Yoga implications for preventing accidental falls in older adults: a systematic review / Implicações do yoga para prevenção de quedas em idosos: uma revisão sistemática

Abstract Introduction: Studies have shown the importance of healthy habits in older adults, emphasizing physical activity or mobility for a better quality of life and to delay physical degeneration in this population. Yoga is one of several exercises recommended for therapeutic purposes to reduce the risk of falls, a common occurrence in this age group. Objective: To synthesize the existing evidence regarding the effects of yoga on quality of life and physical-functional capacity and its contribution to fall prevention in older people. Methods: This systematic review was conducted in August 2020 on the Medline/Pubmed, LILACS, SCOPUS, Web of Science and PEDro databases, with no restrictions for language or year of publication. In line with the eligibility criteria, randomized or quasi-randomized clinical trials were included. Results: A total of 1,190 articles were found, 18 of which were included for data collection. The average sample size was between 16 and 120 participants, consisting of older individuals of both sexes ranging in age from 62 to 85 years. Conclusion: Regular yoga practice has a beneficial effect on the quality of life and physical-functional capacity of older adults, thereby contributing to fall prevention. However, evidence is still limited and further studies are suggested to better elucidate the scope of the effects of yoga as a therapeutic resource.

Resumo Introdução: Estudos têm demonstrado a importância dos hábitos saudáveis em idosos, enfatizando a atividade física ou mobilidade como categoria para uma melhor qualidade de vida nas condições orgânicas e retardo da degeneração física nesse grupo populacional. Dentre diversas atividades físicas, o yoga é conhecido como um dos exercícios indicados e utilizados de forma terapêutica, que pode reduzir o risco de quedas, sendo este um evento prevalente nessa faixa etária. Objetivo: Sintetizar as evidências existentes quanto aos efeitos da prática de yoga na qualidade de vida e capacidade físico-funcional que possam contribuir para a prevenção de quedas em idosos. Métodos: Trata-se de uma revisão sistemática, cujas buscas foram realizadas em agosto de 2020 nas bases de dados Medline/Pubmed, LILACS, SCOPUS, Web of Science e PEDro, sem restrições linguísticas ou de ano de publicação. Seguindo os critérios de elegibilidade, foram incluídos estudos do tipo ensaio clínico randomizado ou quase randomizado. Resultados: Foram encontrados 1190 artigos, sendo incluídos 18 para a coleta dos dados, os quais tinham como amostra uma média de 16 a 120 participantes, sendo esses idosos de 62 a 85 anos e de ambos os sexos. Conclusão: A prática regular de yoga promove benefícios sobre a qualidade de vida e capacidade físico-funcional de idosos que contribuem para a prevenção de quedas. No entanto as evidências ainda são limitadas e sugerem-se novos estudos para melhor elucidação da abrangência dos efeitos do yoga como recurso terapêutico.

Fibroblast growth factor 19 as a countermeasure to muscle and locomotion dysfunctions in experimental cerebral palsy.

BACKGROUND: Cerebral palsy (CP) associates cerebral function damages with strong locomotor defects and premature sarcopenia. We previously showed that fibroblast growth factor 19 (FGF19) exerts hypertrophic effects on skeletal muscle and improves muscle mass and strength in mouse models with muscle atrophy. Facing the lack of therapeutics to treat locomotor dysfunctions in CP, we investigated whether FGF19 treatment could have beneficial effects in an experimental rat model of CP. METHODS: Cerebral palsy was induced in male Wistar rat pups by perinatal anoxia immediately after birth and by sensorimotor restriction of hind paws maintained until Day 28. Daily subcutaneous injections with recombinant human FGF19 (0.1 mg/kg bw) were performed from Days 22 to 28. Locomotor activity and muscle strength were assessed before and after FGF19 treatment. At Day 29, motor coordination on rotarod and various musculoskeletal parameters (weight of tibia bone and of soleus and extensor digitorum longus (EDL) muscles; area of skeletal muscle fibres) were evaluated. In addition, expression of specific genes linked to human CP was measured in rat skeletal muscles. RESULTS: Compared to controls, CP rats had reduced locomotion activity (-37.8% of distance travelled, P < 0.05), motor coordination (-88.9% latency of falls on rotarod, P < 0.05) and muscle strength (-25.1%, P < 0.05). These defects were associated with reduction in soleus (-51.5%, P < 0.05) and EDL (-42.5%, P < 0.05) weight, smaller area of muscle fibres, and with lower tibia weight (-38%, P < 0.05). In muscles from rats submitted to CP, changes in the expression levels of several genes related to muscle development and neuromuscular junctions were similar to those found in wrist muscle of children with CP (increased mRNA levels of Igfbp5, Kcnn3, Gdf8, and MyH4 and decreased expression of Myog, Ucp2 and Lpl). Compared with vehicle-treated CP rats, FGF19 administration improved locomotor activity (+53.2%, P < 0.05) and muscle strength (+25.7%, P < 0.05), and increased tibia weight (+13.8%, P < 0.05) and soleus and EDL muscle weight (+28.6% and +27.3%, respectively, P < 0.05). In addition, it reduced a number of very small fibres in both muscles (P < 0.05). Finally, gene expression analyses revealed that FGF19 might counteract the immature state of skeletal muscles induced by CP. CONCLUSIONS: These results demonstrate that pharmacological intervention with recombinant FGF19 could restore musculoskeletal and locomotor dysfunction in an experimental CP model, suggesting that FGF19 may represent a potential therapeutic strategy to combat the locomotor disorders associated with CP.