Are bioelectrical parameters and functionality associated with postural control in the elderly?

BACKGROUND: Alterations in bioimpedance parameters and postural control occur with aging and contribute to the increased risk of falls. The aim of this study was to evaluate the balance behavior in relation to bioimpedance and functionality. METHODS: We evaluated 21 elderly (men: 77.3 ± 9.5 years; women: 74.2 ± 9.6 years). The balance in standing posture was measured by the movement of the pressure center in seven positions. Bioimpedance was defined by its parameters resistance, reactance and phase angle, and functionality through the Timed Up and Go Test and Short Physical Performance Battery. FINDINGS: In the analysis of the mediolateral velocity at the positions feet separated with open and closed eyes, feet together with eyes closed and semi-tandem with eyes open on the platform, an inverse correlation between balance and bioimpedance variables were verified for all models, with a coefficient of determination varying between 20% and 74%. Inverse and significant correlations between reactance and phase angle in the one-legged-support position were verified, in all adjustment models, with coefficient of determination varying between 62% and 91%. In the analysis of mediolateral velocity for the semi-tandem eyes closed position, positive correlation with TUG and an inverse correlation with bioimpedance parameters and pennation angle were observed, with coefficient of determination varying between 21% and 67%. INTERPRETATION: The postural control is linearly related to bioimpedance parameters and functionality in the elderly. The assessment of balance can provide important information and furnishes useful insights for prevention and treatment strategies in elderly.

Relation between high leisure-time sedentary behavior and low functionality in older adults / Relação entre alto comportamento sedentário no lazer e baixa funcionalidade de idosos

Abstract Sedentary behavior refers to activities with low energy expenditure, usually performed in sitting or lying positions, and includes behavior belonging to the current lifestyle, such as watching television. In the course of aging, this activity is performed for longer periods by individuals on a daily basis. This is worrying, since aging associated with sedentary behavior accentuates functionality decline. The aim of this study was to analyze the relationship between high leisure-time sedentary behavior and low functionality in older adults. The sample consisted of 375 older adults aged 60-97 years (70 ± 7 years), and of these, 114 (30%) were men and 261 (70%) women. Functionality was assessed by two functional tests and information related to sedentary behavior was obtained using the self-reported physical activity questionnaire proposed by Baecke et al. The chi-square test was used to verify the association between sedentary behavior and functionality, and binary logistic regression analysis was used to build the multiple model. Older individuals with high leisure-time sedentary behavior were more likely to have low functionality [OR 2.57; 95% CI 1.40 to 4.71] and [OR 2.35; 95% CI 1.29 to 4.29] regardless of gender, age, smoking, osteoporosis, arthritis / osteoarthritis, low back pain and physical activity. Extended permanence in sedentary behavior was associated with low functionality in older subjects. Preventive measures to stimulate the practice of physical activities and encourage the reduction of time spent in sedentary activities such as watching television should be adopted by health professionals in an attempt to maintain functionality among older adults.

Resumo O comportamento sedentário refere-se à realização de atividades, que tem baixo gasto energético, realizadas nas posições sentadas ou deitadas, e abrange comportamentos pertencentes ao estilo de vida atual, como por exemplo, ver televisão. Com o decorrer do envelhecimento essa atividade é executada por períodos mais prolongados pelos indivíduos diariamente. Isso é preocupante, uma vez que, o envelhecimento associado ao comportamento sedentário acentua o declínio da funcionalidade. O objetivo do presente estudo foi analisar a relação entre alto comportamento sedentário no lazer e baixa funcionalidade de idosos. A amostra foi composta por 375 idosos com idade entre 60 e 97 anos (70±7anos), e desses 114 (30%) eram homens e 261 (70%) mulheres. A funcionalidade foi avaliada por meio de dois testes funcionais e as informações referentes ao comportamento sedentário foram levantadas utilizando-se de questionário de atividade física autorreferido, proposto por Baecke et al. Foi empregado o teste qui-quadrado para verificar a associação entre comportamento sedentário e funcionalidade, e análise de regressão logística binária para construção de modelo múltiplo. Idosos com alto comportamento sedentário no lazer tiveram maior chance de apresentarem baixa funcionalidade [OR:2,57; IC95% 1,40-4,71] e [OR:2,35; IC95% 1,29-4,29] independente de sexo, grupo etário, fumo, osteoporose, artrite/artrose, lombalgia e atividade física. A permanência prolongada em comportamento sedentário foi associada à baixa funcionalidade de idosos. Medidas preventivas como, estimular a prática de atividades físicas e incentivar a redução do tempo despendido em atividades sedentárias, como assistir televisão, devem ser adotadas pelos profissionais da saúde para tentar manter a funcionalidade de idosos.

Is dynamometry able to infer the risk of muscle mass loss in patients with COPD?

INTRODUCTION: Sarcopenia is characterized by a progressive and generalized decrease of strength and muscle mass. Muscle mass loss is prevalent in patients with chronic obstructive pulmonary disease (COPD) as a result of both the disease and aging. Some methods have been proposed to assess body composition (and therefore identify muscle mass loss) in this population. Despite the high accuracy of some methods, they require sophisticated and costly equipment. AIM: The purpose of this study was to infer the occurrence of muscle mass loss measured by a sophisticated method (dual energy X-ray absorptiometry [DEXA]) using a more simple and affordable equipment (dynamometer). METHODS: Fifty-seven stable subjects with COPD were evaluated for anthropometric characteristics, lung function, functional exercise capacity, body composition, and peripheral muscle strength. A binary logistic regression model verified whether knee-extension strength (measured by dynamometry) could infer muscle mass loss (from DEXA). RESULTS: Patients with decreased knee-extension strength were 5.93 times more likely to have muscle mass loss, regardless of sex, disease stage, and functional exercise capacity (P=0.045). CONCLUSION: Knee-extension dynamometry was able to infer muscle mass loss in patients with COPD.

The effects of elastic tubing-based resistance training compared with conventional resistance training in patients with moderate chronic obstructive pulmonary disease: a randomized clinical trial.

OBJECTIVE: To investigate the effects of elastic tubing training compared with conventional resistance training on the improvement of functional exercise capacity, muscle strength, fat-free mass, and systemic inflammation in patients with chronic obstructive pulmonary disease. DESIGN: A prospective, randomized, eight-week clinical trial. SETTING: The study was conducted in a university-based, outpatient, physical therapy clinic. SUBJECTS: A total of 49 patients with moderate chronic obstructive pulmonary disease. INTERVENTIONS: Participants were randomly assigned to perform elastic tubing training or conventional resistance training three times per week for eight weeks. MAIN MEASURES: The primary outcome measure was functional exercise capacity. The secondary outcome measures were peripheral muscle strength, health-related quality of life assessed by the Chronic Respiratory Disease Questionnaire (CRDQ), fat-free mass, and cytokine profile. RESULTS: After eight weeks, the mean distance covered during six minutes increased by 73 meters (±69) in the elastic tubing group and by 42 meters (±59) in the conventional group (p < 0.05). The muscle strength and quality of life improved in both groups (P < 0.05), with no significant differences between the groups. There was a trend toward an improved fat-free mass in both groups (P = 0.05). After the first and last sessions, there was an increase in interleukin 1ß (IL-1ß) and interleukin 10 (IL-10) in both groups, while tumour necrosis factor alpha (TNF-α) was stimulated only in the conventional training group. CONCLUSION: Elastic tubing training had a greater effect on functional exercise capacity than conventional resistance training. Both interventions were equally effective in improving muscle strength and quality of life.

Effects of cigarette smoking intensity on the mucociliary clearance of active smokers.

BACKGROUND: Smoking impairs mucociliary clearance and increases respiratory infection frequency and severity in subjects with and without smoking-related chronic lung diseases. OBJECTIVE: This study evaluated the effects of smoking intensity on mucociliary clearance in active smokers. METHODS: Seventy-five active smokers were grouped into light (1-10 cigarettes/day; n = 14), moderate (11-20 cigarettes/day; n = 34) and heavy smokers (≥21 cigarettes/day; n = 27) before starting a smoking cessation programme. Smoking behaviour, nicotine dependence, pulmonary function, carbon monoxide in exhaled air (exCO), carboxyhaemoglobin (COHb) and mucociliary clearance measured by the saccharin transit time (STT) test were all evaluated. An age-matched non-smoker group (n = 24) was assessed using the same tests. RESULTS: Moderate (49 ± 7 years) and heavy smokers (46 ± 8 years) had higher STT (p = 0.0001), exCO (p < 0.0001) and COHb (p < 0.0001) levels compared with light smokers (51 ± 15 years) and non-smokers (50 ± 11 years). A positive correlation was observed between STT and exCO (r = 0.4; p < 0.0001), STT and cigarettes/day (r = 0.3, p = 0.02) and exCO and cigarettes/day (r = 0.3, p < 0.01). CONCLUSION: Smoking impairs mucociliary clearance and is associated with cigarette smoking intensity.