Greater muscle strength is associated with better hemodynamic parameters, physical, cognitive and kidney function in older nursing-home residents / Maior força muscular está associada a melhores parâmetros hemodinâmicos, função física, cognitiva e renal em idosos residentes em casas de repouso

Objective: To analyze hemodynamic parameters, kidney and cognitive function, and physical performance of institutionalized older adults with high- and low-strength. Method: Cross-sectional study. Twenty-one older adults (11 women, 10 men) participated in this study. Blood samples were collected for analysis of biochemical parameters. Cognitive function was evaluated using the mini-mental state examination (MMSE), clock drawing test (CDT), and verbal fluency test, while physical performance was assessed using the Short Physical Performance Battery (SPPB) and, blood pressure, heart rate, and Framingham Risk Score were evaluated. Result: Based on the median value, participants were divided into low-strength (81.63 ± 3.03 years) and high-strength (82.10 ± 2.11 years). The high-strength group showed significantly lower systolic (138.8 ± 3.6 vs. 116.5 ± 3.1; p<0.05), diastolic (84.9 ± 2.14 vs. 72.9 ± 2.2; p<0.05), mean blood pressure (102.2 ± 2.4 vs. 87.4 ± 2.4; p<0.05), and cardiovascular risk (39.7 ± 4.6 vs. 26.0 ± 3.5; p<0.05) than the low-strength group. In addition, the high-strength group had better HDL-c levels (27.4 ± 1.7 vs. 35.6 ± 3.4; p<0.05), higher estimated glomerular filtration rate (51.5 ± 4.9 vs. 86.2 ± 5.5; p<0.05), and lower creatinine (0.94 ± 0.1 vs 0.57 ± 0.1; p<0.05) than the low-strength group. For cognitive data (MMSE and CDT p<0.05) and physical performance (semi-tandem, tandem and walking speed p<0.05), the high-strength group had better scores compared to the low-strength group. Conclusion: Institutionalized older adults with high-strength has better hemodynamic parameters, physical performance, kidney and cognitive function than those with low-strength levels

Objetivo: Analisar os parâmetros hemodinâmicos, a função física, cognitiva e renal de idosos institucionalizados com alta e baixa força. Método: Estudo transversal. Vinte e um idosos (11 mulheres, 10 homens) participaram do estudo. Foram coletadas amostras de sangue para análise de parâmetros bioquímicos. A função cognitiva foi avaliada por meio do miniexame do estado mental (MEEM), do teste de desenho do relógio (TDR) e do teste de fluência verbal, enquanto o desempenho físico foi avaliado por meio da Short Physical Performance Battery (SPPB) e foram aferidas a pressão arterial, a frequência cardíaca e o escore de risco de Framingham. Resultado: Com base no valor da mediana, os participantes foram divididos em baixa força (81,63 ± 3,03 anos) e alta força (82,10 ± 2,11 anos). O grupo de alta força apresentou pressão arterial sistólica (138,8 ± 3,6 vs. 116,5 ± 3,1; p<0,05), diastólica (84,9 ± 2,14 vs. 72,9 ± 2,2; p<0,05), média (102,2 ± 2,4 vs. 87,4 ± 2,4; p<0,05) e risco cardiovascular (39,7 ± 4,6 vs. 26,0 ± 3,5; p<0,05) significativamente menores do que o grupo de baixa força. Além disso, o grupo de alta força apresentou melhores níveis de HDL-c (27,4 ± 1,7 vs. 35,6 ± 3,4; p<0,05), maior taxa de filtração glomerular estimada (51,5 ± 4,9 vs. 86,2 ± 5,5; p<0,05) e menor creatinina (0,94 ± 0,1 vs. 0,57 ± 0,1; p<0,05) do que o grupo de baixa força. Em relação aos dados cognitivos (MEEM e TDR, p<0,05) e ao desempenho físico (semi-tandem, tandem e velocidade de caminhada, p<0,05), o grupo de alta força apresentou melhores escores em comparação com o grupo de baixa força. Conclusão: Os idosos institucionalizados com altos níveis de força têm melhores parâmetros hemodinâmicos, desempenho físico, função renal e cognitiva do que aqueles com baixos níveis de força.PALAVRAS-CHAVEAvaliação GeriátricaCardiovascularDesempenho CognitivoFunção RenalForça Muscular

Muscle power-related parameters in middle-aged and older Brazilian women: a cross-sectional study.

The present study was conducted to provide normative values for lower-limb muscle power estimated through equations based on the 5 times sit-to-stand (5STS) test in Brazilian older women. In addition, we investigated the association between muscle power parameters and age. The study followed a cross-sectional design. Participants were community-dwelling women. Candidates were considered eligible if they were 18 years or older, lived independently, and possessed sufficient physical and cognitive abilities to perform all measurements required by the protocol. The 5STS test was performed as fast as possible using a standard protocol. Absolute, relative, and allometric muscle power measures were estimated using 5STS-based equations. Two thousand four-hundred seventy-one women participated in the present study. Results indicated that muscle power-related parameters decreased linearly with age. Women 60-69 years showed a marginal reduction in absolute (- 5.2%), relative (- 7.9%), and allometric (- 4.0%) muscle power. A larger reduction was observed in those 70-79 years and reached » of loss in participants ≥ 80, in comparison to middle-aged participants. Pearson's correlation and linear regression analyses indicated that power-related parameters were negatively associated with age. In conclusion, data of the present study provide normative values for lower-limb muscle power parameters according to 5STS-based equations. We observed that muscle power-related parameters declined with age, such that participants 60-69, 70-79, and ≥ 80 years displayed lower absolute and relative muscle power compared middle-aged women. A later decline was observed in allometric muscle power. Relative muscle power declined to a greater extent than other parameters, suggesting a possible window of opportunity for interventions.

Age- and sex-specific normative values for muscle mass parameters in 18,625 Brazilian adults.

Background: The present study aimed to provide age- and sex-specific normative values for muscle mass parameters in Brazilian adults. Methods: Data pertaining to Brazilian adults (18+ years) who attended a nutritional clinical between January 2018 and July 2022 were analyzed. Muscle mass parameters were assessed using a bioimpedance digital scale (InBody 230, GBC BioMed NZ). Assessments were conducted under standard conditions, with participants refraining from physical exercise for 96 h and from eating or drinking (including water) for 8 h before evaluations. Results: A total of 18,625 Brazilian adults were analyzed. Normative values for absolute and relative (height, m2) muscle mass and appendicular muscle mass (ASM) were calculated. In addition, specific age-related changes in muscle mass parameters were observed. In women, muscle mass peaked between the ages of 40-49 before gradually declining at an average rate of 5.7% per decade from the sixth decade of life onwards. ASM reached its peak earlier, during the third decade of life, and started to decline later, from 50 to 59 years. In contrast, absolute and ASM peaked at 40-49 years and declined from the sixth decade of life in men. Both sexes displayed a slightly greater decline in ASM than in muscle mass (13 vs. 12%). Conclusions: The present study provides normative values for absolute and relative muscle mass and ASM in Brazilian adults. Furthermore, important specific age-related changes in muscle mass parameters were observed. These data have public health implications and might serve as a reference tool to guide health professionals.

Resistance Training Combined With Cognitive Training Increases Brain Derived Neurotrophic Factor and Improves Cognitive Function in Healthy Older Adults.

Background: The present study compared the effects of a traditional resistance training (TRT) and resistance training combined with cognitive task (RT + CT) on body composition, physical performance, cognitive function, and plasma brain-derived neurotrophic factor (BNDF) levels in older adults. Methods: Thirty community-dwelling older adults were randomized into TRT (70.0 ± 8.1; 25% men) and RT + CT (66.3 ± 4.6; 31% men). Exercise groups performed a similar resistance training (RT) program, twice a week over 16 weeks. Cognitive Training involved performing verbal fluency simultaneously with RT. Exercise sessions (eight resistance exercises) were performed 2-3 sets, 8-15 repetitions at 60%-70% of 1-repetition maximum (1RM). Body composition, physical function, cognitive performance, and BDNF levels were assessed before and after intervention period. Results: The physical performance was similarly improved in response to both TRT and RT + CT (p = 0.001). However, exclusive improvements on cognitive function (p < 0.001) and BDNF levels (p = 0.001) were observed only after RT + CT. Conclusion: The RT program associated with a cognitive task, improved physical and cognitive performance in healthy older adults.

Cardiovascular Autonomic Responses to Aerobic, Resistance and Combined Exercises in Resistance Hypertensive Patients.

Here, we report the acute effects of aerobic (AER), resistance (RES), and combined (COM) exercises on blood pressure, central blood pressure and augmentation index, hemodynamic parameters, and autonomic modulation of resistant (RH) and nonresistant hypertensive (NON-RH) subjects. Twenty participants (10 RH and 10 NON-RH) performed three exercise sessions (i.e., AER, RES, and COM) and a control session. Hemodynamic (Finometer®, Beatscope), office blood pressure (BP), and autonomic variables (accessed through spectral analysis of the pulse-to-pulse BP signal, in the time and frequency domain-Fast Fourrier Transform) were assessed before (T0), one-hour (T1), and twenty-four (T2) hours after each experimental session. There were no changes in office BP, pulse wave behavior, and hemodynamic parameters after (T0 and T1) exercise sessions. However, AER and COM exercises significantly reduced sympathetic modulation in RH patients. It is worth mentioning that more significant changes in sympathetic modulation were observed after AER as compared to COM exercise. These findings suggest that office blood pressure, arterial stiffness, and hemodynamic parameters returned to baseline levels in the first hour and remained stable in the 24 hours after the all-exercise sessions. Notably, our findings bring new light to the effects of exercise on RH, indicating that RH patients show different autonomic responses to exercise compared to NON-RH patients. This trial is registered with trial registration number NCT02987452.

Effects of Low-Speed and High-Speed Resistance Training Programs on Frailty Status, Physical Performance, Cognitive Function, and Blood Pressure in Prefrail and Frail Older Adults.

Aim: The current study investigated the effects of low-speed resistance training (LSRT) and high-speed resistance training (HSRT) on frailty status, physical performance, cognitive function and blood pressure in pre-frail and frail older people. Material and Methods: Sixty older adults, 32 prefrail and 28 frail, were randomly allocated into LSRT, HSRT, and control group (CG). Before and after intervention periods frailty status, blood pressure, heart rate, and a set of physical performance capabilities and cognitive domains were assessed. Exercise interventions occurred over 16 weeks and included four resistance exercises with 4-8 sets of 4-10 repetitions at moderate intensity. Results: The prevalence of frailty criteria in prefrail and frail older adults were reduced after both LSRT and HSRT. In prefrail, LSRT significantly improved lower-limb muscle strength, while mobility was only improved after HSRT. Muscle power and dual-task performance were significantly increased in both LSRT and HSRT. In frail, LSRT and HSRT similarly improved lower-limb muscle strength and power. However, exclusive improvements in dual-task were observed after LSRT. Memory was significantly increased in prefrail and frail, regardless of the type of resistance training. No significant changes were observed in blood pressure and heart rate. Conclusion: Findings of the present study indicated that both LSRT and HSRT reversed frailty status and improved physical performance in prefrail and frail older adults. Notably, different patterns of improvement were observed among RT protocols. Regarding frailty status, LSRT seemed to be more effective in reverse prefrailty and frailty when compared to HSRT. Greater improvements in muscle strength and power were also observed after LSRT, while HSRT produced superior increases in mobility and dual-task performance. One-leg stand performance was significantly reduced in LSRT, but not HSRT and CG, after 16 weeks. In contrast, RT programs similarly improved verbal memory in prefrail. Finally, no changes in blood pressure and heart rate were observed, regardless of the type of RT. Trial Registration: The protocol was approved by the University of Campinas Human Research Ethics Committee (Protocol No. 20021919.7.0000.5404) and retrospectively registered at ClinicalTrials.gov Protocol Registration and Results System: NCT04868071.

Combined Aerobic and Resistance Exercises Evokes Longer Reductions on Ambulatory Blood Pressure in Resistant Hypertension: A Randomized Crossover Trial.

AIM: The present study compared the acute effects of aerobic (AER), resistance (RES), and combined (COM) exercises on blood pressure (BP) levels in people with resistant hypertension (RH) and nonresistant hypertension (NON-RH). METHODS: Twenty patients (10 RH and 10 NON-RH) were recruited and randomly performed three exercise sessions and a control session. Ambulatory BP was monitored over 24 hours after each experimental session. RESULTS: Significant reductions on ambulatory BP were found in people with RH after AER, RES, and COM sessions. Notably, ambulatory BP was reduced during awake-time and night-time periods after COM. On the other hand, the effects of AER were more prominent during awake periods, while RES caused greater reductions during the night-time period. In NON-RH, only RES acutely reduced systolic BP, while diastolic BP was reduced after all exercise sessions. However, the longest postexercise ambulatory hypotension was observed after AER (~11 h) in comparison to RES (~8 h) and COM (~4 h) exercises. CONCLUSION: Findings of the present study indicate that AER, RES, and COM exercises elicit systolic and diastolic postexercise ambulatory hypotension in RH patients. Notably, longer hypotension periods were observed after COM exercise. In addition, NON-RH and RH people showed different changes on BP after exercise sessions, suggesting that postexercise hypotension is influenced by the pathophysiological bases of hypertension.

Effects of Combined Resistance and Power Training on Cognitive Function in Older Women: A Randomized Controlled Trial.

The present study compared the effects of traditional resistance training (TRT) and combined power training (PT) and TRT (PTRT) on cognitive parameters and serum brain-derived neurotrophic factor (BDNF) levels in non-demented, well-functioning, community-dwelling older women. Forty-five older women were randomized into one of three experimental groups: TRT, PTRT, and control group (CG). Cognitive tests explored global cognitive function, short-term memory, and dual-task performance. Serum BDNF levels were assessed at baseline and after the intervention. Exercise sessions were performed twice a week over 22 weeks. In TRT, exercise sessions were based on three sets of 8-10 repetitions at "difficult" intensity. In PTRT, the first session was based on PT (three sets of 8-10 repetitions at "moderate" intensity), while the second session was similar to the TRT. Our analyses indicated that overall cognitive function, short-term memory, and dual-task performance were similarly improved after TRT and PTRT. Serum BDNF concentrations were not altered by any training protocol. In conclusion, the two RT programs tested in the present trial improved global cognitive function, short-term memory and dual task performance in non-demented, well-functioning, community-dwelling older women. In addition, our findings suggest that mechanisms other than BDNF may be associated with such improvements.

Dynamic Resistance Training Improves Cardiac Autonomic Modulation and Oxidative Stress Parameters in Chronic Stroke Survivors: A Randomized Controlled Trial.

Stroke survivors are at substantial risk of recurrent cerebrovascular event or cardiovascular disease. Exercise training offers nonpharmacological treatment for these subjects; however, the execution of the traditional exercise protocols and adherence is constantly pointed out as obstacles. Based on these premises, the present study investigated the impact of an 8-week dynamic resistance training protocol with elastic bands on functional, hemodynamic, and cardiac autonomic modulation, oxidative stress markers, and plasma nitrite concentration in stroke survivors. Twenty-two patients with stroke were randomized into control group (CG, n = 11) or training group (TG, n = 11). Cardiac autonomic modulation, oxidative stress markers, plasma nitrite concentration, physical function and hemodynamic parameters were evaluated before and after 8 weeks. Results indicated that functional parameters (standing up from the sitting position (P = 0.011) and timed up and go (P = 0.042)) were significantly improved in TG. Although not statistically different, both systolic blood pressure (Δ = -10.41 mmHg) and diastolic blood pressure (Δ = -8.16 mmHg) were reduced in TG when compared to CG. Additionally, cardiac autonomic modulation (sympathovagal balance-LF/HF ratio) and superoxide dismutase were improved, while thiobarbituric acid reactive substances and carbonyl levels were reduced in TG when compared to the CG subjects. In conclusion, our findings support the hypothesis that dynamic resistance training with elastic bands may improve physical function, hemodynamic parameters, autonomic modulation, and oxidative stress markers in stroke survivors. These positive changes would be associated with a reduced risk of a recurrent stroke or cardiac event in these subjects.

Moderate-Intensity Walking Training Improves Depressive Symptoms and Pain in Older Adults with Good Quality of Life: A Controlled Randomized Trial

Abstract Background: Walking training can be an adequate choice to improve physical and psychological conditions in the elderly. Studies have reported positive changes in the quality of life, depressive symptoms and pain. However, baseline characteristics of volunteers have been controlled, and some of previous studies have not investigated these parameters concomitantly. Objectives: To assess the effects of moderate-intensity walking on quality of life, depressive symptoms and physical pain in physically active elderly individuals. Methods: Sixty-nine subjects were recruited and allocated into two groups: training group (n = 40) and control group (n = 29). All were evaluated for quality of life, depressive symptoms and pain. Training group underwent 40 minutes of walking (50-70% of maximum heart rate), 3 days a week for 12 weeks. For statistical analysis, we used the Kolmogorov-Smirnov test, Student's t-test and Split-Plot ANOVA with Bonferroni post hoc, Pearson correlation. Significance level was set at 5%. Results: After 12 weeks of training, depressive symptoms and physical pain significantly reduced in the training group (2.7 ± 2.4 to 1.9 ± 1.8 and 4.3 ± 3.1 to 2.8 ± 2.9, respectively) compared with baseline values, and remained unchanged in the control group. There was a positive, moderate correlation between depressive symptoms and pain (r = 0.30). Conclusion: physically active elderly individuals with good quality of life show improved depressive symptoms after a short-term moderate-intensity walking training program.

Exercício com intensidade autosselecionada para idosos: implicações do afeto em aulas comunitárias / Self-selected intensity exercise for the elderly: implications of affect in community classes

A prescrição da intensidade do exercício de forma autosselecionada em função de maior afeto positivo é uma estratégia utilizada para promover aderência da população na prática de exercícios. Entre-tanto, ainda não foram investigadas as implicações que essa estratégia pode gerar na valência afetiva de idosos em ambientes não laboratoriais e em aulas em grupos. O objetivo desse estudo foi analisar se o exercício com intensidade autosselecionada realizado em grupos de idosos pode influenciar na valência afetiva. A amostra foi composta por 176 idosos, sendo 42 homens, com média de idade 70,70 ± 10,10 anos e 134 mulheres, com média de idade 71,00 ± 6,60 anos. Os idosos vinculados a um centro comunitário reportaram a valência afetiva e percepção subjetiva de esforço após uma caminhada de 30 minutos com intensidade autosselecionada. Os participantes foram alocados em três grupos segundo os tercis de percepção subjetiva de esforço: grupo com baixa (GBPE), média (GMPE) e alta (GAPE) percepção de esforço. Foi identificado que todos grupos se diferenciam entre si na valência afetiva [c² (2) = 50,860; p < 0,05]. A magnitude das diferenças pelo tamanho de efeito foi moderada na análise global (*ES = 0,331) e entre GBPE e GAPE (ES = 0,329). Conclui-se existe uma implicação negativa na valência afetiva em exercício com autosseleção da intensidade rea-lizados por idosos em grupos comunitários, possivelmente causado por fatores psicossociais capazes de influenciar na variabilidade de respostas perceptivas

The self-selected exercise intensity prescription due to greater positive affect is a strategy used to promote adherence of the population to exercise. However, the implications that this strategy may have on the affective valence of the elderly in non-laboratory environments and in group classes have not still investigated. The purpose of this study was to analyze whether self-selected intensity exercise performed in elderly groups can influence affective valence. The sample consisted of 176 elderly, 42 men, with a mean age of 70.70 ± 10.10 years and 134 women, with a mean age of 71.00 ± 6.60 years. The elderly linked to a community center reported affective valence and rating perceived exertion after a 30-minute walk with self-selected intensity. Participants were allocated to three groups according to the terciles of rating perceived exertion: group with low (GBPE), medium (GMPE) and high (GAPE) perceived exertion. It was identified that all groups differ in affective valence [c² (2) = 50,860; p <0.05]. The magnitude of the differences by effect size was moderate in the overall analysis (*ES = 0.331) and between GBPE and GAPE (ES = 0.329). In conclusion, there is a negative implication in affective valence in self-selected exercise intensity performed by the elderly in community groups, possibly caused by psychosocial factors capable of influencing the variability of perceptual responses

Impact of Moderate Aerobic Training on Physical Capacities of Hypertensive Obese Elderly.

The association of old age and chronic conditions, such as hypertension and obesity, can lead to larger decreases in the physical capacities of elderly, compared with their healthy counterparts. Physical exercise has been demonstrated to be efficient in postponing this phenomenon, mainly strength training. However, little is known about the effect of aerobic training on this condition. The aim of this work was to investigate the impact of 12 weeks of moderate-intensity aerobic training on the physical capacities of hypertensive obese older women. Aerobic power, lower limb muscle power, upper limb muscle strength, endurance, and flexibility of 19 hypertensive obese elders were evaluated. Afterward, patients were blindly randomized into control group (CG) and exercise group (EG). EG underwent three sessions/week of 60 min of moderate-intensity aerobic training, during 12 weeks. EG showed increases in VO2max compared with CG (p = .03) and increases in flexibility compared with basal moment (+21.6%; p = .01) after 12 weeks, whereas CG did not show any significant alterations. Moderate aerobic training is capable of inducing increases in maximal aerobic power and flexibility in hypertensive obese elderly. However, other essential physical capacities associated with independence in elderly people (i.e., muscle power and strength) were not responsive to this kind of protocol.

Multicomponent Exercise on Physical Function, Cognition and Hemodynamic Parameters of Community-Dwelling Older Adults: A Quasi-Experimental Study.

This paper reports on a quasi-experimental study that aimed to identify changes in muscle function (i.e., mobility, maximal walking speed, lower limb muscle strength, balance, and transfer capacity), cognition (i.e., executive function) and hemodynamic parameters of community-dwelling Brazilian older adults during a six-month multicomponent exercise program (MCEP). A total of 436 community-dwelling older adults performed functional, cognitive and hemodynamic assessments before and after a six-month MCEP. The program of exercise was performed twice a week over 26 weeks at moderate intensity. Results indicate that balance, mobility (i.e., usual and maximal walking speeds) and transfer capacity (p < 0.05) were significantly improved after the MCEP. Moreover, all hemodynamic parameters (i.e., systolic, diastolic and mean arterial pressures), except for heart rate (p > 0.05), were significantly reduced after the intervention. The current findings indicate that a six-month MCEP may provide physical and hemodynamic benefits in community-dwelling older adults. Nevertheless, our findings need to be confirmed in larger samples and better designed studies.

Correction to: Effects of Carbohydrate Mouth Rinse on Cycling Time Trial Performance: A Systematic Review and Meta-Analysis.

Section 3.2, Fig. 2: The wording on the x-axis which previously read.

Sarcopenia-related parameters in adults with Down syndrome: A cross-sectional exploratory study.

BACKGROUND: People with Down syndrome (DS) experience premature aging. Whether this accelerated aging also involves early declines in muscle mass, strength and physical performance is presently unclear. The present study investigated the prevalence of sarcopenia parameters in adults with DS. In addition, the relationship between well-established muscle mass indexes and a set of body composition, functional, biological, and clinical parameters was explored. METHODS: One hundred-five adults with DS participated in the study. Demographic, clinical, anthropometric, and functional parameters were assessed. Lean body mass (LBM) was estimated using bioelectrical impedance analysis. Bone mineral density (BMD) of the hip and the spine was measured through dual X-ray absorptiometry. For the analysis, participants were categorized into two subgroups (i.e., low and high) for each LBM-related measurement (i.e., crude LBM, LBM to body mass index ratio, and skeletal muscle index) according to their median values. RESULTS: The mean age of participants was 38.4 ±â€¯12.1 years, with 43 men (41%). Muscle mass, handgrip strength, and gait speed were lower than established cutoffs for sarcopenia. All muscle mass indexes were negatively correlated with age. However, only crude LBM and the skeletal muscle index were correlated with a set of anthropometric parameters and BMD. CONCLUSION: Findings from this exploratory study indicate that adults with DS show muscle mass indexes and physical performance levels similar to or lower than older adults with sarcopenia. The assessment of muscle mass and functional status should therefore be included in the routine evaluation of this population starting at young age.

Effects of Carbohydrate Mouth Rinse on Cycling Time Trial Performance: A Systematic Review and Meta-Analysis.

BACKGROUND: Despite the growing number of studies reporting carbohydrate mouth rinse effects on endurance performance, no systematic and meta-analysis review has been conducted to elucidate the level of evidence of carbohydrate mouth rinse effects on cycling trial performance such as time-, work-, and distance-based trials. OBJECTIVES: The objective of this study were to establish the effect of a carbohydrate mouth rinse on cycling performance outcomes such as mean power output and time to complete a trial, together with the risk of bias in the cycling-carbohydrate mouth rinse literature. METHODS: We systematically reviewed randomized placebo-controlled trials that assessed carbohydrate mouth rinse effects on mean power output and time to complete the trial. A random-effects meta-analysis assessed the standardized mean difference between carbohydrate and placebo mouth rinses. RESULTS: Thirteen studies (16 trials) were qualitatively (systematic review) and quantitatively (meta-analysis) analyzed with regard to mean power output (n = 175) and time to complete the trial (n = 151). Overall, the reviewed studies showed a low risk of bias and homogeneous results for mean power output (I2 = 0%) and time to complete the trial (I2 = 0%). When compared with placebo, the carbohydrate mouth rinse improved mean power output (standardized mean difference = 0.25; 95% confidence interval 0.04-0.46; p = 0.02), but not the time to complete the trial (standardized mean difference = - 0.13; 95% confidence interval - 0.36 to 0.10; p = 0.25). CONCLUSION: The present systematic and meta-analytic review supports the notion that a carbohydrate mouth rinse has the potential to increase mean power output in cycling trials, despite showing no superiority over placebo in improving time to complete the trials.

Identification of muscle fatigue by tracking facial expressions.

Resistance training (RT) is performed at distinct levels of intensity from the beginning to the end of exercise sets, increasing the sensation of effort as the exercise progress to more vigorous levels, commonly leading to changes on the facial expression of RT practitioners. The objective of this study is to evaluate changes in facial expressions using the Facial Action Coding System(FACS) and the activation of facial muscles by surface electromyography(sEMG) at two different levels of effort during resistance exercise and to investigate the correlation between facial expression and exercise intensity and fatigue. Eleven healthy male participants [23±6years; 1.77±6 m; 78±10kg] performed a set of arm curl exercise at 50% and 85% 1RM until muscle fatigue. The Surface electromyography (sEMG activity was recorded simultaneously in areas of the epicranius muscle (EM) and zygomatic major muscle (ZM). Facial expression was recorded and blindly scored by five experienced examiners. Scores (0-5) were based on the level of activity of the ZM (lip corner puller-Action Unit 12-FACS) during exercise. Facial expression and sEMG data were obtained during the exercise at the first repetition and at muscle failure. The root mean square (RMS) of the sEMG amplitude of the EM was significantly increased between the first and last repetition (50%1RM:p = 0.002,d = 1.75; and 85%1RM:p = 0.002,d = 1.54). The RMS values for the ZM were significantly increased between the first and last repetition (50%1RM:p<0.001,d = 2.67; 85%1RM:p<0.001,d = 0.50). The RMS values for the ZM were also increased in 85%1RM compared to values obtained from 50%1RM (p = 0.001,d = 1.12) at the first repetition. AU12 scores and RMS values were not statistically different between 85%1RM and 50%1RM at the last repetition. Furthermore, there was a strong correlation (r = 0.61;p = 0.045) between AU12 scores and the sEMG peak for the ZM. In conclusion, changes in facial expression may be directly correlated with different resistance exercise intensities and fatigue.

Moderate Aerobic Training Decreases Blood Pressure but No Other Cardiovascular Risk Factors in Hypertensive Overweight/Obese Elderly Patients.

Hypertension and obesity are prevalent diseases in elderly people, and their combination can cause deleterious effects on physiological system. Moderate intensity aerobic training (MIAT) seems to be a beneficial approach to control and treat these diseases separately. However, few studies have investigated the impact of MIAT on cardiovascular risk factors associated with these conditions (i.e., elevated blood pressure values, blood markers, and body composition). Therefore, the present study was designed to investigate the effects of MIAT on blood pressure, blood markers, and body composition in hypertensive overweight/obese elderly patients. Twenty-four hypertensive overweight/obese elderly patients were randomized into control group (CG) and training group (TG), submitted to 12 weeks of MIAT of 50 min, 3 days per week, at 60% of maximal HR (heart rate). There was a decrease in diastolic blood pressure (-10.1 ± 3.3; p = .01; effect size = 1.29) and mean arterial pressure (MAP; -8.2 ± 3.7; p = .04; effect size = 0.94) following 12 weeks of training in the TG as compared with baseline. There was an increase in triacylglycerol levels in the TG (+0.1 ± 0.0; p = .02). There were no significant changes in body composition for both groups. The present study revealed that 12 weeks of MIAT can decrease blood pressure in hypertensive obese elderly patients, with no significant modifications in blood markers and body composition.

Relative Protein Intake and Physical Function in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies.

(1) Background: The present work aims to conduct a systematic review and meta-analysis of observational studies, in order to investigate the association of relative protein intake and physical function in older adults; (2) Methods: Observational studies, that investigated the association between protein intake and physical function in older adults, were retrieved from MEDLINE, SCOPUS, CINAHL, AgeLine, EMBASE, and Cochrane-CENTRAL. Two independent researchers conducted study selection and data extraction; (3) Results: Very high protein intake (≥1.2 g/kg/day) and high protein intake (≥1.0 g/kg/day) groups showed better lower limb physical functioning and walking speed (WS) performance, respectively, in comparison to individuals who present relative low protein (<0.80 g/kg/day) intake. On the other hand, relative high protein intake does not seem to propitiate a better performance on isometric handgrip (IHG) and chair rise in comparison to relative low protein intake. In addition, there were no significant differences in the physical functioning of high and middle protein intake groups; (4) Conclusions: In conclusion, findings of the present study indicate that a very high (≥1.2 g/kg/day) and high protein intake (≥1.0 g/kg/day) are associated with better lower-limb physical performance, when compared to low protein (<0.80 g/kg/day) intake, in community-dwelling older adults. These findings act as additional evidence regarding the potential need to increase protein guidelines to above the current recommendations. However, large randomized clinical trials are needed to confirm the addictive effects of high-protein diets (≥1.0 g/kg/day) in comparison to the current recommendations on physical functioning. All data are available in the Open ScienceFramework.

Low Protein Intake Is Associated with Frailty in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies.

(1) Background: Several factors have been suggested to be associated with the physiopathology of frailty in older adults, and nutrition (especially protein intake) has been attributed fundamental importance in this context. The objective of this study was to conduct a systematic review and meta-analysis to investigate the relationship between protein intake and frailty status in older adults. (2) Methods: A search of scientific studies was conducted in the main databases (Medline, Scopus, Cochrane library), and in the reference lists of selected articles. The search terms included synonyms and Medical Subject Headings and involved the use of Boolean operators which allowed the combination of words and search terms. Observational studies-cross-sectional and longitudinal-that met the eligibility criteria were included in the review. Article selection and data extraction were performed by two independent reviewers. Meta-analyses with random effects were performed. Publication bias was measured using the Strengthening the Reporting of Observational Studies in Epidemiology instrument. (3) Results: In the final sample, 10 articles, seven cross-sectional and three longitudinal, were included in the present study. Overall, studies investigated a total of 50,284 older adults from three different continents between 2006 and 2018. Four cross-sectional studies were included in the meta-analyses. The results demonstrated that a high protein intake was negatively associated with frailty status in older adults (odds ratio: 0.67, confidence interval = 0.56 to 0.82, p = 0.0001). (4) Conclusions: Our findings suggest that a high consumption of dietary protein is inversely associated with frailty in older adults.