Effects of Detraining on Physical Capacity and Its Relationship With Depressive Symptoms, Quality of Life and Sedentary Behavior in Community-Dwelling Older Adults: A Longitudinal Study.

BACKGROUND: Detraining is the partial or complete loss of physical training-induced adaptations as a result of exercise interruption or reduction. The COVID-19 pandemic led to the discontinuation of many older adult exercise programs and led to increased depressive symptoms (DS), increased sedentary behavior (SB), and decreased quality of life (QoL). OBJECTIVE: To evaluate the effects of detraining, in the pandemic, on physical capacity and its relationship with DS, QoL, and SB of community-dwelling older adults. METHODS: The physical capacity (static balance, dynamic balance, and lower limb and handgrip strength) of 35 participants was assessed prepandemic and after 18 and 24 months of the pandemic. DS, QoL, and SB were evaluated only at 18-month period. The analysis of variance for repeated measures or the Friedman and Pearson or Spearman tests were used for statistical analysis. RESULTS: There was a decline in dynamic balance (p < .001) and strength in the lower limbs (p < .001) in the first 18 months, as well as maintenance in the following 6 months. The reduction in dynamic balance during the 18 months of the pandemic was associated with greater DS (p = .015; r = .414) and worse QoL (p = .024; r = -.381) in this period. More time spent on SB (p = .024; r = .386) in the 18th month was associated with worse dynamic balance in the following 6 months. CONCLUSION: Detraining in the pandemic setting led to long-lasting harmful effects, which can last for 2 years, on the physical capacity of community-dwelling older adults. IMPLICATION: Our findings highlight how periods of detraining can interfere in physical and mental health of older adults.

Monitoring SARS-CoV-2 seroprevalence over time among pregnant women admitted to delivery units: Suitability for surveillance.

OBJECTIVES: To determine SARS-CoV-2 seroprevalence over time and risk factors among pregnant women at delivery in São Paulo, Brazil; and to evaluate the suitability of pregnant women as a sentinel population for SARS-CoV-2 serosurveillance. METHODS: Unselected consecutive pregnant women presenting at the labor ward of a single large hospital between July 20th 2020 to February 21st 2021 were enrolled and tested for SARS-CoV-2 serology using two assays: the rapid chromatic Wondfo One Step (for total IgA and IgG detection) and Roche Elecsys assay (detecting anti-nucleoprotein [N] IgG). SARS-CoV-2 seroprevalence was computed as smooth spline function over time with 95% confidence intervals (CI). Risk factors were evaluated for positivity by each assay. We compared timepoint seroprevalence by the two assays with four concomitant community household surveys (HHS), in which the Roche assay was used, to determine the sensitivity and relevance of the pregnant women population as sentinel population. RESULTS: Overall SARS-CoV-2 seroprevalence was 28.9% (221/763) by Roche and 17.9% (137/763) by Wondfo. Reported symptoms experienced during pregnancy were all significantly correlated with being SARS-CoV-2 seropositive at delivery with any assay (with odds-ratios ranging from 3.0 [95% CI: 2.1-4.3] for coryza to 22.8 [95% CI: 12.3-46.6] for ageusia). Seropositivity by either assay was high in women at delivery in the early period of the pandemic (June 2020), compared with seropositivity in women from the concomitant HHS: 44.1% (95% CI: 21.8-66.4) for Roche, 54.1% (30.9-78.5) for Wondfo, versus 11.4% (95% CI: 9.2-13.6) for HHS. For later periods (October 2020 and January 2021), the seropositivity in women at delivery measured by Roche corresponded well with the prevalence found among women in the HHS using the same assay, whilst prevalence measured by Wondfo dropped. CONCLUSIONS: Women at delivery represent a highly exposed and readily accessible population for sentinel surveillance of emerging infections such as SARS-CoV-2.

Self-management strategies and multicomponent training to mitigate the effects of the interruption of physical exercise programmes in the pandemic context on functionality, sedentary behaviour, physical capacity, mental health, body composition and quality of life in older adults: a blinded randomized controlled study protocol.

BACKGROUND: Considering the confinement recommended by the World Health Organization due to the pandemic caused by COVID-19, many community physical exercise programmes for older adults have had their activities cancelled. In this context, proposing strategies to recover the possible adverse effects of the confinement period is pertinent. The use of self-management strategies associated with regular physical activity reduces sedentary behaviour and improves physical capacity in older adults. Thus, the purpose of this study was to describe a multicomponent training programme combined with a self-management strategy protocol to mitigate the effects of interruptions in physical exercise programmes on functionality, physical capacity, mental health, body composition and quality of life in older adults. METHODS: This will be a blinded, randomized and controlled clinical trial performed in São Carlos, SP, Brazil. Eighty older adults will be divided into two groups: multicomponent training (Multi) and multicomponent training + self-management strategies (Multi+SM). The intervention will be performed over 16 weeks on three alternate days of every week, with 50-min sessions. The assessment of physical capacity will be performed before the interruption of physical exercise programmes (T0: initial assessment, March 2020), preintervention (T1: immediately after the return of the exercise programme) and postintervention (T2). The assessments of physical activity level, quality of life, mental health, functionality and body composition will be performed at T1 and T2. DISCUSSION: The results from this MC+SM protocol will allow us to contribute clinical support to evaluate the variables analysed and to guide future public health policies with the aim of minimizing the possible deleterious effects arising from the physical exercise interruption periods caused by epidemics and pandemics. TRIAL REGISTRATION: RBR-10zs97gk . Prospectively registered in Brazilian Registry of Clinical Trials (ReBEC) on 17 June 2021. Registry name: Use of self-management strategies combined with multicomponent training to mitigate the effects of social distancing due to COVID-19 on capacity, physical capacity, mental health and quality of life in older adults - A blind, randomized and controlled clinical trial.

Cardiac Autonomic Modulation Response Before, During, and After Submaximal Exercise in Older Adults With Intellectual Disability.

The analysis of the heart rate variability (HRV) consists of changes in the time intervals between consecutive R waves. It provides information on the autonomic nervous system regulation and it is a predictor of adverse cardiovascular events. Several studies analyzed this parameter in youth and adults with Intellectual Disability (ID). Nevertheless, there is a lack of information regarding the HRV before, during, and after exercise in older adults with ID. Therefore, we aimed to describe and compare the cardiac autonomic modulation before, during, and after the six-minute walk test (6MWT) in older adults with and without ID. Twenty-four volunteers with ID and 24 without ID (non-ID) participated in this study. HRV was assessed by R-R intervals at rest, during and after the 6MWT. At rest and recovery periods, the participants remained sited. The symbolic analysis was used to evaluate non-linear HRV components. The recovery HR kinetics was assessed by the mean response time, which is equivalent to time constant (τ)+time delay (TD). Between groups differences in HRV variables were not significant. During the recovery period, HR kinetics time variables showed significant better results in non-ID participants (TD: 6±5s vs. 15±11s; τ: 19±10s vs. 35±17s; and MRT: 25±9s vs. 50±11s, all p<0.050). In conclusion, our results suggest that the HRV in older adults with and without ID is similar during rest, exercise, and recovery. Recovery HR kinetics after the 6MWT was slower in older adults with ID. The reason for these results may be a reduced post-exercise vagal rebound in older adults with ID.

Effects of aquatic physical exercise on neuropsychological factors in older people: A systematic review.

BACKGROUND: . There is a lack of standardized protocols and clinical trials for older adults involving neuropsychological factors in the literature. Furthermore, no systematic review has been published investigating this theme. PURPOSE: . The purpose of this systematic review was to analyze the effects of aquatic physical exercise on neuropsychological factors in older adults. METHODS: . A systematic review (CRD42020176899) was conducted, using articles from Pubmed, Web of Science, Scopus, Cochrane Library, Science Direct and Medline published until March 2020 (without limit of previous year). Eligibility criteria for selecting studies were: clinical trials; samples with a mean age of 65 years old and over; articles involving aquatic physical exercise; and presenting neuropsychological outcomes (behavior, cognition, psychological, mental health). RESULTS AND DISCUSSION: . The search yielded 801 records and 16 studies were included, totaling: 1707 older adults, with a mean age of 71.3 years old (range of mean ages in the studies: 65.3 to 88.4 years old) and a predominance of women. Aquatic physical exercise showed positive results in the mental component of quality of life, fear of falling, mood, anxiety and internal health locus of control in healthy sedentary older adults. Only one study out of 5 carried out with older adults with osteoarthritis showed improvements in psychological well-being after aquatic intervention. Older women with osteopenia or osteoporosis showed improvements in the mental component of quality of life. Studies on dementia showed a significant improvement in behavioral and psychological symptoms after aquatic intervention and no effect on depressive symptoms. CONCLUSION: . Based on the results of this systematic review, aquatic physical exercise has positive effects on quality of life, fear of falling, cognitive functions, mood, anxiety and internal health locus of control in sedentary community-dwelling older people. It can be a great resource for carrying out physical activities in this population.

Effects of physical exercise on the cognition of older adults with frailty syndrome: A systematic review and meta-analysis of randomized trials.

OBJECTIVES: To analyze the effects of physical exercise on the cognition of community-dwelling older adults with frailty syndrome, through randomized clinical trials. DATA SOURCES: Articles published until March 2020 were searched in the databases Science Direct, Scopus, Web of Science, PubMed, Lilacs, Cochrane, IEEE, EMBASE, and SciELO. Search terms included frailty, aged, exercise, rehabilitation, and cognition. For the Portuguese language, equivalent terms were used. STUDY SELECTION: Only randomized clinical trials that used physical exercise as an intervention method in community-dwelling older adults (≥ 60y.) with frailty syndrome, and which performed cognitive assessments before and after the intervention were included. DATA EXTRACTION: Two authors performed data extraction using predefined data fields. The risk of bias of the six included studies was assessed using the PEDro scale. DATA SYNTHESIS: In total, 4501 studies were found. After the selection process, 6 studies were included in the systematic review and 4 studies in the meta-analysis, all with a low risk of bias. The studies included 655 community-dwelling older adults with frailty syndrome. The types of intervention varied, with multicomponent physical exercise being the most frequent. The cognitive assessments were diverse, and the Mini-mental State Examination, Trail Making Test forms A and B, and Digit Span test were the most frequently applied. A meta-analysis was performed with Global Cognition and Trail Making Test forms A and B. The data from the meta-analysis showed that physical exercise improves Global Cognition (Mean Difference = 2.26; 95% CI, 0.42 - 4.09; P = 0.02) and mental flexibility (Trail Making Test B) (Mean Difference = -30.45; 95% CI; - 47.72 - -13.19; P = 0.0005). CONCLUSION: Interventions with physical exercise promote benefits in global cognition and mental flexibility of older adults with frailty syndrome.

Associations of sedentary behavior bouts with community-dwelling older adults' physical function.

The study aim was to explore associations between sedentary behavior (SB) bouts and physical function in 1360 community-dwelling older adults (≥65 years old). SB was measured using an ActiGraph wGT3X + accelerometer for seven consecutive days at the dominant hip and processed accordingly. Various SB bout lengths were assessed including: 1- to 9-minutes; 10- to 29-minutes; 30- to 59-minutes; and ≥60-minutes, as well as maximum time spent in a SB bout. Total SB time was adjusted for within the SB bout variables used (percentage SB time in the SB bout length and number of SB bouts per total SB hour). Physical function was assessed using the 2-minute walk test (2MWT), 5-times sit-to-stand (chair stand) test, and unipedal stance test (UST). Hierarchical linear regression models were utilized. Covariates such as moderate-vigorous physical activity (MVPA), demographic and health characteristics were controlled for. Lower percentage time spent in ≥60-minute SB bouts was significantly (P < .05) associated with longer 2MWT distance while lower numbers of ≥60-minute SB bouts were associated with longer 2MWT distance, shorter chair stand time and longer UST time. There were mixed associations with physical function for 10- to 29-minute SB bouts. In a large cohort of European older adults, prolonged SB bouts lasting ≥60-minutes appear to be associated with reduced physical function after controlling for MVPA and numerous other important covariates. Besides reducing SB levels, these findings suggest there is a need to regularly interrupt prolonged SB to improve physical function in older adults.

Accelerometer-Measured Sedentary and Physical Activity Time and Their Correlates in European Older Adults: The SITLESS Study.

BACKGROUND: Sedentary behavior (SB) and physical activity (PA) are important determinants of health in older adults. This study aimed to describe the composition of accelerometer-measured SB and PA in older adults, to explore self-reported context-specific SB, and to assess sociodemographic and functional correlates of engaging in higher levels of SB in participants of a multicenter study including four European countries. METHOD: One thousand three hundred and sixty community-dwelling older adults from the SITLESS study (61.8% women; 75.3 ±â€…6.3 years) completed a self-reported SB questionnaire and wore an ActiGraph accelerometer for 7 days. Accelerometer-determined compositional descriptive statistics were calculated. A fixed-effects regression analysis was conducted to assess the sociodemographic (country, age, sex, civil status, education, and medications) and functional (body mass index and gait speed) correlates. RESULTS: Older adults spent 78.8% of waking time in SB, 18.6% in light-intensity PA, and 2.6% in moderate-to-vigorous PA. Accelerometry showed that women engaged in more light-intensity PA and walking and men engaged in higher amounts of moderate-to-vigorous PA. Watching television and reading accounted for 47.2% of waking time. Older age, being a man, single, taking more medications, being obese and overweight, and having a slower gait speed were statistically significant correlates of more sedentary time. CONCLUSIONS: The high amount of SB of our participants justifies the need to develop and evaluate interventions to reduce sitting time. A clinically relevant change in gait speed can decrease almost 0.45 percentage points of sedentary time. The distribution of context-specific sedentary activities by country and sex showed minor differences, albeit worth noting.

Complexity of knee extensor torque in patients with frailty syndrome: a cross-sectional study.

BACKGROUND: Frailty syndrome is characterized by a marked reduction in physiological reserves and a clinical state of vulnerability to stress. Torque complexity analysis could reveal changes in the musculoskeletal systems that are the result of having the syndrome. OBJECTIVE: The aim of this study was to evaluate the complexity of submaximal isometric knee extensor torque in frail, pre-frail, and non-frail older adults. A secondary aim was to analyze the torque complexity behavior in different force levels in each group. METHODS: A cross-sectional study was conducted. Forty-two older adults were divided into three groups: non-frail (n=15), pre-frail (n=15), and frail (n=12). The data collected included body composition, five times sit-to-stand test, walking speed, and isometric knee extensor torque at 15, 30, and 40% of maximal voluntary contraction. The knee extensor torque variability was evaluated by coefficient of variation, and the torque complexity was evaluated by approximate entropy and sample entropy. RESULTS: The frail group presented a reduction in body mass and peak torque value compared to the non-frail group. Also, the frail group showed worse physical performance (on the five times sit-to-stand test and walking speed) compared to the pre-frail and non-frail groups. In addition, the frail older adults showed reduced torque complexity compared to the non-frail group. Finally, the association between torque complexity and force levels remained similar in all groups. CONCLUSION: Torque complexity is reduced in the presence of frailty syndrome.

Accuracy of mobility tests for screening the risk of falls in patients with mild cognitive impairment and alzheimer's disease / Acurácia de testes de mobilidade para o rastreio do risco de quedas no comprometimento cognitivo leve e doença de Alzheimer / Exactitud de las pruebas de movilidad para detectar riesgo de caídas en el deterioro cognitivo leve y en la enfermedad de Alzheimer

ABSTRACT Identifying gait and balance disorders in the earlier stages of Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI) could reduce or prevent falls in older adults. This cross-sectional study aimed to determine which mobility tests best discriminate the risk of falls in MCI and mild AD. Functional mobility was assessed by the timed up and go test (TUG) and 10-meter walk test (10MWT). A calendar of falls was produced, with follow-up via telephone calls during 6 months. For the MCI Group (n=38), time spent on the 10MWT was the best variable for discriminating fallers, with a cut-off point of 10.69 seconds associated with the highest accuracy (76.3%). In the AD Group (n=37), 10MWT cadence was the best variable for discriminating fallers, with a cut-off point of 101.39 steps per minute associated with an accuracy of 81.1%. As a conclusion, 10MWT time and cadence were the most accurate variables for screening the risk of falls in MCI and mild AD, respectively. The 10MWT is a functional, simple and easy test and it should be widely used in clinical practice.

RESUMO A identificação de distúrbios da marcha e do equilíbrio em estágios iniciais da doença de Alzheimer (DA) e do comprometimento cognitivo leve (CCL) pode reduzir ou prevenir quedas na população idosa. Transversal, este estudo tem como objetivo determinar quais testes de mobilidade melhor discriminam o risco de quedas em idosos com CCL e DA leve. A mobilidade funcional foi avaliada pelo timed up and go test (TUG) e o teste de velocidade de marcha de 10 metros (10MWT). Foi produzido um calendário de quedas, com acompanhamento via contato telefônico durante 6 meses. Para o grupo CCL (n=38), o tempo gasto no 10MWT foi a melhor variável para discriminar caidores, com nota de corte de 10,69 segundos associada a maior precisão (76,3%). No grupo DA (n=37), a cadência do 10MWT foi a melhor variável para discriminar os caidores, com nota de corte de 101,39 passos por minuto associada a uma precisão de 81,1%. Como conclusão, o tempo e a cadência do 10MWT foram as variáveis mais precisas para rastrear o risco de quedas em idosos com CCL e DA leve, respectivamente. O 10MWT é um teste funcional, simples e fácil e pode ser amplamente utilizado na prática clínica.

RESUMEN La identificación de los trastornos de marcha y del equilibrio en las primeras etapas de la enfermedad de Alzheimer (EA) y del deterioro cognitivo leve (DCL) puede reducir o prevenir las caídas en la población anciana. Estudio transversal que tiene como objetivo determinar qué pruebas de movilidad discriminan mejor el riesgo de caídas en los ancianos con DCL y EA leve. La movilidad funcional se evaluó mediante el timed up and go test (TUG) y la prueba de velocidad de marcha de 10 metros (10MWT). Se elaboró un calendario de caídas, con seguimiento vía contacto telefónico durante 6 meses. En el grupo DCL (n=38), el tiempo empleado en el 10MWT fue la mejor variable para discriminar las caídas, con un puntaje de corte de 10,69 segundos asociado a una mayor precisión (76,3%). En el grupo de EA (n=37), la cadencia de 10MWT fue la mejor variable para discriminar las caídas, con un puntaje de corte de 101,39 pasos por minuto asociada a una precisión del 81,1%. Se concluye que el tiempo y la cadencia de 10MWT fueron las variables más precisas para detectar el riesgo de caídas en los ancianos con DCL y EA leve, respectivamente. El 10MWT es una prueba funcional, simple y fácil, y se puede utilizarla ampliamente en la práctica clínica.

Pre-Frail Multicomponent Training Intervention project for complexity of biological signals, functional capacity and cognition improvement in pre-frail older adults: A blinded randomized controlled study protocol.

AIM: Frailty syndrome is related to decreased physiological complexity, functional capacity and cognition. Physical exercise has been suggested to slow down and reverse this syndrome. However, evidence of its effectiveness is not as straightforward as conventionally admitted, as there is a lack of trials with rigorous methodology. The purpose of this study was to describe the Pre-Frail Multicomponent Training Intervention protocol. METHODS: Cardiovascular, motor control and neuromuscular systems of pre-frail older adults will be assessed by measuring the complexity of the output of these systems. Functional capacity and cognition will be assessed by specific tools. A 16-week training protocol will be carried out on three alternate days, with 60-min sessions, and combining aerobic, muscle strength, flexibility and balance exercises. The objective of this intervention is to improve the cardiovascular, motor control and neuromuscular systems, as well as functional capacity and cognition of pre-frail older adults. The assessment of these systems will be carried out using gold standard devices. RESULTS: The results of the present study might allow clinical and functional support for the evaluation of the variables analyzed. CONCLUSION: This protocol is easily reproducible and requires low-cost materials, thus the Pre-Frail Multicomponent Training Intervention could be a therapeutic strategy for pre-frail older adults. Geriatr Gerontol Int 2019; 19: 684-689.

Dual-Task Performance: Influence of Frailty, Level of Physical Activity, and Cognition.

BACKGROUND AND PURPOSE: Cognition and level of physical activity have been associated with frailty syndrome. The development of tools that assess deficits related to physical and cognitive frailties simultaneously are of common interest. However, little is known about how much these aspects influence the performance of dual-task tests. Our aims were (a) to verify the influence of frailty syndrome and objectively measured physical activity and cognition on the Timed Up and Go (TUG) test and Timed Up and Go associated with dual-task (TUG-DT) performances; and (b) to compare TUG and TUG-DT performances between older adults who develop frailty syndrome. METHODS: Sixty-four community-dwelling older adults were divided into frail, prefrail, and nonfrail groups, according to frailty phenotype. Assessments included anamnesis, screening of frailty syndrome, cognitive assessment (Addenbrooke's Cognitive Examination), placement of a triaxial accelerometer to assess level of physical activity, and TUG and TUG-DT (TUG associated with a motor-cognitive task of calling a phone number) performances. After 7 days, the accelerometer was removed. A multiple linear regression was applied to identify which independent variables could explain performances in the TUG and TUG-DT. Subsequently, the analysis of covariance test, adjusted for age, cognition, and level of physical activity covariates, was used to compare test performances. RESULTS: There were no differences in cognition between groups. Significant differences in the level of physical activity were found in the frail group. Compared with the frail group, the nonfrail group required less time and fewer steps to complete the TUG. Regarding the TUG-DT, cognition and age influenced the time spent and number of steps, respectively; however, no differences were found between groups. CONCLUSIONS: Frail older adults presented worse performance in the TUG when compared with nonfrail older adults. The dual-task test does not differentiate older adults with frailty syndrome, regardless of cognitive performance.

Performance of Different Timed Up and Go Subtasks in Frailty Syndrome.

BACKGROUND AND PURPOSE: Gait speed, mobility, and postural transitions should be taken into account in older adults with frailty syndrome and can be assessed by the Timed Up and Go (TUG) Test. However, it is unclear which TUG subtasks have greater influence in identifying frail people and whether prefrail individuals present with any reduced subtask performance. The objective of this study was to investigate the differences in performance of TUG subtasks between frail, prefrail, and nonfrail older adults. METHODS: A cross-sectional study was performed with community-dwelling older adults, including 43 nonfrail, 30 prefrail, and 7 frail individuals. The TUG subtasks (sit-to-stand, walking forward, turning, walking back, and turn-to-sit) were assessed using a Qualisys motion system. Data were captured by Qualisys Track Manager software and processed by Visual 3D software. The Matlab program was used to detect, separate, and analyze the TUG subtasks. Statistical significance was set at α= .05 and SigmaPlot software (11.0) was used. RESULTS AND DISCUSSION: The total time to complete the TUG was significantly longer among frail participants than among those who were prefrail and nonfrail. Statistically significant differences in temporal parameters in the turning, walking forward, and walking back subtasks between nonfrail/prefrail and frail older people were found. In addition, the transition TUG subtasks (average and peak velocities of the trunk) distinguished the frail group from the other groups, demonstrating altered quality of movement. CONCLUSIONS: The findings support the value of analyzing the TUG subtasks to improve understanding of mobility deficits in frailty syndrome.

Impact of a dual task intervention on physical performance of older adults who practice physical exercise / Impacto de uma intervenção de dupla tarefa no desempenho físico de idosos praticantes de exercício físico

Abstract Physical exercises, especially multicomponent training, can improve cognitive functions and physical impairments in older adults. The aim this study was to purpose of this two-arm clinical trial was to investigate the effects of the addition of a dual task to multicomponent training on physical performances of community-dwelling older adults who practice physical exercise. Seventy-one older adults were divided into a Control Group (CG) and Intervention Group (IG). Participants of the CG performed isolated multicomponent training, participants of the IG performed multicomponent training associated with cognitive tasks and both protocols lasted 12 weeks. The assessment consisted of flexibility, handgrip strength, lower limb strength, balance, functional mobility and aerobic capacity. The CG presented greater flexibility than the IG, regardless of time. There was a worse performance in lower limb strength, regardless of group. The addition of a dual task to the multicomponent training was not able to improve physical performances of older adults. Further studies are needed to confirm whether the dual task training contributes to both cognitive and physical benefits in older adults who practice physical exercise.

Resumo Exercícios físicos, especialmente o treinamento multicomponente, podem melhorar funções cognitivas e distúrbios motores em idosos. Objetivou-se investigar os efeitos da adição da dupla tarefa sobre o treinamento multicomponente nas performances motoras de idosos da comunidade praticantes de exercício físico. Setenta e um idosos foram divididos em Grupo Controle (GC) e Grupo Intervenção (GI). Participantes do GC realizaram treinamento multicomponente isolado e participantes do GI realizaram treinamento multicomponente associado a tarefas cognitivas, ambos protocolos com duração de 12 semanas. A avaliação consistiu de flexibilidade, força de preensão palmar, força de membros inferiores, equilíbrio, mobilidade funcional e capacidade aeróbica. O GC apresentou maior flexibilidade do que o GI, independente do tempo. Houve uma piora na performance de força de membros inferiores, independente do grupo. A adição da dupla tarefa sobre o treinamento multicomponente não foi capaz de melhorar performances físicas de idosos. Estudos futuros são necessários para confirmar se o treinamento de dupla tarefa traz benefícios cognitivos e também físicos em idosos praticantes de exercício físico.

Respiração lenta e profunda aumenta a modulação vagal em gestantes / Deep and slow breathing increases vagal modulation in pregnant women

OBJETIVOS: Comparar a resposta da modulação autonômica da frequência cardíaca de gestantes e mulheres não gestantes, antes e após a manobra de acentuação da arritmia sinusal respiratória. MÉTODOS: Foi realizado um estudo transversal com amostra de 24 mulheres, divididas em dois grupos: grupo gestantes (independente da idade gestacional) e grupo controle (não gestantes). A avaliação consistiu em registro dos intervalos RR por um cardio frequencímetro, para análise de índices lineares e não lineares da variabilidade da frequência cardíaca. As avaliações foram feitas no repouso em decúbito lateral esquerdo, antes e após a manobra de acentuação da arritmia sinusal respiratória, que consiste em respirações lentas de cinco a seis ciclos por minuto. A razão expiração/inspiração e a diferença entre a inspiração e a expiração foram avaliadas durante a manobra. Foram comparados os resultados obtidos entre os dois grupos (gestantes e não gestantes), assim como os obtidos em cada grupo, antes e após a manobra. Para a análise estatística o nível de significância considerado foi p<0,05. RESULTADOS: Os índices lineares mostraram valores iniciais da modulação simpática (banda de baixa frequência) aumentados nas gestantes quando comparadas às mulheres não gestantes (gestantes: 68,9±28,1; controles: 49,3±11,7; p=0,002). Após a manobra respiratória, o índice obtido pela raiz quadrada da média do quadrado das diferenças entre os intervalos RR normais adjacentes aumentou no grupo gestantes (pré- manobra: 34,5±5,7; pós-manobra: 38,9±5,8; p=0,027), indicando aumento da atuação parassimpática para essa população após a aplicação da manobra. Além disso, houve aumento dos valores de complexidade, sugeridos pela entropia de Shanon após a manobra, para ambos os grupos, sendo o aumento maior nas gestantes. Em relação aos índices avaliados durante a manobra, ambos os grupos apresentaram valores da razão expiração/inspiração maiores que 1, o que sugere integridade do sistema nervoso autônomo. CONCLUSÕES: Houve melhora da regulação do sistema nervoso autônomo ao final da manobra respiratória para as gestantes, sugerindo que o padrão de respiração lenta e profunda possa aumentar a modulação vagal e conferir efeito cardioprotetor, além de ocasionar relaxamento e sensação de bem-estar.

AIMS: To compare the responses of the heart rate autonomic modulation in pregnant and non-pregnant women before and after the respiratory sinus arrhythmia maneuver. METHODS: A cross-sectional study was conducted with a sample of 24 women, divided into two groups: pregnant group (independent of gestational age) and control group (non-pregnant). The evaluation consisted of recording the RR intervals using a cardiofrequencimeter, for analysis of linear and nonlinear indices of heart rate variability. The evaluations were made at rest in left lateral decubitus, before and after the maneuver of accentuation of respiratory sinus arrhythmia, consisting of slow breaths five to six cycles per minute. The expiration/inspiration ratio and the difference between inspiration and expiration were evaluated during the maneuver. Results were compared between the two groups (pregnant and non-pregnant), as well as those obtained in each group before and after the maneuver. For the statistical analysis the level of significance considered was p<0.05. RESULTS: Linear indices showed increased baseline sympathetic modulation (low frequency band) in pregnant women when compared to non-pregnant women (pregnant women: 68.9±28.1; non pregnant women: 49.3±11.7; p=0,002). After the respiratory maneuver, the root mean square of successive differences in the RR intervals index increased in the pregnant group (pre-maneuver: 34.5±5.7; post-maneuver: 38.9±5.8; p=0,002) indicating an increase in the parasympathetic system for this population after the maneuver. In addition, there was an increase in the complexity values after the maneuver, suggested by the Shanon entropy for both groups, being the increase higher in the pregnant women. Regarding the indices evaluated during the respiratory sinus arrhythmia maneuver, both groups presented expiration/inspiration ratio values greater than 1, which suggests integrity of the autonomic nervous system. CONCLUSIONS: There was an improvement in the regulation of the autonomic nervous system after the respiratory maneuver for pregnant women, suggesting that the slow and deep breathing pattern may increase vagal modulation and confer a cardioprotective effect, besides causing relaxation and a sense of well-being.

Perfil de idosos admitidos em serviço de fisioterapia frente à sazonalidade / Profile of elderly admitted to a physical therapy center as a function of seasonality

OBJETIVOS: Analisar o perfil e a prevalência de doenças em idosos admitidos em duas estações do ano distintas, em um serviço público de fisioterapia de um município de médio porte localizado em zona de clima subtropical de altitude. MÉTODOS: Um estudo transversal analisou prontuários de pacientes encaminhados nos meses que compreenderam o verão e o inverno de 2011. Foram incluídos os prontuários de idosos (acima de 60 anos de idade) de ambos os sexos e excluídos os prontuários sem informações sobre o diagnóstico médico atual. Foram coletadas as variáveis idade e sexo e os diagnósticos atuais e pregressos. Para análise comparativa quanto ao perfil dos idosos admitidos nos dois períodos do ano, utilizou-se o teste Qui-quadrado. RESULTADOS: Foram analisados dados de 71 idosos. A média de idade foi de 69,2±8,1 anos e 48 (70,4%) eram do sexo feminino. Os diagnósticos mais frequentes no momento do encaminhamento foram de doenças traumato-ortopédicas (60,6%). O maior número de admissões ocorreu durante o inverno (62,0%). Os diagnósticos no momento do encaminhamento foram, respectivamente no verão e no inverno: traumatoortopédicos 17 (63,0%) e 26 (59,1%); reumatológicos 3 (11,1%) e 10 (22,7%); neurológicos 5 (18,5%) e 4 (9,1%); pós-operatório 2 (7,4%) e 4 (9,1%) (p=0,64). CONCLUSÕES: No inverno ocorreu maior demanda de encaminhamentos de idosos ao serviço de fisioterapia em comparação ao verão, com predomínio de mulheres em ambas as estações do ano. As causas de encaminhamento mais prevalentes foram relacionadas à traumatoortopedia, mas não houve diferença significativa na frequência dos diagnósticos conforme a estação do ano. O conhecimento sobre o perfil dos idosos admitidos em serviços de fisioterapia é importante para o planejamento de ações voltadas a essa faixa etária, com a realização de campanhas de informação, prevenção e promoção da saúde.

AIMS: To analyze the profile and the prevalence of diseases in elderly patients admitted to a physical therapy center in a medium-sized Brazilian city located in a subtropical zone in two different seasons of the year. METHODS: A cross-sectional study assessed the medical records of patients treated during summer and winter months in 2011. Medical records of male and female elderly patients (aged over 60 years) were included, and those without information on present medical diagnosis were excluded. Age and sex and both current and previous diagnostic records were analyzed. The chi-square test was used for the comparative analysis of the profile of the elderly patients for both seasons. RESULTS: Seventy-one medical records were analyzed. The mean age was 69.2±8.1 years and 48 (70.4%) patients were female. There was a higher prevalence of trauma-orthopedic diseases (60.6%). The greatest number of admissions was in winter (62.0%). At the time of referral, there were 17 cases (63.0%) of trauma-orthopaedic diseases in summer and 26 (59.1%) in winter; 3 cases (11.1%) of rheumatologic diseases in summer and 10 (22.7%) in winter; 5 cases (18.5%) of neurologic disorders in summer and 4 (9.1%) in winter; and 2 cases (7.4%) of postoperative complications in summer and 4 (9.1%) in winter (p=0.64). CONCLUSIONS: There was a greater demand for referrals of elderly patients to the physical therapy center in winter than in summer, with a predominance of female patients in both seasons. The most prevalent causes of referral were related to trauma-orthopaedic diseases, but there was no significant difference in the frequency of diagnoses according to season. Knowledge about the profile of the elderly admitted to physical therapy centers is important for targeting actions at this age group, conducting information, prevention, and health promotion campaigns.

Effects of the Addition of a Dual Task to a Supervised Physical Exercise Program on Older Adults' Cognitive Performance.

The purpose of this study was to investigate the effects of the addition of a dual task to multicomponent training on cognition of active older adults. Eighty physically active older adults were divided into an intervention group (IG) and a control group (CG). Both groups performed multicomponent training over 12 weeks. The IG simultaneously performed exercises and cognitive tasks. The Mini-Mental State Examination, the Montreal Cognitive Assessment, and the Clock Drawing Test were used for cognitive assessments. The Timed Up and Go Test associated with a cognitive task was used for dual-task assessment. Significant interactions were not observed between groups in terms of the cognitive variables or the dual-task performance. An interaction was observed only for Timed Up and Go Test performance, which was better in the CG than in the IG. Active older adults showed no improvement in cognition following the addition of the dual task to the multicomponent training.

Perception of barriers to physical exercise in women population over 60

Abstract Aims This study evaluated the possible barriers to the permanence of physical exercise (PE) of old women. Methods The study population comprised 61 old women participants for at least one year of a supervised PE program, who underwent anamnesis, and applied the Barriers Questionnaire to Physical Activity Practice in the Elderly (QBPAFI). Exploratory factorial analysis was used to evaluate QBPAFI data. The analysis of principal component was applied to the 22 questions through orthogonal rotation to analyze the correlation between the questions. The Kaiser-Meyer-Olkin test was applied to evaluate the suitability of the sample size, and the Bartlett's test to assess whether the original matrix correlation is an identity matrix. Eigenvalues greater than 1 were considered for analysis. Results The motivational factor was the major determinant of perceived barriers (43.3%), followed by psychosocial (12.29%), facilities and appearance (8.75%), and exercise conditions (8.10%) factors. Conclusion Knowing the benefits of physical activity, and the main barriers that prevent the permanence of active old people to physical exercise programs, new strategies must be taken to increase the rate of adherence of this group.(AU)