Plasma Levels of Interleukin 2 (IL-2) Associated with Hearing Loss Evaluation in the Elderly.

CONTEXT: Presbycusis can be mediated by the effects of inflammatory processes on the auditory system, and these aging biological mechanisms remain poorly studied. AIMS: The aim of this study was to determine whether plasma biomarkers are associated with hearing disorders caused by aging in the elderly. SETTINGS AND DESIGN: Cross-sectional study with 106 participants in the Active Aging Project, 93 (88%) females and 13 (12%) males, with an average age of 70 years. METHODS AND MATERIAL: Audiological evaluation was performed with pure tone audiometry and collection of peripheral blood for the measurement of plasma levels of interleukins 2, 4, 6, and 10, tumor necrosis factor-α, and interferon-γ by means of flow cytometry. STATISTICAL ANALYSIS USED: The SPSS (v.0, SPSS Inc., Chicago, USA) was used for the analysis of the data obtained. For all data analyzed, the significance level adopted was P < 0.05 and 95% confidence interval. RESULTS: There were statistically significant correlations between male and IL-2 (P = 0.031; rs = 0.210), mean II of the right ear (P = 0.004; rs = 0.279), longer in years (P = 0.002; rs = 0.307) and in hours (P = 0.004; rs = 0.281) of noise exposure also in males. CONCLUSIONS: In the present study, there was an association between the male gender and higher plasma levels of IL-2, an increase in the average hearing in the right ear, and greater time in years and hours of exposure to noise. There was a predominance of mild sensorineural hearing loss and worsening of hearing related to age, characteristics of presbycusis.

Resistance Training for Older Women: Do Adaptive Responses Support the ACSM and NSCA Position Stands?

PURPOSE: The optimal intensity of resistance training (RT) to improve muscular, physical performance, and metabolic adaptations still needs to be well established for older adults. Based on current position statements, we compared the effects of two different RT loads on muscular strength, functional performance, skeletal muscle mass, hydration status, and metabolic biomarkers in older women. METHODS: One hundred one older women were randomly allocated to perform a 12-wk whole-body RT program (eight exercises, three sets, three nonconsecutive days a week) into two groups: 8-12 repetitions maximum (RM) and 10-15RM. Muscular strength (1RM tests), physical performance (motor tests), skeletal muscle mass (dual-energy X-ray absorptiometry), hydration status (bioelectrical impedance), and metabolic biomarkers (glucose, total cholesterol, HDL-c, HDL-c, triglycerides, and C-reactive protein) were measured at baseline and posttraining. RESULTS: Regarding muscular strength, 8-12RM promoted higher 1RM increases in chest press (+23.2% vs +10.7%, P < 0.01) and preacher curl (+15.7% vs +7.4%, P < 0.01), but not in leg extension (+14.9% vs +12.3%, P > 0.05). Both groups improved functional performance ( P < 0.05) in gait speed (4.6%-5.6%), 30 s chair stand (4.6%-5.9%), and 6 min walking (6.7%-7.0%) tests, with no between-group differences ( P > 0.05). The 10-15RM group elicited superior improves in the hydration status (total body water, intracellular and extracellular water; P < 0.01), and higher gains of skeletal muscle mass (2.5% vs 6.3%, P < 0.01), upper (3.9% vs 9.0%, P < 0.01) and lower limbs lean soft tissue (2.1% vs 5.4%, P < 0.01). Both groups improved their metabolic profile. However, 10-15RM elicited greater glucose reductions (-0.2% vs -4.9%, P < 0.05) and greater HDL-c increases (-0.2% vs +4.7%, P < 0.01), with no between-group differences for the other metabolic biomarkers ( P > 0.05). CONCLUSIONS: Our results suggest that 8-2RM seems more effective than 10-15RM for increasing upper limbs' muscular strength, whereas the adaptative responses for lower limbs and functional performance appear similar in older women. In contrast, 10-15RM seems more effective for skeletal muscle mass gains, and increased intracellular hydration and improvements in metabolic profile may accompany this adaptation.

Effect of Resistance Exercise Order on Cardiovascular Disease Risk Factors in Older Women: A Randomized Controlled Trial.

We compared the effects of two specific resistance training (RT) exercise orders on cardiovascular risk factors. Forty-four untrained older women (>60 years) were randomly assigned to three groups: control (CON, n = 15), multi-joint to single-joint (MJ-SJ, n = 14), and single-joint to multi-joint (SJ-MJ, n = 15) exercise orders. Training groups performed a whole-body RT program (eight exercises, 3 × 10−15 repetitions for each exercise) over 12 weeks in 3 days/week. Body fat, triglycerides, total cholesterol, HDL-c, LDL-c, VLDL-c, glucose, IL-6, IL-10, TNF-α, C-reactive protein, total radical-trapping antioxidant (TRAP), advanced oxidation protein products (AOPP), ferrous oxidation-xylenol (FOX), and nitric oxide concentrations (NOx) were determined pre- and post-intervention. Significant interaction group × time (p < 0.05) revealed reducing fat mass and trunk fat and improvements in glucose, LDL-c, IL-10, TNF-α, C-reactive protein, FOX, and AOPP concentrations in both training groups, without differences between them (p > 0.05). The results suggest that 12 weeks of RT, regardless of exercise order, elicit positive adaptations on body fat and metabolic biomarkers similarly in older women.

Effect of Resistance Exercise Orders on Health Parameters in Trained Older Women: A Randomized Crossover Trial.

PURPOSE: This study aimed to compare the effects of four resistance exercise orders on muscular strength, body composition, functional fitness, cardiovascular risk factors, and mental health parameters in trained older women. METHODS: The intervention lasted 63 wk. Sixty-one physically independent women (>60 yr) after completing a 12-wk resistance training (RT) preconditioning phase were randomized into four different exercise orders groups to perform 12 wk of RT: multijoint to single-joint and upper- to lower-body, single-joint to multijoint and upper- to lower-body, multijoint to single-joint and lower- to upper-body, and single-joint to multijoint and lower- to upper-body. This was followed by a 12-wk detraining period and another 12-wk RT in which exercise orders were crossed over between MJ-SJ and SJ-MJ conditions. Body composition (dual-energy x-ray absorptiometry), muscular strength (one-repetition maximum tests), functional fitness (gait speed, walking agility, 30-s chair stand, and 6-min walk tests), cardiovascular risk factors (glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, C-reactive protein, advanced oxidation protein product, total radical-trapping antioxidant parameter, and nitric oxide), depressive (Geriatric Depression Scale) and anxiety symptoms (Beck Anxiety Inventory), and cognitive performance (Montreal Cognitive Assessment, Trail Making, verbal fluency, and Stroop test) were analyzed. RESULTS: After the final training period, all groups presented significant improvements ( P < 0.05) in almost all analyzed variables (muscular strength, body composition, functional tests, blood biomarkers, and mental health parameters), without significant difference among exercise orders. CONCLUSIONS: Our results suggest that RT exercise orders in which MJ, SJ, upper, or lower-body exercises are performed first have similar effects on health parameters in trained older women.

Reproducibility of dynamometers in handrail format in evaluating handgrip strength and traction in young and older adults.

BACKGROUND: The aim of the present study was twofold: (1) to assess the reproducibility of two dynamometers in handrail format to measure handgrip strength and traction force in the young and older adults; (2) to compare the handgrip strength and traction of these two populations. APPROACH: Twenty-four volunteers (12 older adults and 12 young adults) performed a functional effort related to handgrip strength and traction force during stair climbing. The participants were evaluated two times (separated by one week) using a coupled dynamometer that quantifies the muscular effort in grip and traction simultaneously to simulate stair climbing in bus service. RESULTS: The young adults performed significantly better (p < 0.04) than the older adults in both handgrip and traction efforts (medium to large effect size), with excellent reliability (Intraclass Coefficient Correlation > 0.9) and low error of measure. The dynamometers were able to discriminate the two population groups (sensitive validity) and showed excellent reproducibility estimates for handgrip and traction strength in both young and older adults. CONCLUSION: These instruments could be useful in assessing handgrip and traction strength needed to climb stairs, especially for the older adults, who normally have more difficulty performing this task.

Volume Reduction: Which Dose is Sufficient to Retain Resistance Training Adaptations in Older Women?

We compared the effects of different resistance training (RT) volume reduction strategies on muscular strength and lean soft-tissue (LST) in older women. Fifty-seven physically independent women (>60 years) performed a 20-week pre-conditioning phase of a standardized whole-body RT program (eight exercises, three sets, 8-12 repetitions, three sessions a week), and were then randomly assigned to one of the following conditions: reduced volume for a single set (RV1, n=20) or two sets (RV2, n=19), or maintained volume of three sets (MV, n=18) for 8 weeks (specific training phase). Muscular strength in the chest press, leg extension, and preacher curl exercises was determined by one-repetition maximum tests. A dual-energy X-ray absorptiometry device was used to estimate LST. An increase in muscular strength (16.3-32.1%) and LST (3.2-7.9%) was observed after the pre-conditioning phase. There was an increase in chest press for all groups (9.4-16.7%) after the specific training phase. In contrast, only MV increased significantly in the leg extension (4.4%). No between-group differences were revealed for LST in the specific training phase. Our results suggest that reduced RT volume from three to one set per exercise for 8 weeks seems sufficient to retain neuromuscular adaptations in older women.

Effects of Three Resistance Exercise Orders on Muscular Function and Body Composition in Older Women.

The purpose of the present study was to compare the effects of three resistance exercise orders on muscular strength, body composition, and functional fitness in trained older women. Forty-five women (aged ≥60 years), after performing 12 weeks of a pre-conditioning resistance-training program were randomly assigned in one of the following groups that performed the exercises in the following orders: multi-joint to single-joint order (MJ-SJ, n=15), single-joint to multi-joint order (SJ-MJ, n=15), and alternating between upper and lower body order (ALT, n=15). Specific training intervention lasted 12 weeks (3x/week) and was composed of eight exercises performed in three sets of 15/10/5 repetitions, with increasing load through the sets. Muscular strength was estimated by one-repetition maximum tests; body composition was assessed by whole-body dual-energy x-ray absorptiometry, and functional fitness was analyzed with a sequence of four motor tests. All groups improved similarly in muscular strength (Cohen's effect size: MJ-SJ=0.45; SJ-MJ=0.48; ALT=0.45), skeletal muscle mass (MJ-SJ=0.08; SJ-MJ=0.07; ALT=0.09), and functional test performance (MJ-SJ=0.38; SJ-MJ=0.20; ALT=0.31), but no change was observed for body fat (P>0.05). The results suggest that 12 weeks of resistance training induce positive changes in muscle morphofunctionality, regardless of the exercise order employed in trained older women.

How many balance task trials are needed to accurately assess postural control measures in older women?

Taking the average of different trials is recommended for better balance assessment, but few studies have really proven this point under different balance conditions. OBJECTIVE: To assess the effects of averaging trials of five different balance tasks on postural control measures in older women. METHODS: A total of 90 older women (means: Age: 68 years; Weight: 67 kg; Height: 1.56 m; Body mass index, 27 kg/m2) participated in this study. The participants completed five balance tasks with three performance trials for each task on a force platform in random order. The participants completed a total of three 30-s trials of tasks with 30 s of rest between trials. Repeated measure ANOVA and coefficient of variation were computed to compare differences for one trial vs. averaging across two or three trials on center of pressure (COP) sway values. RESULTS: There were no significant differences (P > 0.05) in COP sway values when comparing one vs. the average of two or three trials for all balance tasks. However, the coefficient of variation was higher for three trials (10-40%) than two (6-37%) or one trial (3-23%) for COP parameters. CONCLUSIONS: Based on reduction of variability, the present study recommends the averaging of a minimum of two trials for balance assessment in older women. The results of the current study have implications for balance assessment in older people in fall prevention programs.

Phase Angle Is Moderately Associated With Muscle Quality and Functional Capacity, Independent of Age and Body Composition in Older Women.

BACKGROUND AND PURPOSE: There is a growing body of evidence indicating that phase angle (PhA) can be used as an indicator of nutritional status, disease prognosis, and mortality risk; however, it is still unknown whether PhA can be used as an explanator of functional capacity and muscle quality in older women. The main purpose of this cross-sectional study was to explore whether PhA is associated with muscle quality and functional capacity in older women, regardless of total and regional body composition. METHODS: A total of 125 older women-66.7 (4.7) years; 65.6 (10.9) kg body mass; 156.1 (5.2) cm height; 26.9 (4.0) kg/m body mass index-participated in this study. Anthropometric, PhA, body composition (whole-body dual-energy x-ray absorptiometry) and muscle quality (defined as total muscular strength per kilogram of appendicular lean soft tissue) were measured. The functional capacity was assessed by 4 tests: 10-m walk test, rising from sitting position, rising from ventral decubitus position, and rising from a chair and walking around the house. The summing z-scores for the 4 tests was used as a continuous functional capacity score. Linear regression analysis was conducted to test whether PhA is related to the dependent variables (muscle quality and functional capacity), after adjusting for potential covariates. RESULTS: The PhA presented a small-to-moderate relationship with muscle quality (r = 0.27; P < .01) and functional capacity (r = 0.31; P < .01), respectively. These relationships remained significant after adjustment for age, lower limb lean soft tissue, and total fat mass for muscle quality (ß= 0.55; P < .01) and functional capacity (ß= 1.38; P < .01). CONCLUSION: Our findings suggest that healthy elderly women with higher values of PhA have a better muscle quality and functionality, regardless of age and body composition.

One-legged stance sway of older adults with and without falls.

Postural instability is a common problem among older people, and it is associated with mobility impairments, activity limitation and fear of falling. The evaluation of postural control can contribute to the early detection of balance deficits and help health professionals to manage this problem to prevent falls in older adults. The aim of this study was to identify center of pressure cut-offs to differentiate between older adults with and without falls in the past 12 months. The participants were 170 older adults (mean age 67 years, 50 fallers and 120 non-fallers). Center of pressure area and sway velocity in the anterior-posterior and medio-lateral directions were assessed using a force platform during three 30s one-legged stance trials with eyes open. The mean across trials was used for analysis. The time-limit (how long the participant was able to stay in one-legged stance, up to 30s) was also assessed. Fallers had poorer postural control than non-fallers (effect size ≥ 0.52, P <0.05). The cut-offs identified were 10.3 cm2 for Center of pressure area, 2.9 cm/s for velocity in the anterior-posterior, and 3.4 cm/s for medio-lateral velocity. The force platform parameters obtained an area under the curve of 0.72, with sensitivity of 78% and specificity of 68%. There were no significant differences between non-fallers and fallers for time-limit variable (17 seconds vs. 18 seconds). Force platform parameters during one-legged stance were associated with history of falls in older adults. The cut-offs obtained acceptable area under curve, sensitivity and specificity, with center of pressure area presenting the best performance to differentiate between fallers and non-fallers.

Effects of Whey Protein Supplementation Pre- or Post-Resistance Training on Muscle Mass, Muscular Strength, and Functional Capacity in Pre-Conditioned Older Women: A Randomized Clinical Trial.

Aging is associated with sarcopenia and dynapenia, with both processes contributing to functional dependence and mortality in older adults. Resistance training (RT) and increased protein intake are strategies that may contribute to health improvements in older adults. Therefore, the aim was to investigate the effects of whey protein (WP) supplementation consumed either immediately pre- or post-RT on skeletal muscle mass (SMM), muscular strength, and functional capacity in pre-conditioned older women. Seventy older women participated in this investigation and were randomly assigned to one of three groups: whey protein pre-RT and placebo post-RT (WP-PLA, n = 24), placebo pre-RT and whey protein post-RT (PLA-WP, n = 23), and placebo pre- and post-RT (PLA-PLA, n = 23). Each group ingested 35 g of WP or PLA. The RT program was carried out over 12 weeks (three times per week; 3 × 8⁻12 repetition maximum). Body composition, muscular strength, functional capacity, and dietary intake were assessed pre- and post-intervention. Two-way analysis of covariance (ANCOVA) for repeated measures, with baseline scores as covariates were used for data analysis. A time vs. group interaction (p < 0.05) was observed with WP-PLA and PLA-WP presenting greater increases compared with PLA-PLA for SMM (WP-PLA = 3.4%; PLA-WP = 4.2%; PLA-PLA = 2.0%), strength (WP-PLA = 8.1%; PLA-WP = 8.3%; PLA-PLA = 7.0%), and the 10-m walk test (WP-PLA = −10.8%; PLA-WP = −11.8%; PLA-PLA = −4.3%). Whey protein supplementation was effective in promoting increases in SMM, muscular strength, and functional capacity in pre-conditioned older women, regardless of supplementation timing. This trial was registered at ClinicalTrials.gov: NCT03247192.

Physical Activity and Sitting Time Are Specifically Associated With Multiple Chronic Diseases and Medicine Intake in Brazilian Older Adults.

The purpose of the study was to clarify the independent association between sedentary behavior and physical activity with multiple chronic diseases and medicine intake in older individuals. Sedentary behavior and physical activity were measured by questionnaires. Diseases and medication use were self-reported. Poisson's regression was adopted for main analysis, through crude and adjusted prevalence ratio and confidence interval of 95%. For men, sedentary time >4 hr/day presented a 76% higher prevalence of ≥2 chronic diseases, while physical inactivity increases the likelihood of using ≥2 medicines in 95%. For women, sedentary behavior >4 hr/day presented an 82% and 43% greater prevalence for ≥2 chronic diseases and the intake of ≥2 medicines, respectively. Sedentary behavior represents an independent associated factor of multiple chronic diseases in older men and women. In addition, inactivity for men and sedentarism for women are associated with the amount of medicine intake.

Resistance training prescription with different load-management methods improves phase angle in older women.

The purpose of the present study was to investigate the effect of two different resistance training (RT) prescription methods on phase angle (PA) in older women. Seventy-six older women (68.5 ± 5.7 years) were randomly assigned to one of three groups: two training groups that performed an eight-week RT programme either in a constant load (CT, n = 25) or an ascending pyramidal load (PR, n = 26) routine three times per week, or a control group (CG, n = 25) that performed no exercise. The CT programme consisted of three sets of 8-12 repetition maximum (RM) with a constant load for the three sets, whereas the PR training consisted of three sets of 12/10/8 RM with incremental loads for each set. PA was assessed by whole-body spectral bioelectrical impedance. After the RT period, both CT and PR achieved higher (P < .05) values of PA (CT = 5.76 ± 0.59°, PR = 5.63 ± 0.61°, CG = 5.48 ± 0.46°) compared to the CG; however, there was no difference (P > .05) between trained groups. The results suggest that eight weeks of RT based on a PR and CT load routines promote an improvement in PA, and both prescription methods performed similarly.

Static and Functional Balance in Individuals With COPD: Comparison With Healthy Controls and Differences According to Sex and Disease Severity.

BACKGROUND: Studies have shown that individuals with COPD have impaired body balance, probably caused by the disease's multisystemic manifestations plus age-related decline in balance, potentially increasing the risk of falling and its consequences. However, little is known about the profile of individuals with COPD who present balance impairments, especially related to sex and disease severity stages. The aim of this work was to compare static and functional balance between subjects with COPD and healthy controls and to check possible differences according to sex and degrees of disease severity. METHODS: Forty-seven subjects with COPD and 25 healthy controls were included in this study. Their static balance was assessed in one-legged stance using a force platform and functional balance with the Timed Up and Go test. Additionally, participants performed spirometry, the 6-min walk test and isometric quadriceps maximal voluntary contraction assessment. Disease severity was classified according to the Global Initiative for Obstructive Lung Disease stages and BODE (body mass index, air-flow obstruction, dyspnea, and exercise capacity) scores. RESULTS: In comparison with healthy controls, subjects with COPD had worse static (center of pressure displacement area: 9.3 ± 1.9 cm2 vs 11.6 ± 4.0 cm2, respectively, P = .01) and functional balance (Timed Up and Go test: 8.5 ± 1.3 s vs 10.3 ± 1.8 s, respectively, P < .001). In the COPD group, men performed better in the Timed Up and Go test than women (9.8 ± 1.2 s vs 10.9 ± 2.2 s, respectively, P = .03), whereas women presented a better static balance in comparison with men for all parameters related to center of pressure (P < .005 for all). Disease severity did not affect any balance results. CONCLUSIONS: Individuals with COPD had worse static and functional balance in comparison with healthy controls. Sex can mediate these results, depending on the type of balance evaluation (force platform or functional test). Balance performance was similar among the groups classified according to disease severity.

Angiotensin-II blockage, muscle strength, and exercise capacity in physically independent older adults.

[Purpose] This study aimed to assess the exercise capacity and muscle strength in elderly people using drugs for angiotensin-II blockage. [Subjects and Methods] Four hundred and seven older adults were recruited for this study. Data about comorbidities and medication use were recorded and the individuals were divided into three groups: control group- elderly people with normal exercise capacity (n=235); angiotensin-converting enzyme inhibitor group - individuals using angiotensin-converting enzyme inhibitors (n=140); and angiotensin-II receptor blocker group- patients using angiotensin-II receptor blockers (n= 32). Exercise capacity was evaluated by a 6-minute walking test and muscle strength was measured using a handgrip dynamometer. [Results] Patients from the angiotensin-converting enzyme inhibitor group (mean: 99 ± 12%) and the angiotensin-II receptor blocker group (mean: 101 ± 14%) showed higher predicted values in the 6-minute walking test than the control group patients (mean: 96 ± 10%). Patients from the angiotensin-converting enzyme inhibitor group (mean: 105 ± 19%) and the angiotensin-II receptor blocker group (mean: 105.1 ± 18.73%) showed higher predicted values of muscle strength than control group patients (mean: 98.15 ± 18.77%). [Conclusion] Older adults using angiotensin-converting enzyme inhibitors or angiotensin-II receptor blockers have better functional exercise capacity and muscle strength.

Prevalence of dyslipidemia in adolescents: comparison between definitions.

INTRODUCTION: The indiscriminate use of different diagnostic criteria for the definition of dyslipidemia may result in inaccurate interpretations, which could compromise diagnosis and therefore the therapeutic and prophylactic actions to be taken. OBJECTIVE: To analyze possible differences in prevalence rates of dyslipidemia in adolescents based on three diagnostic definitions. METHODS: A cross-sectional study was conducted of a representative sample of Brazilian adolescents between 11 and 16 years of age. Blood samples were collected from 1000 students (423 boys and 577 girls) to determine fasting total cholesterol (TC), HDL and LDL cholesterol, and triglycerides (TG). The prevalence of dyslipidemia was established according to three definitions: those of the National Cholesterol Education Program (NCEP), the Brazilian Society of Cardiology (BSC), and the National Health and Nutrition Examination Survey (NHANES). RESULTS: Significant differences (p<0.01) were found between the diagnostic criteria for TC (BSC 38.3%; NCEP 11.2%; NHANES 4.8%), HDL cholesterol (BSC 30.0%; NCEP 15.8% NHANES 18.4%), LDL cholesterol (BSC and NCEP 10.8% and NHANES 5.9%), and TG (BSC and NCEP 4.7% and NHANES 1.3%). The overall prevalence of dyslipidemia was 61% (BSC), 28.6% (NCEP) and 24.2% (NHANES). Agreement rates varied significantly (kappa 0.15-0.90). CONCLUSIONS: Although a high prevalence of dyslipidemia was observed in this study regardless of the diagnostic criteria used, the wide variation in rates highlights the need to establish a single definition with appropriate discriminatory power for adolescents.

Effect of different types of exercise on postural balance in elderly women: a randomized controlled trial.

Different types of exercise are indicated for the elderly to prevent functional capacity limitations due to aging and reduce the risk of falls. This study aimed to evaluate the effect of three different exercises (mini-trampoline, MT; aquatic gymnastics, AG and general floor gymnastics, GG) on postural balance in elderly women. Seventy-four physically independent elderly women, mean age 69±4 years, were randomly assigned to three intervention groups: (1) MT (n=23), (2) AG (n=28), and (3) GG (n=23). Each group performed physical training, including cardiorespiratory, muscular strength and endurance, flexibility and sensory-motor exercises for 12 weeks. To determine the effects on each intervention group, five postural balance tasks were performed on a force platform (BIOMEC 400): the two-legged stand with eyes open (TLEO) and two-legged stand with eyes closed (TLEC); the semi-tandem stand with eyes open (STEO) and semi-tandem stand with eyes closed (STEC) and the one-legged stand. Three trials were performed for each task (with 30s of rest between them) and the mean was used to compute balance parameters such as center of pressure (COP) sway movements. All modalities investigated such as the MT, AG and GG were significantly (P<0.05) efficient in improving the postural balance of elderly women after 12 weeks of training. These results provide further evidence concerning exercise and balance for promoting health in elderly women.

Effect of trunk extensor fatigue on the postural balance of elderly and young adults during unipodal task.

Muscle fatigue can influence the various mechanisms that regulate balance. Few studies have investigated the effects of trunk extensor muscle fatigue on postural control. The purpose of this study was to evaluate the impact of trunk extensor fatigue during a one-leg balance test in young and elderly adults, as well as to determine the time necessary to recover posture control after fatigue. A total of 36 subjects (18 elderly and 18 young adults) participated in the study. Subjects were tested on a force platform to assess the postural control parameters associated with center of pressure (COP) movements, before and after a fatiguing trunk extension-flexion exercise on a roman chair carried out to exhaustion. Post-fatigue effects and postural control recovery were investigated at different times in minutes (MIN): immediately post-fatigue (postIME), after 5 (rec5MIN), 10 (rec10MIN), and 20 min (rec20MIN). Elderly subjects had greater sway (P < 0.05) than young adults in all COP parameters. In both groups, there was an increase in postIME sway compared with pre-fatigue values for all COP parameters. However, the differences were significant only for the COP velocity parameter, with more pronounced effects in young adults that did not return to pre-fatigue values at the end of rec20MIN. The present study demonstrated a significant effect of trunk extensor muscle fatigue on postural control, which was more evident in young adults than in the elderly.

Age-related differences in time-limit performance and force platform-based balance measures during one-leg stance.

Poor posture control has been associated with an increased risk of falls and mobility disability among older adults. This study was conducted to assess the test-retest reliability and sensitivity to group differences regarding the time-limit (TLimit) of one-leg standing and selected balance parameters obtained with a force platform in older and young adults. A secondary purpose was to assess the relationship between TLimit and these balance parameters. Twenty-eight healthy older adults (age: 69±5years) and thirty young adults (age: 21±4years) participated in this study. Two one-leg stance tasks were performed: (1) three trials of 30s maximum and (2) one TLimit trial. The following balance parameters were computed: center of pressure area, RMS sway amplitude, and mean velocity and mean frequency in both the anterio-posterior and medio-lateral directions. All balance parameters obtained with the force platform as well as the TLimit variable were sensitive to differences in balance performance between older and young adults. The test-retest reliability of these measures was found to be acceptable (ICC: 0.40-0.85), with better ICC scores observed for mean velocity and mean frequency in the older group. Pearson correlations coefficients (r) between balance parameters and TLimit ranged from -0.16 to -0.54. These results add to the current literature that can be used in the development of measurement tools for evaluating balance in older and young adults.

Physical activity in daily life in physically independent elderly participating in community-based exercise program / Atividade física na vida diária de idosos fisicamente independentes participantes de programas de exercício físico oferecidos à comunidade

BACKGROUND: It is unclear whether participation in exercise programs specifically developed for elderly translates into a more active lifestyle. OBJECTIVES: To compare the objectively measured level of physical activity in daily life (PADL) between physically independent elderly who participate or do not participate in community-based exercise programs; and to evaluate which factors are associated with the higher level of PADL in these subjects. METHOD: 134 elderly participants in community-based exercise programs (PG) and 104 non-participants (NPG) had their level of PADL measured using pedometers during 7 days. Other measurements: 6-minute walking test (6MWT), incremental shuttle walking test (ISWT), muscle strength, flexibility and balance. RESULTS: The PG had higher 1-week mean daily step count than NPG (8314 [IQR 5971-10060] vs. 6250 [IQR 4346-8207] steps/day, p<0.0001), as well as higher step count in any day of the week. There was a higher proportion of physically active subjects (>8000 steps/day) in PG than in NPG (37% vs. 16%, respectively; p<0.001), as well as the proportion of sedentary subjects (<5000 steps/day) (14% vs. 33%, respectively; p<0.001). Participation in exercise programs, 6MWT and ISWT explained a higher daily steps count (model r²=0.56, p<0.0001). CONCLUSIONS: In physically independent elderly, a higher level of physical activity in daily life occurs in those who participate in community-based exercise programs, regardless of the weekday and including non-program days. Participation of elderly in community-based exercise programs should be more systematically available and encouraged due to its close link to higher activity levels and better exercise capacity.

CONTEXTUALIZAÇÃO: Não está claro se a participação em programas de exercício físico específicos para idosos se traduz em um estilo de vida mais ativo. OBJETIVOS: Comparar o nível de atividade física na vida diária (AFVD) entre idosos fisicamente independentes (IFI) participantes e não participantes de programas de exercício oferecidos à comunidade e estudar os fatores associados ao maior nível de AFVD nesses indivíduos. MÉTODO: Cento e trinta e quatro IFI participantes de programas de exercício (GP) e 104 não participantes (GNP) tiveram seu nível de AFVD avaliado utilizando-se pedômetros durante sete dias. Outras avaliações foram teste de caminhada de 6 minutos (TC6min), incremental shuttle walking test (ISWT), força muscular, flexibilidade e equilíbrio. RESULTADOS: O GP apresentou maior média de passos/dia em sete dias do que o GNP (mediana [IRQ25%-75%] 8314[5971-10060] vs 6250[4346-8207] passos/dia, p<0,0001), bem como maior número de passos em qualquer dia da semana. Houve maior proporção de idosos fisicamente ativos (>8000 passos/dia) no GP em comparação com o GNP (37% vs 16%, respectivamente; p<0,001), assim como menor proporção de sedentários (<5000 passos/dia) (14% vs 33% respectivamente; p<0,001). Um modelo de regressão linear múltipla mostrou que participação em programas, TC6min e ISWT explicaram uma maior média de passos/dia (r²=0,56, p<0,0001). CONCLUSÕES: Em IFI, maior nível de AFVD ocorreu naqueles participantes de programas de exercício oferecidos à comunidade, mesmo analisando-se finais de semana e dias sem programa. A participação nesse tipo de programa deveria ser encorajada devido à sua relação com um estilo de vida mais ativo e melhor capacidade de exercício.