensive and hypertensive older patients. Methods: The study included 183 subjects, 97 normotensives, of which 53 were controlled normotensives (CNS), and 44 uncontrolled normotensives (UNS), as well as 86 hypertensives, of which 43 were controlled hypertensives (CHS), and 43 uncontrolled hypertensives (UHS). Volunteers were recruited and blood pressure and heart rate measurements were made before and after a 6-month multicomponent exercise program. The program of physical exercise was performed twice a week for 26 weeks. The physical exercises program was based on functional and walking exercises. Exercise sessions were performed at moderate intensity. Results: The results indicated that UHS showed a marked decrease in systolic (−8.0 mmHg), diastolic (−11.1 mmHg), mean (−10.1 mmHg), and pulse pressures, heart rate (−6.8 bpm), and double product (−1640 bpm mmHg), when compared to baseline. Similarly, diastolic (−5.5 mmHg) and mean arterial (−4.8 mmHg) pressures were significantly decreased in UNS. Concomitantly, significant changes could be observed in the body mass index (−0.9 kg/m2;−1.5 kg/m2) and waist circumference (−3.3 cm; only UHS) of UNS and UHS, which may be associated with the changes observed in blood pressure. Conclusions: In conclusion, the data of the present study indicate that a 6-month multicomponent exercise program may lead to significant reductions in blood pressure, heart rate, and double product of normotensive and hypertensive patients with high blood pressure values.

Resumen Objetivo: El presente estudio tuvo como objetivo investigar los efectos de un programa de ejercicios multicomponente de 6 meses sobre la presión arterial, la frecuencia cardíaca y el doble producto de pacientes mayores hipertensos y normotensos (incontrolados y controlados). Método: 183 sujetos, 97 normotensos - 53 normotensos controlados (SNC) y 44 normotensos no controlados (SNU) - y 86 hipertensos - 43 hipertensos controlados (CHS) y 43 hipertensos no controlados (UHS) -, fueron reclutados y sometidos a evaluaciones (presión arterial y frecuencia cardíaca) antes y después de un programa de ejercicios multicomponente de 6 meses. El programa de ejercicio se realizó dos veces por semana durante 26 semanas. El programa de ejercicios físicos se basó en ejercicios funcionales y de caminar. Las sesiones de ejercicio se realizaron a intensidad moderada. Resultados: Los resultados indicaron que UHS presentó una marcada disminución en presión sistólica (−8.0 mmHg), diastólica (−11.1 mmHg), media (−10.1 mmHg) y de pulso, frecuencia cardíaca (−6.8 lpm) y doble producto (−1640 lpm mmHg) cuando se compara con la línea base. De manera similar, las presiones diastólica (−5.5 mmHg) y arterial media (−4.8 mmHg) se redu- jeron significativamente en los SNU. Concomitantemente, fue posible observar alteraciones significativas en el índice de masa corporal (−0.9 kg/m2; −1.5 kg/m2) y circunferencia de cintura (−3.3 cm, solo UHS) de UNS y UHS, lo que puede estar asociado con los cambios observados en la presión arterial. Conclusiones: En conclusión, los datos del presente estudio indican que un programa de ejercicio multicomponente de 6 meses puede provocar reducciones significativas en la presión arterial, frecuencia cardíaca y doble producto de pacientes normotensos e hipertensos con valores de presión arterial alta.

Short-term combined exercise training improves cardiorespiratory fitness and autonomic modulation in cancer patients receiving adjuvant therapy.

The present study aimed to investigate the impact of a short-term exercise training (ET) on the cardiorespiratory fitness and autonomic modulation of women with breast cancer who were receiving adjuvant radiotherapy, chemotherapy or hormonotherapy. Eighteen women previously diagnosed with breast cancer receiving adjuvant radiotherapy, chemotherapy or hormone therapy were randomly allocated into breast cancer nonexercise (BC) and exercise groups (BC+Ex). Moreover, nine healthy physically inactive volunteers were recruited to compose the noncancer control group (CG). The BC+Ex group was underwent to a combined ET program, which was based on resistance, aerobic and flexibility exercises. ET was performed 3 times a week, on nonconsecutive days, for 4 weeks at the hospital room under the professional supervision. In turn, BC and CG remained without be engaged in physical exercise programs. Volunteers were evaluated regarding their cardiorespiratory fitness and autonomic modulation (i.e., time, frequency domains, and nonlinear [symbolic analysis]) before and after the end of the ET program. A priori, data indicate that women patients with breast cancer showed impaired exercise tolerance, as well as autonomic dysfunction in comparison with age-matched healthy control subjects. However, a 1-month combined ET program could reverse such impairments, so that after the intervention, BC+Ex and CG showing similar results in the cardiorespiratory test and heart rate variability analysis. In conclusion, data of the current study indicate that 1 month of ET is able to reverse impaired cardiorespiratory fitness and autonomic modulation in women with breast cancer receiving adjuvant therapy.

Cutoff values for appendicular skeletal muscle mass and strength in relation to fear of falling among Brazilian older adults: cross-sectional study

ABSTRACT CONTEXT AND OBJECTIVE: Sarcopenia is an emerging public health issue in Brazil. Because of its high prevalence and the lack of national data, the objective here was to identify cutoff points for appendicular skeletal muscle (ASM) and handgrip strength in relation to fear of falling among Brazilian older adults. DESIGN AND SETTING: Cross-sectional study; in the community. METHODS: Participants underwent morphological and functional evaluations; and were asked about previous falls and fear of falling. Different adjustments to ASM and handgrip strength were used. Slow walking speed was defined as < 0.8 m/s or 1.0 m/s. Gender and age groups were compared using t tests, analysis of variance (ANOVA), chi-square test or Fisher's exact test. Receiver operating characteristic curves were used to identify cutoffs for ASM and handgrip strength in relation to fear of falling. RESULTS: 578 older adults participated in this study. Function levels decreased with increasing age, and body composition differed between the sexes. In relation to fear of falling, the cutoffs for ASM adjusted for body mass index (BMI) were < 0.85 for men and < 0.53 for women; the cutoffs for absolute handgrip strength and relative handgrip strength (adjusted for BMI) were 30.0 kgf and 21.7 kgf, and 1.07 and 0.66, for men and women, respectively. CONCLUSION: The values presented can be used as references in clinical practice and research. We recommend use of ASM adjusted for BMI and choosing between absolute and relative handgrip strength for men and women, according to study needs.

The importance of animal studies in exercise science

Abstract The validity and relevance of research with animals for the development of knowledge in Exercise Science have for long been discussed. Given the complexity of the biological systems, the use of animal models offers a significant contribution to uncover new findings about acute and chronic effects of exercise, particularly when these studies in humans have limitations and ethical implications. There have been notable findings using experimental animals either in basic sciences or in clinical studies involving physiology, pharmacology, genetic, biochemistry, urology, endocrinology and cancer. This article presents a brief review of scientific research using animal models with a focus on exercise training as an effective tool for the prophylaxis and treatment of different pathological processes, which are the basis of many concepts taught and used in undergraduate courses and graduate programs, as well as in new researches showed in scientific conference meetings in numerous areas of science.(AU)