Lumbo-Pelvic Rhythm Monitoring Using Wearable Technology with Sensory Biofeedback: A Systematic Review.

As an essential lower-back movement pattern, lumbo-pelvic rhythm (LPR) during forward trunk flexion and backward return has been investigated on a large scale. It has been suggested that abnormalities in lumbo-pelvic coordination are related to the risk of developing low back disorders. However, considerable differences in the approaches used to monitor LPR make it challenging to integrate findings from those investigations for future research. Therefore, the aim of this systematic review was to summarize the use of wearable technology for kinematic measurement with sensory biofeedback for LPR monitoring by assessing these technologies' specific capabilities and biofeedback capacities and exploring their practical viability based on sensor outcomes. The review was developed following the PRISMA guidelines, and the risk of bias was analyzed using the PREDro and STROBE scales. PubMed, Web of Science, Scopus, and IEEEXPLORE databases were searched for relevant studies, initially returning a total of 528 articles. Finally, we included eight articles featuring wearable devices with audio or vibration biofeedback. Differences in protocols and limitations were also observed. This novel study presents a review of wearable tracking devices for LPR motion-mediated biofeedback for the purpose of correcting lower back posture. More research is needed to determine the long-term effectiveness of these devices, as well as their most appropriate corresponding methodologies.

Is Acute Lower Back Pain Associated with Heart Rate Variability Changes? A Protocol for Systematic Reviews.

Acute lower back pain (ALBP) is an extremely common musculoskeletal problem. ALBP consists of a sudden onset of short-duration pain in the lower back. However, repeated attacks can make the pain chronic. It can be measured through a self-report scale as well as through physical and physiological evaluations. Heart Rate Variability (HRV) has been used to evaluate the body's response to pain. However, to the best of our knowledge, no clear consensus has been reached regarding the relationship between both variables and on an optimal protocol for ALBP evaluation based on HRV. The objective of this review is to analyze the relationship and effectiveness of HRV as an instrument for measuring ALBP. Furthermore, we consider the influence of different types of interventions in this relationship. The protocol of this review was previously recorded in the International Prospective Register of Systematic Reviews (number CRD42023437160). The PRISMA guidelines for systematic reviews and PubMed, WOS and Scopus databases are employed. Studies with samples of adults with ALBP are included. This study sets out a systematic review protocol to help identify the relationship between HRV and ALBP. Understanding this relationship could help in designing early detection or action protocols that alleviate ALBP.

Genomically matched therapy in refractory colorectal cancer according to ESMO Scale for Clinical Actionability of Molecular Targets: experience of a comprehensive cancer centre network.

Efficiency of expanded genomic profiling (EGP) programmes in terms of final inclusion of patients in genomically matched therapies is still unknown. Fit patients with advanced and refractory colorectal cancer (CRC) were selected for an EGP programme. Next-generation sequencing (NGS) analysis from formalin-fixed paraffin-embedded tumour samples was performed. The purpose was to describe the prevalence of genomic alterations defined by the ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT), as well as the percentage of patients finally included in genomically guided clinical trials. In total, 187 patients were recruited. Mutational profile was obtained in 177 patients (10 patients were failure due to insufficient tumour sample), copy number alterations in 41 patients and fusions in 31 patients. ESCAT-defined alterations were detected in 28.8% of the intention-to-analyse population. BRAF V600E was clustered in ESCAT I, with a prevalence of 3.7%, KRAS G12C and ERBB2 amplification were clustered in ESCAT II, whose prevalence was 4.2% and 1.6%, respectively. Most alterations were classified in ESCAT III (mutations in ERBB2, PIK3CA or FGFR genes and MET amplification) and IV (mutations in BRAF non-V600E, ERBB3, FBXW7, NOTCH, RNF43), with a single prevalence under 5%, except for PIK3CA mutation (9%). The final rate of inclusion into genomically guided clinical trials was 2.7%, including therapies targeting BRAF V600E or RNF43 mutations in two patients each, and ERBB2 mutation in one patient. In conclusion, EGP programmes in patients with advanced CRC are feasible and identify a subset of patients with potentially druggable genomic alterations. However, further efforts must be made to increase the rate of patients treated with genomically guided therapies.

Impacto del nivel de actividad física y estado civil en la vulnerabilidad de la salud psicofísica en personas mayores de 60 años: mayor atención sociosanitaria / Impacto do nível de atividade física e do estado civil na vulnerabilidade de saúde psicofísica em pessoas com mais de 60 anos: maior cuidado social e de saúde / Impact of physical activity level and marital status on the vulnerability of psychophysical health in people over 60 years of age: greater health care

Antecedentes: Actualmente se desconocen con exactitud las repercusiones de vivir solo/a en personas mayores sanas sobre el nivel de actividad física (AF) practicada, relaciones sociales, atención sociosanitaria requerida y salud subjetiva. Objetivos: El objetivo ha sido evaluar diferencias en salud, relaciones sociales y atención sociosanitaria de personas mayores activas en función de su nivel de AF y situación familiar (estado civil). Metodología: Participan 397 personas mayores de 61 años (M=69,65; DT=4,71; 64,7% mujeres y 35,3% hombres), pertenecientes a dieciocho centros deportivos, sociales y zonas exteriores deportivas de Alicante. Se utilizó el IPAQ para evaluar la AF y CUBRECAVI para los indicadores de calidad de vida. Se realizó un análisis de varianza multivariados (MANOVAs) para estudiar las diferencias entre los/as participantes según su nivel de AF y su situación familiar. La significación se estableció en p <,05. Resultados: Los resultados mostraron que la salud subjetiva (p<,001; VCramer=,291), frecuencia de relaciones sociales (p<,001, ƞ2=,028) y satisfacción con los servicios sociosanitarios (p=,009; VCramer=,147) difieren según el nivel de AF. La frecuencia y satisfacción de las relaciones sociales (p<,001, ƞ2=,252) y la utilización de los servicios sociosanitarios difieren según la situación familiar (p=,032; VCramer=,153). Conclusión: En conclusión, el estado de bastante satisfacción con su salud subjetiva y con el uso de servicios sociosanitarios es directamente proporcional al nivel de actividad física practicada. Las relaciones sociales de solteros son menos satisfactorias y frecuentes, utilizando más los servicios sociosanitarios.

Background: Currently, the repercussions of living alone in healthy older people on the level of physical activity (PA) practiced, social relationships, required social health care, and subjective health are unknown. Objective: The objective has been to evaluate differences in health, social relations, and socio-sanitary care of active older people according to their level of PA and family situation (marital status). Methodology: 397 older people than 61 years (M=69.65; DT=4.71; 64.7% women and 35.3% men), belonging to eighteen sports, social centers and outdoor sports areas of Alicante. The IPAQ was used to assess PA and CUBRECAVI for the quality of life indicators. A multivariate analysis of variance (MANOVAs) was performed to study the differences between the participants according to their levelof PA and their family situation. Significance was set at p<.05. Results: The results showed that subjective health (p<.001; VCramer=.291), frequency of social relationships (p<.001, ƞ2=.028) and satisfaction with social and health services (p=.009; VCramer=.147) differ according to the level of PA. The frequency and satisfaction of social relationships (p<.001, ƞ2=.252) and the use of social and health services differ according to thefamily situation (p=.032; VCramer=.153). Conclusions: In conclusion, the state of enough satisfaction with their subjective health and with the use of social and health services is directly proportional to the level of physical activity practiced. Singles social relationships are less satisfactory and frequent, using more social health services. (AU)

Fundo: Atualmente, são desconhecidas as repercussões exatas de morar sozinho em idosos saudá veis sobre o nível de atividade física (AF) praticada, relações sociais, cuidados sociais e de saúde necessários e saúde subjetiva. Objetivos: O objetivo foi avaliar as diferenças de saúde, relações sociais e cuidados socio saúde de idosos ativos de acordo com seu nível de AF e situação familiar (estado civil). Metodologia: Participaram pessoas com mais de 61 anos (M=69,65; DP=4,71; 64,7% mulheres e 35,3% homens), pertencentes a dezoito centros desportivos e sociais e áreas desportivasao ar livre em Alicante. O IPAQ foi utilizado para avaliar AF e CUBRECAVI para indicadores de qualidade de vida. Uma análise de variância multivariada (MANOVAs) foi realizada para estudar as diferenças entre os participantes de acordo com seu nível de AFe sua situação familiar. A significância foi estabelecida em p<0,05. Resultados: Os resultados mostraram que a saúde subjetiva (p<0,001; VCramer=0,291), frequência de relacionamentos sociais (p<0,001, ƞ2=0,028) e satisfação com os serviços sócio-saúde (p=0,009; VCramer=0,147) diferem dependendo do nível de AF. A frequência e satisfação das relações sociais (p<0,001, ƞ2=0,252) e o uso de serviços socio saúde diferem de acordo com a situação familiar (p=0,032; VCramer=0,153). Conclusão: Em conclusão, o estado de satisfação suficiente com a sua saúde subjetiva e com a utilização dos serviços sócio sanitários é diretamente proporcional ao nível de atividade física praticada. As relações sociais dos solteiros são menos satisfatórias e frequentes, utilizando mais serviços sociais e de saúde. (AU)

Multicomponent Physical Exercise Training in Multimorbid and Palliative Oldest Adults.

Exercise counteracts aging and pathology symptoms, but there is still scarce research on exercise programs for multimorbid and/or palliative old patients (MPO-Ps). In order to analyze whether the multicomponent physical-cognitive training is beneficial for this population, 17 MPO-Ps (81.59 ± 5.63 years) completed a >26 weeks home-based intervention (20-50 min/session, three sessions/week). Twenty-eight supervised and thirty-two autonomous sessions were gradually distributed along three phases: supervised training (ST), reduced supervision training (RST), and autonomous training (AT). Physical function (gait speed, hand grip and lower-limb strength, balance, and agility), mental status (MMSE), and autonomy in daily living (the Barthel Index) were assessed. Categorical analyses regarding the changes in the walking aids used in the test were added to improve the assessment of strength and agility along the intervention. Despite important study limitations, such as the small sample size and lack of a control group, and despite the MPO-Ps' very low baseline fitness and initial exercise intolerance, they benefited from the dual-tasking approach, especially in autonomy, lower-limb strength, and balance. Agility improvements were shown only by categorical analyses. As expected, most benefits increased the supervision (ST phase). Gait speed and cognitive status maintained despite the total autonomy in training in the last phase. Further research with larger samples should confirm if multicomponent physical-cognitive exercise, individualized and tailored on daily-basis, together with technical assistance and medical supervision, benefits this MPO-Ps population, and if it can be prescribed to them with security, in spite some of them already being palliative patients.

Physical Activity and the Improvement of Autonomy, Functional Ability, Subjective Health, and Social Relationships in Women over the Age of 60.

Regarding functional ability, autonomy, promotion of social relationships and health, little scientific evidence has been found of physical practice in active women over 60 years of age. Hence, the goal of this study was to assess the functional abilities and autonomy, social relationships and subjective health of physically active older women according to the level of activity practiced. The IPAQ and CUBRECAVI scales were applied to a sample of 257 women between 61 and 93 years old (M = 69.44, SD = 4.61). Statistically significant outcomes were obtained in functional ability and autonomy according to their level of physical activity (p = 0.001): greater satisfaction and frequency of social relationships with a mild level of physical activity (p = 0.011), and statistically significant differences in the degree of satisfaction with their health according to the level of physical activity they practice (p < 0.001). The results showed that those with high physical activity obtained better levels of functional abilities and autonomy. Additionally, dissatisfaction with one's own health is associated with low levels of physical activity. In conclusion, it could be said that the practice of mild physical exercise in older women encourages greater autonomy and functional ability for activities of daily living, which results in independence in everyday life in addition to fostering social links as well as gaining a better satisfaction with their own health, with the socio-emotional benefits that this can bring.

Development and Validation of an Early Mortality Risk Score for Older Patients Treated with Chemotherapy for Cancer.

Background: Estimation of life expectancy in older patients is relevant to select the best treatment strategy. We aimed to develop and validate a score to predict early mortality in older patients with cancer. Patients and Methods: A total of 749 patients over 70 years starting new chemotherapy regimens were prospectively included. A prechemotherapy assessment that included sociodemographic variables, tumor/treatment variables, and geriatric assessment variables was performed. Association between these factors and early death was examined using multivariable logistic regression. Score points were assigned to each risk factor. External validation was performed on an independent cohort. Results: In the training cohort, the independent predictors of 6-month mortality were metastatic stage (OR 4.8, 95% CI [2.4-9.6]), ECOG-PS 2 (OR 2.3, 95% CI [1.1-5.2]), ADL ≤ 5 (OR 1.7, 95% CI [1.1-3.5]), serum albumin levels ≤ 3.5 g/dL (OR 3.4, 95% CI [1.7-6.6]), BMI < 23 kg/m2 (OR 2.5, 95% CI [1.3-4.9]), and hemoglobin levels < 11 g/dL (OR 2.4, 95% CI (1.2-4.7)). With these results, we built a prognostic score. The area under the ROC curve was 0.78 (95% CI, 0.73 to 0.84), and in the validation set, it was 0.73 (95% CI: 0.67-0.79). Conclusions: This simple and highly accurate tool can help physicians making decisions in elderly patients with cancer who are planned to initiate chemotherapy treatment.

Inspiratory Muscle Strength and Cardiorespiratory Fitness Association With Health-Related Quality of Life in Healthy Older Adults.

The main purpose of this study was to explore similarities and differences in the association between two capabilities affecting the cardiorespiratory system (overall and multifactorial cardiorespiratory fitness and inspiratory muscle strength) and the health-related quality of life (HRQoL), in a group of active healthy seniors. Sixty-five individuals (age, 73.01 ± 5.27 years; 53 women) who participated regularly in a multicomponent training program completed the EuroQol 5D-5L questionnaire, the 6-min walking test (6MWT), and the maximum inspiratory pressure test (MIP). Non-parametric correlations (Spearman's rho) were conducted to analyze the association between HRQoL indices (EQindex and EQvas), MIP, and 6MWT, considering both, the whole sample and men and women separately. Furthermore, partial correlation was made by controlling age and sex. We found a moderate association between HRQoL and cardiorespiratory fitness (EQvas: r = 0.324, p = 0.009; EQindex: r = 0.312, p = 0.011). Considering sex, relationship EQvas-6MWT decrease to small (r = 0.275; p = 0.028) whereas EQindex-6MWT remained moderated (r = 0.425; p = 0.000). When we considered women and men separately, the association between HRQoL and 6MWT appeared only in women, while the observed strong trend (p = 0.051) toward a large and positive association between EQindex and MIP, mediated by the covariate age, appeared only in men. Conversely to the cardiorespiratory fitness, MIP is not a limiting factor of HRQoL in healthy active elderly. Moreover, MIP and HRQoL should be included in the assessment of exercise interventions because they provide different information about the cardiorespiratory system deterioration. Similarly, EQvas and EQindex confirm to be complementary in the assessment of HRQoL. Furthermore, like aging process is different for men and women, the association between MIP and cardiorespiratory fitness with HRQoL may behave differently, so keeping on research these associations could help to improve training programs for this population.

Prediction of Chemotoxicity, Unplanned Hospitalizations and Early Death in Older Patients with Colorectal Cancer Treated with Chemotherapy.

PURPOSE: To identify risk factors for toxicity, unplanned hospitalization (UH) and early death (ED) in older patients with colorectal carcinoma (CRC) initiating chemotherapy. METHODS: 215 patients over 70 years were prospectively included. Geriatric assessment was performed before treatment, and tumor and treatment variables were collected. The association between these factors and grade 3-5 toxicity, UH and ED (<6 months) was examined by using multivariable logistic regression. Score points were assigned to each risk factor. RESULTS: During the first 6 months of treatment, 33% of patients developed grade 3-5 toxicity, 31% had UH and 23% died. Risk factors were, for toxicity, instrumental activities of daily living, creatinine clearance, weight loss and MAX2 index; for UH, Charlson Comorbidity Score, creatinine clearance, weight loss, serum albumin, and metastatic disease; and for ED, basic activities in daily living, weight loss, metastatic disease, and hemoglobin levels. Predictive scores were built with these variables. The areas under receiver operation characteristic (ROC) curves for toxicity, UH and ED were 0.70 (95% CI: 0.64-0.766), 0.726 (95% IC: 0.661-0.799) and 0.74 (95% IC: 0.678-0.809), respectively. CONCLUSION: Simple scores based on geriatric, tumor and laboratory characteristics predict severe toxicity, UH and ED, and may help in treatment planning.

Undertreatment and overtreatment in older patients treated with chemotherapy.

BACKGROUND: Inconsistent doses and schemes are commonly used in older patients receiving cancer chemotherapy. We performed this study in patients with cancer and age ≥ 70 years to determine the frequency of undertreatment and overtreatment as well as factors influencing the decision to modify chemotherapy doses. PATIENTS AND METHODS: Patients aged ≥70 years starting new chemotherapy regimens were prospectively included in a multicentre study. The schedule and drug doses were determined by the treating oncologist. Pre-chemotherapy assessment included sociodemographics, treatment details and geriatric assessment (GA) variables. Association between these factors and undertreatment (use of less intensive cancer treatment [LICT] in a fit patient) or overtreatment (use of standard cancer treatment in an unfit older patient) were examined by multivariate logistic regression. RESULTS: Three- hundred ninety-seven patients were included, 43% of whom received LICT. If not adjusted for GA, toxicity did not differ between those receiving LICT (38%) or standard doses of chemotherapy (37%). If the dose of chemotherapy was analyzed according to the results of GA 61 (15%) patients had been undertreated and 133 (34%) had been overtreated. Undertreatment was related with increasing age and decreased renal function. Factors related with overtreatment were younger age, curative intention of treatment, prescription of G-CSF as primary prophylaxis and adequate cognitive status. Overtreated patients had more grade 3-4 toxicity than those receiving treatment adapted to fragility (42% vs 31%; p < 0.05). CONCLUSIONS: The use of chemotherapy without considering GA leads to overtreatment more commonly than undertreatment in older patients with cancer. Oncologists should take into account the results of GA to stratify patients and to avoid under or overtreatment.

The effects of stress on cardiovascular disease and Alzheimer's disease: Physical exercise as a counteract measure.

AD is a complicated multi-systemic neurological disorder that involves different biological pathways. Several risk factors have been identified, including chronic stress. Chronic stress produces an alteration in the activity of the hypothalamic pituitary adrenal (HPA) system, and the autonomic nervous system (ANS), which over time increase the risk of AD and also the incidence of cardiovascular disease (CVD) and risk factors, such as hypertension, obesity and type 2 diabetes, associated with cognitive impairment and AD. Considering the multi-factorial etiology of AD, understanding the complex interrelationships between different risk factors is of potential interest for designing adequate strategies for preventing, delaying the onset or slowing down the progression of this devastating disease. Thus, in this review we will explore the general mechanisms and evidence linking stress, cardiovascular disease and AD, and discuss the potential benefits of physical activity for AD by counteracting the negative effects of chronic stress, CVD and risk factors.

Predicting Chemotherapy Toxicity in Older Patients with Cancer: A Multicenter Prospective Study.

BACKGROUND: Standard oncology tools are inadequate to distinguish which older patients are at higher risk of developing chemotherapy-related complications. MATERIALS AND METHODS: Patients over 70 years of age starting new chemotherapy regimens were prospectively included in a multicenter study. A prechemotherapy assessment that included sociodemographics, tumor/treatment variables, and geriatric assessment variables was performed. Association between these factors and the development of grade 3-5 toxicity was examined by using logistic regression. RESULTS: A total of 551 patients were accrued. Chemotherapy doses (odds ratio [OR] 1.834; 95% confidence interval [CI] 1.237-2.719) and creatinine clearance (OR 0.989; 95% CI 0.981-0.997) were the only factors independently associated with toxicity. Only 19% of patients who received reduced doses of chemotherapy and had a creatinine clearance ≥40 mL/minute had grade 3-4 toxicity, compared with 38% of those who received standard doses or had a creatinine clearance <40 mL/minute (p < .0001). However, no satisfactory multivariate model was obtained using different selection approaches. CONCLUSION: Chemotherapy doses and renal function were identified as the major risk factors for developing severe toxicity in the older patient. These factors should be considered when planning to initiate a new chemotherapy regimen and should also lead to a closer follow-up in these patients. IMPLICATIONS FOR PRACTICE: Older patients are more vulnerable to chemotherapy toxicity. However, standard tools are inadequate to identify who is at higher risk of developing chemotherapy-related complications. Chemotherapy doses (standard vs. reduced) and renal function were identified as the major risk factors for developing severe toxicity in the elderly. These factors should be considered when planning to initiate a new chemotherapy regimen and should also lead to a closer follow-up.

Satisfaction with Life, Subjective Well-Being and Functional Skills in Active Older Adults Based on Their Level of Physical Activity Practice.

Studies about the influence of physical activity on life satisfaction, functional ability and subjective well-being in physically active older adults without cognitive impairment are very few for the moment. Therefore, the aim of this research was to evaluate the life satisfaction, functional skills and subjective well-being of physically active older adults based on the level of activity practiced. The IPAQ (International Physical Activity), CUBRECAVI and LSIA (Life Satisfaction Index) scales were tested for a sample of 397 Spanish older adults between 61 and 93 years of age (M = 69.65; SD = 4.71). The results showed that those who performed high physical activity obtained higher scores in functional skills (p < 0.01) and in the activities of daily living (p < 0.01). In addition, subjective well-being (p < 0.01) and the functional autonomy of older adults (p < 0.01) were related to the level of physical activity that they practiced. In conclusion, it could be said that the older adults with a high level of physical activity have more functional skills and less difficulties performing the activities of daily living, and that they value their autonomy and health better.

Entrenamiento Neuromotor en pacientes ancianos pluripatológicos en las Unidades de Hospitalización a Domicilio: estudio piloto / Neuromotor Training in elderly multi-pathological patients in the Home Hospitalization Units: a pilot study / Treinamento neuromotor em pacientes idosos multipatológicos nas Unidades de Internação Domiciliar: estudo piloto

Introducción: El envejecimiento se acompaña de factores de riesgo cuya reducción mejora la supervivencia. La actividad física incide sobre ellos, lo que realza su papel preventivo y su valor como tratamiento no-farmacológico. Dada la escasez de programas de entrenamiento específicos para ancianos pluripatológicos, sobre todo durante el periodo de inicio de resolución de la actividad clínica de una enfermedad aguda, o de la exacerbación de una o varias de las enfermedades crónicas, el presente estudio piloto analiza la viabilidad y efectos de un programa corto de entrenamiento neuromotor en estos pacientes ingresados en UHD (Unidad de Hospitalización Domiciliaria). Método: 11 ancianos pluripatológicos (82,2±6,9 años, 8 hombres) completaron 4 semanas de entrenamiento funcional con orientación neuromuscular y cognitiva, con evaluación pre-post sobre capacidad funcional (equilibrio, marcha, fuerza de tren inferior y agilidad), composición corporal y calidad de vida -6 semanas, incluida la evaluación-. Se realizaron dos sesiones domiciliarias supervisadas y una tercera autónoma semanalmente. Resultados: Los ancianos mejoraron en equilibrio y marcha (Tinetti-total: 14,0±9,0 vs 17,9±7,3 puntos; p =0,007), fuerza (test sentarse y levantarse 30-s: 3,0±3,7 vs 4,1±4,1 reps.; p =0,034), agilidad (TUG-test categorizado; p =0,001) y peso (82,2±14,0 vs 79,2±13,9 kg; p =0,036), aunque no en calidad de vida relacionada con la salud (SF-36-v2: 32,9±7,8 vs 31,2±7,7 puntos; p =0,722). La presencia del técnico aumentó el cumplimiento un 20%. Conclusiones: El dinamismo de UHD es idóneo para implantar programas de actividad física especializada que frenen los efectos devastadores del binomio envejecimiento-inactividad. Una corta duración no les resta eficacia

Introduction: Aging is linked to a various risk factors whose reduction improves survival. Physical activity affects many of them, what enhances its preventive role and its value as a non-pharmacological treatment. Given the scarcity of specific training programs for elderly people with multiple pathologies, especially during the start period of resolution of the clinical activity of an acute disease, or the exacerbation of one or several of the chronic diseases, the present pilot study aims to analyze the feasibility and effects of a short neuromotor training program in these patients admitted to UHD (Home Hospitalization Unit). Methods: 11 elderly patients (82.2±6.9 years, 8 men; acute phase of disease) completed 4 weeks of a neuromuscular and cognitive orientated functional training program, with pre-post assessment of functional capacity (i.e. balance, gait speed, lower limb strength and agility), body composition and quality of life -6 weeks, including the evaluation-. There were 2 supervised sessions and a third autonomous session every week. Results: Significant improvements were found in balance and gait (Tinetti-total: 14.0±9.0 vs 17.9±7.3 points; p =0.007), strength (30-seconds Chair Stand Test: 3.0±3; p =0.001), agility (TUG-test categorized; p =0.001) and weight (82.2±14.0 vs. 79.2±13.9 kg; p =0.036), but not in health-related quality of life (SF-36-v2: 32.9±7.8 vs 31.2±7.7 points; p =0.722). The technician's presence increased adherence to the program by 20%. Conclusions: The dynamism of UHD is ideal for implementing specialized physical activity programs that counteract the devastating effects of the binomial aging-inactivity. A short duration does not reduce effectiveness

Introdução: O envelhecimento é acompanhado por fatores de risco cuja redução melhora a sobrevida. A atividade física os afeta, o que aumenta seu papel preventivo e seu valor como tratamento não farmacológico. Dada a escassez de programas específicos de treinamento para pacientes idosos, especialmente durante o período da iniciação da resolução da atividade clínica de uma doença aguda, ou da exacerbação de uma ou mais das doenças crônicas, o presente estudo piloto analisa a viabilidade e os efeitos de um programa curto de treinamento neuromotor nesses pacientes internados em UHD (Unidade de Internação Domiciliar). Método: 11 idosos com múltiplas patologias (82,2±6,9 anos, 8 homens, doença de fase aguda) completaram 4 semanas de treinamento funcional com orientação neuromuscular e cognitiva, com avaliação pré-pós de capacidade funcional (equilíbrio, marcha, menor força e agilidade do trem), composição corporal e qualidade de vida -6 semanas, incluindo avaliação-. Foram realizadas duas sessões domiciliares supervisionadas e uma sessão semanal autônoma. Resultados: Os idosos melhoraram em equilíbrio e marcha (Tinetti-total: 14,0±9,0 vs 17,9±7,3 pontos, p=0,007), força (teste de sentar e levantar 30-s: 3,0±3,7 vs 4,1±4,1 repetições, p=0,034), agilidade (teste categorizado pelo TUG, p=0,001) e peso (82,2±14,0 vs 79,2±13,9 kg; p=0,036), embora não na qualidade de vida relacionada à saúde (SF-36-v2: 32,9±7,8 vs 31,2±7,7 pontos, p=0,722). A presença do técnico aumentou a conformidade em 20%. Conclusões: O dinamismo da UHD é ideal para a implementação de programas especializados de atividade física que neutralizam os efeitos devastadores do binômio envelhecimento-inatividade. Uma curta duração não reduz a eficácia