Localized hamstring bioimpedance in marathon runners is related to muscle high-energy enzyme serum levels and predicts race time.

Introduction: The aim was to analyze the response of serum levels of inflammatory, high-energy muscle biomarkers and hamstring localized bioimpedance (L-BIA) measurements to marathon running and to ascertain whether they correlate with each other or with race time. Methods: Blood samples and hamstrings tetra-polar L-BIA measurements from 14 Caucasian male recreational athletes at the Barcelona Marathon 2019 were collected at base line, immediately after and 48 h post-race. Serum C reactive protein (sCRP), creatinine kinase (sCK) and lactate dehydrogenase (sLDH) were determined using an AU-5800 chemistry analyzer. L-BIA was obtained at 50 kHz with a Quantum V Segmental phase-sensitive bioimpedance analyzer. Results: Median sCRP increased (4-fold) after 48 h post-race. Median sCK and sLDH levels increased immediately post-race (3-fold, 2-fold) and 48h post-race (5-fold, 1-fold). Left, right and combined hamstring reactance (Xc) and phase angle (PhA) increased immediately post-race. Xc combined hamstring pre- and immediately post-race correlated with race-time and with sCK and sLDH median levels pre-race. Xc combined hamstring pre- and immediately post-race > 15.6 Ω and 15.8 Ω, respectively, predicted the race time of 3:00:00 h. Conclusion: L-BIA reactance (Xc) is an objective direct, real time, easy, noninvasive bioelectrical parameter that may predict muscle and marathon athlete performance.

Indirect Rectus Femoris Injury Mechanisms in Professional Soccer Players: Video Analysis and Magnetic Resonance Imaging Findings.

OBJECTIVE: To describe injury mechanisms and magnetic resonance imaging (MRI) findings in acute rectus femoris (RF) injuries of soccer players using a systematic video analysis. DESIGN: Descriptive case series study of consecutive RF injuries from November 2017 to July 2022. SETTING: Two specialized sports medicine hospitals. PARTICIPANTS: Professional male soccer players aged between 18 and 40 years, referred for injury assessment within 7 days after a RF injury, with an available video footage of the injury and a positive finding on an MRI. INDEPENDENT VARIABLES: Rectus femoris injury mechanisms (specific scoring based on standardized models) in relation to RF muscle injury MRI findings. MAIN OUTCOME MEASURES: Rectus femoris injury mechanism (playing situation, player/opponent behavior, movement, and biomechanics), location of injury in MRI. RESULTS: Twenty videos of RF injuries in 19 professional male soccer players were analyzed. Three different injury mechanisms were seen: kicking (80%), sprinting (10%), and change of direction (10%). Isolated single-tendon injuries were found in 60% of the injuries. Of the kicking injuries, 62.5% included complete tendon ruptures, whereas both running injuries and none of the change of direction injuries were complete ruptures. The direct tendon was involved in 33% of the isolated injuries, and the common tendon was affected in all combined injuries. CONCLUSIONS: Rectus femoris injuries typically occur during kicking among football players. Most of the RF injuries involve a complete rupture of at least one tendon. Kicking injuries can also affect the supporting leg, and sprinting can cause a complete tendon rupture, whereas change of direction seems not to lead to complete ruptures.

Phase angle in localized bioimpedance measurements to assess and monitor muscle injury.

Localized bioimpedance (L-BIA) measurements are an innovative method to non-invasively identify structural derangement of soft tissues, principally muscles, and fluid accumulation in response to traumatic injury. This review provides unique L-BIA data demonstrating significant relative differences between injured and contralateral non-injured regions of interest (ROI) associated with soft tissue injury. One key finding is the specific and sensitive role of reactance (Xc), measured at 50 kHz with a phase-sensitive BI instrument, to identify objective degrees of muscle injury, localized structural damage and fluid accretion, determined using magnetic resonance imaging. The predominant effect of Xc as an indicator of severity of muscle injury is highlighted in phase angle (PhA) measurements. Novel experimental models utilizing cooking-induced cell disruption, saline injection into meat specimens, and measurements of changing amounts of cells in a constant volume provide empirical evidence of the physiological correlates of series Xc as cells in water. Findings of strong associations of capacitance, computed from parallel Xc (XCP), with whole body counting of 40-potassium and resting metabolic rate support the hypothesis that parallel Xc is a biomarker of body cell mass. These observations provide a theoretical and practical basis for a significant role of Xc, and hence PhA, to identify objectively graded muscle injury and to reliably monitor progress of treatment and return of muscle function.

Adaptation and validation of the Person-centered Care Assessment Tool (P-CAT) to the Portuguese population.

BACKGROUND: The relevance of person-centred care as an optimising approach to the quality of care provided to older adults has sparked the development of important instruments that measure this approach at residential care facilities and requires validation for the Portuguese population. OBJECTIVES: This study aims to adapt and validate the Person-centered Care Assessment Tool (P-CAT) to the Portuguese population. METHODS: The P-CAT assesses the level of person-centred care provided by residential care facilities, according to staff. The process of adapting the P-CAT to the Portuguese population includes its translation, backtranslation and a pilot study. To recruit participants for the validation study, we contacted the Portuguese residential care facilities with emails provided in the official registries, and the study was also divulged on social media. RESULTS: The study had the participation of 573 staff members. The mean score of P-CAT was 50.76 (SD = 7.65). The exploratory factor analysis showed three dimensions: the extent of care personalisation, the amount of organisational support and the degree of environmental accessibility. The results show good internal consistency for the total scale (α = 0.809) and good temporal stability in the test-retest assessed by intraclass correlation coefficient (0.893). CONCLUSIONS: This version of the P-CAT for the Portuguese population has shown adequate psychometric properties and contributes to the study of care provided at residential care facilities in Portugal through self-reporting from staff. IMPLICATIONS FOR PRACTICE: The availability of this instrument is useful for professional practice and research purposes and supports technical and scientific advancements that are necessary for the evolution of care frameworks.

Injury epidemiology in the men’s and women’s Spanish rollerhockey league: a descriptive study / Epidemiología lesional en la liga española de hockey patines masculina yfemenina: un estudio descriptivo

The purpose of the present study is to describe the injury patterns among male and female athletes of the Spanish Rink hockey league. A cross-sectional study was performed, concerning the time-loss injuries (the athlete is prevented to participate in a training session / game because of the injury registered by the medical staff of every team. 137 athletes were included (98 male, age 26.7 ± 5.9 years; 39 female, age 23.3 ± 4.6 years). Ninety-four time-loss injuries were recorded, being the most frequent the muscle injury (38 episodes, 40.4%), especially the ones affecting the adductor longus muscle (23 episodes, 60,5% of the muscle injuries). The majority of the registered injuries were classified as mild (1-7 days of time-loss) but the and the median return-to-play was 19.4 ± 29.6 days. Eight episodes of reinjury were described (8.5% of total injuries) and 2 injuries required surgical treatment (2.1% of total injuries). Concerning female athletes, we can highlight a increased number of ligament injuries in the lower limbs compared with male athletes and the absence of tendinopathies causing time-loss. The knee injuries were the injuries with a higher return-to-play in goalkeepers. The present study is the first to describe the injury patterns among rink hockey elite athletes and must set a starting point to study and prevent injuries in this sport.(AU)

El propósito del presente estudio es describir los patrones lesionales durante una temporada de los deportistas de la máxima competición masculina y femenina de Hockey Patines en España. Se realizó un estudio descriptivo de las lesiones con baja deportiva (el/la deportista no puede participar como mínimo en un entrenamiento o partido debido a la lesión) recogidas por los equipos biomédicos de cada equipo. Se estudiaron 137 deportistas (98 hombres, con una media de edad de 26,7 ± 5,9 años y 39 mujeres con una media de edad de 23,3 ± 4,6 años) Se recogieron un total de 94 lesiones con baja deportiva, siendo las más frecuentes las lesiones musculares (38 episodios, 40,4% de las lesiones totales), en especial del músculo aductor largo (23 episodios, 60,5% de las lesiones musculares). La mayoría de lesiones registradas fueron leves (1-7 días de baja deportiva) aunque el tiempo medio de baja fue de 19,4 ± 29,6 días. Se recogieron 8 episodios de relesión (8,5% de las lesiones totales) y 2 lesiones que precisaron tratamiento quirúrgico (2,1% de las lesiones totales). Al estudiar a las deportistas femeninas destaca que presentaron un mayor número de lesiones ligamentosas de extremidades inferiores en comparaciones con los varones y no se describió ningún episodio de tendinopatía.Al estudiar las lesiones específicas de los porteros/as se evidenció que las lesiones que causaban más baja deportiva eran las lesiones de rodilla. El presente estudio es el primero en describir las lesiones en jugadores/as de primer nivel de hockey patines y debe marcar un punto de partida para el estudio y prevención de las lesiones en este deporte.(AU)

From the drama of unoccupied time and isolation due to Covid-19's pandemic to the need for person-centered care at residential care facilities in Portugal.

During the pandemic, restrictive measures were implemented at Portuguese residential care facilities (PRCF), such as isolating residents and ceasing collective activities. It is important to understand how PRCF are implementing activities that allow residents to occupy their time and fight isolation. As such, we aim to analyze whether: 1. new activities were implemented for residents (identifying which were carried out); 2. occupation activities were provided to isolated residents in their rooms (identifying which were carried out); 3. the implementation of activities is associated with variables like the amount of staff. This is an exploratory, quantitative, and cross-sectional study. An online questionnaire was sent by email to 2325 PRCF and entities were asked to share it with their workers. The study was also divulged on social networks. Data collection occurred between July 8th and October 18th, 2020. The study had 784 staff members participating and 90.8% reported that new activities were implemented at their facilities, predominantly videocalls. Concerning isolated residents most respondents (64.4%) stated that providing activities was impossible. Results showed that those PRCF that expanded teams had a higher percentage of new activities and activities with residents isolated in bedrooms. These results are alarming because while residents should have had more resources to cope with the pandemic, higher risks of unoccupied time and isolation existed, a dramatic situation for its potentially harmful consequences. Focusing on sanitary issues (and less on older adults) may reinforce traditional care models that had shown negative impacts before the pandemic. This highlights the need to evolve the care paradigm during and beyond the pandemic at PRCF: with Person-Centered Care as an option.

Staff Assessment Person-Directed Care Questionnaire: Adaptation and Validation for the Portuguese Population.

Person-centered care aims to increase and guarantee the quality of care at residential care facilities for older adults. The implementation and development of this approach requires validated assessment tools, which are still lacking in Portugal. This study aims to adapt and validate for the Portuguese population the internationally and widely used essential instrument that is the Staff Assessment Person-Directed Care (SAPDC). The adaptation of the SAPDC included its translation, back translation, and a pilot-study. For validation, staff members were recruited by distributing the study via email and on social media. Respondents included 546 native Portuguese-speaking staff members working at residential care facilities for over 6 months. The mean score of SAPDC was 165.74 (SD = 36.78). The exploratory factor analysis showed eight conceptually distinct dimensions, considered adequate by the expert team. The total scale showed a very good internal consistency (α = .96) and excellent temporal stability assessed by Intraclass Correlation Coefficient (> .90). Providing a Portuguese version of the SAPDC is useful to substantiate technical and scientific advancements and define policies with implications on evolving care approaches. This tool helps optimize the quality and dignification of gerontological practices, which is urgent at Portuguese residential care facilities.

Correlates to psychological distress in frail older community-dwellers undergoing lockdown during the COVID-19 pandemic.

BACKGROUND: This study identifies correlates of the lockdown's psychological distress in frail older community-dwellers (Catalonia, Spain). METHODS: Participants from a community frailty intervention program, with a comprehensive geriatric assessment within the 12-months pre-lockdown and COVID-19 free during the first pandemic wave (March-May 2020), underwent a phone assessment past the lockdown to assess COVID-19-related emotional distress (DME) as well as other sociodemograhic, clinical and psychosocial factors. RESULTS: Of the 94 frail older adults (age = 82,34 ± 6,12 years; 68,1% women; 38,3% living alone), 84,9% were at risk of experiencing moderate-to-high psychological distress, according to the backward stepwise logistic regression model obtained (χ2 = 47,007, p < 0,001, Nagelkerke R2 = 0,528), based on the following factors: absence of depressive symptoms before lockdown (OR = 0,12, p = 0,014, 95%CI[0,023-0,647]), not carrying out leisure activities during lockdown (OR = 0,257, p = 0,023, 95%CI[0,079-0,832]) and currently experiencing high malaise due to COVID-19 situation (OR = 1,504, p < 0,001, 95%CI[1,241-1,822]). DISCUSSION: These findings suggest that it is necessary to favour a prior overall health status and to empower frail older community-dwellers in the use of a broad repertoire of coping strategies in the face of adversity to foster mental health and keep at bay the potential emotional impact of the situation generated by the COVID pandemic.

Caring and Working during the COVID-19 Pandemic: Perspective of Portuguese Residential Care Facility Workers.

Residential care facilities (RCF) for older people are facing high demands due to the COVID-19 pandemic. The aim of this study was to explore the workers' perspectives on the changes in work and care dynamics amidst the first wave of the pandemic at Portuguese RCF. This is a descriptive, quantitative, and cross-sectional study. An online questionnaire about pandemic-induced changes in work and care dynamics was sent to 2325 RCF. These entities were then asked to share it with their workers. The participants (n = 784) were mostly women (92.7%) and mostly composed of technical directors (41.6%) and direct-care workers (17.1%). The respondents reported that during the first wave of the pandemic, when compared to the pre-pandemic period, there were greater difficulties in providing care related to the basic necessities of older people (52.7%); direct-care workers were required to work more consecutive hours in each shift (69.95%); direct-care workers had to live at RCF (14.8%), and there were changes concerning the possibility of promoting person-centered care (PCC) practices. It also revealed that focusing on disease prevention and sanitary measures alone facilitates practices that reinforce the traditional model of procedure-centered care and have negative consequences on the rights and well-being of those living and working at RCF, exposing and accentuating preexisting vulnerabilities. This study considers the pandemic's serious implications and alarming questions about basic care, dignity, living, and working conditions at Portuguese RCF. These notions reinforce the need for change through redefining care policies and practices in Portuguese RCF beyond the pandemic. The current situation provides an opportunity to adopt a formal PCC model.

Differentiation Between Tendinous, Myotendinous and Myofascial Injuries by L-BIA in Professional Football Players.

PURPOSE: To differentiate by localized bioimpedance (L-BIA) measurements 24 h after injury, between tendinous, myotendinous junction (MTJ), and myofascial junction (MFJ) injuries, previously diagnosed by MRI exam. To evaluate by L-BIA, the severity of MTJ injuries graded from 1 to 3, and to determine the relationship between days to return to play (RTP) and L-BIA measurements. METHODS: 3T MRI and tetra polar L-BIA was used to analyzed 37 muscle injuries 24 h after injury in 32 male professional football players, (23.5 ± 1.5 kg m-2; 1.8 ± 0.1 m; 20-30 year.) between the 2016-2017 and 2017-2018 seasons. Muscle injuries were classified by The British Athletics Muscle Injury Classification (BAMIC). Percentage difference of L-BIA parameters [resistance (R), reactance (Xc), and phase angle (PA)] of the injured side were calculated considering contralateral non-injured side as the reference value. RESULTS: According to BAMIC classification and by MRI exam, we found tendinous (n = 4), MTJ (n = 26), and MFJ (n = 7) muscle injuries. In addition, MTJ injuries were grouped according to the severity of injury in grade 1 (n = 11), grade 2 (n = 8), and grade 3 (n = 7). Significant decrease (P < 0.01) was found in the L-BIA parameters R, Xc, and PA, in both MTJ and MFJ as well as in the different grades of MTJ injuries. In particular, in Xc (P < 0.001), which is related to muscle cell disruption. Regarding days to RTP, there was statistical significance among the three different grades of MTJ injuries (P < 0.001), especially when grade 1 was compared to grade 3 and grade 2 compared to 3. CONCLUSION: L-BIA is a complementary method to imaging diagnostic techniques, such as MRI and US, to quantify MTJ and MFJ injuries. In addition, the increase in the severity of the MTJ injury resulted in higher changes of the Xc parameter and longer time to RTP.

Fat Oxidation Rates in Professional Soccer Players.

PURPOSE: Large interindividual variation exists in maximal fat oxidation (MFO) rates and the exercise intensity at which it occurs (FATMAX). However, there are no data describing the shape of the fat oxidation curve or if individual differences exist when tested on separate occasions. Furthermore, there are limited data on fat metabolism in professional team sport athletes. Therefore, the aim of this study was to test-retest the concavity (shape) and intercept (height) of fat oxidation curves within a group of professional soccer players. METHOD: On two occasions, 16 professional male soccer players completed a graded exercise test in a fasted state (≥5 h). Rates of fat oxidation were determined using indirect calorimetry. Maximal oxygen uptake (V˙O2max) was measured to calculate FATMAX (%V˙O2max). The shape of the fat oxidation curves were modeled on an individual basis using third-degree polynomial. Test-by-test differences, in the shape and vertical shift of the fat oxidation curves, were established to assess within-individual variability. RESULTS: Average absolute MFO was 0.69 ± 0.15 g·min (range, 0.45-0.99 g·min). On a group level, no significant differences were found in MFO between the two tests. No differences were found (P > 0.05) in the shape of the fat oxidation curves in 13 of 16 players (test 1 vs test 2). There were also no differences (P > 0.05) in the vertical shift of the fat oxidation curves in 10 players. CONCLUSIONS: In general, the shape of the fat oxidation curve does not change within an individual; however, the vertical shift is more susceptible to change, which may be due to training status and body composition. Understanding a player's metabolism may be of value to practitioners working within sport, with regard to personalizing nutrition strategies.

La longitud del tendón libre no está asociada al tiempo de vuelta a la competición en las lesiones musculares del bíceps femoral / Length of the free tendon is not associated with return to play time in biceps femoris muscle injuries / La longitud del tendó lliure no està associada al temps de retorn a la competició en les lesions musculars del bíceps femoral

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Cognitive frailty: A conceptual systematic review and an operational proposal for future research.

OBJECTIVE: To analyze the definition of "cognitive frailty" and to study the conceptual and operational definitions used and their implications for empirical research. The relationships between this concept and cognitive reserve, the role of neuropathology and brain reserve, motor signs of aging and the reversibility of cognitive frailty are also discussed. STUDY DESIGN: Systematic review of empirical studies identified from Medline Advanced 1966, CINAHL, Web of Science, PsycINFO, and Scopus until August 2017. MAIN - OUTCOME MEASURES: Effect sizes. The quality of the articles was assessed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement. Three independent reviewers participated in the study selection and data extraction. RESULTS: Nineteen studies involving 31,707 participants met the inclusion criteria. Significant associations were reported between cognitive frailty and physical frailty or gait speed. Screening instruments were usually used to determine objective cognitive decline rather than extensive neuropsychological assessments. Educational level was the only indicator of cognitive reserve that was systematically included in the evaluation of cognitive frailty. Motor decline and gait variables were not systematically included in protocols for the assessment of cognitive frailty. CONCLUSIONS: A strong operational definition would benefit both the development of treatments to counter cognitive frailty and the assessment of treatment effectiveness. Nevertheless, since there is clear agreement regarding the importance of interventions for and the prevention of cognitive frailty, randomized controlled trials investigating the efficacy of preventive interventions are necessary.

Evaluación cognitiva global en personas vascoparlantes con demencia en estadios avanzados. Validación al euskera de la escala Severe Mini Mental State Examination (SMMSE-eus) / Overal cognitive assessment in Basque-speaking people with advanced dementia. Validation to the Basque language of the Severe Mini-Mental State Examination SMMSE (SMMSE-eus)

Introducción: La adaptación y validación al euskera de pruebas para la evaluación del deterioro cognitivo avanzado es una necesidad no cubierta para personas mayores vascoparlantes. El presente trabajo realiza el estudio de validación al euskera de la escala Severe Mini Mental State Examination (SMMSE-eus). Material y métodos: En el estudio participaron 109 sujetos con demencia avanzada (MEC<15) clasificados según la escala de Deterioro global (GDS) con GDS 5-7 y que dominaban tanto el euskera como el castellano. Resultados: Los resultados mostraron que el SMMSE-eus muestra una alta consistencia interna (α=0,92), una buena fiablidad test-restest (r=0,88; p<0,01) y una alta fiabilidad interjueces (CCI=0,99; p<0,00) tanto para la puntuación global como para cada uno de los ítems. Conclusiones: Tanto la alta consistencia interna como el alto nivel de fiabilidad interjueces y los resultados obtenidos en el test-retest hacen del SMMSE-eus un instrumento apropiado como escala breve en la valoración del deterioro cognitivo grave de personas vascoparlantes. Por ello el SMMSE-eus puede ser considerado válido, fiable y una alternativa importante para evaluar en su lengua materna, en este caso en euskera, la capacidad cognitiva en personas con demencia avanzada

Introduction: Adaptation and validation to the Basque language of tests to assess advanced cognitive impairment is a not covered need for Basque-speaking people. The present work shows the validation of the Basque version of the Severe Mini Mental State Examination (SMMSE). Material and methods: A total of 109 people with advanced dementia (MEC<15) took part in the validation study, and were classified as GDS 5-7 on the Geriatric Depression Scale (GDS). All participants were Spanish-Basque bilingual. Results: It was shown that SMMSE-eus has a high internal consistency (alpha=0.92), a good test-retest reliability (r=0.88; P<.01), and a high inter-rater reliability (CCI=0.99; P<.00) for the overall score, as well as for each item. Conclusions: Both the high internal consistency and inter-rater reliability, and to a lesser extent, test-retest reliability, made the SMMSE-eus a valid test for the brief assessment of cognitive status in people with advanced dementia in Basque-speaking people. For this reason, the SMMSE-eus is a usable and reliable alternative for assessing Basque-speaking people in their mother-tongue, or preferred language

The complexity of loneliness.

Loneliness is a prevalent and global problem for adult populations, and a number of different studies have linked it to multiple chronic conditions, including: heart disease, lung disease, cardiovascular disease, hypertension, atherosclerosis, stroke, and metabolic disorders, such as obesity and metabolic disease. Is a major predictor of psychological problems, such as depression, psychological stress, and anxiety. Loneliness is linked to overall morbidity and mortality in adult populations. But limited interventions have demonstrated long-term effectiveness in reducing loneliness in adults with these same chronic conditions. Our research of the extant literature addresses the following question: What evidence exists regarding the relationships between loneliness and health? We focus on recent findings with respect to the links between loneliness and health.

[Overal cognitive assessment in Basque-speaking people with advanced dementia. Validation to the Basque language of the Severe Mini-Mental State Examination SMMSE (SMMSE-eus)]. / Evaluación cognitiva global en personas vascoparlantes con demencia en estadios avanzados. Validación al euskera de la escala Severe Mini Mental State Examination (SMMSE-eus).

INTRODUCTION: Adaptation and validation to the Basque language of tests to assess advanced cognitive impairment is a not covered need for Basque-speaking people. The present work shows the validation of the Basque version of the Severe Mini Mental State Examination (SMMSE). MATERIAL AND METHODS: A total of 109 people with advanced dementia (MEC<15) took part in the validation study, and were classified as GDS 5-7 on the Geriatric Depression Scale (GDS). All participants were Spanish-Basque bilingual. RESULTS: It was shown that SMMSE-eus has a high internal consistency (alpha=0.92), a good test-retest reliability (r=0.88; P<.01), and a high inter-rater reliability (CCI=0.99; P<.00) for the overall score, as well as for each item. CONCLUSIONS: Both the high internal consistency and inter-rater reliability, and to a lesser extent, test-retest reliability, made the SMMSE-eus a valid test for the brief assessment of cognitive status in people with advanced dementia in Basque-speaking people. For this reason, the SMMSE-eus is a usable and reliable alternative for assessing Basque-speaking people in their mother-tongue, or preferred language.

Defining and Estimating Healthy Aging in Spain: A Cross-sectional Study.

Purpose of the Study: Using an operational continuum of healthy aging developed by U.S. researchers, we sought to estimate the prevalence of healthy aging among older Spaniards, inform the development of a definition of healthy aging in Spain, and foster cross-national research on healthy aging. Design and Methods: The ELES pilot study is a nationwide, cross-sectional survey of community-dwelling Spaniards 50 years and older. The prevalence of healthy aging was calculated for the 65 and over population using varying definitions. To evaluate their validity, we examined the association of healthy aging with the 8 foot up & go test, quality of life scores and self-perceived health using multiple linear and logistic regression. Results: The estimated prevalence of healthy aging varied across the operational continuum, from 4.5% to 49.2%. Prevalence figures were greater for men and those aged 65 to 79 years and were higher than in the United States. Predicted mean physical performance scores were similar for 3 of the 4 definitions, suggesting that stringent definitions of healthy aging offer little advantage over a more moderate one. Implications: Similar to U.S. researchers, we recommend a definition of healthy aging that incorporates measures of functional health and limiting disease as opposed to definitions requiring the absence of all disease in studies designed to assess the effect of policy initiatives on healthy aging.

Socioeconomic, emotional, and physical execution variables as predictors of cognitive performance in a Spanish sample of middle-aged and older community-dwelling participants.

BACKGROUND: Cognitive performance is not easily predicted, since different variables play an important role in the manifestation of age-related declines. The objective of this study is to analyze the predictors of cognitive performance in a Spanish sample over 50 years from a multidimensional perspective, including socioeconomic, affective, and physical variables. Some of them are well-known predictors of cognition and others are emergent variables in the study of cognition. METHODS: The total sample, drawn from the "Longitudinal Study Aging in Spain (ELES)" project, consisted of 832 individuals without signs of cognitive impairment. Cognitive function was measured with tests evaluating episodic and working memory, visuomotor speed, fluency, and naming. Thirteen independent variables were selected as predictors belonging to socioeconomic, emotional, and physical execution areas. Multiple linear regressions, following the enter method, were calculated for each age group in order to study the influence of these variables in cognitive performance. RESULTS: Education is the variable which best predicts cognitive performance in the 50-59, 60-69, and 70-79 years old groups. In the 80+ group, the best predictor is objective economic status and education does not enter in the model. CONCLUSIONS: Age-related decline can be modified by the influence of educational and socioeconomic variables. In this context, it is relevant to take into account how easy is to modify certain variables, compared to others which depend on each person's life course.

Aspectos clínicos y de imagen en el diagnóstico y seguimiento de lesiones proximales de la porción larga del bíceps femoral (lesión del tendón libre y de la unión miotendinosa). A propósito de dos casos / Clinical and imaging aspects of assessment and management of proximal long head biceps femoris injury (free-tendon and miotendinosus junction injuries). A report of two cases

Las lesiones agudas de los isquiotibiales son las más frecuentes en el fútbol profesional y la porción larga del bíceps (PLBF) es el músculo más afectado, siendo las localizaciones proximales las más habituales con importantes características clínicas, como el tiempo de baja y el riesgo de relesión. Se presentan dos casos clínicos de lesiones proximales de PLBF: una lesión miotendinosa típica y una menos frecuente que afecta al tendón libre de PLBF. Las lesiones de la unión miotendinosa localizadas en los isquiotibiales pueden tratarse de manera conservadora, aunque las lesiones de los futbolistas profesionales, cuando la cantidad de tejido conectivo afectado es grande (tendón libre), deben ser tratadas quirúrgicamente (AU)

Acute hamstring injury is the most common muscle damage in professional footballers and long head biceps femoris (LHBF) is the most commonly affected muscle with proximal locations being most prevalent with important clinical features such as time of recovery and risk of re-injury. Two clinical reports of proximal LHBF injuries are presented: a typical miotendinosus junction (MTJ) injury and a less common injury affecting the free-tendon of LHBF. MTJ injuries located in hamstrings can be treated conservatively but in professional football players, when the amount of connective tissue involved is great (free-tendon) injuries have to be treated surgically (AU)

Enfermedad de Müller-Weiss: a propósito de un caso en un futbolista en etapa formativa / Müller-Weiss disease: Presentation of a case in a football player in the training stage

Aunque muchos autores la consideran una osteonecrosis, la enfermedad de Müller-Weiss es una displasia del escafoides tarsiano producida en la infancia, pero que se mantiene asintomática hasta la edad adulta. La fisiopatología es debida a un retraso en la osificación, asociado a una compresión de la porción lateral del escafoides tarsiano por el astrágalo lateralizado y en varo. El compromiso suele ser bilateral y simétrico

Although many authors consider Müller- Weiss syndrome as a osteonecrosis, it is a navicular dysplasia occurring in childhood that remains asymptomatic until adulthood. It is caused by a delay in the ossification of the navicular associated with the compression of the lateral portion of the tarsal navicular by the talus that is shifting laterally and in varus. There is usually bilateral and symmetrical involvement