Plasma Inflammatory Biomarkers and Anorexia of Ageing among Community-Dwelling Older Adults: An Exploratory Analysis of the MAPT Study.

Anorexia of aging and biological aging might share physiological underpinnings. The aim of this secondary analysis was to investigate the associations between circulating inflammation-related markers and anorexia of aging in community-dwelling older adults. C-reactive protein (CRP), tumor necrosis factor receptor-1 (TNFR-1), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and growth/differentiation factor-15 (GDF-15) were measured in plasma. Anorexia of aging was defined by the response "severe/moderate decrease in food intake" to the first item of the Mini-Nutritional Assessment. We included 463 subjects (median age=74y, IQR=71-78; 63.1% women). 33 subjects (7.1%) presented with anorexia at baseline, whereas 25 out of 363 (6.9%) developed it along 1-year follow-up. We found that TNFR1 (OR=1.74, 95%CI=1.27-2.39) and GDF-15 (OR=1.38, 95%CI=1.01-1.89) were associated with a significant increase in the odds of presenting with anorexia of aging cross-sectionally. No further significant associations were found. Biological aging mechanisms might be involved in the pathogenesis of anorexia of aging.

Circulating Levels of Apelin, GDF-15 and Sarcopenia: Lack of Association in the MAPT Study.

OBJECTIVES: Apelin and GDF-15 have been proposed as biomarkers of age-related sarcopenia but evidence in human models is scarce. This study aimed to explore the associations between blood apelin and GDF-15 with sarcopenia incidence and the evolution of sarcopenia components over two years in older adults >70 years. DESIGN: Secondary longitudinal analysis of the Multidomain Alzheimer Preventive Trial. PARTICIPANTS: Older adults (>70 years) attending primary care centers in France and Monaco. SETTING: Community. MEASUREMENTS: Serum Apelin (pg/mL) and plasma GDF-15 (pg/mL) were measured. Outcomes included sarcopenia defined by the European Working Group on Sarcopenia in Older People (EWGSOP) and its determinants (appendicular lean mass [ALM] evaluated through a Dual-energy X-ray Absorptiometry (DXA) scan, handgrip strength (HGS) and the 4-meter gait speed) measured over 2 years. Linear mixed models and logistic regression were used to explore the longitudinal associations. RESULTS: We included 168 subjects from MAPT (median age=76y, IQR=73-79; 78% women). Serum apelin was not significantly associated with sarcopenia incidence (OR=1.001;95%CI=1.000,1.001;p-value>0.05 in full-adjusted models) nor with ALM (ß=-5.8E-05;95%CI=-1.0E-04,2.12E-04;p>0.05), HGS (ß=-1.1E-04;95%CI=-5.0E-04,2.8E-04;p>0.05), and GS (ß=-5.1E-06;95%CI=-1.0E-05,2.0E-05;p>0.05) in fully adjusted models. Similarly, plasma GDF-15 was not associated with both the incidence of sarcopenia (OR=1.001,95%CI=1.000,1.002,p>0.05) and the evolution of its determinants ([ALM, ß=2.1E-05;95%CI=-2.6E-04,3.03E-04;p>0.05], HGS [ß=-5.9E-04;95%CI=-1.26E-03,8.1E-05; p>0.05] nor GS [ß=-2.6E-06;95%CI=-3.0E-05, 2.3E-05;p>0.05]) in fully adjusted models. CONCLUSIONS: Blood apelin and GDF-15 were not associated with sarcopenia incidence or with the evolution of sarcopenia components over a 2-year follow-up in community-dwelling older adults. Well-powered longitudinal studies are needed to confirm or refute our findings.

Randomized controlled trial comparing the effectiveness of the ultrasound-guided galvanic electrolysis technique (USGET) versus conventional electro-physiotherapeutic treatment on patellar tendinopathy.

BACKGROUND: Patellar tendinopathy has a high prevalence rate among athletes. Different therapeutic options can be found in the current literature, but none of them has been clearly established as the gold standard. The purpose of this study is to compare, in a randomized controlled trial, the clinical efficacy of eccentric exercise combined with either an ultrasound-guided galvanic electrolysis technique (USGET) or conventional electrophysiotherapy to treat patellar tendinopathy. METHODS: Sixty patients diagnosed with patellar tendinopathy were randomized into two groups. Group 1 (n = 30) received electrophysiotherapy treatment consisting of ultrasound, laser and interferential current techniques. Group 2 (n = 30) received USGET. Both groups did the same standardized eccentric exercise program. Periodic assessments of the subjects were carried out with the Victorian Institute of Sport Assessment-Patella (VISA-P) score. An analysis of means and a survival study were performed. RESULTS: There were statistically significant differences in the VISA-P between the baseline and final follow-up in each treatment group. Group 1 (conventional electrophysiotherapy) went from 52.5 ± 18.8 to 61.9 ± 13.7 (in VISA-P < 90 subgroup) and from 69.1 ± 9.1 to 95.2 ± 2.5 (in VISA-P > 90 subgroup). Group 2 (USGET) went from 51.4 ± 17.9 to 63.3 ± 14.3 (in VISA-P < 90 subgroup) and from 66.3 ± 13.1 to 97.1 ± 1.7 (in VISA-P > 90 subgroup). There were statistically significant correlations between the baseline and final score in the VISA-P > 90 subjects upon completing the study but no statistically significant correlations between subjects with VISA-P < 90. The mean number of sessions applied was 22.6 ± 2.5 in Group 1 and 3.2 ± 0.9 in Group 2. The success probability in Group 1 was 36.1% versus 72.4% in Group 2. The difference was statistically significant. CONCLUSION: The results obtained with the combination of USGET and eccentric exercise reported better outcomes than with the conventional electrophysiotherapy techniques in the treatment of patellar tendinopathy.

Propuesta de un protocolo de fisioterapia en el impingement interno del hombro / Proposal of a physical therapy protocol in the internal shoulder impingement

El síndrome de impingement o pinzamiento interno es una patología frecuente en el hombro del deportista que realiza lanzamientos. Se describió por primera vez en 1991; sin embargo, no ha sido hasta hace 3 o 4 años, principalmente con el avance de la artroscopia de hombro, cuando se ha comenzado a introducir en los diagnósticos médicos y fisioterápicos. El objetivo de este estudio es proponer unas pautas de actuación fisioterápica en el tratamiento de este síndrome. Para ello, se somete a valoración a 2 pacientes diagnosticados de impingement interno y tratados mediante un protocolo fisioterápico justificado en función de la fisiopatología de la lesión y de las estructuras implicadas. Los resultados obtenidos se resumen en un hombro funcional para el gesto del lanzamiento, y por tanto para el deporte, validando así las pautas propuestas

The impingement symptom is a frequent pathology in sportsmen's shoulders which realize the gesture of throwing. It was described the first time in 1991; however, it wasn't until three or four years ago, mainly through arthroscopic surgery, when it started to appear in medical and physiotherapeutic diagnostics. The objective of the study is to propose guidelines for the correct physiotherapeutic treatment of this syndrome. For this study, 2 patients diagnosed impingement have been evaluated and treated under the physiotherapeutic protocol adapted to the physiopathology of the injury and the structures implied. The results obtained in a functional shoulder that realizes the gesture of throwing, and in consequence sports, prove the efficiency of the guidelines proposed

Fisioterapia en las prótesis de hombro. Protocolo de actuación / Physiotherapy in the arthroplasty of shoulder. Protocol of treatment

En las fracturas graves y lesiones degenerativas de hombro, las secuelas principales son el déficit de la función y el dolor. El tratamiento quirúrgico más indicado para este tipo de lesiones es la artroplastia de hombro. El objetivo de este estudio es establecer unas pautas de actuación fisioterápica posteriores a este tipo de cirugía. Para ello, se someten a valoración 14 pacientes operados con prótesis de hombro y tratados todos ellos mediante un protocolo fisioterápico, justificado en función de la técnica quirúrgica empleada y el proceso biológico de cicatrización de las estructuras implicadas. El tratamiento incluye cinesiterapia pasiva y activa, fisioterapia antiálgica y electroterapia. La duración del tratamiento osciló entre 4 y 18 meses, siendo la moda de 6 meses. Los resultados obtenidos se resumen en un control eficaz del dolor con una función del hombro útil pero limitada, validando por tanto las pautas propuestas

In the serious fractures and degenerative lesions of shoulder, the main sequels are the deficit of the function and the pain. The most suitable surgical treatment for this type of lesions is the shoulder arthroplasty. The objective of this study is to establish some rules of physiotherapy treatment later to this surgery type. For it, they valued to 14 patients operated with shoulder arthroplasty and treaties all them by protocol of physiotherapy justified in function of the technique surgical employee and the biological process of scaring of the implied structures. The treatment includes passive and active kinesiterapy, analgesic physiotherapy and electrotherapy. The duration of the treatment oscillated between 4 and 18 months, being, the mode of 6 months. The obtained results, summary in an effective control of the pain with a function of the useful but limited shoulder, validating the proposed rules therefore