Dynapenic Abdominal Obesity as a Risk Factor for Metabolic Syndrome in Individual 50 Years of Age or Older: English Longitudinal Study of Ageing.

OBJECTIVES: To analyse whether dynapenic abdominal obesity is a risk factor for Metabolic syndrome (MetS) and its components in individuals 50 years of age or older. DESIGN: A longitudinal study was conducted with an eight-year follow-up. SETTING: Representative sample of community-dwelling participants of the English Longitudinal Study of Ageing (ELSA). PARTICIPANTS: 3,952 individuals free of MetS at baseline. MEASUREMENTS: Dynapenic abdominal obesity was defined based on waist circumference (> 102 cm for men and > 88 cm for women) and grip strength (< 26 kg for men and < 16 kg for women). The participants were classified as non-abdominally obese/non-dynapenic (NAO/ND - reference group), abdominally obese/non-dynapenic (AO/ND), non-abdominally obese/dynapenic (NAO/D) and abdominally obese/dynapenic (AO/D). The outcome was the incidence of MetS based on the presence of three or more of the following criteria: hypertriglyceridemia, hyperglycaemia, low HDL cholesterol, arterial hypertension or body mass index ≥ 30 kg/m2 throughout eight-year follow-up. Additionally, the incidence of each component of MetS was also analyzed. Poisson regression models were run and controlled for sociodemographic, behavioural and clinical variables. RESULTS: The mean age of the participants was 65 years and 55% were women. The prevalence of AO/ND, NAO/D and AO/D were 35.3, 4.3 and 2.2%, respectively. At the end of follow-up 558 incident cases of MetS were recorded. The adjusted model demonstrated that although abdominal obesity was a risk factor for MetS (IRR: 2.26; 95% CI: 1.87 - 2.73), the IRR was greater in AO/D individuals (IRR: 3.34; 95% CI: 2.03 - 5.50) compared with ND/NAO group. Furthermore, ND/AO was a risk factor for incidence of hypertriglyceridemia (IRR: 1.27; 95% CI: 1.06 - 1.52), hyperglycaemia (IRR: 1.41; 95% CI: 1.18 - 1.69), low HDL cholesterol (IRR: 1.70; 95% CI: 1.32 - 2.19) and BMI ≥ 30 kg/m2 (IRR: 2.58; 95% CI: 2.04 - 3.26) while D/AO was a risk factor for hyperglycaemia (IRR: 1.78; 95% CI: 1.02 - 3.10), low HDL cholesterol (IRR: 2.36; 95% CI: 1.10 - 5.08), and BMI ≥ 30 kg/m2 (IRR: 2.79; 95% CI: 1.38 - 5.62). CONCLUSIONS: Dynapenic abdominal obesity increases the risk of MetS, with a higher IRR compared to obesity alone. The understanding of this synergic action could guide specific clinical strategies, enabling the prevention of metabolic changes that can lead to cardiovascular disease, disability and death.

Perspectiva de la práctica clínica de fisioterapeutas colombianos en el manejo de la disfunción de la articulación sacroilíaca. Estudio descriptivo / Perspective in clinical practice of colombian physical therapists in the management of sacroiliac joint dysfunction. A descriptive study

Antecedentes y objetivo La disfunción de la articulación sacroilíaca (DASI) caracterizada por hipermovilidad o hipomovilidad de la articulación puede estar presente en un 13-30% de las personas con dolor lumbar de origen idiopático, por ello se consideró relevante analizar el abordaje fisioterapéutico realizado a pacientes con diagnóstico de DASI, en Bucaramanga (Colombia). Métodos Estudio observacional descriptivo transversal. Para la recolección de la información se elaboró un cuestionario de 31 preguntas, para ser respondido vía web, al que se evaluó la validez facial y de contenido. Se incluyeron datos sociodemográficos, de formación de los fisioterapeutas participantes y procedimientos de evaluación e intervención utilizados en la consulta. Resultados Participaron 147 fisioterapeutas, 86,4% mujeres, 22,5% con formación de posgrado. El 70,4% reconocieron la DASI como causa de dolor lumbar y el 43,5% declaró no utilizar pruebas específicas para el diagnóstico de la DASI. Las modalidades de tratamiento más informadas fueron ejercicio terapéutico, electroterapia, calor húmedo y masaje. Conclusiones La mayoría de los participantes reconocen la DASI como causa de dolor lumbar. Las pruebas de provocación de dolor para establecer el diagnóstico de la DASI no fueron utilizadas por la mayoría de los participantes. Tampoco se reportó el uso de ejercicios de estabilización lumbopélvica, útiles en la rehabilitación de personas con DASI. Estos hallazgos indican la necesidad de capacitar a los fisioterapeutas participantes en el estudio sobre el diagnóstico y el tratamiento de personas con DASI, para favorecer la recuperación y la calidad de vida de esta población (AU)

Background and aim Sacroiliac joint dysfunction (SIJD) is characterized by hypermobility or hypomobility of the joint and could be present in 13%–30% of people with low back pain of idiopathic origin. Therefore, it was important to analyse the physiotherapeutic clinical approach for patients diagnosed with SIJD in Bucaramanga (Colombia). Methods An observational descriptive cross-sectional study was conducted. The information was collected through a 31-question web survey, with face and content validation. Sociodemographic data, data on the training of the therapists and evaluation and intervention procedures used in the consultation were included. Results 147 physiotherapists participated, 86.4% were women, 22.5% with postgraduate training. Seventy point four percent recognized SIJD as cause of low back pain and 43.5% stated that they did not use a specific test to diagnose SIJD. The most reported treatment modalities were therapeutic exercise, electrotherapy, humid heat, and massage. Conclusions Most of the participants recognize SIJD as a cause of low back pain. Pain provocation tests were not used by most of the participants. Neither was the use of lumbopelvic stabilization exercises reported, required in SIJD rehabilitation. These findings show there is a need for training for the physiotherapists who participated in the study in the diagnosis and treatment of people with SIJD, to improve the recovery and quality of life of this population (AU)