Effects of traditional concurrent training and multicomponent training composed by strength training and dance classes on functional and cognitive capacity of older adults: a study protocol / Efeitos do treinamento combinado tradicional e do treinamento multicomponente composto por treinamento de força e aulas de dança na capacidade funcional e cognitiva de idosos: protocolo de estudo

The combination of strength and aerobic training (concurrent training - TG) has been a widely used intervention for improving health outcomes. Also, dance has been well described as a great aerobic activity and can be an interesting option to compose an alternative multicomponent training pro-gram. Therefore, the aim of the present protocol study is to describe the methods that will be used in a randomized controlled trial (RCT) design to identify and compare the impacts of traditional TG composed by strength and aerobic training and a multicomponent training consisting of strength training combined with dance classes (DG) on functional and cognitive capacity and quality of life of older people. The sample of RCT will consist of men and women aged between 60 and 75 years. Both interventions will occur twice a week for 12 weeks with progressive intensity and volume. Functional capacity will be assessed by gait, balance, sitting and standing and climbing tests. Strength will be assessed through one repetition maximum test (1RM) in knee extension exercise, and handgrip using a hand dynamometer. Muscle thickness will be assessed using quadriceps ultrasound. Muscle power will be assessed in the knee extension exercise at 30 and 70% of 1RM using an encoder. Aerobic capacity will be assessed using the 6-minute walk test. Quality of life and cognitive performance will be assessed by questionnaires. Comparisons between groups over time will be carried out using Generalized Estimating Equations with a significance level of p<0.01. This protocol follows the rec-ommendations of SPIRIT-2013.

A combinação de treinamento de força e aeróbico (treinamento combinado - TC) tem sido uma interven-ção amplamente utilizada para melhorar desfechos de saúde. Além disso, a dança tem sido bem descrita na literatura como uma ótima atividade aeróbica e pode ser uma opção interessante para compor um programa alternativo de treinamento multicomponente. Portanto, o objetivo do presente protocolo de estudo é descrever os métodos que serão utilizados em um ensaio clínico randomizado (ECR) que visa identificar e comparar os impactos do TC tradicional composto por treinamento de força e aeróbico e de um treinamento multi-componente composto por treinamento de força combinado com aulas de dança sobre capacidade funcional, cognitiva e qualidade de vida de idosos. A amostra do ECR será composta por homens e mulheres com idade entre 60 e 75 anos. Ambas as intervenções ocorrerão duas vezes por semana durante 12 semanas com intensidade e volume progressivos. A capacidade funcional será avaliada por meio de testes de marcha, equilíbrio, sentar e levantar e subir escadas. A força será avaliada por meio do teste de uma repetição máxima (1RM) no exercício de extensão de joelhos e por meio do teste de preensão palmar com o dinamômetro manual. A espessura muscular será avaliada por meio de ultrassonografia do quadríceps. A potência muscular será ava-liada no exercício de extensão de joelhos a 30 e 70% de 1RM por meio de um transdutor linear de posição. A capacidade aeróbica será avaliada por meio do teste de caminhada de 6 minutos. A qualidade de vida e o desempenho cognitivo serão avaliados por meio de questionários. As comparações entre os grupos ao longo do tempo serão realizadas por meio de Equações de Estimativas Generalizadas com nível de significância p<0,01. Este protocolo segue as recomendações do SPIRIT-2013.

Cut-off score of the modified Ashworth scale corresponding to walking ability and functional mobility in individuals with chronic stroke.

PURPOSE: To determine the optimal cut-off score for the Modified Ashworth Scale (MAS) corresponding to unfavorable outcomes for mobility and walking ability. METHODS: The level of plantar flexor muscle spasticity and the 10-meter walking test (10mWT), timed up and go (TUG), and five time sit-to-stand (FTSTS) outcomes were evaluated in individuals after stroke. The correlation between MAS and the tests was investigated, and the optimal cut-off score, sensitivity, and specificity were evaluated through receiver operating characteristic (ROC) curve. RESULTS: Twenty-one participants with chronic stroke and plantar flexors spasticity (11 men; 10 women; mean age = 57.6 ± 12.5 years) participated in the study. Significant correlations between MAS and 10mWT (r= -0.45; p < 0.05), MAS and TUG (r = 0.48; p < 0.05) were found. The optimal cut-off scores were MAS > 2 for unfavorable 10mWT (sensitivity = 100%; specificity = 54.5%; ROC = 0.782) and MAS ≤ 2 for favorable TUG outcomes (sensitivity = 55.5%; specificity = 91.6%; ROC = 0.782). CONCLUSIONS: This study revealed that moderate level of plantar flexors spasticity results in the highest sensitivity to predict poor gait speed performance and the highest specificity to predict good mobility performance in individuals after stroke. These findings will help clinicians in their evidence-based decision making on the role of spasticity for mobility and walking ability.Implications for rehabilitationModerate level of spasticity (MAS <2) is the optimal cut-off score for 10mWT and TUG tests.Reducing the level of spasticity of plantar flexors below this cut-off point might be associated with an increased walking speed in this population.MAS <2 might not limit walking and mobility in individuals after stroke.Calf muscles spasticity might not compromise five time sit-to-stand (FTSTS) performances and might be related to a smaller influence on the sit to stand task.

Interindividual variability of adaptations following either traditional strength or power training combined to endurance training in older men: A secondary analysis of a randomized clinical trial.

This study aimed to investigate the interindividual responses following two different concurrent training (CT) regimens in neuromuscular, cardiorespiratory and functional outcomes of older men. Thirty-five older men (65.8 ± 3.9 years) were randomly allocated into one of two CT groups: power training (PT) + high-intensity interval training (HIIT) (n = 17); or traditional strength training (TST) + HIIT (n = 18). Maximal dynamic strength (one-repetition maximum, 1RM), rate of force development at 100 milliseconds (RDF100), countermovement jump power (CMJ), quadriceps femoris muscle thickness (QF MT), functional tests (sit-to-stand, timed-up-and-go, and stair climbing), and peak oxygen consumption (VO2peak) were assessed pre-, post-8 and post-16 weeks of training. The Chi-squared test was used for assessing differences in the prevalence of responders (Rs), non-responders (NRs), and adverse responders (ARs). Similar prevalence of individual responses (Rs, NRs and ARs) between groups were observed after intervention in almost all outcomes: 1RM; power at CMJ; QF MT, and functional tests (P > 0.05). However, a significant difference in the distribution of Rs, NRs and ARs between groups was observed in the RFD100 after 16 weeks (p = 0.003), with PT + HIIT group presenting high prevalence of Rs than TST + HIIT (100 % vs. 50 %). The inclusion of explosive-type of contractions in a concurrent training regime induces greater responsiveness in the RFD100 in older men, while no differences compared to traditional strength training are observed in maximal strength, muscle size, VO2peak, and functional performance.

Dance as an Intervention to Reduce Fall Risk in Older Adults: A Systematic Review With a Meta-Analysis.

The purpose of this study was to summarize the evidence from randomized clinical trials on the effects of dance on fall risk in older adults through a systematic review with meta-analysis. Fall risk was assessed through timed up and go, Berg Balance Scale, or one-leg stand tests. Data are presented as mean differences for timed up and go test and standardized mean differences for Berg Balance Scale and one-leg stand tests between treatments with 95% confidence intervals, and calculations were performed using random effects models. Significance was accepted when p < .05. A significant difference was found between dance interventions and the control groups in the general analysis of fall risk assessed by timed up and go (mean differences: -1.446 s; 95% confidence interval [-1.586, -1.306]; p < .001) and Berg Balance Scale and one-leg stand tests (standardized mean differences: 0.737; 95% confidence interval [0.508, 0.966]; p < .001) in favor of the intervention group. Different dance interventions decreased the fall risk in older practitioners.

Rating of Perceived Exertion as a Method to Determine Training Loads in Strength Training in Elderly Women: A Randomized Controlled Study.

Objective: The aim of this study was to compare the effects of training using loads from a repetition maximum value (%1RM) and rating of perceived exertion (RPE) in elderly women. Methods: Twenty-five elderly women (60-75 years old) were randomly assigned to a group that trained using loads determined by 1RM test (G%; n = 12) or to a group that trained using loads determined by RPE (GPE; n = 13). Elderly women trained for 12 weeks using five exercises performed with 2-3 sets of 8-15 repetitions. Loads progressed from 45% to 75% of 1RM (G%) and from 13 to 18 from Rating Perceived Exertion of Borg Scale (GPE). The outcome measures, 1RM and maximum repetitions (RMs with 70% 1RM), were assessed before, between and after training programs. Results: Increased 1RM value and RMs were observed in both groups (20-42%, p < 0.001 and 56-76%, p < 0.001, respectively, for %G; and 17-56%, p < 0.001 and 47-106%, p < 0.001, respectively, for GPE), without differences between them. Conclusions: Prescribing loads using the RPE and 1RM might be similarly effective for training elderly women in order to promote strength gains. As a practical application, RPE could be an additional method to determine training loads. In spite of the promising results of the present study, it is not possible to state that the use of RPE is effective in monitoring loads during sub maximal strength training in elderly and more research must be carried out to confirm it.

Relationship between schoolchildrens levels of physical activity, anthropometric indices and pulmonary function / Relação entre níveis de atividade física, índices antropométricos e função pulmonar de escolares

ABSTRACT Objective: To evaluate and to correlate levels of physical activity with the pulmonary function of children with and without a diagnosis of asthma. Methods: This study was conducted in two phases with schoolchildren aged between eight and 16 years old in Porto Alegre/RS. In the first phase (cross sectional), the sample was classified as asthmatic if a physician had ever diagnosed them with asthma and if they reported symptoms and treatment for the disease in the past 12 months. In the second phase (control-case), the following were measured: anthropometry, physical activity levels, time spent in front of screens, and lung function (spirometry). Data are presented in mean and standard deviation or median and interquartile interval and by absolute and relative values. Chi-square, Student's t-test or Mann-Whitney test and Spearman correlation were applied, with p<0.05 being significant. Results: 605 students participated in the study, 290 children with a clinical diagnosis of asthma and 315 classified as a control. 280 (47.3%) were male children, with an average age of 11.0±2.3 years old. The spirometric values showed differences in the classifications of airway obstruction levels between the asthma and control groups (p=0.005), as well as in the response to bronchodilator use for FEV1/FVC (p=0.023). In the correlation assessment, there was no correlation between physical activity with anthropometric values, nor with pulmonary function, pre-and post-bronchodilator. Conclusions: The study demonstrates that there is no relationship between either anthropometric values or physical activity levels with pulmonary function of asthmatic children.

RESUMO Objetivo: Avaliar e correlacionar os níveis de atividade física com a função pulmonar de crianças com e sem diagnóstico de asma. Métodos: Estudo realizado em duas fases, em escolares de oito a 16 anos de Porto Alegre (RS). Na fase I (transversal), classificaram-se como asmáticos os escolares com diagnóstico positivo de um médico alguma vez na vida, com crises e tratamento para a doença nos últimos 12 meses. Na fase II (caso controle), foram avaliados: antropometria, níveis de atividade física e tempo gasto em frente às telas e função pulmonar (espirometria). Os dados são apresentados por média e desvio padrão ou mediana e intervalo interquartil e por valores absolutos e relativos, sendo aplicados os testes χ2, t de Student ou de Mann-Whitney e correlação de Spearman, com valor de significância p<0,05. Resultados: Participaram do estudo 605 escolares, 290 crianças com diagnóstico clínico de asma e 315 classificadas como controle. Do total, 280 (47,3%) crianças eram do sexo masculino, com média de idade de 11,0±2,3 anos. Os valores espirométricos demonstraram diferenças nas classificações dos níveis de obstrução das vias aéreas entre grupos asma e controle (p=0,005), além da resposta ao uso de broncodilatador, para o volume expiratório forçado no primeiro segundo (VEF1)/capacidade vital forçada (CVF) (p=0,023). Não houve correlação entre a prática de atividades físicas e valores antropométricos, tampouco entre a função pulmonar e o pré e pós-uso de broncodilatador. Conclusões: O estudo demonstrou não existir relação entre valores antropométricos e níveis de atividade física com a função pulmonar de crianças asmáticas em idade escolar.

RELATIONSHIP BETWEEN SCHOOLCHILDREN'S LEVELS OF PHYSICAL ACTIVITY, ANTHROPOMETRIC INDICES AND PULMONARY FUNCTION.

OBJECTIVE: To evaluate and to correlate levels of physical activity with the pulmonary function of children with and without a diagnosis of asthma. METHODS: This study was conducted in two phases with schoolchildren aged between eight and 16 years old in Porto Alegre/RS. In the first phase (cross sectional), the sample was classified as asthmatic if a physician had ever diagnosed them with asthma and if they reported symptoms and treatment for the disease in the past 12 months. In the second phase (control-case), the following were measured: anthropometry, physical activity levels, time spent in front of screens, and lung function (spirometry). Data are presented in mean and standard deviation or median and interquartile interval and by absolute and relative values. Chi-square, Student's t-test or Mann-Whitney test and Spearman correlation were applied, with p<0.05 being significant. RESULTS: 605 students participated in the study, 290 children with a clinical diagnosis of asthma and 315 classified as a control. 280 (47.3%) were male children, with an average age of 11.0±2.3 years old. The spirometric values showed differences in the classifications of airway obstruction levels between the asthma and control groups (p=0.005), as well as in the response to bronchodilator use for FEV1/FVC (p=0.023). In the correlation assessment, there was no correlation between physical activity with anthropometric values, nor with pulmonary function, pre-and post-bronchodilator. CONCLUSIONS: The study demonstrates that there is no relationship between either anthropometric values or physical activity levels with pulmonary function of asthmatic children.

Differential impact of endurance, strength, or combined training on quality of life and plasma serotonin in healthy older women.

Aging is associated with a progressive decline in physical and neurophysiological functions, and some studies suggest that cerebral serotonin is decreased in older adults. These factors contribute to reduced ability to perform daily activities, influencing quality of life (QoL). Regular physical activity has demonstrated important benefits in reversing ageing effects; however, little is known whether different training protocols might induce differential effects on QoL. The aim of this study was to verify the effects of different types of training on QoL and its relation with plasma serotonin in healthy older women. Forty-eight older women were randomly assigned in four groups: Strength Training (ST), Endurance Training (ET), Combined Training (CT), and Control Group (CG) which was instructed not to engage in any physical exercise during the study time. Participants underwent 12 weeks of training twice a week. Plasma serotonin and a scoring system questionnaire SF-36 for evaluation of QoL were assessed at baseline and after the completion of training protocols. When comparing pre- and post-training periods all trained groups showed improvement in QoL, but the CT improved more domains. Plasma serotonin was significantly lower in the ST and in the CT groups in comparison with controls after the 12-week training. Significant correlations of plasma serotonin with physical functioning, role-physical, general health, vitality, and mental health were observed. CT resulted in higher amelioration in QoL, in comparison with ET or ST only. All training protocols induced significant reductions in peripheral serotonin levels, which were negatively correlated with improvements in QoL.