Evidence-Based Prehabilitation.

Prehabilitation is essential for optimizing post-operative outcomes. In addition to the benefits in terms of improved functional capacity, it leads to a significant reduction in medical and surgical complications, as well as shorter hospital stays. Multimodal interventions, including adapted physical activity and nutritional management, offer the most promising results. However, the diversity of protocols and the non-effectiveness of some of them highlight the importance of identifying the most interesting ones, in order to improve the effectiveness of this approach in surgery.

[Cardiac rehabilitation in adults with congenital heart diseases]. / Réadaptation cardiaque des adultes avec cardiopathies congénitales.

The great advances in the medical and surgical management of congenital heart diseases have allowed many children to reach adulthood with often a good hemodynamic result. Nevertheless most of these adults have a limitation of their functional capacity. This limitation is more or less important, penalizes them in their daily life and alters their quality of life. The origin of this limitation is generally multifactorial. It is linked, of course, to the severity of the heart disease and the quality of the operative result. But there is very often a physical deconditioning. It can be secondary to the heart disease but is often secondary to a lack of physical activity. It is the parents, sometimes overprotective, but frequently the doctors who imposed, often wrongly, this restriction. It is essential to take this dimension into account in view of the important benefits expected for health and quality of life. Cardiac rehabilitation is a privileged tool for providing advice in a suitable environment. This requires close collaboration between cardiac rehabilitators and congenital cardiologists to offer appropriate care. We bring here some reflections and the basic elements to guide the re-training of these patients.

Capacidad funcional relacionada con actividad física del adulto mayor en Tunja, Colombias / Functional capacity related to elderly physical activity in Tunja, Colombia / Capacidade funcional relacionada com a atividade física de idosos em Tunja, Colombia / Relation entre la capacité fonctionnelle et l'activité physique chez la personne âgée à Tunja, Colombie

Resumen Objetivo: Comparar la capacidad funcional a través de las medidas de evaluación, basadas en la ejecución MEBE con la realización o no de actividad física en adultos mayores de los Centros Vida de Tunja - Colombia. Materiales y métodos: Estudio cuantitativo, descriptivo, con diseño Transversal de asociación o cross sectional. Población de 1,492 adultos mayores que pertenecen al programa de adultos mayores de la Alcaldía de la Ciudad de Tunja, (Boyacá), Colombia, denominado Centros Vida, de los cuales 245 adultos son clasificados en activos y 1,247 como no activos; se obtuvo una muestra para grupos independientes de 44 adultos activos grupo A y 88 no activos grupo B. El nivel de actividad física en los dos grupos fue medido a través del PASE (The Physical Activiy Scale Elderly) y la capacidad funcional con las pruebas de Tinetti, balance estático, alcance funcional, incorporarse de una silla y velocidad de la marcha. Se realizó un análisis univariado y bivariado aplicando la prueba de Chi cuadrado de Pearson, U de Mann Whitney y cálculo de los respectivos OR con sus intervalos de confianza. Resultados: No hay relación estadísticamente significativa entre velocidad de la marcha y la realización o no de actividad física. Las pruebas de tandem, semitandem, incorporarse de una silla y el método utilizado presentó asociación con la realización o no de actividad física. Conclusiones: Las pruebas que medían el riesgo de caída y velocidad de la marcha son independientes a la práctica de actividad física, mientras que las demás variables muestran dependencia para la práctica o no de actividad física.

Abstract Objective: To compare functional capacity through functional assessment measures based on the MEBE implementation with physical activity or not in older adults in the Centros Vida de Tunja - Colombia. Materials and methods: Quantitative, descriptive study, with cross sectional design. Population of 1,492 older adults who belong to the program of sénior citizens of the City of Tunja, (Boyacá), Colombia, called Centros Vida, of which 245 adults are classified as active and 1,247 as non-active. A sample was obtained for independent groups of 44 active adults group A and 88 non-active group B. The level of physical activity in the two groups was measured through the PASE (The Physical Activity and Scale Elderly) and the functional capacity with the tests of Tinetti, static balance, functional range, incorporating a chair and speed of the march. A univariate and bivariate analysis was performed applying the Pearson Chi square test, Mann Whitney U test and calculation of the respective ORs with their confidence intervals. Results: There is no statistically significant relationship between walking speed and physical activity or not. The tests of Tandem, Semitandem, incorporate of a chair and the method used presented association with the realization or not of physical activity. Conclusions: The tests that measure the risk of fall and speed of gait are independent to the practice of physical activity while the other variables show dependence for the practice or not of physical activity.

Resumo Objetivo: Comparar a capacidade funcional através de medidas de avaliação funcional baseadas em MEBE com a realização ou não de atividade física em idosos nos Centros de Vida de Tunja - Colõmbia. Materiais e métodos: Estudo descritivo quantitativo, com um desenho de seção transversal ou transversal. População de 1492 idosos que pertencem ao programa da cidade de Tunja, (Boyacá), denominados Centros de Vida, dos quais 245 adultos são classificados como ativos e 1247 como náo ativos; foi obtida uma amostra para grupos independentes de 44 adultos ativos grupo A e de 88 para o grupo não ativo B. O nivel de atividade física nos dois grupos foi medido através de PASE (Physical Activiy Scale Elderly) e a habilidade funcional com os testes Tinetti, balado estático, faixa funcional, incorporando uma cadeira e a velocidade do passeio. Uma análise univariada e bivariada foi realizada aplicando o teste do quadrado Chi de Pearson, o teste de Mann Whitney U e calculando as respectivas ORs com seus intervalos de confiança. Resultados: Não existe uma relação estatisticamente significativa entre a velocidade de caminhada e a atividade física ou não. Os testes de Tandem, Semitandem, incorporação de uma cadeira e o método utilizado apresentam associação com a realização ou náo de atividade física. Conclusões: Os testes que medem o risco de queda e velocidade da marcha sáo independentes da prática da atividade física enquanto as outras variáveis demostram dependencia para a prática ou náo da atividade física.

Résumé Objectif: Comparer la capacité fonctionnelle de personnes agées participant au programme Centros Vida de Tunja - Colombie, au moyen de mesures d'évaluation basées sur l'exécution (MEBE), en relation avec leur niveau d'activité physique. Matériel et méthodes: Étude quantitative, descriptive et transversale. La population considérée incluait 1492 personnes agées participant au programme Centros Vida destiné aux personnes agées de la ville de Tunja (Boyacá), Colombie. 245 de ces personnes ont été classées comme actives et 1247 inactives. Un échantillon a été constitué avec deux groupes indépendants: le groupe A avec 44 personnes actives et le groupe B avec 88 personnes non actives. Le niveau d'activité physique dans les deux groupes a été mesuré avec le PASE (Physical Activity Scale Elderly) et la capacité fonctionnelle avec les tests de Tinetti, d'équilibre statique, d'extension fonctionnelle, du lever de chaise et de la vitesse de la marche. Une analyse univariée et bivariée a été effectuée en appliquant le test Chi au carré de Pearson, le test U de Mann Whitney et le calcul des OR respectifs avec leur intervalle de confiance. Résultats: Il n'a pas été trouvé de relation statistiquement significative entre la vitesse de la marche et la réalisation ou non d'activité physique. Les tests d'équilibre en tandem et semi-tandem, du lever de chaise et la méthode utilisée ont présenté une association avec la réalisation ou non d'activité physique. Conclusions: Les résultats des tests utilisés pour mesurer le risque de chute et la vitesse de la marche se sont révélés indépendants de la pratique d'activité physique, mais les autres variables sont apparues dépendantes de cette pratique.

Age, human performance, and physical employment standards.

The proportion of older workers has increased substantially in recent years, with over 25% of the Canadian labour force aged ≥55 years. Along with chronological age comes age-related declines in functional capacity associated with impairments to the cardiorespiratory and muscular systems. As a result, older workers are reported to exhibit reductions in work output and in the ability to perform and/or sustain the required effort when performing work tasks. However, research has presented some conflicting views on the consequences of aging in the workforce, as physically demanding occupations can be associated with improved or maintained physical function. Furthermore, the current methods for evaluating physical function in older workers often lack specificity and relevance to the actual work tasks, leading to an underestimation of physical capacity in the older worker. Nevertheless, industry often lacks the appropriate information and/or tools to accommodate the aging workforce, particularly in the context of physical employment standards. Ultimately, if appropriate workplace strategies and work performance standards are adopted to optimize the strengths and protect against the vulnerability of the aging workers, they can perform as effectively as their younger counterparts. Our aim in this review is to evaluate the impact of different individual (including physiological decline, chronic disease, lifestyle, and physical activity) and occupational (including shift work, sleep deprivation, and cold/heat exposure) factors on the physical decline of older workers, and therefore the risk of work-related injuries or illness.

Exercise training at the intensity of maximal fat oxidation in obese boys.

The objectives of this study were to explore the effects of 10 weeks of exercise training at the intensity of maximal fat oxidation rate (FATmax) on body composition, cardiovascular fitness, and functional capacity in 8- to 10-year-old obese boys. This is a school-based interventional study. Twenty-six obese boys and 20 lean boys were randomly allocated into the exercise and control groups. Measurements of body composition, FATmax through gas analyses, predicted maximal oxygen uptake, and functional capacity (run, jump, abdominal muscle function, and body flexibility) were conducted at baseline and at the end of experiments. Two exercise groups participated in 10 weeks of supervised exercise training at individualized FATmax intensities, for 1 h per day and 5 days per week. FATmax training decreased body mass (-1.0 kg, p < 0.05), body mass index (-1.2 kg/m(2), p < 0.01), fat mass (-1.2 kg, p < 0.01), and abdominal fat (-0.13 kg, p < 0.01) of the trained obese boys. Their cardiovascular fitness (p < 0.05) and body flexibility (p < 0.05) were also improved after training. The lean boys showed improvements in cardiovascular fitness after training (p < 0.05). FATmax training increased the FATmax in obese boys from 0.35 ± 0.12 g/min to 0.38 ± 0.13 g/min, but this change was not statistically significant. In addition, there was no change in daily energy intake for all participants before and after the experimental period. Results of this study suggest that FATmax is an effective exercise training intensity for the treatment of childhood obesity.

Sedentary time is not independently related to postural stability or leg strength in women 50-67 years old.

Most research on sedentary behaviour has focused on cardiometabolic outcomes and markers of metabolic dysfunction, while neuromuscular outcomes have received less attention. The objective of the present study was to determine whether sedentary time is negatively associated with laboratory-based measures of lower body muscular strength and postural stability in middle-aged women. Forty-nine women (56.6 ± 4.1 years) participated in the study. Participants wore an ActiGraph GT3X accelerometer for 7 days to quantify sedentary time and physical activity. Following a familiarization session, assessments of lower body muscular strength and postural stability were performed. Peak torque of knee extensors and flexors was assessed using an isokinetic dynamometer. Postural stability was assessed using computerized dynamic posturography and a composite equilibrium score (CES) was calculated. Participants spent 9.4 ± 1.3 h per day (65% of wear time) sedentary and 28.2 ± 17.3 min per day (3.3% of wear time) in moderate to vigorous physical activity (MVPA). Postural stability and relative peak torque of the knee flexors were significantly associated with time spent sedentary (r = -0.35, p = 0.01 and r = -0.31, p = 0.03, respectively). Multiple linear regression analyses showed that after adjusting for MVPA, sedentary time was not significantly related to either CES or peak torque of the knee extensors or flexors. In contrast to our hypothesis, postural stability and leg strength were not independently related to sedentary time. While sedentary behaviour may be an important risk factor for cardiometabolic disease, the present results suggest MVPA may be more important to neuromuscular outcomes.