Unraveling the unparalleled benefits of orienteering versus hiking on gait performance and cognition: A randomized clinical trial.

METHODS: Physical activities and sports in nature offer opportunities for leisure, health, and well-being. A randomized clinical trial (RCT) compared the effects of training, dualtask orienteering and single-task hiking in independent older adults (n = 90) allocated into three groups: orienteering group (OG), hiking group (HG) and control group (CG). Timed Up and Go (TUG) tests, including a dual-task (TUG-DT), and cognitive tests were administered. Differences were analyzed by Generalized Estimating Equations (GEE) and the effect size (ES) was calculated. Unpaired and paired tests were used for the evaluation of basic differences and after 24 weeks of intervention. RESULTS: This RCT highlights the interaction effects between groups and time. Only the OG in TUGDT reduced by 6 s, with change of 42% (ES=0.77). Likewise, Dual TUG + cognitive stops (TUG-DT+ CS) and Dual TUG + cognitive stops + cognitive errors (TUG-DT + CS + CE), reduced 7 (ES=0.85) and 8 (ES=0.90) seconds (<0.001). The task cost improved by 75% for OG and 24% for HG (p = 0.001), with an ES of 0.56 for OG. For cognition, there was a 49.2% increase (ES=2.00) for OG and 16.5% for HG in executive functions and visuospatial skills, a 31.4% increase (ES=1.64) for OG and 14.7% for HG in processing speed, and a 39.8% increase (ES=1.62) for OG and 6.5% for HG in memory. All interactions were <0.001. CONCLUSION: The orienteering demonstrated that has potential benefits in effectively improving gait performance and preventing cognitive decline in older adults. Brazilian Registry of Clinical Trials (ReBEC): RBR-99jmmpf.

Improving the impact of pharmacy interventions in hospitals.

The clinical and pharmaceutical interventions of pharmacy professionals are considered impactful inputs towards optimised patient care and safety, by rationalising prescriptions, enhancing therapeutic choices and reducing and preventing medication errors and adverse effects. Pharmacy interventions (PIs), related to the identification, prevention and resolution of drug-related problems, should be recorded for optimal clinical governance and potential health outcomes.Between October 2020 and October 2021, the community hospitals at Powys Teaching Health Board recorded 158 PIs, corresponding to 0.4 interventions per staff per week. Only two members of the team were recording these PIs. Poor indicative PIs can result in lost opportunities for medication optimisation and prescribing rationalisation, increased costs and unidentified training potential.The aims of this project were (1) to record 180 interventions between 22 November 2021 and 8 April 2022 (20 weeks), corresponding to an average threefold increase, compared to the interventions recorded between October 2020 and October 2021 (52 weeks); (2) to have all hospital pharmacy staff recording at least one intervention during the same period.The number of interventions recorded and the number of pharmacy staff recording each intervention were two process measures. The project was completed through two Plan-Do-Study-Act cycles and applied theory on managing change in healthcare.The most successful intervention influencing positively the process measures was the implementation of a new Pharmacy Intervention Record Tool (xPIRT) toolkit that included an online recording tool (xPIRT) and an interactive panel with up-to-date results from all interventions recorded (xPIRT Dashboard). Motivating change was proven to be one of the best determinants of user satisfaction and engagement that contributed to meet the project's targets. xPIRT Dashboard provided staff the capacity to act on possible personal motivators and the possibility to improving care with medicines on their wards. The implementation of xPIRT toolkit was able to increase the representativity and significance of PIs recorded by the hospital pharmacy team, and it is expected to be used for personal professional development, demonstrating team activity and impact, service planning, prescribing practice optimisation and to identify education/training needs. This toolkit can be easily applied and adapted to other health organisations, settings and services.

Aerobic exercise 3 times per week in adult rats did not influence the progression of periodontal disease.

Introduction: Physical exercise has proven efficacy in the prevention and treatment of chronic diseases, and its anti-inflammatory effect has been evaluated as a potential preventive factor in the progression of periodontal disease, in addition to improving physiological parameters. Methods: To test this hypothesis regarding its preventive factor, we evaluated the effects of aerobic training on the progression of periodontal disease in 8-month-old Wistar rats (n = 44). The animals underwent a swimming protocol lasting six weeks, with periodontal disease induced by ligature in the fifth week, totaling fourteen days of ligature placement. Anthropometric parameters were measured for subsequent calculations of BMI and Lee's Index. Interleukin-1ß testing was performed to measure serum inflammatory parameters, and alveolar bone loss was measured using images to calculate the area of loss. Results: The trained animals showed no significant differences compared to the non-trained animals in terms of anthropometric measures. Regarding the area of bone loss, although there were significant differences between the groups with and without periodontal disease, exercise did not demonstrate an impact on rats with the disease. IL-1ß analysis did not detect any measurable values in the samples in either group. Discussion: These findings indicate that the applied exercise protocol was not sufficient to attenuate the progression of periodontal disease. This study did not find an effective impact of physical exercise on the analyzed parameters; however, the results are important in highlighting that the experimental animal model for inducing periodontal disease is efficient, which may encourage further investigations to determine factors that can attenuate its progression. Similarly, the application or development of new exercise protocols that can benefit and enrich the discussion on its positive effects in this disease is important, as there is already evidence suggesting an effective relationship between exercise and disease progression.

Trunk variability and local dynamic stability during gait after generalized fatigue induced by incremental exercise test in young women in different phases of the menstrual cycle.

Purpose: The purpose of this study was to identify how generalized fatigue along with hormonal changes throughout the menstrual cycle affects trunk variability and local dynamic stability during gait. Methods: General fatigue was induced by an incremental test on a treadmill, and the menstrual cycle was divided into three phases: follicular, ovulatory, and luteal. Twenty-six healthy, young volunteers (aged 18 to 28 years) who did not use oral contraceptives or other hormonal drugs with a regular menstrual cycle participated in the study. They walked on the treadmill for 4 min at the preferred speed, before the incremental test, followed by four sets of 4 min alternating between walking, also at preferred speed, and resting. From trunk kinematic data, the following were extracted: the mean of the standard deviation along strides, as a measure of variability, and the maximum Lyapunov exponent, as a measure of local dynamic stability (LDS). Results: After the incremental test, variability increased, and LDS decreased. However, they showed a tendency to return to the initial value faster in women compared to previous results for men. In the follicular phase, which has less hormonal release, the volunteers had an almost complete recovery in LDS soon after the first rest interval, suggesting that female hormones can interfere with fatigue recovery. Nevertheless, concerning the LDS, it was significantly lower in the luteal phase than in the follicular phase. Conclusion: Women that are not taking oral contraceptives should be aware that they are susceptible to increased gait instabilities in the pre-menstrual phase after strenuous activities.

Modelling anaerobic peak power assessed by the force-velocity test among late adolescents.

OBJECTIVES: The aim of this study was to examine the concurrent contributions of body size, estimates of whole-body composition, and appendicular volume in addition to participation in competitive basketball to explain inter-individual variance in anaerobic peak power output during late adolescence. The study also tested non-participation versus participation in basketball as an independent predictor of peak power output. METHODS: The sample of this cross-sectional study was composed of 63 male participants (basketball: n=32, 17.0±0.9 years; school: n=31, 17.4±1.0 years). Anthropometry included stature, body mass, circumferences, lengths, and skinfolds. Fat-free mass was estimated from skinfolds and lower limbs volume predicted from circumferences and lengths. Participants completed the force-velocity test using a cycle ergometer to determine peak power output. RESULTS: For the total sample, optimal peak power was correlated to body size (body mass: r=0.634; fat-free mass: r=0.719, lower limbs volume: r=0.577). The best model was given by fat-free mass and explained 51% of the inter-individual variance in force-velocity test. The preceding was independent of participating in sports (i.e., the dummy variable basketball vs. school did not add significant explained variance). CONCLUSION: Adolescent basketball players were taller and heavier than school boys. The groups also differed in fat-free mass (school: 53.8±4.8 kg; basketball: 60.4±6.7 kg), which was the most prominent predictor of inter-individual variance in peak power output. Briefly, compared to school boys, participation in basketball was not associated with optimal differential braking force. Higher values in peak power output for basketball players were explained by a larger amount of fat-free mass.

Modelling anaerobic peak power assessed by the force-velocity test among late adolescents

SUMMARY OBJECTIVES: The aim of this study was to examine the concurrent contributions of body size, estimates of whole-body composition, and appendicular volume in addition to participation in competitive basketball to explain inter-individual variance in anaerobic peak power output during late adolescence. The study also tested non-participation versus participation in basketball as an independent predictor of peak power output. METHODS: The sample of this cross-sectional study was composed of 63 male participants (basketball: n=32, 17.0±0.9 years; school: n=31, 17.4±1.0 years). Anthropometry included stature, body mass, circumferences, lengths, and skinfolds. Fat-free mass was estimated from skinfolds and lower limbs volume predicted from circumferences and lengths. Participants completed the force-velocity test using a cycle ergometer to determine peak power output. RESULTS: For the total sample, optimal peak power was correlated to body size (body mass: r=0.634; fat-free mass: r=0.719, lower limbs volume: r=0.577). The best model was given by fat-free mass and explained 51% of the inter-individual variance in force-velocity test. The preceding was independent of participating in sports (i.e., the dummy variable basketball vs. school did not add significant explained variance). CONCLUSION: Adolescent basketball players were taller and heavier than school boys. The groups also differed in fat-free mass (school: 53.8±4.8 kg; basketball: 60.4±6.7 kg), which was the most prominent predictor of inter-individual variance in peak power output. Briefly, compared to school boys, participation in basketball was not associated with optimal differential braking force. Higher values in peak power output for basketball players were explained by a larger amount of fat-free mass.

The 180° Turn Phase of the Timed Up and Go Test Better Predicts History of Falls in the Oldest-Old When Compared With the Full Test: A Case-Control Study.

The 180° turn phase of the test may better differentiate the oldest-old regarding their history of falls. This is a case-control study designed to detect the ability of the 180° turn timed up and go (TUG) phase to detect a history of falls in the oldest-old. Sixty people aged 85 years and older were assessed in their homes. The single-task and dual-task TUG tests were performed using an inertial sensor (G-Walk). Sociodemographic data, physical activity levels, mental status, depressive symptoms, concern for falls occurrence, number of medicines in use, self-perception of balance, and the functional reach test were also assessed. The logistic regressions revealed the 180° turn phase of both the single-task and dual-task TUG was almost three times better than the full TUG test to detect a history of falls, thus providing insights that can be used to better assess functional mobility in the oldest-old.

Using xPIRT to Record Pharmacy Interventions: An Observational, Cross-Sectional and Retrospective Study.

Medication errors and omissions can potentially cause harm, prolong a hospital stay, lead to co-morbidities and even death. Pharmacy interventions (PI) ensure that these errors are identified and addressed, leading to improved patient safety and prescriber practice. Particularly in community hospitals, many only having general practitioners and not specialist doctors in their medical teams, PIs assume a strategic role. The PIs recorded throughout 8 months (between November 2021 and June 2022) in the community hospital wards in Powys, Wales, UK, using xPIRT (Pharmacy Intervention Recording Tool), a new pharmacy intervention record toolkit, were subjected to a retrospective analysis. The data were organised by location, drug, severity, acceptance, cost avoidance and intervention type. Significant prescribing errors were identified, which can potentially be different from those recorded in acute settings. Our results also informed on the need for integrated electronic prescribing systems paired with a PI recording tool to address effectively prescribing inaccuracies. Overall, this study was able to identify pharmacy teams as key to improve patient safety and care while contributing to significant cost-savings, through the recording of PI using xPIRT.

Perfil da fisioterapia na reabilitação de indivíduos com doença de Alzheimer: um estudo transversal / Perfil de la fisioterapia en la rehabilitación de personas con enfermedad de Alzheimer: un estudio transversal / Profile of physical therapy in the rehabilitation of individuals with Alzheimer's disease: a cross-sectional study

RESUMO O estudo analisou o perfil de atuação dos fisioterapeutas do Rio de Janeiro (RJ) e do Rio Grande do Sul (RS) no manejo da pessoa com doença de Alzheimer (DA). Foram obtidas 256 respostas a um questionário enviado via endereço eletrônico dos Conselhos Regionais de Fisioterapia e Terapia Ocupacional das regiões 2 (RJ) e 5 (RS) - CREFITOS 2 e 5 -, entre março e dezembro de 2020. O questionário tinha 36 perguntas fechadas, cujas variáveis foram agrupadas em: (1) caracterização da amostra; (2) dados específicos sobre a profissão de fisioterapeuta; e (3) questões relacionadas à DA. Neste artigo serão analisadas apenas as questões relacionadas à DA. Todas as questões eram de múltipla escolha, com 2 até 15 opções de resposta. A maioria dos respondentes (88,3%) já atendeu paciente com DA, mas 50,8% fariam uma revisão de literatura para atender novamente esses pacientes. O principal objetivo relatado no manejo do indivíduo com DA foi "retardar a progressão das perdas motoras". As condutas foram significativamente diferentes conforme a fase da doença (p<0,001). Mais de 85% citaram como benefício que a fisioterapia "retarda a dependência física". Este estudo deixa evidente a necessidade de mais pesquisas que abordem especificamente as fases intermediária e avançada da DA, pois, até o momento, a literatura se mostra inconclusiva e com pouca evidência em relação à fisioterapia no manejo dessas pessoas, impossibilitando a criação de manuais e/ou padronização de condutas específicas a cada estágio da doença.

RESUMEN Este estudio analizó el perfil de actuación de los fisioterapeutas de Rio de Janeiro (RJ) y de Rio Grande do Sul (RS) en el manejo de personas con enfermedad de Alzheimer (EA). Un total de 256 respuestas se obtuvo de un cuestionario enviado electrónicamente a los Consejos Regionales de Fisioterapia y Terapia Ocupacional de las regiones 2 (RJ) y 5 (RS) -CREFITOS 2 y 5-, en el período de marzo a diciembre de 2020. El cuestionario constaba de 36 preguntas cerradas, con variables que se agruparon en: (1) caracterización de la muestra; (2) datos específicos sobre la profesión de fisioterapeuta; y (3) preguntas relacionadas con EA. Este artículo solo analizó los problemas relacionados con la EA. Todas las preguntas eran de opción múltiple, con 2 a 15 opciones de respuesta. La mayoría de los encuestados (88,3%) ya había asistido a pacientes con EA, pero el 50,8% haría una revisión de la literatura para asistir nuevamente a estos pacientes. El principal objetivo informado en el manejo del individuo con EA fue "retrasar la progresión de las pérdidas motoras". Las conductas fueron significativamente diferentes según el estadio de la enfermedad (p<0,001). Más del 85% citó como beneficio que la fisioterapia "retrasa la dependencia física". Este estudio apunta la necesidad de más investigaciones que aborden específicamente las etapas intermedias y avanzadas de la EA, ya que la literatura existente es poco concluyente y con poca evidencia respecto a la fisioterapia en el manejo de estas personas con la enfermedad, lo que impide la elaboración de manuales y/o estandarización de conductas específicas para cada estadio de la enfermedad.

ABSTRACT This study analyzes the working profile of physical therapists from the states of Rio de Janeiro (RJ) and Rio Grande do Sul (RS) in the management of people with Alzheimer's disease (AD). A total of 256 responses were obtained to a questionnaire sent via the electronic address of the Regional Councils of Physical Therapy and Occupational Therapy (CREFITOS) 2 (RJ) and 5 (RS), from March to December 2020. The questionnaire comprises 36 closed questions, the variables of which were grouped into: (1) sample characterization; (2) specific data on the profession of physical therapist; and (3) issues related to AD. In this article, only issues related to AD will be analyzed. All questions were multiple choice with 2 to 15 options of answer. Most respondents (88.3%) had already treated patients with AD, but 50.8% needed to review the literature to assist these patients. The main objective reported in the management of the individual with AD was to "delay the progression of motor losses." The practices were significantly different according to the stage of the disease (p<0.001). More than 85% of the participants cited as a benefit that physical therapy "delays physical dependence." This study shows the need for further studies that specifically address the intermediate and advanced stages of AD since the current literature is inconclusive and with little evidence regarding physical therapy in the management of this population, making it impossible to create manuals and /or standardization of specific practices for each stage.

Isolation and Characterisation of Quercitrin as a Potent Anti-Sickle Cell Anaemia Agent from Alchornea cordifolia.

Alchornea cordifolia Müll. Arg. (commonly known as Christmas Bush) has been used traditionally in Africa to treat sickle cell anaemia (a recessive disease, arising from the S haemoglobin (Hb) allele), but the active compounds are yet to be identified. Herein, we describe the use of sequential fractionation coupled with in vitro anti-sickling assays to purify the active component. Sickling was induced in HbSS genotype blood samples using sodium metabisulphite (Na2S2O5) or through incubation in 100% N2. Methanol extracts of A. cordifolia leaves and its sub-fractions showed >70% suppression of HbSS erythrocyte sickling. The purified compound demonstrated a 87.2 ± 2.39% significant anti-sickling activity and 93.1 ± 2.69% erythrocyte sickling-inhibition at 0.4 mg/mL. Nuclear magnetic resonance (NMR) spectra and high-resolution mass spectroscopy identified it as quercitrin (quercetin 3-rhamnoside). Purified quercitrin also inhibited the polymerisation of isolated HbS and stabilized sickle erythrocytes membranes. Metabolomic comparisons of blood samples using flow-infusion electrospray-high resolution mass spectrometry indicated that quercitrin could convert HbSS erythrocyte metabolomes to be like HbAA. Sickling was associated with changes in antioxidants, anaerobic bioenergy, and arachidonic acid metabolism, all of which were reversed by quercitrin. The findings described could inform efforts directed to the development of an anti-sickling drug or quality control assessments of A. cordifolia preparations.

Evaluation of Electromyographic Activity of Masticatory Muscles in Adults with Posterior Crossbite.

Introduction: There is evidence that patients with posterior crossbite (PXB) have neuromuscular changes in the masticatory muscles. However, up to the present time, the relationship among these changes on the electromyographic activity of the masticatory muscles is still unclear. Objective: To systematic review the available literature on the electromyographic activity of masticatory muscles in adults with PXB. Methods: Between August 22 and September 9, 2020, we searched the following seven electronic databases: PubMed, EMBASE, Web of Science, Cochrane Library, SciELO, LILACS, and Scopus. No restrictions were applied regarding the language and year of publication. This systematic review was registered in the Prospective Register of Systematic Reviews (PROSPERO - CRD42020205057) database and conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. After data selection and extraction, the methodological quality of the selected studies was conducted independently by two reviewers, using two different evaluation tools. Results: 6957 records were initially located after the search process. In the end, eight papers were selected. Most studies were classified as having average to low methodological quality and moderate to high risk of bias. Based on the available evidence, adult patients with PXB have electromyographic activity changes in the masticatory muscles when compared with individuals without PXB. Moreover, adult patients with unilateral posterior crossbite (UPXB) have asymmetrical electromyographic activity when the crossbite side is compared with the noncrossbite side. Conclusion: Despite the lack of studies with high methodological quality, electromyographic evaluation of masticatory muscles should be considered in the diagnosis and in the orthodontic treatment plan of patients with PXB. Prospective studies with a higher sample size and follow-up time, conducted using a rigorous scientific methodology, are necessary to reach a more reliable conclusion.

Influence of Different Dual-Task Conditions During Straight or Curved Walking on Gait Performance of Physically Active Older Women With Cognitive Decline.

Real-world walking requires shifting attention from different cognitive demands to adapt gait. This study aims to evaluate the effect of dual tasking on spatiotemporal gait parameters of older adults. Participants were asked to perform a primary complex single-walking task, consisting of a fast-paced linear and a curved gait. Primary task was performed separately and simultaneously with different motor and cognitive secondary tasks. Spatiotemporal gait parameters, walk ratio, and walk stability ratio were measured. Apart from stride length, which stood relatively unchanged, gait speed and cadence were strongly affected by cognitive dual tasking. Cadence seems to be the most impacted by dual tasking during curved gait as it combines challenges of both primary and secondary tasks. Also, during curved phase, walking ratio was significantly lower and stability ratio was greater demonstrating that participants adopted a cautious gait where maintenance of stability took preference over efficiency.

Biomechanical responses of Nordic walking in people with Parkinson's disease.

In healthy adults, Nordic walking (NW) is known to increase the external mechanical energy fluctuations, though the external work is unaltered due to an improved pendulum-like recovery in comparison with free walking (FW). We aimed to compare mechanical, pendulum-like, and spatiotemporal parameters of gait at different speeds with and without NW poles in people with Parkinson's disease and healthy controls. The study included 11 people (aged 65.6 ± 7.0 years) with idiopathic Parkinson's disease, scoring between 1 and 1.5 on the Hoehn and Yahr scale (H&Y), and nine healthy controls (aged 70.0 ± 5.6 years). All the people were experienced Nordic walkers. Walking tests were performed at 1.8 km h-1 and 4.7 km h-1 , on eight 3D force platforms on a walkway. We found greater pendulum-like energy recovery (p < 0.05) in the Parkinson group during NW than in FW, while external mechanical work remained similar (p > 0.05). People with Parkinson's disease showed a major increase in vertical and forward energy fluctuations using poles than in healthy controls. In addition, the Parkinson group showed increased stride frequency and reduced stride length compared to controls in the NW and FW conditions. Our findings partly justify the lower walking economy in Parkinson's disease due to reduced pendulum-like mechanism at commonly used speeds. NW alters gait mechanics similarly in Parkinson group and healthy control, increasing the total mechanical work. Therefore, NW can be a compelling strategy for rehabilitation because of its potential for improving functional mobility, increasing pendulum-like mechanism in Parkinson's disease.

The improvement of cardiorespiratory fitness in healthy women after a 12-week Classical Pilates training / A melhoria da aptidão cardiorrespiratória em mulheres saudáveis depois de 12 semanas de treinamento no Pilates Clássico

Aims: to evaluate the effects of 12 weeks of Pilates training (Classical Method) on cardiorespiratory fitness and heart rate responses of healthy sedentary women. Method: fifteen women (average age 29±4) performed 12 weeks of Pilates training for 60 minutes, three times per week (Pilates Group). Thirteen women (average age 29±5) as controls maintained their routine activities (Control Group). The exercises' introduction was by the degree of difficulty with changes in the plane of movements; smaller base of support; spinal rotations and extensions; use of abdominal muscles in prone position. Heart rate was monitored and recorded during all sessions using a heart frequency meter. Results: ANOVA analysis results revealed significant difference in Pilates Group (p < 0.05) between pre and post measures of VO2peak (+13%), fat percentage (- 3.3%), free fat mass (+ 2.8 kg), and muscular endurance in the abdominal area (+61%), lower limbs (+75%) and upper limbs (+68%). The percent of Maximum Heart Rate achieved in the 6th (79.25%) and 12th (79.86%) weeks of training increased from the first week (73.4%). Physical fitness in Control Group remained unchanged. Conclusion: twelve weeks of Pilates training positively affected overall physical fitness in previously sedentary healthy women. Furthermore, the increase in VO2peak and achieved Maximum Heart Rate was significant even with no specific aerobic training.

Objetivos: avaliar os efeitos de 12 semanas de treinamento de Pilates (Método Clássico) sobre o condicionamento cardiorrespiratório e respostas da frequência cardíaca de mulheres sedentárias saudáveis. Métodos: quinze mulheres realizaram 12 semanas de treinamento de Pilates durante 60 minutos, três vezes por semana (Grupo Pilates), com média de idade 29±4 anos. Treze mulheres com idade compatível com os controles mantiveram suas atividades rotineiras (Grupo Controle), com média de idade de 29±5 anos. A introdução dos exercícios foi pelo grau de dificuldade com mudança nos planos de movimento; menor base de suporte; rotação e extensão da coluna; e ativação da musculatura abdominal em posição de decúbito ventral. A frequência cardíaca foi monitorada e gravada durante todas as sessões usando um frequencímetro. Resultados: Os resultados da ANOVA revelaram diferença significativa no Grupo Pilates (p < 0,05) entre medidas pré e pós de VO2pico (+13%), percentual de gordura (- 3,3%), massa gorda livre (+ 2,8 kg), e resistência muscular da área abdominal (+61%), membros inferiores (+75%) e dos membros superiores (+68%). O percentual de Frequência Cardíaca Máxima alcançado na sexta (79,25%) e na décima primeira (79,86%) semanas de treinamento aumentou a partir da primeira semana (73,4%). A aptidão física do Grupo Controle permaneceu inalterada. Conclusão: doze semanas de treinamento de Pilates afetaram positivamente o condicionamento físico geral em mulheres saudáveis anteriormente sedentárias. Além disso, o aumento do VO2pico e da Frequência Cardíaca Máxima foi significativo mesmo sem treinamento aeróbico específico.

Intersubjectivity and the meaning of Nordic Walking practice in the view of people with Parkinson's disease: a pilot study / Intersubjetividade e o significado da prática do Nordic Walking na visão de pessoas com doença de Parkinson: um estudo piloto

Aims: whilst Nordic Walking (NW) practice is spreading worldwide, few studies have addressed the issue of intersubjectivity and the perception of PD individuals practicing NW and its possible impact on their daily life across different countries and cultures. This pilot study sought to explore the possible relationship between the habit of practicing NW and the perception of functionality and quality of life in the participants' cultural context. Methods: the focus group (FG) technique was used, with 10 individuals participating in a NW program. Results: content analysis revealed five main discourse categories: a) "NW benefits for people with PD"; b) "incorporation of the NW poles in daily life"; c) "Belonging to a NW group as a treatment aid"; d) "how PD people feel about their condition"; and, finally, e) "the present and the future: expectations and issues". Conclusion: in general, NW was found to generates positive content regarding coping with PD, beyond the biomechanical and quantitative functional effects previously studied. We suggest NW might be an important adjuvant resource for improving perceived functionality among people with PD.

Objetivos: embora a prática de Caminhada Nórdica (CN) esteja se espalhando pelo mundo, poucos estudos abordaram a questão da intersubjetividade e a percepção dos indivíduos com doença de Parkinson que praticam CN e seu possível impacto em sua vida diária em diferentes países e culturas. Este estudo piloto buscou explorar a possível relação entre o hábito de praticar CN e a percepção de funcionalidade e de qualidade de vida no contexto cultural dos participantes. Métodos: foi utilizada a técnica de grupo focal, com 10 indivíduos participantes de um programa de CN. Resultados: a análise de conteúdo revelou cinco categorias discursivas principais: a) "Benefícios da CN para pessoas com doença de Parkinson"; b) "incorporação dos bastões de CN na vida diária"; c) "pertencer a um grupo de CN como recurso auxiliar de tratamento"; d) "como as pessoas com doença de Parkinson se sentem sobre sua condição"; e, por fim, e) "o presente e o futuro: expectativas e questões". Conclusão: de maneira geral, a CN gerou conteúdo positivo sobre o enfrentamento da doença de Parkinson, além dos efeitos biomecânicos e funcionais quantitativos previamente estudados. Sugerimos que a CN possa ser um recurso adjuvante importante para melhorar a percepção de funcionalidade em pessoas com doença de Parkinson.

Effects of additional load at different heights on gait initiation: A statistical parametric mapping of center of pressure and center of mass behavior.

The purpose of this study was to investigate the effects of different vertical positions of an asymmetrical load on the anticipatory postural adjustments phase of gait initiation. Sixty-eight college students (32 males, 36 females; age: 23.65 ± 3.21 years old; weight: 69.98 ± 8.15 kg; height: 1.74 ± 0.08 m) were enrolled in the study. Ground reaction forces and moments were collected using two force platforms. The participants completed three trials under each of the following random conditions: no-load (NL), waist uniformly distributed load (WUD), shoulder uniformly distributed load (SUD), waist stance foot load (WST), shoulder stance foot load (SST), waist swing foot load (WSW), and shoulder swing foot load (SSW). The paired Hotelling's T-square test was used to compare the experimental conditions. The center of pressure (COP) time series were significantly different for the SUD vs. NL, SST vs. NL, WST vs. NL, and WSW vs. NL comparisons. Significant differences in COP time series were observed for all comparisons between waist vs. shoulder conditions. Overall, these differences were greater when the load was positioned at the shoulders. For the center of mass (COM) time series, significant differences were found for the WUD vs. NL and WSW vs. NL conditions. However, no differences were observed with the load positioned at the shoulders. In conclusion, only asymmetrical loading at the waist produced significant differences, and the higher the extra load, the greater the effects on COP behavior. By contrast, only minor changes were observed in COM behavior, suggesting that the changes in COP (the controller) behavior are adjustments to maintain the COM (controlled object) unaltered.

Margins of stability of persons with transtibial or transfemoral amputations walking on sloped surfaces.

Gait is a complex motor skill. However, most falls in humans occur during gait, and people with lower limb amputation have an increased risk of falls. Thus, this study evaluated the stability of persons with unilateral amputation by quantifying the margin of stability (MoS) during gait, to contribute to understanding the strategies adopted by these people to reduce falls. The participants were divided into 3 groups: persons with transtibial amputations (n = 12, 32.27 ± 10.10 years, 76.9 ± 10.3 kg, 1.74 ± 0.06 m); persons with transfemoral amputations (n = 13, 32.21 ± 8.34 years, 72.55 ± 10.23 kg, 1.73 ± 0.05 m); and controls (n = 15, 32.2 ± 10.17 years, 75.4 ± 9.25 kg, 1.75 ± 0.05 m), who walked for 4 min on a level and sloped (8% down and up) treadmill. The pelvic and foot marker kinematic data were used to estimate the center of mass and base of support, and from these, the MoS was estimated. Although both groups of persons with amputations showed higher values for the ML MoS than did the control group (transtibial: 8.81 ± 1.79, 8.97 ± 1.74, 8.79 ± 1.76, transfemoral: 10.15 ± 2.03, 10.60 ± 1.98, 10.11 ± 1.75, control: 8.13 ± 1.30, 7.18 ± 1.85, 8.15 ± 1.57, level, down, and up, respectively), only the transfemoral group presented a significant higher value compared to the control group. Our findings suggest that the documented limitations in persons with amputations, especially with transfemoral amputation, are exacerbated in situations that require more skills, such as walking on sloped surfaces, triggering protective mechanisms.

Allometric Scaling of Force-velocity Test Output Among Pre-pubertal Basketball Players.

Basketball is characterized by high-intensity episodes predominantly reliant on anaerobic metabolism. The force-velocity test enables individual determination of an optimal braking force and emerged as appropriate to estimate optimal peak power. It has rarely been used in youth basketball. This study aimed to examine the contribution of body size, composition, and biological maturation to interindividual variation in force-velocity test output among pre-pubertal basketball players. The sample consisted of 64 male participants (8.4-12.3 years). Stature, sitting height, body mass and two skinfolds were measured, and leg length estimated. Fat-free mass and lower limb volume were estimated from anthropometry. Age at peak height velocity was predicted from maturity offset. Optimal peak power was correlated with all body size descriptors (correlation: 0.541-0.700). Simple allometric models explained 30-47% of inter-individual variance, with fat-free mass being the best predictor of performance. Whole-body fat-free mass (as a surrogate for active muscle mass) plus the indicator of maturation emerged as the best proportional allometric model (53% explained variance). Even at pre-pubertal ages, the interpretation of the force-velocity test requires assessing the metabolically active component of body mass.

Molecular Docking Suggests the Targets of Anti-Mycobacterial Natural Products.

Tuberculosis (TB) is a major global threat, mostly due to the development of antibiotic-resistant forms of Mycobacterium tuberculosis, the causal agent of the disease. Driven by the pressing need for new anti-mycobacterial agents several natural products (NPs) have been shown to have in vitro activities against M. tuberculosis. The utility of any NP as a drug lead is augmented when the anti-mycobacterial target(s) is unknown. To suggest these, we used a molecular reverse docking approach to predict the interactions of 53 selected anti-mycobacterial NPs against known "druggable" mycobacterial targets ClpP1P2, DprE1, InhA, KasA, PanK, PknB and Pks13. The docking scores/binding free energies were predicted and calculated using AutoDock Vina along with physicochemical and structural properties of the NPs, using PaDEL descriptors. These were compared to the established inhibitor (control) drugs for each mycobacterial target. The specific interactions of the bisbenzylisoquinoline alkaloids 2-nortiliacorinine, tiliacorine and 13'-bromotiliacorinine against the targets PknB and DprE1 (-11.4, -10.9 and -9.8 kcal·mol-1; -12.7, -10.9 and -10.3 kcal·mol-1, respectively) and the lignan α-cubebin and Pks13 (-11.0 kcal·mol-1) had significantly superior docking scores compared to controls. Our approach can be used to suggest predicted targets for the NP to be validated experimentally, but these in silico steps are likely to facilitate drug optimization.