Multicomponent Physical Program: Effects on Physical Fitness of Older Women of Different Age Groups.

Purpose: Experimental studies investigating the outcomes of physical exercise among age-stratified groups of older women are still incipient. This study aimed to investigate the effects of a ten-month multicomponent physical program on the physical fitness of older women in three age-stratified groups (60-69 years, 70-79 years, and ≥80 years). Method: Participants (n = 141) were divided into three age groups: GR1 60-69 years (n = 45; 65.2 ± 2.3 years); GR2 70-79 years (n = 67; 72.9 ± 2.9 years), GR3 ≥80 years (n = 29; 83.5 ± 4.5 years). The participants performed the multicomponent physical program and were evaluated before and after the intervention with Senior Fitness Test. Data were analyzed using generalized estimating equations, Bonferroni test (p ≤.05) and effect size (Cohen's d). Results: For the group factor, there were significant differences in lower limb strength (p = .003), upper limb strength (p < .001), upper limb flexibility (p < .001), balance/agility (p < .001), and cardiorespiratory fitness (p < .001). For the time factor, significant differences were observed in lower limb strength (GR2, p = .014, small effect size), upper limb strength (GR1, p = .003; GR2, p < .001; GR3, p = .017; small effect sizes), lower limb flexibility (GR1, p = .025, non-significant effect size), cardiorespiratory fitness (GR1, p < .001, medium effect size; GR2, p = .002; small effect size). Conclusion: Physical fitness improved with training, but effects differed between age groups. Positive effects were observed for GR1 and GR2, whereas GR3 showed maintenance of physical fitness. Aging interferes more strongly in women aged 80 years and older and it is necessary for specific training programs for this age group. .

Static Balance in Hereditary Spastic Paraplegias: a Cross-sectional Study.

Motor and somatosensory pathway dysfunction due to degeneration of long tracts in hereditary spastic paraplegias (HSP) indicates that postural abnormalities may be a relevant disease feature. However, balance assessments have been underutilized to study these conditions. How does the static balance of individuals with HSP with eyes open and closed differ from healthy controls, and how does it relate to disease severity? This cross-sectional case-control study assessed the static balance of 17 subjects with genetically confirmed HSP and 17 healthy individuals, evaluating the center of pressure (COP) variables captured by a force platform. The root-mean-square of velocities and mean of displacements amplitudes in mediolateral and anteroposterior axes were correlated with disease severity. All COP parameters' performances were significantly impaired in HSP subjects compared to controls (p < 0.001 for all comparisons). COP with eyes open and closed differed for all variables within the HSP group, whereas in the control group, differences were observed only for anteroposterior velocity and amplitude. Spastic Paraplegia Rating Scale presented moderate direct correlations with the most COP variables (Rho = - 0.520 to - 0.736). HSP individuals presented significant postural instability with eyes open and to a greater extent with eyes closed, corroborating the clinical findings of somatosensorial and proprioceptive pathways dysfunction. The degrees of proprioceptive and motor impairments are mutually correlated, suggesting that similar pathophysiological mechanisms operate for the degeneration of these long tracts. COP parameters can be seen as disease severity biomarkers of HSP, and they should be assessed in future clinical trials.

Long-term progression of clinician-reported and gait performance outcomes in hereditary spastic paraplegias.

Introduction: Hereditary spastic paraplegias (HSPs) are a heterogeneous group of neurodegenerative diseases in which little is known about the most appropriate clinical outcome assessments (COAs) to capture disease progression. The objective of this study was to prospectively determine disease progression after 4.5 years of follow-up with different clinician-reported (ClinRO) and gait performance outcomes (PerFOs). Methods: Twenty-six HSP patients (15 SPG4, 5 SPG7, 4 SPG5, 2 SPG3A) participated in this single-center cohort study in which the ClinRO: Spastic Paraplegia Rating Scale; and the PerFOs: 10-meters walking test and timed-up and go (TUG), at self-selected and maximal walking speeds; Locomotor Rehabilitation Index; and 6-min walking test were performed at baseline and after 1.5 (18 patients) and 4.5 (13 patients) years. Results: In the 3-year interval between the second and third assessments, significant progressions were only found in PerFOs, while in the overall 4.5 years of follow-up, both PerFOs and ClinROs presented significant progressions. The progression slopes of COAs modeled according to the disease duration allowed the estimation of the annual progression of the outcomes and sample size estimations for future clinical trials of interventions with different effect sizes. TUG at maximal walking speed was the only COA capable of differentiating subjects with a worse compared to a stable/better impression of change and would require the smallest sample size if chosen as the primary endpoint of a clinical trial. Discussion: These findings indicate that both performance and clinician-reported outcomes can capture long-term progression of HSPs, with some PerFOs presenting greater sensitivity to change. The presented data are paramount for planning future disease-modifying and symptomatic therapy trials for this currently untreatable group of diseases.

Determinants of Dual-task Gait Speed in Older Adults with and without Parkinson's Disease.

Mobility difficulties for people with Parkinson's disease (PwPD) are more pronounced when they perform a simultaneous cognitive task while walking. Although it is known that neurodegeneration results in widespread motor and brain impairments, few studies have comprehensively examined possible physical and mental determinants of dual task walking in PwPD. In this cross-sectional study, we aimed to investigate if and how muscle strength (sit-to-stand 30-sec test), cognition (mini-mental state examination) and functionality (timed up and go test) affect walking performance (10-meter walking test) with and without arithmetic dual task from older adults with and without Parkinson's disease. Walking speed was reduced by 16% and 11% with arithmetic dual task for PwPD (from 1.07±0.28 to 0.91±0.29 m.s-1, p<0.001) and older adults (from 1.32±0.28 to 1.16±0.26 m.s-1, p=0.002) compared to essential walking. The cognitive state was similar among the groups, but it was only associated with the dual-task walking speed in PwPD. In PwPD, lower limb strength was the better predictor of speed, whereas mobility was more related to it in older adults. Therefore, future exercise interventions aiming to improve walking in PwPD should consider these findings to maximize their effectiveness.

Effects of aging on arm coordination at different walking speeds.

BACKGROUND: Previous work has shown that the mean continuous relative phase and coordination variability of lower limbs are modified in older adults when walking. RESEARCH QUESTION: Here, we propose to understand the extent to which such control mechanisms for upper limbs are present during gait. Specifically, we seek to understand if aging and gait speed constraints influence the interjoint control of upper limbs during walking. METHODS: This observational study evaluated thirty-three participants, divided into older (n = 20, age 66.4 ± 4.3 years; mass: 77.2 ± 14.2 kg; height: 165 ± 9.20 cm) and young adults (n = 13, age 29.5 ± 4.7 years; mass 75.5 ± 9.6 kg; height: 172 ± 6.24 cm) were asked to walk at 0.28, 0.83, 1.38 m.s-1 on a level treadmill while their segmental movements were simultaneously registered with 3D motion capture system. We calculated the mean continuous relative phase and coordination variability (continuous relative phase variability) in elbow-shoulder and shoulder-hip pairs, and a generalized estimating equation was used to test the main and interaction effects of age and speed. RESULTS: Older adults had a reduced continuous relative phase (more in-phase coordination) of upper limbs at whole stance for elbow-shoulder, at loading response for shoulder-hip, at mid-stance and terminal stance for elbow-shoulder and shoulder-hip in comparison to young adults at different speeds (p < 0.05). The coordination variability of upper limbs was greater (higher continuous relative phase variability) in older than young adults at 0.28 and 1.38 m.s-1. SIGNIFICANCE: These findings substantiate the altered motor control role of upper limbs in gait aging, suggesting that lower self-selected speed may be related to the reduced ability to control arm movement during the intermediate phases of gait.

Determinants of age-related decline in walking speed in older women.

Background: Walking speed is reduced with aging. However, it is not certain whether the reduced walking speed is associated with physical and coordination fitness. This study explores the physical and coordination determinants of the walking speed decline in older women. Methods: One-hundred-eighty-seven active older women (72.2 ± 6.8 years) were asked to perform a 10-m walk test (self-selected and maximal walking speed) and a battery of the Senior fitness test: lower body strength, lower body flexibility, agility/dynamic balance, and aerobic endurance. Two parameters characterized the walking performance: closeness to the modeled speed minimizing the energetic cost per unit distance (locomotor rehabilitation index, LRI), and the ratio of step length to step cadence (walk ratio, WR). For dependent variables (self-selected and maximal walking speeds), a recursive partitioning algorithm (classification and regression tree) was adopted, highlighting interactions across all the independent variables. Results: Participants were aged from 60 to 88 years, and their self-selected and maximal speeds declined by 22% and 26% (p < 0.05), respectively. Similarly, all physical fitness variables worsened with aging (muscle strength: 33%; flexibility: 0 to -8 cm; balance: 22%; aerobic endurance: 12%; all p < 0.050). The predictors of maximal walking speed were only WR and balance. No meaningful predictions could be made using LRI and WR as dependent variables. Discussion: The results suggest that at self-selected speed, the decrease in speed itself is sufficient to compensate for the age-related decline in the motor functions tested; by contrast, lowering the WR is required at maximal speed, presumably to prevent imbalance. Therefore, any excessive lowering of LRI and WR indicates loss of homeostasis of walking mechanics and invites diagnostic investigation.

Online Exercise Training Program for Brazilian Older Adults: Effects on Physical Fitness and Health-Related Variables of a Feasibility Study in Times of COVID-19.

The COVID-19 pandemic brought negative consequences such as social isolation and limited access to health services, especially for older adults. The objective was to evaluate effects of an online exercise training program and physical fitness and health-related variables on Brazilian older adults during the COVID-19 pandemic and secondarily to assess the feasibility and application of an online program. A study was developed with twenty older adults who participated in a 9-month online exercise program. The physical fitness, depressive symptoms, concern about falling, and quality of life were assessed pre- and post-intervention. One-way repeated measures ANOVA and effect size was used. The feasibility was proven by the adherence to the program, in addition to the absence of identification of adverse effects. The results showed that physical fitness was improved (upper limb strength) or maintained (lower limb strength, lower and upper limb flexibility, cardiorespiratory fitness), as well as for most of the health-related variables (depressive symptoms, concern about falling, and quality of life domains). The study was developed in the first COVID-19 lockdown in Brazil, but positive and important results were obtained. This research supports the feasibility of the online exercise training program and provides a basis for an online exercise program for older adults.

Progression of Functional Gait in Hereditary Spastic Paraplegias.

Hereditary spastic paraplegias (HSP) are characterized by progressive deterioration of axonal projections of upper motor neurons leading to abnormal locomotion. The clinical course of HSP as well as the definition of the best instruments to assess its progression is largely unknown. The aim of this study was to investigate the progression of functional gait in individuals with HSP and to define sensitivity to change, minimal clinically important difference (MCID), and validity of timed functional tests of gait (TFT). The study was constituted of two phases: a cross-sectional study and a prospective cohort of 18 months. Twenty-five patients (17 being SPG4), and twenty-five age- and sex-matched control individuals performed TFT. Spastic paraplegia rating scale (SPRS), ten-meter walking test (10MWT), timed up and go test (TUG), both at self-selected and maximal walking speeds, and six-minute walking test (6MWT) were performed on baseline in both groups and after 18 months of follow-up only in the HSP cohort. In the cross-sectional analysis, all TFTs performances were greatly impaired in HSP patients compared to controls. After 18 months of follow-up, TFTs did not differ significantly from baseline in the statistical analysis, with some tests showing more frequent improvement than worsening. We have provided effect size measures and MCID for the evaluated instruments. HSPs clearly compromised TFTs performances, which were valid instruments for assessing disease severity. However, TFTs and SPRS did not capture the very slow motor evolution of HSPs, reinforcing the necessity of additional biomarkers of disease progression.

Does a Multicomponent Exercise Program Improve Physical Fitness in Older Adults? Findings From a 5-Year Longitudinal Study.

The objective was to assess the physical fitness of older adults participating in a 5-year multicomponent exercise program. The sample consisted of 138 older adults aged 60-93 years (70.4 ± 7.8 years) evaluated with the Senior Fitness Test (muscle strength, flexibility, balance, and cardiorespiratory fitness). The multicomponent program was carried out between the months of March and November of each year. Data were analyzed using generalized estimating equations (factor year: Year 1, Year 2, Year 3, Year 4, and Year 5; factor time: pretest and posttest) with Bonferroni's post hoc test. Participation in the multicomponent exercise program for 5 years (baseline pretest Year 1 and follow-up Year 5) improved lower and upper limb strength, lower limb flexibility, and balance and cardiorespiratory fitness, while upper limb flexibility was maintained. Year-by-year analysis revealed variable patterns for each fitness parameter. The results of this study show the potential benefits of implementing a long-term community-based exercise program.

O trabalho com o idoso: organização didático-pedagógica dos projetos de extensão universitária do curso de Educação Física / The work with the elderly: educational didactic organization of the projects of university extension of the course of Physical Education / El trabajo con el anciano: organización didáctica pedagógica de los proyectos de extensión universitaria del curso de Educación Física

O objetivo foi analisar a organização didático-pedagógica de projetos de extensão universitária, que desenvolvem atividades físicas regulares e supervisionadas, para o público idoso. Pesquisa qualitativa com dez professores coordenadores que responderam a um questionário com perguntas abertas. Percebeu-se que as características dos projetos são similares, em sua maioria, acompanhando a evolução do estudo do envelhecimento humano, além de esclarecer como são planejadas e desenvolvidas as atividades para o público idoso.

The objective was to analyze the educational didactic organization of university extension projects, which develop regular and supervised physical activities, for the elderly public. Qualitative research, ten coordinating teachers answered a questionnaire with open questions. It was noticed that the characteristics of the projects are similar, mostly, following the evolution of the study of human aging, in addition to clarifying how the activities for the elderly are planned and developed.

El objetivo fue analizar la organización didáctico-pedagógica de proyectos de extensión universitaria, que desarrollan actividades físicas regulares y supervisadas, para el público anciano. Investigación cualitativa con diez profesores coordinadores que respondieron a un cuestionario con preguntas abiertas. Se percibió que las características de los proyectos son similares, en su mayoría, acompañando la evolución del estudio del envejecimiento humano, además de aclarar cómo se planifican y desarrollan las actividades para el público anciano.

Idosos caidores e não caidores: programa de exercício multicomponente e prevalência de quedas / Elderly fallers and non-fallers: physical fitness and falls prevalence

Introdução: O episódio de queda esta presente em 40% da população idosa. A atividade física regular apresenta-se como uma estratégia de melhoria das capacidades da aptidão física e prevenção de quedas para idosos. Objetivo: analisar a aptidão física de idosos caidores e não caidores antes e após a participação em programa de exercício multicomponente, verificar se ocorre a redução de quedas. Métodos: Estudo de coorte, 156 idosos participantes de um programa de extensão universitária; classificados em dois grupos: caidores (n=25) e não caidores (n=131). Aplicou-se a bateria de avaliação de Rikli e Jones. Utilizou-se o método de Equações de Estimativas Generalizadas, adotando-se como fatores tempo e grupo, com post hoc de Bonferroni. Resultados: A análise indicou diferença estatística significante em algumas das relações dos fatores tempo e grupo. Conclusão: Aptidão física indicou melhores resultados, destacando-se a capacidade força. Houve diminuição da prevalência de quedas no grupo caidores. (AU)

Introduction: The incident of fall is present in 40% of the elderly population. Regular physical activity is a strategy for improving physical fitness capacity and to prevent falls in elderly. Objective: To analyze the physical fitness of elderly fallers and non-fallers before and after participation in a multicomponent exercise program, to verify if fall reduction occurs. Methods: A cohort study, 156 elderly participants of a university extension program; divided in two groups: fallers (n = 25) and non-fallers (n = 131). Applied to assessment battery of physical fitness Rikli and Jones. We used the Generalized Estimation Equation method (GHG), adopting as factors time and group and the Bonferroni test. Results: The analysis indicated a statistically significant difference in some of the relations of time and group factors. Conclusion: Physical fitness indicated better results, highlight strength capacity. Decrease in the prevalence of falls in the fallers group. (AU)

Postural balance program: variables related to falls in elderly / Programa físico de equilíbrio: variáveis associadas às quedas em idosos

ABSTRACT The aim of this study was to analyze the effects of a balanced program for preventing falls in the elderly. The sample consisted of 17 subjects (age: 75.73 ± 8.57). The tests used were one foot , Timed Up and Go (TUG), functional reach (AF), strength (IMF) and flexibility of the lower limbs (FLEXMI) of Rikli and 19 Jones (1999) protocol, FES-I questionnaire. For data analysis we used the comparative statistics with the Wilcoxon test (p = 0.05) between pre and post-test. For the analysis of the classification of balance tests we used distribution calculations (frequency and percentage). There was no statistically significant change between the pre and post-training in the variables AU, TUG and FLEXMI. The classification of the results showed improved post-test, showing a tendency to improve balance after training and helping to prevent falls

RESUMO O objetivo do estudo foi analisar os efeitos de um programa físico de equilíbrio em variáveis associadas às quedas em idosos. Participaram do programa 17 indivíduos com média de idade de 75,73 anos. Foram utilizados os testes de apoio unipodal , TimedUpand Go (TUG), alcance funcional (AF), força (FMI), flexibilidade de membros inferiores (FLEXMI) e o questionário FES-I. Para a análise dos dados utilizou-se o teste de Wilcoxon (p≤0,05) para comparação entre os dois momentos de avaliação. Para a análise da classificação dos testes de equilíbrio utilizou-se cálculos de distribuição (frequência e percentual) dos períodos pré e pós-treinamento. Os resultados apontaram mudança estatística significante entre o período pré e pós-treinamento nas variáveis AU, TUG e FLEXMI. A classificação dos resultados indicou melhora no pós-teste, havendo assim uma tendência na melhora do equilíbrio após o treinamento, auxiliando na prevenção de quedas.

Relação entre equilíbrio dinâmico e qualidade de vida de participantes de um programa de atividade física voltado ao público idoso / Relationship between dynamic balance and quality of life in participants of physical activity in a program for old people

Introdução: O equilíbrio corporal é um dos fatores mais importantes associados às quedas, sendo a atividade física uma ferramenta para a melhora deste equilíbrio. Objetivo: Verificar a associação entre equilíbrio dinâmico e qualidade de vida de participantes de um projeto de extensão voltado para a atividade física em idosos. Métodos: Realizou-se estudo do tipo transversal e ex post facto com amostra de 94 indivíduos. tilizaram-se questionário sociodemográfico, teste de levantar, andar 2,44 m e voltar a sentar e instrumento SF-36. Resultados: Houve correlações significativas entre o equilíbrio dinâmico e todos os domínios do SF-36, inclusive o somatório geral de qualidade de vida, indicando que quanto maior a pontuação da qualidade de vida, melhores os resultados de equilíbrio. Conclusão: Ressalta-se a importância de um trabalho focado no equilíbrio corporal, buscando melhorar a qualidade de vida e a percepção dos idosos em relação à sua autonomia e independência em tarefas do cotidiano.

Introduction: Postural balance is one of the most important factors associated to falls. Physical activity has been a tool to improve this balance. Objective: To investigate the association between dynamic balance and quality of life in participants of an extension project focused on physical activity for older adults. Methods: A cross-sectional and ex post facto study was conducted. The sample consisted of 94 subjects. We used a sociodemographic questionnaire, test stand, walk 2.44 m and back to sit in a chair and the SF-36. Results: There were significant correlations between the dynamic balance and all domains of the SF-36, included general sum of quality of life. This result indicates that higher scores in quality of life, better is the results of balance. Conclusion: Thus, we have to focus on working on body balance in order to improve quality of life of the elderly and their awareness of autonomy and independence in daily tasks.

Motivos de desistência em um programa de atividades física para idosos / Reasons for dropout in a program of physical activity for elderly

O objetivo do estudo foi investigar os motivos de desistência de atividade física em um programa para idosos. A amostra foi composta por 31 participantes desistentes de um projeto de extensão. Foi utilizada a entrevista estruturada com perguntas abertas através de contato telefônico. Conclui-se que o interesse existe para a manutenção das atividades, porém as condições de saúde não possibilitam a sua prática na mesma perspectiva, indicando a necessidade de outros modos de atenção.(AU)

The aim of this study was to investigate the reasons for abandonment of physical activity in a program for seniors. The sample consisted of 31 participants dropped out of the project. The instrument was structured with open-ended questions by telephone interview. There is interest in continuing activities, but health conditions do not allow the practice in the same perspective, indicating the need for other modes of attention.(AU)

Motivos de desistência em um programa de atividades física para idosos / Reasons for dropout in a program of physical activity for elderly

O objetivo do estudo foi investigar os motivos de desistência de atividade física em um programa para idosos. A amostra foi composta por 31 participantes desistentes de um projeto de extensão. Foi utilizada a entrevista estruturada com perguntas abertas através de contato telefônico. Conclui-se que o interesse existe para a manutenção das atividades, porém as condições de saúde não possibilitam a sua prática na mesma perspectiva, indicando a necessidade de outros modos de atenção.

The aim of this study was to investigate the reasons for abandonment of physical activity in a program for seniors. The sample consisted of 31 participants dropped out of the project. The instrument was structured with open-ended questions by telephone interview. There is interest in continuing activities, but health conditions do not allow the practice in the same perspective, indicating the need for other modes of attention.

Relação entre flexibilidade e dor em idosos ativos / Relationship between flexibility and pain in elderly physically active

O objetivo foi verificar a relação entre a flexibilidade e a dor em idosos ativos. Amostra composta por 12 homens (75,5±5,23) (GH) e 57 mulheres (67,95± 8.0) (GM). Para avaliar a flexibilidade: “sentado e alcançar” (FLEXMI) e “alcançar atrás das costas” (FLEXMS), para a avaliação da dor: o domínio DOR do questionário SF-36. A análise estatística indicou correlação significativa positiva entre a FLEXMI (p=0,009) e FLEXMS (p=0,003) com o domínio DOR no GM. Quanto maior a flexibilidade, menor é a dor.(AU)

The aim of this study was to investigate the relationship between flexibility and pain in active elderly. Sample consisted of 12 men (75.5 ± 5.23) (GH) and 57 women (67.95 ± 8.0) (GM). Flexibility was assessed by “sit and reach" (FLEXMI) and "reach up the back" (FLEXMS) tests; pain was assessed by PAIN domain of SF-36 questionnaire. Statistical analysis indicated significant positive correlation between FLEXMI (p=0.009) and FLEXMS (p=0.003) with the domain PAIN in GM. The greater the flexibility, the less pain.(AU)

Relação entre flexibilidade e dor em idosos ativos / Relationship between flexibility and pain in elderly physically active

O objetivo foi verificar a relação entre a flexibilidade e a dor em idosos ativos. Amostra composta por 12 homens (75,5±5,23) (GH) e 57 mulheres (67,95± 8.0) (GM). Para avaliar a flexibilidade: “sentado e alcançar” (FLEXMI) e “alcançar atrás das costas” (FLEXMS), para a avaliação da dor: o domínio DOR do questionário SF-36. A análise estatística indicou correlação significativa positiva entre a FLEXMI (p=0,009) e FLEXMS (p=0,003) com o domínio DOR no GM. Quanto maior a flexibilidade, menor é a dor.

The aim of this study was to investigate the relationship between flexibility and pain in active elderly. Sample consisted of 12 men (75.5 ± 5.23) (GH) and 57 women (67.95 ± 8.0) (GM). Flexibility was assessed by “sit and reach" (FLEXMI) and "reach up the back" (FLEXMS) tests; pain was assessed by PAIN domain of SF-36 questionnaire. Statistical analysis indicated significant positive correlation between FLEXMI (p=0.009) and FLEXMS (p=0.003) with the domain PAIN in GM. The greater the flexibility, the less pain.