Estimation of fat mass in Southern Brazilian female adolescents: development and validation of mathematical models / Estimativa da massa gorda em adolescentes do sexo feminino do sul do Brasil: desenvolvimento e validação de modelos matemáticos

abstract This study aimed to develop and validate the first mathematical models, based on anthropometric properties, to estimate fat mass (FM) in a heterogeneous sample of female adolescents. A cross-sectional and quantitative study conducted with 196 individuals aged 12 to 17 years from the metropolitan region of Curitiba, Paraná, Brazil. The participants were randomly divided into two groups: regression sample (n = 169) and validation sample (n = 27). Dual-energy X-ray absorptiometry (DXA) was used as the reference method to determine body fat in relative and absolute values. Stature, body mass, waist girth and triceps, subscapular, biceps, iliac crest, abdominal, front thigh and medial calf skinfold thickness were defined as independent variables and measured according to an international technical protocol. Statistical analyzes used the Ordinary Least Square (OLS) regression model, paired t test and Pearson correlation. Four multivariate mathematical models with high determination coefficients (R2 ≥90%) and low estimated standard errors (SEE = ≤2.02 kg) were developed. Model 4 stands out for its low number of independent variables and significant statistical performance (R2 = 90%; SEE = 1.92 kg). It is concluded that the four mathematical models developed are valid for estimating FM in female adolescents in southern Brazil.

resumo Este estudo teve como objetivo desenvolver e validar os primeiros modelos matemáticos, baseados em propriedades antropométricas, para estimar a massa gorda (MG) em uma amostra heterogênea de adolescentes do sexo feminino. Estudo transversal e quantitativo conduzido com 196 indivíduos de 12 a 17 anos da região metropolitana de Curitiba, Paraná, Brasil. Os participantes foram divididos aleatoriamente em dois grupos: amostra de regressão (n = 169) e amostra de validação (n = 27). A absorciometria de raios X de dupla energia (DXA) foi usada como método de referência para determinar a gordura corporal em valores relativos e absolutos. A estatura, a massa corporal, o perímetro da cintura e a espessura das dobras cutâneas do tríceps, subescapular, bíceps, crista ilíaca, abdominal, coxa anterior e panturrilha medial foram definidas como variáveis independentes e mensuradas de acordo com um protocolo técnico internacional. As análises estatísticas utilizaram modelo de regressão Ordinary Least Square (OLS), teste t pareado e correlação de Pearson. Foram desenvolvidos quatro modelos matemáticos multivariados com altos coeficientes de determinação (R2 ≥90%) e baixos erros padrão estimados (SEE = ≤2,02 kg). O modelo 4 destaca-se pelo baixo número de variáveis independentes e desempenho estatístico significativo (R2 = 90%; SEE = 1,92 kg). Conclui-se que os quatro modelos matemáticos desenvolvidos são válidos para estimar a MG em adolescentes do sexo feminino do sul do Brasil

Thermography as an aid for the complementary diagnosis of nodules in the thyroid gland.

BACKGROUND: Considering the estimate that thyroid cancer will become the fourth most prevalent type of tumor, improving its diagnosis is a necessity. The gold standard for evaluating thyroid nodules is ultrasound followed by biopsy. These tests, however, have limitations, especially in nodules smaller than 0.5 cm. Dynamic infrared thermography is an imaging method that does not require ionizing radiation or contrast injection. The aim of the study was to analyze the thermal behavior of thyroid nodules through infrared thermography using the cold stress protocol. RESULTS: The Wilcoxon test showed thermal differences between groups (control and healthy, p < 0.001). The difference in the thermal behavior of the nodular tissues was evidenced by the longitudinal analysis. When comparing the nodules, it was possible to verify that the beginnings of tissue heating is significant (p = 0.001). In addition, the variability analysis showed a "well" effect, which occurred in period t-1 (pre-cooling time) to period t = 3 (time three minutes). Benign nodules had a variation ratio of 1.81 compared to malignant nodules. CONCLUSION: Benign nodules present a different thermal behavior than malignant nodules, and both present different behavior than normal tissue. For the analysis of nodules, the protocol used with cold stress, dynamic thermography and the inclusion of time t-1 were essential for the differentiation of nodules in the thyroid gland. Therefore, we recommend the continuance of these parameters for future studies. METHODS: Thirty-three individuals with nodules in the thyroid region and nine healthy individuals participated in this descriptive exploratory study. In total, 42 nodules were evaluated, 11 malignant and 31 benign. The region of interest was exposed to cold stress for 30 s. First, the image was captured before the cold stress and subsequently, the images were assessed every 30 s, over a 10-min time period after cold stress. The perfusion and the thermal behavior of the tissues were evaluated by longitudinal analysis based on the number of pixels in each time period. The statistical tests of Wilcoxon, F-Snedecor and longitudinal models would assist in data analysis.

A century of skinfolds for body composition estimation: what we learned? / Um século das dobras cutâneas para estimativa da composição corporal: o que aprendemos?

abstract In 2021, we reached the centenary of the creation of the first body composition assessment model based on the use of skinfolds. A hundred years after Matiegka's application in 1921 to the analysis of "human efficiency", this point of view study seeks to bring reflections on the continuous applicability of the method, historical points, relevant advances, and possible projections for the future. Indeed, the comparability of skinfolds with multicompartmental reference methods shows several advantages and disadvantages; if on the one hand we have low cost, speed, and reproducibility, on the other hand we have problems associated with the quality of the equipment, the evaluator's skill and mainly the adequate choice of the predictive model. Thus, when it comes to the assessment of body composition, skinfolds are still a good option for application in different contexts by health professionals as long as the evaluator pays attention to the critical aspects that may represent sources of errors (for example, the level of training/experience, correct skinfold location). Even with the numerous advances in the area, there is solidity and continuity for the application of skinfolds for the future.

resumo No ano de 2021 chegamos ao centenário da criação do primeiro modelo de avaliação da composição corporal a partir do uso de dobras cutâneas. Passado cem anos da aplicação por Matiegka em 1921 para análise da "eficiência humana", esse estudo de ponto de vista busca trazer reflexões sobre a contínua aplicabilidade do método, pontos históricos, avanços relevantes e possíveis projeções para o futuro. De fato, a comparabilidade das dobras cutâneas com métodos de referência multicompartimanentais mostra diversas vantagens e desvantagens; se por um lado temos o baixo custo, rapidez, reprodutibilidade, por outro lado temos problemas associados a qualidade do equipamento, habilidade do avaliador e principalmente a escolha adequada do modelo preditivo. Deste modo, em se tratando de avaliação da composição corporal, as dobras cutâneas continuam sendo uma boa opção de aplicação em diferentes contextos por profissionais da saúde desde que o avaliador se atente aos aspectos críticos que podem representar fontes de erros (por exemplo o nível de treinamento/experiência, local correto da prega cutâneas). Mesmo com os inúmeros avanços da área, percebe-se uma solidez e continuidade para a aplicação das dobras cutâneas para o futuro.

Validity and accuracy of body fat prediction equations using anthropometrics measurements in adolescents.

BACKGROUND: The pediatric relative fat mass (RFM) has been recently presented and validated as an index for estimating percentage body fat (%BF) in North American children and adolescents. Similar to body mass index (BMI) and tri-ponderal mass index (TMI), RFM uses anthropometric measures (i.e., weight, height and waist circumference) to estimate body composition. The primary purpose of this study was to validate the newly developed RFM equation for %BF prediction in Southern Brazilian adolescents; as secondary objective, we compared %BF estimation from BMI- and TMI-derived equations. METHODS: A total of 631 individuals (434 boys) aged 11 to 18 were analyzed. Bland-Altman analyses were used to determine concordance between predicted equations and %BF measured by DXA; results are presented using mean difference (i.e., bias) and standard deviation. Sensitivity and specificity were calculated for %BF percentile classifications. RESULTS: RFM underestimated %BF in 65.2% of boys (- 4.3 ± 2.8%) and 84.8% of girls (- 5.3 ± 2.7%). In contrast, TMI overestimated %BF in 62.9% of boys (4.0 ± 2.9%) and 56.3% (3.5 ± 3.0%) of girls. The performance of BMI showed mixed results; %BF was overestimated in 68.4% of boys (5.0 ± 4.0%) and underestimated in 67.5% of girls (- 3.9 ± 2.6%), all p < 0.001. Although, RFM had the highest specificity for %BF percentile classifications, sensitivity was low and inferior to BMI and TMI. CONCLUSION: TMI was superior to RFM and BMI in predicting %BF in Southern Brazilian adolescents. Using RFM, BMI or TMI equations for %BF prediction without a population-specific correction factor may lead to incorrect interpretations. We suggest that correction factors should be investigated to improve the accuracy of these surrogate indices for body composition assessment. LEVEL OF EVIDENCE: Level V, cross sectional descriptive study.

Lean mass reference curves in adolescents using dual-energy x-ray absorptiometry (DXA).

The body composition phenotype of low lean mass (LM) has been associated with metabolic disorders and impaired physical functioning in the pediatric population. Abnormalities in body composition may be identified using reference curves; however, no reference data on LM is available for Brazilian adolescents. The purpose of this study was to present reference data, including percentile curves, of whole body LM, lean mass index (LMI), appendicular lean mass (ALM), and fat mass for Southern Brazilian adolescents. This was a cross-sectional study of adolescents aged 12-17 years from a southern region in Brazil, who had body composition assessed using dual energy x-ray absorptiometry (DXA). Percentile values and reference curves employing the Lambda, Mu and Sigma method (LMS) were computed for LM, LMI (lean mass/height2), ALM and fat mass. Data on 541 adolescents (68.6% boys) was included. Sex differences in growth trajectories were observed for absolute and adjusted LM, with boys presenting greater LM quantity with advancing ages than girls (66.9% and 17.4% difference between the ages of 12 and 17 for boys and girls, respectively). The values corresponding to the lowest percentile (3rd) of LMI ranged between 10.63 to 13.93 kg/m2 in boys and 11.13 to 12.03 kg/m2 among girls aged 12-17 years. This study established the first LM, LMI, and ALM reference curves in Southern Brazilian adolescents, which can potentially be used in association with functional measures to identify LM abnormalities during growth.

Thermal Asymmetries and Mean Foot Temperature.

Foot problems can cause pain and discomfort, limiting the activities of many individuals. Infrared thermography may be useful for early detection of abnormal temperatures using various ways of calculating the mean foot temperature (MFT) to analyze asymmetries and differences between different groups. The aim of this study was to compare two protocols for calculating the MFT, identifying the magnitude of asymmetries in several regions and their correlations with the forehead temperature and brain temperature tunnel(BTT).Nineteen healthy volunteers of both genders aged between 18 and 55 years participated in the study.Data collection included anamnesis, body mass measurement, stature, glycaemia, body core temperature and acquisition of thermal images of the feet and face. The Wilcoxon test revealed that the mean foot temperature calculated using hallux, 2nd, 3rd, 4th and 5th toes, 1st, 3rd and 5th metatarsal heads and heel, was lower than that calculated without the four lesser toes (Z = -2.636, p = 0.008).However, the asymmetry between the two feet was the same in both cases (medianof 0.4 °C). The correlations of the MFT with the forehead temperature and BTT were positive and significant for the two forms of calculation, and the correlation was stronger when all toes were used to calculate the mean (forehead: ρ = 0.654, p = 0.002, BTT: ρ = 0.617, p = 0.005). The study showed the relevance of the toes in the analysis of the MFT, and it may be important to evaluate asymmetries in the toes to detect abnormal thermal patterns. This finding suggests that it is preferable to use MFT calculated with all toes.

Reduction in knee pain symptoms in athletes using an acupuncture protocol / Redução da sintomatologia dolorosa de joelho em atletas utilizando protocolo de acupuntura

ABSTRACT Pain in the lower limbs is common in athletes and a limiting factor in performance. Acupuncture has shown positive effects as an analgesic treatment and may potentially be used for pain reduction in runners. This study aimed to analyze the parameters associated with knee pain by correlating strength parameters of the musculature assessed in runners treated with acupuncture. A descriptive longitudinal study was conducted on 34 runners of both sexes aged 20 to 52 years, who presented with knee-related pain from January to June, 2015. Two pain questionnaires and a maximal strength test with electromyographic evaluation of the rectus femoris, vastus lateralis, and medialis muscles were used, and patients were monitored during five follow-up visits after an acupuncture protocol. All participants reported experiencing a decrease in knee pain after treatment. The affected limbs showed an increase in average strength by 34% and 25% compared to the contralateral limb. An increase in the number of motor units recruited for the three muscles was observed in both limbs. In conclusion, the proposed acupuncture protocol was effective in reducing pain symptoms in the knee region of athletes, thus influencing their gain in strength and muscle balance. Level of Evidence IV, Case series.

RESUMO A dor em membros inferiores é comum em atletas e representa um aspecto limitante ao rendimento. Buscando atenuação para a dor desta população, utiliza-se a acupuntura por apresentar bons efeitos na analgesia. Objetivo: analisar os parâmetros relacionados à dor de joelho correlacionando os parâmetros de força das musculaturas avaliadas em corredores submetidos a tratamento de acupuntura. Métodos: Foi realizado um estudo longitudinal, de janeiro a junho de 2015, com 34 corredores de 20 a 52 anos de ambos os sexos, que apresentassem dor de joelho. Foram aplicados dois questionários de dor e um teste de força máxima com avaliação eletromiográfica dos músculos reto femoral, vasto lateral e medial, com cinco atendimentos seguindo um protocolo de acupuntura. Resultados: Todos os voluntários relataram diminuição da dor de joelho após o tratamento. A média de força do membro afetado teve incremento de 34% e do membro contralateral de 25%. Verificou-se aumento no número de recrutamento de unidades motoras para os três músculos avaliados em ambos os membros. Conclusão: O protocolo proposto se mostrou eficaz na diminuição da sintomatologia dolorosa na região de joelhos de atletas corredores, interferindo no ganho de força e no equilíbrio muscular. Nível de Evidência IV, Série de casos.

Body fat percentage in adolescents from Curitiba-PR metropolitan region: reference data using LMS method / Percentual de gordura corporal em adolescentes de Curitiba-PR e região metropolitana: dados de referência utilizando o método LMS

Abstract Percentile indicators, aided in its development by biomedical engineering, relative to body fat distribution in adolescents are able to help health professionals in better diagnosing overweight and obesity. The aim of this study was to calculate percentile values to body fat in adolescents aged between 12 and 17 years from the Curitiba-PR and its metropolitan region composed of 29 municipalities, having as reference method the dual energy x-ray absorptiometry (DXA) technology. After applying inclusion criteria for the adolescents, anthropometric measures of body fat and stature were taken, as well as evaluation of the body composition through DXA. The statistical analysis was grounded in the presentation of percentilic values developed by Cole and Green's LMS method, where L stands for the skewness curve, M for the mean curve and S for the variance curve. In total, 390 boys were evaluated. The fat percentage values tend to show a decrease between the ages of 12 (22.8±5.1%) and 16 years (17.9±2.9%). Moreover, for the superior percentiles: 90th and 97th re-start to increase at the age of 17 after showing a decrease in the previous years. The L, M and S parameters, altogether with the percentiles created to evaluate body fat are interesting tools to tendency and evolution analyses, as well as to enable inferences to be made about the body composition of adolescents.

Resumo Indicadores percentílicos referentes a distribuição da gordura corporal em adolescentes auxiliam profissionais da saúde em um melhor diagnóstico de sobrepeso e obesidade. O objetivo deste estudo foi calcular valores percentílicos para a gordura corporal de adolescentes com idades entre 12-17 anos de Curitiba-PR e região metropolitana formada ao todo por 29 municípios, tendo como método de referência a tecnologia de absorciometria de raios-X de dupla energia (DXA). Após a aplicação dos critérios de inclusão os adolescentes foram coletadas medidas antropométricas de massa corporal e estatura, além da avaliação da composição corporal com auxílio da DXA. A análise estatística teve como base a apresentação de valores percentílicos a partir do método LMS de Cole e Green, onde L representa a curva de assimetria, M a curva da média e S a curva da variação. Foram avaliados 390 meninos. Os valores de percentual de gordura tendem a apresentar um decréscimo entre as idades de 12 (22.8±5.1%) e 16 anos (17.9±2.9%). Além disso, para os percentis superiores: 90th e 97th voltam a crescer na faixa de 17 anos após redução nas idades anteriores. Os parâmetros L, M e S e os percentis criados para percentual de gordura são ferramentas interessantes para análises de tendência e evolução, bem como para que se façam inferências sobre a composição corporal de adolescentes.

Prevalence of excessive body fat among adolescents of a south Brazilian metropolitan region and State capital, associated risk factors, and consequences.

BACKGROUND: The prevalence of overweight/obesity has become a major concern for public health in developing countries. Risk factors need to be well documented so that these countries develop public policies to fight the problem. Thus, the objective of this study is to determine the prevalence of excess fat among adolescents of a South Brazilian State Capital associated with risk factors and their consequences. METHODS: This study was conducted between 2014 and 2016 with adolescents aged 11-18 years. The following body composition measurements were collected: body mass, height, waist circumference, fat mass and bone mineral density (this latter through dual energy X-ray absorptiometry). Biochemical data as glucose, total cholesterol, and triglycerides were also collected. Finally, socioeconomic questionnaires were applied, as well as questionnaires regarding: the education level of guardians, active transportation, time spent with sedentary activities and physical activities. Odds ratios and chi-square test were applied in statistical analysis. RESULTS: Data from 675 adolescents, from which 70% were males, were analyzed. The mean age was 14.7 ± 1.8 years. The prevalence of excess fat was 18.2% in boys and 92.1% in girls. As for sedentary lifestyle and physical inactivity, having one of these factors increased the risk of being overweight by 7.9 times for boys and 3.0 times for girls. In boys, there was a significant association between excess fat and waist circumference (p = 0.000; OR = 13.5; CI = 7.0-25.9), physical activity level (p = 0.000; OR = 4.0; CI = 2.5-6.5), triglycerides (p = 0.019; OR = 2.2; CI = 1.1-4.2) and total cholesterol (p = 0.000; OR = 2.6; CI = 1.6-4.5). In girls, there was an association between having excess fat and an increase in total cholesterol (p = 0.000; OR = 8.0; CI = 2.6-24.4). CONCLUSIONS: The high prevalence of excess fat was greater than what was described by some studies conducted in developed countries. This reality demonstrates the need to implement public policies that can directly promote the reduction of sedentary habits and reinforce the importance of adopting an active lifestyle.

REDUCTION IN KNEE PAIN SYMPTOMS IN ATHLETES USING AN ACUPUNCTURE PROTOCOL.

Pain in the lower limbs is common in athletes and a limiting factor in performance. Acupuncture has shown positive effects as an analgesic treatment and may potentially be used for pain reduction in runners. This study aimed to analyze the parameters associated with knee pain by correlating strength parameters of the musculature assessed in runners treated with acupuncture. A descriptive longitudinal study was conducted on 34 runners of both sexes aged 20 to 52 years, who presented with knee-related pain from January to June, 2015. Two pain questionnaires and a maximal strength test with electromyographic evaluation of the rectus femoris, vastus lateralis, and medialis muscles were used, and patients were monitored during five follow-up visits after an acupuncture protocol. All participants reported experiencing a decrease in knee pain after treatment. The affected limbs showed an increase in average strength by 34% and 25% compared to the contralateral limb. An increase in the number of motor units recruited for the three muscles was observed in both limbs. In conclusion, the proposed acupuncture protocol was effective in reducing pain symptoms in the knee region of athletes, thus influencing their gain in strength and muscle balance. Level of Evidence IV, Case series.

A dor em membros inferiores é comum em atletas e representa um aspecto limitante ao rendimento. Buscando atenuação para a dor desta população, utiliza-se a acupuntura por apresentar bons efeitos na analgesia. Objetivo: analisar os parâmetros relacionados à dor de joelho correlacionando os parâmetros de força das musculaturas avaliadas em corredores submetidos a tratamento de acupuntura. Métodos: Foi realizado um estudo longitudinal, de janeiro a junho de 2015, com 34 corredores de 20 a 52 anos de ambos os sexos, que apresentassem dor de joelho. Foram aplicados dois questionários de dor e um teste de força máxima com avaliação eletromiográfica dos músculos reto femoral, vasto lateral e medial, com cinco atendimentos seguindo um protocolo de acupuntura. Resultados: Todos os voluntários relataram diminuição da dor de joelho após o tratamento. A média de força do membro afetado teve incremento de 34% e do membro contralateral de 25%. Verificou-se aumento no número de recrutamento de unidades motoras para os três músculos avaliados em ambos os membros. Conclusão: O protocolo proposto se mostrou eficaz na diminuição da sintomatologia dolorosa na região de joelhos de atletas corredores, interferindo no ganho de força e no equilíbrio muscular. Nível de Evidência IV, Série de casos.

Development and evaluation of low-cost walker with trunk support for senior citizen.

OBJECTIVE: Develop and evaluate a low-cost walker with trunk support for senior citizens. METHOD: Two-stage descriptive study: development of a walker with trunk support and evaluation with fourth age senior citizens. RESULTS: Twenty-three fourth age senior citizens were selected. The evaluated criteria were the immediate influence of the walker on the static stabilometry with baropodometer and the evaluation of gait with accelerometers monitoring time and amplitude of the hip movement. There was a significant decrease in the body oscillation of senior citizens with the use of the developed walker, and there were changes in the joint amplitudes of the hip, but they were not significant. CONCLUSION: Using low-cost materials, it was possible to develop and equipment that met resistance and effectiveness requirements. The walker interfered in the balance of the senior citizens, reducing significantly the static body oscillation.

Ergonomic evaluation of workload by milk production - a bibliometric analysis.

INTRODUCTION AND OBJECTIVE: The purpose of this study was to select in a structured manner the relevant articles with scientific recognition, and simultaneously identify the characteristics of these publications that may scientifically enrich the theme in a portfolio of papers. The theme involves ergonomics in milk production as a criterion for evaluating and improving organizational performance in the milking sector. MATERIAL AND METHODS: The study used ProKnow-C as a theoretical instrument for intervention. RESULTS: The main results show: i) a bibliographic portfolio of 18 items aligned with the view adopted by researchers which served as a theoretical framework for this research; ii) The article entitled "Wrist positions and movements as possible risk factors during machine milking", by Marianne Stål, Gert-Åke Hansson and Ulrich Moritz in 1999 and published in the Journal of Applied Ergonomics presented the highest scientific recognition, iii) the authors highlighted in the bibliographic portfolio or in its references researching the subject are Gert-Åke Hansson, Marianne Stål and Stefan Pinzke, and iv) the International Journal of Industrial Ergonomics shows the highest number of scientific articles in the bibliographic portfolio. CONCLUSIONS: The studies selected using the methodology indicate research in ergonomics focused on the production of milk in rural areas, specifically in the milking sector, are generally related to the health and safety of the workers.

Body composition and prediction equations using skinfold thickness for body fat percentage in Southern Brazilian adolescents.

OBJECTIVES: The purpose of this study was to: a) determine the nutritional status of Brazilian adolescents, and; b) present a skinfold thickness model (ST) to estimate body fat developed with Brazilian samples, using dual energy x-ray absorptiometry (DXA) as reference method. METHODS: The main study group was composed of 374 adolescents, and further 42 adolescents for the validation group. Weight, height, waist circumference measurements, and body mass index (BMI) were collected, as well as nine ST-biceps (BI), triceps (TR), chest (CH), axillary (AX) subscapularis (SB), abdominal (AB), suprailiac (SI), medial thigh (TH), calf (CF), and fat percentage (%BF) obtained by DXA. RESULTS: The prevalence of overweight in adolescents was 20.9%, and obesity 5.8%. Regression analysis through ordinary least square method (OLS) allowed obtainment of three equations with values of R2 = 0.935, 0.912 and 0.850, standard error estimated = 1.79, 1.78 and 1.87, and bias = 0.06, 0.20 and 0.05, respectively. CONCLUSION: the innovation of this study lies in presenting new regression equations for predicting body fat in Southern Brazilian adolescents based on a representative and heterogeneous sample from DXA.

Development and evaluation of low-cost walker with trunk support for senior citizen / Desenvolvimento e avaliação de andador de baixo custo com suporte de tronco para idosos / Desarrollo y evaluación de andadores de bajo costo con soporte de tronco para ancianos

Abstract OBJECTIVE Develop and evaluate a low-cost walker with trunk support for senior citizens. METHOD Two-stage descriptive study: development of a walker with trunk support and evaluation with fourth age senior citizens. RESULTS Twenty-three fourth age senior citizens were selected. The evaluated criteria were the immediate influence of the walker on the static stabilometry with baropodometer and the evaluation of gait with accelerometers monitoring time and amplitude of the hip movement. There was a significant decrease in the body oscillation of senior citizens with the use of the developed walker, and there were changes in the joint amplitudes of the hip, but they were not significant. CONCLUSION Using low-cost materials, it was possible to develop and equipment that met resistance and effectiveness requirements. The walker interfered in the balance of the senior citizens, reducing significantly the static body oscillation.

Resumo OBJETIVO Desenvolver e avaliar um andador de baixo custo com sustentação de tronco para idosos. MÉTODO Estudo descritivo de duas fases: desenvolvimento de um andador com suporte de tronco e avaliação com idosos de quarta idade. RESULTADOS Foram selecionados 23 idosos de quarta idade. Os critérios avaliados foram a influência imediata do andador na estabilometria estática com baropodômetro e avaliação da marcha com acelerômetros monitorando tempo e amplitude de movimento de quadril. Houve diminuição significativa da oscilação corporal dos idosos com a colocação do andador desenvolvido e mudanças nas amplitudes articulares do quadril, porém estas não foram significativas. CONCLUSÃO Utilizando materiais de baixo custo, foi possível desenvolver um equipamento que atendeu aos requisitos de resistência e eficácia. O andador interferiu no equilíbrio dos idosos, diminuindo significativamente a oscilação corporal estática.

Resumen OBJETIVO Desarrollar y evaluar un andador de bajo costo con soporte de tronco para ancianos. MÉTODO Estudio descriptivo de dos fases: desarrollo de un andador con soporte de tronco y evaluación con ancianos de cuarta edad. RESULTADOS Se seleccionaron 23 ancianos de cuarta edad. Los criterios evaluados fueron la influencia inmediata del andador en la estabilometría estática con baropodómetro y evaluación de la marcha con acelerómetros monitoreando tiempo y amplitud de movimiento de cadera. Se observó una disminución significativa de la oscilación corporal de los ancianos con la colocación del andador desarrollado y cambios en las amplitudes articulares de la cadera, pero éstas no fueron significativas. CONCLUSIÓN Utilizando materiales de bajo costo, fue posible desarrollar un equipo que cumplió con los requisitos de resistencia y eficacia. El andador interfirió en el equilibrio de los ancianos, disminuyendo significativamente la oscilación corporal estática.

Portable A-Mode Ultrasound for Body Composition Assessment in Adolescents.

OBJECTIVES: Ultrasound (US) imaging is a low-cost, highly feasible alternative method for monitoring the nutritional status of a population; however, only a few studies have tested the body composition agreement between US and reference standard methods, especially in adolescents. The purposes of this study were to assess the agreement of portable US with a reference standard method, dual-energy x-ray absorptiometry (DXA), for body fat percentage (BF%) in adolescents and to verify whether the use of a new mathematical model, based on the anatomic thickness obtained by US, is capable of improving BF% prediction. METHODS: This research was a descriptive study. Measures of total body mass, BF% on DXA, and BF% on US were collected from 105 adolescents. RESULTS: The participants included 71 male adolescents (median age ± interquartile range, 14.0 ± 2.0 years) and 34 female adolescents (13.0 ± 2.3 years). Ultrasound yielded significantly lower BF% values than DXA for male (mean ± SD, US, 9.6% ± 6.6%; DXA, 20.0% ± 7.2%; R= 0.848; P< .05) and female (US, 22.5% ± 5.7%; DXA, 30.3% ± 4.9%; R = 0.495; P < .05) participants. In addition, Bland-Altman analysis showed low concordance. When a multivariate regression was tested, the results improved for both sexes (US, 20.3% ± 4.6%; R= 0.848; P= .503) and female participants (US, 29.0% ± 5.7%; R = 0.712; P = .993) with a standard estimate of error of 1.57%. CONCLUSIONS: This study has shown that US applied in a specific regression for BF% prediction in adolescents has a strong correlation with DXA as well as concordance with Bland-Altman analysis.

Mathematical model for body fat percentage of children with cerebral palsy

Abstract Introduction The aim of this study was to develop a specific mathematical model to estimate the body fat percentage (BF%) of children with cerebral palsy, based on a Brazilian population of patients with this condition. Method This is a descriptive cross-sectional study. The study included 63 Caucasian children with cerebral palsy, both males and females, aged between three and ten-years-old. Participants were assessed for functional motor impairment using the Gross Motor Function Classification System (GMFCS), dual energy x-ray absorptiometry (DXA) and skinfold thickness. Total body mass (TBM) and skinfolds thickness from: triceps (Tr), biceps (Bi), Suprailiac (Si), medium thigh (Th), abdominal (Ab), medial calf (Ca) and subscapular (Se) were collected. Fat mass (FM) was estimated by dual energy x-ray absorptiometry (gold standard). Results The model was built from multivariate linear regression; FM was set as a dependent variable and other anthropometric variables, age and sex, were set as independent variables. The final model was established as F%=((0.433xTBM + 0.063xTh + 0.167xSi - 6.768) ÷ TBM) × 100, the R2 value was 0.950, R2adjusted=0.948 and the standard error of estimate was 1.039 kg. Conclusion This method was shown to be valid to estimate body fat percentage of children with cerebral palsy. Also, the measurement of skinfolds on both sides of the body showed good results in this modelling.

Obesity Impact Evaluated from Fat Percentage in Bone Mineral Density of Male Adolescents.

OBJECTIVE: To analyze bone mineral density (BMD) values in adolescents and to assess obesity impact, measured through body fat #x2013;on this variable through the assessment by DEXA. METHODOLOGY: A total of 318 males adolescents (12-17 years) were evaluated considering weight, height, body mass index (BMI), bone mineral density (BMD), fat and lean mass. BMD was assessed for the arms, legs, hips, and lumbar regions, as well as for total amount. Stratification of the nutritional status was determined by body fat (%BF) percentage; comparison of groups was scrutinized by analysis of variance; and the association of variables was performed using Pearson's test. RESULTS: There was a progressive increase in weight, height, and BMD for all evaluated age groups following the advance of chronological age. A negative correlation was found between the %BF with BMD in all evaluated segments. Significant differences were found between the eutrophic group compared to the overweight group and the obesity group in the evaluated segments (P <0.01) noting a reduction of up to 12.92% for the lumbar region between eutrophic and obese. CONCLUSION: The results suggest that increase %BF is associated with lower BMD among male adolescents.

Portable A-Mode Ultrasound for Body Composition Assessment in Adolescents.

OBJECTIVES: Ultrasound (US) imaging is a low-cost, highly feasible alternative method for monitoring the nutritional status of a population; however, only a few studies have tested the body composition agreement between US and reference standard methods, especially in adolescents. The purposes of this study were to assess the agreement of portable US with a reference standard method, dual-energy x-ray absorptiometry (DXA), for body fat percentage (BF%) in adolescents and to verify whether the use of a new mathematical model, based on the anatomic thickness obtained by US, is capable of improving BF% prediction. METHODS: This research was a descriptive study. Measures of total body mass, BF% on DXA, and BF% on US were collected from 105 adolescents. RESULTS: The participants included 71 male adolescents (median age ・} interquartile range, 14.0 ・} 2.0 years) and 34 female adolescents (13.0 ・} 2.3 years). Ultrasound yielded significantly lower BF% values than DXA for male (mean ・} SD, US, 9.6% ・} 6.6%; DXA, 20.0% ・} 7.2%; R= 0.848; P< .05) and female (US, 22.5% ・} 5.7%; DXA, 30.3% ・} 4.9%; R = 0.495; P < .05) participants. In addition, Bland-Altman analysis showed low concordance. When a multivariate regression was tested, the results improved for both sexes (US, 20.3% ・} 4.6%; R= 0.848; P= .503) and female participants (US, 29.0% ・} 5.7%; R= 0.712; P = .993) with a standard estimate of error of 1.57%. CONCLUSIONS: This study has shown that US applied in a specific regression for BF% prediction in adolescents

Comparison between methods of assessing lumbosacral curve obtained by radiographic image.

OBJECTIVE: To investigate the correlation between different radiographic methods in the evaluation of the lumbosacral concavity. METHODS: The sample consisted of 52 individuals with ages ranging from 18 to 28 years old. The procedures related to radiographic image collection were carried out in collaboration with a diagnostic imaging center of a hospital in Curitiba, PR, Brazil. The angles of the lumbosacral concavity were evaluated by the following methods: Centroid, Cobb1L1-S1, Cobb2L1-L5, Cobb3L2-S1 Cobb4T12-S1, Posterior Tangent and Trall. RESULTS: High correlation coefficients (r ranging from 0.77 to 0.89) were found among variations of the Cobb method. Additionally, we propose a categorical classification of angle values obtained by each method. We also analyzed the influence of the level of the inflection point between the lumbar lordosis and thoracic kyphosis in determining the evaluation method to be used. The inflection point had a higher incidence in the region between the twelfth thoracic vertebra and the first lumbar vertebra (63.5%). CONCLUSION: The correlation and agreement between methods vary considerably. Moreover, the thoracolumbar inflection point should be considered when choosing the method of assessing patients.

Comparison between methods of assessing lumbosacral curve obtained by radiographic image

OBJECTIVE: To investigate the correlation between different radiographic methods in the evaluation of the lumbosacral concavity. METHODS: The sample consisted of 52 individuals with ages ranging from 18 to 28 years old. The procedures related to radiographic image collection were carried out in collaboration with a diagnostic imaging center of a hospital in Curitiba, PR, Brazil. The angles of the lumbosacral concavity were evaluated by the following methods: Centroid, Cobb1L1-S1, Cobb2L1-L5, Cobb3L2-S1 Cobb4T12-S1, Posterior Tangent and Trall. RESULTS: High correlation coefficients (r ranging from 0.77 to 0.89) were found among variations of the Cobb method. Additionally, we propose a categorical classification of angle values obtained by each method. We also analyzed the influence of the level of the inflection point between the lumbar lordosis and thoracic kyphosis in determining the evaluation method to be used. The inflection point had a higher incidence in the region between the twelfth thoracic vertebra and the first lumbar vertebra (63.5%). CONCLUSION: The correlation and agreement between methods vary considerably. Moreover, the thoracolumbar inflection point should be considered when choosing the method of assessing patients. Level of Evidence I, Diagnostic Study.