Developing a Multiprofessional Mobile App to Enhance Health Habits in Older Adults: User-Centered Approach.

BACKGROUND: Although comprehensive lifestyle habits are crucial for healthy aging, their adherence tends to decline as individuals grow older. Sustaining a healthy life over time poses a motivational challenge. Some digital tools, such as smartphone apps aimed at promoting healthy habits, have been used to counteract this decline. However, a more profound investigation is necessary into the diverse experiences of users, particularly when it concerns older adults or those who are unfamiliar with information and communications technologies. OBJECTIVE: We aimed to develop a mobile app focused on promoting the health of older adults based on the principles of software engineering and a user-centered design. The project respected all ethical guidelines and involved the participation of older adults at various stages of the development of the app. METHODS: This study used a mixed methods approach, combining both quantitative and qualitative methodologies for data collection. The study was conducted in Ribeirão Prêto, São Paulo, Brazil, and involved 20 older adults of both genders who were aged ≥60 years and enrolled in the Physical Education Program for the Elderly at the University of São Paulo. The research unfolded in multiple phases, encompassing the development and refinement of the app with active engagement from the participants. RESULTS: A total of 20 participants used a mobile health app with an average age of 64.8 (SD 2.7) years. Most participants had a high school education, middle-class status, and varying health literacy (mean score 73.55, SD 26.70). Overall, 90% (18/20) of the participants owned smartphones. However, 20% (4/20) of the participants faced installation challenges and 30% (6/20) struggled with web-based searches. The focus groups assessed app usability and satisfaction. Adjustments increased satisfaction scores significantly (Suitability Assessment of Materials: 34.89% to 70.65%; System Usability Scale: 71.23 to 87.14). Participant feedback emphasized font size, navigation, visual feedback, and personalization, and suggestions included health device integration, social interaction, and in-app communication support. CONCLUSIONS: This study contributes to the development of health care technologies tailored to the older adult population, considering their specific needs. It is anticipated that the resulting app will serve as a valuable tool for promoting healthy habits and enhancing the quality of life for older adults.

Fourteen weeks of multicomponent training associated with flexibility training modifies postural alignment, joint range of motion and modulates blood pressure in physically inactive older women: a randomized clinical trial.

Background: Body relaxation and pain reduction are some of the reported benefits of flexibility training (through active stretching exercises), however their effects on posture and blood circulation are uncertain. We aimed to investigate the effects of flexibility training (through active stretching exercises) in combination with multicomponent training (MT) on blood pressure (BP), and the correlation with changes in body alignment and flexibility in physically inactive women. Methods: Women aged 60-70 years were into three groups: multicomponent training group (MT), multicomponent training plus flexibility training group (FT), and control group (CG). After randomization, the resting blood pressure was measured and the participants were reallocated into subgroups according to pressure values >130/80 mmHg (This classification is according to the American Heart Association (AHA), resulting in the subgroups: flexibility training (FT); flexibility training for hypertensive patients (FTSAH); multicomponent training (MT); multicomponent training for hypertensive patients (MTSAH); control group (CG); control group of hypertensive patients (CGSAH). The interventions lasted 14 weeks. Systolic (sBP) and diastolic (dBP) BP, range of motion (flexion and extension), and postural analysis by asymmetry in the frontal plane and asymmetry in the sagittal plane, displacement and the flexibility test were collected before (Pre) and after training (Post). In total, 141 women participated in the study (without SAH: FT = 23, MT = 20, and CG = 21; with SAH: FTSAH = 28, MTSAH = 23, and CGSAH = 26). Results: Systolic blood pressure, in the pre and post moments were: FT (116 ± 6.7 vs. 114 ± 4.7); FTSAH (144 ± 16.5 vs. 121 ± 10.1); MT: (120 ± 6.8 vs. 121 ± 7.3); MTSAH: (137 ± 10.6 vs. 126 ± 13.0); CG: (122 ± 5.3 vs. 133 ± 19.2); and CGSAH: (140 ± 9.7 vs. 143 ± 26.2), presenting an F value (p-value - group x time) of 12.00 (<0.001), with improvement in the groups who trained. The diastolic blood pressure in the pre and post moments were: FT (71 ± 4.7 vs. 74 ± 6.8); FTSAH (88 ± 9.6 vs. 70 ± 12.0); MT: (74 ± 4.5 vs. 77 ± 11.7); MTSAH: (76 ± 10.4 vs. 76 ± 10.2); CG: (69 ± 7.11 vs. 82 ± 11.4); and CGSAH: (76 ± 13.4 vs. 86.6 ± 7.7), presenting an F value (p-value - group x time) of 8.00 (p < 0.001), with improvement in the groups who trained. In the Elastic Net Regression, sBP was influenced by height (ß: -0.044); hip flexion (ß: 0.071); Shoulder extension (ß: 0.104); low back flexion (ß: 0.119) and dBP (ß: 0.115). In the Elastic Net Regression, dBP was influenced by asymmetry in the sagittal plane variables (0.040); asymmetry in the frontal plane (ß: 0.007); knee flexion (ß: -0.398); BM (ß: 0.007); Shoulder flexion (ß: -0.142); Hip flexion (ß: -0.004); sBP (ß: 0.155) and Ankle Flexion (ß: -0.001). Conclusion: The displacement of the asymmetry in the frontal plane and asymmetry in the sagittal plane, and the increase in the flexion position in the hip, lumbar, head, and knee regions, influenced the highest-pressure levels. Multicomponent training associated with flexibility training promoted improvement in body alignment, COM, and joint angles, and decreased blood pressure.

Rapid kidney function decline and increased risk of heart failure in patients with type 2 diabetes: findings from the ACCORD cohort : Rapid kidney function decline and heart failure in T2D.

BACKGROUND: Impaired kidney function and albuminuria are associated with increased risk of heart failure (HF) in patients with type 2 diabetes (T2D). We investigated whether rapid kidney function decline over time is an additional determinant of increased HF risk in patients with T2D, independent of baseline kidney function, albuminuria, and other HF predictors. METHODS: Included in the study were 7,539 participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study with baseline urinary albumin-to-creatinine ratio (UACR) data, who had completed 4 years of follow-up and had ≥ 3 eGFR measurements during that period (median eGFR/year = 1.9, IQR 1.7-3.2). The association between rapid kidney function decline (eGFR loss ≥ 5 ml/min/1.73 m2/year) and odds of HF hospitalization or HF death during the first 4 years of follow-up was estimated by logistic regression. The improvement in risk discrimination provided by adding rapid kidney function decline to other HF risk factors was evaluated as the increment in the area under the Receiving Operating Characteristics curve (ROC AUC) and integrated discrimination improvement (IDI). RESULTS: Over 4 years of follow-up, 1,573 participants (20.9%) experienced rapid kidney function decline and 255 (3.4%) experienced a HF event. Rapid kidney function decline was associated with a ~ 3.2-fold increase in HF odds (3.23, 95% CI, 2.51-4.16, p < 0.0001), independent of baseline CVD history. This estimate was not attenuated by adjustment for potential confounders, including eGFR and UACR at baseline as well as at censoring (3.74; 95% CI 2.63-5.31). Adding rapid kidney function decline during follow-up to other clinical predictors (WATCH-DM score, eGFR, and UACR at study entry and end of follow-up) improved HF risk classification (ROC AUC = + 0.02, p = 0.027; relative IDI = + 38%, p < 0.0001). CONCLUSIONS: In patients with T2D, rapid kidney function decline is associated with a marked increase in HF risk, independent of starting kidney function and/or albuminuria. These findings highlight the importance of serial eGFR measurements over time to improve HF risk estimation in T2D.

Older postmenopausal women with lower lean mass have hypermethylated sites in the PI3K-Akt pathway.

Introduction: The decrease in lean mass is directly related to the loss of independence, muscle strength, and worse quality of life over the years. Although the genetic determinants of muscle mass were well recognized, recent literature has been uncovering new epigenetic factors affecting the state of muscular tissue. This study aimed to verify differences in the DNA methylation profile among Brazilian postmenopausal women aged 50-70 years according to the lean mass evaluation. Methods: A cross-sectional study comprised 40 women aged 50-70 years. After K-means cluster analysis the 40 participants were divided into two groups, the Lower Lean Mass group with 20 participants (61.1 ± 4.6 years) and the Higher Lean Mass group with 20 participants (60.7 ± 3.2 years). Lean mass was measured by dual-energy X-ray emission densitometry (DEXA). The participants' DNA was extracted using the Salting Out technique and subsequently, the Illumina 850k EPIC Infinium Methylation BeadChip was performed to obtain methylation data. Results: We obtained 1,913 differentially methylated sites (p ≤ 0.005 of ß > 5% and ß < -5%) in a total of 979 genes between groups (p ≤ 0.005; -5% > ß > 5%). In addition, the PI3K-Akt pathway had the greatest power of significance with an FDR of 4.6 × 10-3. Conclusion: Our results demonstrate a differentiation between specific sites of different genes, which have essential functions in body composition and energy metabolism, supporting future studies that aim to relate lean mass with epigenetics.

Does Multicomponent Training Improve Cognitive Function in Older Adults Without Cognitive Impairment? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVES: To carry out a systematic review and meta-analysis to verify the effects of multicomponent training on the cognitive function of older adults without cognitive impairment. DESIGN: Systematic review and meta-analysis. SETTING AND PARTICIPANTS: Adults aged 60 years and older. METHODS: The searches were accomplished through MEDLINE (via PubMed), EMBASE, Cochrane Library, Web of Science, SCOPUS, LILACS, and Google Scholar databases. We performed the searches up to November 18, 2022. The study included only randomized controlled trials and older adults without any cognitive impairment (dementia, Alzheimer's, mild cognitive impairment, neurologic diseases). Risk of Bias 2 tool and PEDro scale was performed. RESULTS: Ten randomized controlled trials were included in the systematic review, of which 6 (involving 166 participants) were compiled in the meta-analysis of random effects models. The Mini-Mental State Examination and Montreal Cognitive Assessment were used to assess global cognitive function. The Trail-Making Test (TMT) (A and B domains) was performed by 4 studies. Compared with the control group, multicomponent training increases the global cognitive function (standardized mean difference = 0.58, 95% CI: 0.34-0.81, I2 = 11%; P < .001). Regarding TMT-A and TMT-B, multicomponent training decreases the time performed in the tests (TMT-A: mean difference = -6.70, 95% CI: -10.19 to -3.21; I2 = 51%; P = .0002) (TMT-B: mean difference = -8.80, 95% CI: -17.59 to -0.01; I2 = 69%; P = .05). The PEDro scale for the studies in our review ranged from 7 to 8 (mean = 7.4 ± 0.5), meaning good methodologic quality, and most studies were judged as at least low in terms of risk of bias. CONCLUSION AND IMPLICATIONS: Multicomponent training improves cognitive function in older adults without cognitive impairment. Therefore, a possible protective effect of multicomponent training for cognitive function in older adults is suggested.

Nitrate-rich beet juice intake on cardiovascular performance in response to exercise in postmenopausal women with arterial hypertension: study protocol for a randomized controlled trial.

BACKGROUND: There is no evidence of the use of beetroot juice with a previously recommended dose of nitrate (NO3) (> 300 mg) on the cardiovascular performance during and recovery following exercise in postmenopausal women with systemic arterial hypertension (SAH). METHODS: We will investigate the effects of beetroot juice rich in NO3 acutely (800 mg) and during a week with daily doses (400 mg) on blood pressure, heart rate (HR), cardiac autonomic control, endothelial function, inflammatory, hormonal, and stress biomarkers oxidative stress and enzymes involved in nitric oxide synthesis and mitochondrial regulation, under resting conditions, as well as mediated by submaximal aerobic exercise sessions. Through a randomized, crossover, triple-blind, placebo-controlled clinical trial, 25 physically inactive women with SAH will undergo an acute and 1-week trial, each with two intervention protocols: (1) placebo and (2) beetroot, in which will ingest beet juice with or without NO3 in its composition with a 7-day washout interval. On collection days, exercise will be performed on a treadmill for 40 min at a speed corresponding to 65-70% of VO2peak. The collection of variables (cardiovascular, autonomic, and blood samples for molecular analyses) of the study will take place at rest (135 min after ingestion of the intervention), during exercise (40 min), and in the effort recovery stage (during 60 min) based on previously validated protocols. The collections were arranged so that the measurement of one variable does not interfere with the other and that they have adequate intervals between them. DISCUSSION: The results of this research may help in the real understanding of the nutritional compounds capable of generating safety to the cardiovascular system during physical exercise, especially for women who are aging and who have cardiovascular limitations (e.g., arterial hypertension) to perform physical exercise. Therefore, our results will be able to help specific nutritional recommendations to optimize cardiovascular health. TRIAL REGISTRATION: ClinicalTrials.gov NCT05384340. Registered on May 20, 2022.

Association between ACE and ACTN3 genetic polymorphisms and the effects of different physical training models on physically active women aged 50 to 75.

The aim of this study was to analyze the association between ACE (DD + ID versus II) and ACTN3 (TT + TC versus CC) polymorphisms in the response of multicomponent physical training programs and combined in the health parameters of physically active women aged 50 to 75 years. Participants were randomly divided into two groups: multi-component training and combined training. Intervention lasted 14 weeks, 180 minutes a week. Genomic DNA was extracted from blood samples and genotyping analyzes were performed by conventional and real-time PCR. Associations were observed between polymorphisms in anthropometric measurements, blood pressure, physical capacity and quality of life in both models physical training, with improvement in group II - (ACE- multicomponent training in terms of abdominal circumference and sit-to - Combined training in terms of waist circumference) and TT + TC group (ACTN3 - multicomponent training in tests of muscle strength and mental quality of life domain, and combined training in body mass index, waist circumference, diastolic blood pressure, upper limb strength and cardiorespiratory capacity). Fourteen weeks of multicomponent and combined physical training in physically active women aged 50 to 75 years resulted in greater health benefits for genotypes II (ACE) and TT + TC (ACTN3).

Bitter Orange (Citrus aurantium L.) Intake Before Submaximal Aerobic Exercise Is Safe for Cardiovascular and Autonomic Systems in Healthy Males: A Randomized Trial.

Background: There are still no studies of the cardiovascular safety of the isolated use of Citrus aurantium in aerobic submaximal exercise. Objective: To evaluate the effect of C. aurantium supplementation on the recovery of cardiorespiratory and autonomic parameters following a session of submaximal aerobic exercise. Methods: Twelve healthy male adults achieved a crossover, randomized, double-blind, and placebo-controlled trial. C. aurantium (600 mg, p-synephrine at 30% amount [180 mg]) or placebo (600 mg of starch) were ingested 90 min before evaluation in randomized days. We evaluated systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), heart rate (HR) and, HR variability indexes at Rest and during 60 min of recovery from exercise. Results: Citrus aurantium ingestion accelerated the reduction in SBP after exercise, anticipated the return of vagal modulation of the heart after exercise via the HF (ms2), pNN50 (%), and 2 UV% indices. Moreover, rushed the output of sympathetic modulation after exercise via the 0V% index. No unfavorable cardiovascular effects were achieved for HR, DBP, PP, and MAP parameters. Conclusions: Citrus aurantium was shown to be safe for the cardiovascular and autonomic systems alongside submaximal aerobic exercise in healthy males.

Taurine as a possible antiaging therapy: A controlled clinical trial on taurine antioxidant activity in women ages 55 to 70.

OBJECTIVE: Based on the antioxidant effects of taurine, which are capable of controlling oxidative stress in the aging process, the aim of this study was to investigate the effects of taurine supplementation on biomarkers of oxidative stress in women 55 to 70 y of age. METHODS: A double-blind study was conducted with 24 women (61.4 ± 4.2 y, body mass index 31.4 ± 5.1 kg/m²). The participants were randomly assigned to either a control group (GC, n = 11), supplemented with placebo (1.5 g of starch); or a taurine group (GTAU, n = 13), supplemented with taurine (1.5 g), for 16 wk. As primary outcomes, taurine and oxidative stress marker levels were determined in plasma samples. Anthropometry, functional capacity testing, and plasma mineral levels were evaluated as secondary outcomes. The evaluations were performed pre- and postintervention. Food consumption was assessed before, during, and after the intervention. The results were analyzed by two-way repeated analysis of variance measures mixed model, with the Sidak post hoc (P < 0.05). RESULTS: Taurine and superoxide dismutase (SOD, antioxidant enzyme) plasma levels were increased in the GTAU group. SOD levels also were higher than in the GC group after supplementation. Glutathione reductase levels decreased regardless of the intervention. Malondialdehyde levels increased only in the GC participants. CONCLUSION: Taurine supplementation prevented the decrease in the antioxidant enzyme SOD, suggesting taurine as a strategy to control oxidative stress during the aging process.

Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis.

Background: Although there are a considerable number of clinical studies on nitrate (NO3) rich beetroot juice (BRJ) and hypertension, it is difficult to indicate the real effects of NO3 from BRJ on the BP of hypertensive patients because there are still no estimates of the effects of NO3 derived from BRJ on the BP of hypertension patients. Objective: To clarify these effects, we developed a systematic literature review with a meta-analysis of randomized clinical trials (RCTs). Design: The searches were accomplished through EMBASE, Cochrane Library, MEDLINE, CINAHL, Web of Science, and LILACS databases. The study included single or double-blinded RCTs and participants older than 18 years with hypertension [systolic BP (SBP) > 130 mmHg and diastolic BP (DBP) > 80 mmHg]. NO3 BRJ was required to be consumed in a format that possibly blinded participants/researchers. These studies should also report the SBP and DBP values (mmHg) measured before and after the treatment. Risk of Bias tools and GRADE were enforced. Results: Seven studies were included (218 participants). BRJ intervention time ranged from 3 to 60 days with daily dosages of 70-250 mL of BRJ. After the intervention with NO3 from BRJ, SBP underwent significant changes (p < 0.001) of -4.95 (95% CI: -8.88; -1.01) (GRADE: ⊕⊕⊕○ Moderate), but not for DBP (p = 0.06) -0.90 mmHg (95% CI: -3.16; 1.36) (GRADE: ⊕⊕⊕○ Moderate), compared to the control group. Conclusions: The NO3 derived from BRJ reduces SBP, but not DBP in patients with arterial hypertension. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269339.

Analytical and toxicological aspects of dithiocarbamates: an overview of the last 10 years.

Compilation studies related to toxicological aspects and also biological monitoring and analysis methods for specific fungicides and, mainly, those that belong to the class of the dithiocarbamates (DTCs) have not been carried out at least in the last ten years. DTCs - dimethyldithiocarbamates, ethylenebisditiocarbamates, propylenebisditiocarbamates - are organosulfur compounds that form complexes due to the presence of different chemical elements, which bind strongly and inhibit enzymes that are essential to the functioning of the organism, causing a serious proven adverse effect on biological systems, such as alteration of thyroid hormones, teratogenesis and neurotoxicity. It is still evident, as shown by world data, that the growing consumption of fungicides has increasingly exposed the population in general and, in particular, workers who deal with these substances. There is a scarcity of studies in the literature discussing the toxicological and analytical aspects that are important for understanding the real effects of DTCs and monitoring human exposure to them. Therefore, the aim of this work was to expose, in a comprehensive way and through a narrative review, gaps in research related to the fungicides of the DTCs class, their metabolites, as well as the toxicological and analytical aspects involved. The review is divided into two parts: (1) Toxicological aspects, including toxicokinetics, toxicodynamics and toxidromes; and (2) Analytical Toxicology, which comprises biomarkers, sample preparation and identification/quantification methods.

Caffeine intake and its influences on heart rate variability recovery in healthy active adults after exercise: A systematic review and meta-analysis.

AIMS: Results regarding the effects of caffeine (CAF) intake on the autonomic control of heart rate recovery exercise remain inconclusive. Thus far, no study has used effect measures to pool the results of different experiments. We aim to assess the acute effect of CAF intake before exercise on the recovery of heart rate variability (HRV) after exercise through a systematic review and meta-analysis. DATA SYNTHESIS: Randomized controlled clinical trials were included; sample composed of physically active or trained adults; CAF should be offered/ingested before exercise, with dosage between 100 and 400 mg or between 2 and 6 mg/kg and administration/ingestion route analogous in the protocols; studies required to present results of HRV indices before and after exercise. Bias risk analysis and meta-analysis were performed. Twelve studies were included in the qualitative synthesis and five studies were encompassed in the quantitative synthesis (meta-analysis). For the Root-mean-square standard deviation (RMSSD) index we revealed p = 0.67, Total 95% confidence interval (95% CI) ranged from -0.45 to 0.29, and 66.7% for heterogeneity between groups were reported. Concerning the High Frequency (HF) index, we observed p = 0.22, Total 95% CI that ranged from -0.34 to 0.30, and 44% for heterogeneity between groups. CONCLUSIONS: CAF intake did not affect heart rate variability recovery after exercise.

Effects of Combined Versus Multicomponent Training in Physically Active Women Aged 50-75 Years.

Purpose: This study aimed to compare the effects of combined training (CT) and multicomponent training (MT) on different health parameters in physically active women aged between 50 and 75 years. Method: The participants were randomly divided into two training groups (CT and MT), lasting 180 min per week, for 14 consecutive weeks of training with the level of physical activity, anthropometric measurements, blood pressure, strength, cardiorespiratory skills, coordination, flexibility, agility, and quality of life. Results: Participants who underwent CT and MT training showed positive responses regarding the assessment of body mass, waist circumference, lower limb resistance and strength, upper limb strength, and mental domain related to the quality of life. However, only participants undergoing CT were able to increase agility and cardiorespiratory capacities. Conclusion: 14 weeks of CT were more efficient to improve physical capacities in physically active women aged between 50 and 75 years when compared to MT.

Periodized combined training in physically active overweight women over 50 years

Abstract Aim: This quasi-experimental study, analyzes if periodized combined training's influence on plasma cytokine levels, muscle strength, and cardiorespiratory fitness in physically active women with overweight and/or obesity over 50 years. Methods: The sample was composed of 33 physically active women who were randomly allocated to three groups: Non-Periodized (NP) (n = 11); Undulating Periodization (UP) (n = 9); and Flexible Undulating Periodization (FUP) (n = 13). This study was conducted for 17 weeks, which included adaptation (weeks 1-3), baseline testing (week 4), training program (weeks 5-16), and post-evaluation (week 17). The training frequency comprised of three weekly sessions, with 30 min of aerobic exercise and 45 min of strength exercises. The data were analyzed using descriptive statistics and analysis of variance. The level of significance was p ≤ 0.05. Results: No differences were observed in weight parameters, plasma levels of cytokines, and biochemical parameters in any group, before and after the completion of the training period. Participants demonstrated increase in strength of the upper limbs in the UP (p = 0.032) and FUP (p = 0.021) groups, an increase in aerobic fitness in the NP (p = 0.041) and UP (p = 0.005) groups, and an increase in the amount of time of vigorous activity per week in the NP group (p = 0.019). Conclusion: This study shows that periodized combined training in physically active women with overweight and/or obesity over 50 years proved to be beneficial for all groups; although, the UP group exhibited better performance.

The Impact of ACTN3 Gene Polymorphisms on Susceptibility to Exercise-Induced Muscle Damage and Changes in Running Economy Following Downhill Running.

This study aimed to investigate if ACTN3 gene polymorphism impacts the susceptibility to exercise-induced muscle damage (EIMD) and changes in running economy (RE) following downhill running. Thirty-five healthy men were allocated to the two groups based on their ACTN3 gene variants: RR and X allele carriers. Neuromuscular function [knee extensor isometric peak torque (IPT), rate of torque development (RTD), and countermovement, and squat jump height], indirect markers of EIMD [muscle soreness, mid-thigh circumference, knee joint range of motion, and serum creatine kinase (CK) activity], and RE (oxygen uptake, minute ventilation, blood lactate concentration, and perceived exertion) for 5-min of running at a speed equivalent to 80% of individual maximal oxygen uptake speed were assessed before, immediately after, and 1-4 days after a 30-min downhill run (-15%). Neuromuscular function was compromised (P < 0.05) following downhill running with no differences between the groups, except for IPT, which was more affected in the RR individuals compared with the X allele carriers immediately (-24.9 ± 6.9% vs. -16.3 ± 6.5%, respectively) and 4 days (-16.6 ± 14.9% vs. -4.2 ± 9.5%, respectively) post-downhill running. EIMD manifested similarly for both the groups except for serum CK activity, which was greater for RR (398 ± 120 and 452 ± 126 U L-1 at 2 and 4 days following downhill running, respectively) compared with the X allele carriers (273 ± 121 and 352 ± 114 U L-1 at the same time points). RE was compromised following downhill running (16.7 ± 8.3% and 11 ± 7.5% increases in oxygen uptake immediately following downhill running for the RR and X allele carriers, respectively) with no difference between the groups. We conclude that although RR individuals appear to be more susceptible to EIMD following downhill running, this does not extend to the changes in RE.

Effect of Flexibility Training Associated with Multicomponent Training on Posture and Quality of Movement in Physically Inactive Older Women: A Randomized Study.

BACKGROUND: Multicomponent training has considerable adherence among older populations, but there is a lack of literature on the benefits of this training on older people's posture. Literature also lacks stretching protocols that work the body in an integrated/unified way and respect the principle of individuality in exercise training. We evaluated the effect of a multicomponent training protocol combined or not with flexibility training in improving the posture and quality of movement in physically inactive older women, according to a score lower than 9.11 in the Modified Baecke Questionnaire for the Elderly (MBQE). METHODS: 142 participants were evaluated and randomized in three training groups: multicomponent training (MT = 52), multicomponent and flexibility training (MFT = 43), and a control group (CG = 47). We evaluated joint amplitude using goniometry, flexibility with sit and reach and hands behind the back tests, quality of movement with the functional movement screen, and posture using biophotogammetry. RESULTS: The MFT group had 15 parameters-flexibility and posture-with a very large effect size (ES > 1.30) and nine with average ES (0.50-0.79). MT presented two variables with large ES (0.80-1.25) and seven with average ES. CG presented three variables with high ES and five with average ES. Both interventions improved the quality of movement. CONCLUSIONS: These results demonstrate that 14 weeks of multicomponent and flexibility training in a group intervention can improve flexibility and posture levels in physically inactive older women.

Quality of Movement Is Associated With Cognitive Function in Physically Inactive Older Women.

The relationship between the quality of movement, considering different global and universal basic patterns of movement and cognition domains in older adults remain unclear. The current study explored this association in physically inactive older women. In total, 187 participants, aged 60-70 years (mean = 64.9, SD = 6.9 years), were recruited from a physical education program in a public university. The older adults performed the following tests: Functional Movement Screen, Montreal Cognitive Assessment, and Modified Baecke Questionnaire for the Older Adults. The regression analysis showed an association between age (ß = -0.11, 95% confidence interval, CI, [-0.10, 0.30], p = .03); visuospatial abilities (ß = 0.36, 95% CI [0.24, 1.23], p < .001); language (ß = 0.23, 95% CI [0.20, 1.08], p < .001); and orientation domains (ß = 0.13, 95% CI [0.11, 1.22], p = .016) of the Montreal Cognitive Assessment and the Functional Movement Screen. The quality of movement was related to both age and cognitive performance, such as the visuospatial abilities, language, and orientation domains, in physically inactive older women.

Effect of Combined Training on Muscle Co-Activation and Functional Capacity in Older Women: a Pilot Study / Efeito do Treinamento Combinado na Coativação Muscular e Capacidade Funcional em Mulheres Idosas: um Estudo Piloto

Aging is characterized by morphological and functional declines, including impairment in muscle performance and functional capacity. Herein, changes were investigated in strength promoted by combined training and its effects on muscle co-activation in older women. After tree-week adaptation period, thirteen healthy older women (60.2 ± 6.2 years) underwent a 12-week training program, three sessions a week, one hour per session, divided into 30 minutes of aerobic exercise on a treadmill or cycle ergometer and 30 minutes of strength training. Muscle strength tests and cardiopulmonary fitness assessment were performed before and after the intervention. The results herein showed improvements in strength, functional capacity, and lower limb muscle activation, but no differences in muscle co-activation. In conclusion, the data of this study suggest that 12weeks of combined training exercise may not be effective in inducing muscle co-activation but may help prevent or mitigate the decline in muscle performance and functional capacity in the older population. (AU)

O envelhecimento é caracterizado por declínios morfológicos e funcionais, incluindo prejuízo no desempenho muscular e capacidade funcional. Aqui, investigamos as mudanças na força promovidas pelo treinamento combinado e seus efeitos na coativação muscular em mulheres idosas. Após três semanas de adaptação, treze idosas saudáveis (60,2 ± 6,2 anos) realizaram um programa de treinamento por 12 semanas, três sessões semanais, uma hora por sessão, divididas em 30 minutos de exercício aeróbio em esteira ou cicloergômetro e 30 minutos de treinamento de força. Testes de força muscular e avaliação da aptidão cardiopulmonar foram realizados antes e após à intervenção. Nossos resultados mostraram melhorias na força, capacidade funcional e ativação muscular dos membros inferiores, mas nenhuma diferença na coativação muscular. Em conclusão, nossos dados sugerem que 12 semanas de exercícios de treinamento combinado podem não ser eficazes na indução da coativação muscular, mas podem ajudar a prevenir ou diminuir o declínio muscular e a melhora da capacidade funcional na população idosa. (AU)

Does bariatric surgery improve cardiac autonomic modulation assessed by heart rate variability? A systematic review.

Our study aimed to explore the influence of bariatric surgery (BS) on heart rate (HR) variability (HRV) through a systematic review. Manuscripts were selected based on electronic searches of the MEDLINE, EMBASE, and CINAHL databases from the inception of each database up to year 2020, and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Searching of these studies was systematized using the Population Intervention Comparison Outcome Study Design strategy. We selected randomized and nonrandomized controlled trials and cohorts from prospective studies that reported the influence of BS on HRV. We assessed the quality rating using the Black and Downs questionnaire. Following the screening and eligibility stages, 14 studies were included in the review. All studies agreed that BS promotes an increase in parasympathetic HR control and HRV and a decrease in HR. Yet the literature does not provide evidence that these outcomes are directly caused by the surgical procedure. There is limited evidence to support that patients with type 2 diabetes have greater improvement in HRV as an interim measure, to individuals without. The decrease in insulin resistance was correlated with the increase in HRV in some studies, but, other studies are unsupportive of this outcome. Improvements in 2 metabolic parameters (e.g., leptin, N-terminal pro B-type natriuretic peptide) were connected with superior increases in HRV. This review demonstrated that BS promotes an increase in HRV, indicating improved autonomic control of HR.

NOS3 Polymorphisms Can Influence the Effect of Multicomponent Training on Blood Pressure, Nitrite Concentration and Physical Fitness in Prehypertensive and Hypertensive Older Adult Women.

Associations of endothelial nitric oxide synthase (NOS3) polymorphisms with hypertension and response to exercise training in prehypertensive and hypertensive older adult women remain unclear. This study used a multicomponent program (various capacities and motor skills) in the physical training intervention. It analyzed the influence of NOS3 polymorphisms [-786T > C, 894G > T (Glu298Asp), and intron 4b/a] on the response of blood pressure (BP), nitrite concentration, and physical fitness in older adult women. Fifty-two participants aged between 50 and 80 underwent body mass index, BP, 6-min walk, elbow flexion, and sit and stand-up tests to assess physical fitness. The intervention duration was 12 weeks, twice a week, on non-consecutive days. Each session lasted 90 min, maintaining an intensity between 13 (moderate) and 15 (intense), controlled by the Subjective Effort Perception Scale. Plasma/blood samples were collected to assess nitrite concentration and genotyping. The statistical analysis included Fisher's exact test and linear mixed-effects models. The multicomponent training's positive effect was observed with a similar response in both prehypertensive and hypertensive groups. However, carriers of different genotypes demonstrated different responses to training: the decreases in systolic and diastolic BP and increases in nitrite expected from the physical training were smaller in variant genotype than ancestral genotype carriers, especially in the hypertensive group. At positions -786T > C and Glu298Asp, only the ancestral genotypes showed a decrease in diastolic BP (Δ% = -8.1, and Δ% = -6.5, respectively) and an increase on nitrite (Δ% = 19.1, and Δ% = 24.1, respectively) in the hypertensive group. Our results show that the benefits of a multicomponent training intervention seem to be genotype-dependent. It should be possible to consider genetic variants when selecting an exercise treatment intervention.