Inflammatory biomarkers at different stages of Sarcopenia in older women.

In recent years, studies have found that Sarcopenia alters inflammatory biomarkers. However, the behavior of inflammatory biomarkers at different stages of Sarcopenia is not well understood. This study aimed to compare a broad panel of inflammatory biomarkers in older women at different stages of Sarcopenia. The study included 71 Brazilian community-dwelling older women. Muscle Strength was assessed by using handgrip strength (Jamar dynamometer). The Short Physical Performance Battery (SPPB) was performed to assess the physical performance, and body composition was assessed by DEXA. Sarcopenia was diagnosed and classified according to the EWGSOP2 criteria. Blood was drawn, and inflammatory biomarkers associated with Sarcopenia (IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, TNF, adiponectin, leptin, resistin, BDNF, sTNFr-1 and sTNFr-2) was analysed. After diagnosis and classification of sarcopenia, 45% of women did not present Sarcopenia (NS, N = 32), 23.9% were diagnosed with Sarcopenia Probable (SP, N = 17), 19,7% with Sarcopenia Confirmed (SC, N = 14), and 11.3% with Severe Sarcopenia (SS, N = 8). The analysis of inflammatory biomarkers revealed that the more advanced the stage of Sarcopenia, the higher the levels of BDNF, IL-8, sTNFr-1, and sTNFr-2. The assessment of BDNF, IL-8, sTNFr-1, and sTNFr-2 levels may be an adjuvant tool in diagnosis and severity classification of Sarcopenia in older Brazilian women.

Accuracy of handgrip and respiratory muscle strength in identifying sarcopenia in older, community-dwelling, Brazilian women.

Certain cut-off points for sarcopenia screening and diagnosis are arbitrary and based on European populations, with normative references often obtained from healthy young adults. Although respiratory skeletal muscle strength tests represent low-cost clinical measures commonly performed in clinical practice by health professionals, a gap remains regarding whether respiratory skeletal muscle strength tests are adequate and sensitive measures for sarcopenia screening. This study aimed to verify the value of handgrip and respiratory muscle strength as possible discriminators to identify sarcopenia and to establish cut-off points for sarcopenia screening in community-dwelling, Brazilian women. In a cross-sectional study, 154 community-dwelling, Brazilian women (65-96 years) were assessed for appendicular skeletal muscle mass, handgrip (HGS), and respiratory muscular strength, including maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). The data were analyzed using the ROC curve and the Youden Index determined cut-off points. Statistical significance was set at 5%. 88 participants (57%) were sarcopenic. MEP (OR 0.98 [95%CI 0.97, 1.00], p = 0.023) and HGS (OR 0.82 [95% CI 0.75, 0.90], p < 0.001) were independent factors for sarcopenia in older. The optimal cut-off points for identifying sarcopenia were ≤ 77 cmH2O for MEP (AUC = 0.72), and ≤ 20 kg for HGS (AUC = 0.80). Simple muscular strength tests, including HGS and MEP, may be considered in the identification of sarcopenia in older, community-dwelling, Brazilian women. Future work is still needed to assess external validation of the proposed cut-offs before the clinical application.

Adiponectin Is a Contributing Factor of Low Appendicular Lean Mass in Older Community-Dwelling Women: A Cross-Sectional Study.

Inflammation is a chronic, sterile, low-grade inflammation that develops with advanced age in the absence of overt infection and may contribute to the pathophysiology of sarcopenia, a progressive and generalized skeletal muscle disorder. Furthermore, a series of biomarkers linked to sarcopenia occurrence have emerged. To aid diagnostic and treatment strategies for low muscle mass in sarcopenia and other related conditions, the objective of this work was to investigate potential biomarkers associated with appendicular lean mass in community-dwelling older women. This is a cross-sectional study with 71 older women (75 ± 7 years). Dual-energy X-ray absorptiometry was used to assess body composition. Plasmatic blood levels of adipokines (i.e., adiponectin, leptin, and resistin), tumor necrosis factor (TNF) and soluble receptors (sTNFr1 and sTNFr2), interferon (INF), brain-derived neurotrophic factor (BDNF), and interleukins (IL-2, IL-4, IL-5, IL-6, IL-8, and IL-10) were determined by enzyme-linked immunosorbent assay. Older women with low muscle mass showed higher plasma levels of adiponectin, sTNFr1, and IL-8 compared to the regular muscle mass group. In addition, higher adiponectin plasma levels explained 14% of the lower appendicular lean mass. High adiponectin plasmatic blood levels can contribute to lower appendicular lean mass in older, community-dwelling women.

Evaluation of clinical and radiographic measures and reliability of the quadriceps angle measurement in elderly women with knee osteoarthritis / Avaliação das medidas radiográficas e clínicas e confiabilidade do ângulo do quadríceps em idosas com osteoartrite de joelhos

Introduction Knees osteoarthritis (OA) is a complex degenerative disease with intra-articular changes affecting the amplitude of the quadriceps angle (Q). To measure this variable, it is necessary to use reliable protocols aiming at methodological reproducibility. The objective was to evaluate the intra-examiner and inter-examiner reliability of clinical and radiographic measures of the Q angle and to investigate the relationship between the degree of OA and the magnitude of this angle in the elderly. Materials and methods 23 volunteers had the Q angle measured by two evaluators at 48-h interval. Clinical measurements were collected by using the universal goniometer in the same position adopted in the radiographic examination. Results The intra-examiner reliability was good (0.722 to 0.763) for radiographic measurements and low (0.518 to 0.574) for clinical assessment, while inter-examiner reliability was moderate (0.634) for radiographic measurements and low (0.499) to the clinics. The correlation analysis between the radiographic values with the OA classification showed no correlation between them (p = 0.824 and r = -0.024). Conclusion Clinically, it is suggested that the radiographic examination is preferable to evaluate the Q angle of elderly women with knee osteoarthritis. Moreover, the magnitude of this angle did not correlate with the degree of impairment of OA in this population.

Introdução A osteoartrite (OA) de joelhos é uma doença degenerativa complexa com alterações intra-articulares que comprometem a amplitude do ângulo do quadríceps (Q). Para mensuração dessa variável, é necessária a utilização de protocolos que apresentem confiabilidade, visando reprodutibilidade metodológica. Objetivo Avaliar a confiabilidade intra e interexaminadores das medidas clínicas e radiográficas do ângulo Q e verificar se existe relação entre o grau de OA e a magnitude deste ângulo em idosas. Materiais e métodos 23 voluntárias, tiveram o ângulo Q mensurado por 2 avaliadores, com intervalo de 48 horas. As medidas clínicas foram coletadas por meio do goniômetro universal na mesma posição adotada no exame radiográfico. Resultados A confiabilidade intraexaminador foi boa (0,722–0,763) nas medidas radiográficas e baixa (0,518–0,574) nas medidas clínicas, enquanto a confiabilidade interexaminadores foi moderada (0,634) nas medidas radiográficas e baixa (0,499) nas clínicas. A análise da correlação entre os valores radiográficos com a classificação da OA não demonstrou correlação entre os mesmos (p = 0,824 e r = -0,024). Conclusão Clinicamente, sugere-se que o exame radiográfico seja preferível para avaliação do ângulo Q de idosas com OA de joelhos. Além disto, a magnitude deste ângulo não se relacionou com o grau de acometimento da OA nesta população.

Effect of aerobic training on plasma cytokines and soluble receptors in elderly women with knee osteoarthritis, in response to acute exercise.

The aim of this study was to evaluate levels of interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), and soluble forms of the TNF-α receptor (sTNFR1 and sTNFR2) from plasma taken from the peripheral blood of elderly individuals presenting with osteoarthritis (OA) of the knee. These patients underwent aerobic treatment through the use of physical exercises. The study consisted of a longitudinal analysis of older individuals presenting clinical and radiographic diagnosis of knee OA that were submitted to 12 weeks of aerobic treatment. The individuals were evaluated during acute exercise or after chronic exercise. During acute exercise (walking slowly on the mat), blood samples of the patients were collected before, immediately after, and 30 min following the end of training. After chronic exercise (aerobic walking training, three times/week for 12 weeks), patient blood samples were obtained for comparison. Additionally, clinical and functional assessments (WOMAC test and 6-min walk) were performed at the end of all physical exercises. Plasma concentrations of cytokines and soluble receptors were measured by ELISA. Aerobic training increased the plasma concentration of sTNR1; however, it decreased the plasma concentration of sTNFR2, when compared with levels of resting patients. Acute exercise differentially affects the levels of sTNFR1 dependent on when the samples were taken, before and after aerobic training. However, the levels of sTNFR2 were not affected by training. For the population studied, we observed differences in the levels of sTNFR1 and sTNFR2 following acute and chronic exercise. Other additional factors, like the level of inactivity of the individual and the type of physical exercise that patients are exposed to, need to be considered as well. The variation in the levels of soluble receptors correlated with functional improvement; however, the inflammatory osteoarthritis markers (IL-6 and TNF-α) were unaffected by the walking exercises.

Confiabilidade do limiar de lactato identificada pelo método visual / Reliability of identifying lactate threshold by use of visual method

O limiar de lactato (LL) é utilizado como um marcador da acidose metabólica e representa o momento durante o exercício em que o lactato sanguíneo começa aumentar de forma exponencial. Este LL tem sido utilizado como medidor de condicionamento físico, indicador sensível do estado do treinamento aeróbico em sujeitos saudáveis e doentes, além disso, auxilia na identificação do estímulo de treinamento ideal e na prescrição da intensidade de treinamento. O objetivo do presente estudo foi avaliar a confiabilidade intra e interexaminadores das medidas do LL obtidas através do método de detecção visual. Para isso, 31 voluntárias do sexo feminino (67,50 ± 4,41 anos; 1,52 ± 0,07 m; 64,55 ± 11,46 kg), aparentemente saudáveis e no período pós-menopausa, participaram do estudo. O LL foi determinado a partir de um teste realizado na esteira ergométrica até a fadiga, que consistiu de estágios com carga progressiva (variação da velocidade e/ou inclinação). Amostras de sangue foram coletadas por meio de uma punção na polpa digital do dedo médio a cada 3 minutos durante o teste. Em seguida, foram construídos os gráficos do método de detecção visual (software Prisma5) a partir da concentração de lactato sanguíneo coletado a cada estágio do exercício (intervalo de 3 minutos) em função da taxa de trabalho correspondente ao consumo de oxigênio (VO2) estimado durante o teste na esteira. A análise estatística foi realizada através do Coeficiente de Correlação Intraclasse (CCI). A confiabilidade intraexaminador foi excelente (0,950 - 0,952) e a confiabilidade interexaminadores foi boa (0,789 - 0,770). Dessa forma,sugere-se que o método de detecção visual é uma forma segura e confiável para detectar o LL na prática clínica e em pesquisas.

The lactate threshold (LT) is used as a marker for metabolic acidosis and represents the time during the exercise in which blood lactate begins to increase exponentially. LT has been used as a measurer of physical capacity,a sensitive indicator of the state of aerobic training in healthy and sickpatients, in addition, assists in identifying the optimal training stimulus and the prescription of training intensity. The aim of this study was to evaluate the reliability, intra and interrater, of the LT obtained by a visual detection method. For this, 31 female volunteers (67.50 ± 4.41 years, 1.52± 0.07 m, 64.55 ± 11.46 kg), apparently healthy and postmenopausal, participated in the study. The LT was determined from a test performed on a treadmill, which consisted of stages with progressive workload(variation of speed and/or incline), until the patient experienced fatigue. Blood samples were collected from a finger prick of the middle finger every 3 minutes during the test. Next, the visual detection method graphics were constructed (software Prisma5) from the blood lactate concentration collected at each stage of exercise (3 minute intervals) depending on the work rate corresponding to oxygen consumption (VO2) estimated during the treadmill test. Statistical analysis was performed by the intraclass correlation coefficient (ICC). Intrarater reliability was excellent (0.950- 0.952) and interrater reliability was good (0.789 - 0.770). Thus, it has been determined that the visual detection method is a safe and reliable way to detect the LT in clinical practice and research.

Anti-inflammatory effects of low-level light emitting diode therapy on Achilles tendinitis in rats.

BACKGROUND AND OBJECTIVES: The present study investigated the effects of low-level light emitting diode (LED) therapy (880 +/- 10 nm) on inflammatory process in a experimental model of Achilles tendinitis induced by collagenase. STUDY DESIGN/MATERIALS AND METHODS: Fifty-six male Wistar were separated into seven groups (n = 8), three groups in the experimental period of 7 days and four groups in the experimental period of 14 days, the control group (CONT), tendinitis group (TEND), LED therapy group (LEDT) for both experimental periods, and LED therapy group 7th to 14th day (LEDT delay) for 14 days experimental period. The LED parameters was 22 mW CW of optical output power, distributed in an irradiation area of 0.5 cm(2), with an irradiation time of 170 seconds, the applied energy density was 7.5 J/cm(2) in contact. The therapy was initiated 12 hours after the tendinitis induction, with a 48-hour interval between the irradiations. The histological analysis and inflammatory mediators were quantified. RESULTS: Our results showed that LED decreases the inflammatory cells influx and mRNA expression to IL-1 beta, IL-6, tumor necrosis factor-alpha (TNF-alpha) in both phase, and cyclooxygenase-2 (COX-2) just in initial phase (P < 0.05). CONCLUSION: Our results suggest that the anti-inflammatory therapy with low-power LED (880 nm) enhanced the tissue response in all groups. We can conclude that the LED was able to reduce signs of inflammation in collagenase-induced tendinitis in rats by reducing the number of inflammatory cells and decrease mRNA expression of cytokines.

O efeito imediato da manipulação talocrural na estabilidade unipodal de tornozelo / Immediate effects of talocrural manipulation on ankle monopodalic stability

A articulação talocrural é essencial para o desenvolvimento da marcha, adaptando-se aos diversos tipos de superfícies, estando diretamente relacionada com o equilíbrio e estabilidade. Técnicas de manipulação osteopática têm sido usadas para tratar distúrbios e restaurar a mecânica articular, e podem influenciar diretamente o sistema de controle postural. O objetivo do estudo foi analisar as alterações na estabilidade unipodal de tornozelo geradas por meio da aplicação de uma técnica de thrust. Participaram deste estudo 20 homens com idade 22±2 anos, divididos em dois grupos: G1 (n=10) grupo que recebeu a técnica manipulativa e G2 (n=10) controle. A técnica utilizada foi a manipulação talocrural no membro inferior dominante. Os valores estabilométricos foram obtidos pela plataforma Cibex Reactor antes e cinco minutos após a aplicação da técnica em G1. Os voluntários de G2 foram submetidos ao mesmo protocolo de avaliação, porém sem receber a técnica thrust. Foram obtidos os seguintes resultados: Em G1, observou-se diferenças estatisticamente signifi cantes após a manipulação talocrural (p<0,05), antes os voluntários apresentaram valores estabilométricos de 8.169 pontos. Após a intervenção experimental houve uma queda de 14,35% (6.996 pontos), indicando que houve uma alteração na estabilidade quando comparado ao grupo controle, o qual não obteve diferenças nos resultados. Assim, sugere-se que a manipulação pode ser eficaz na melhora do equilíbrio e estabilidade unipodal de tornozelo.

The talocrural joint is essential for the gait development. It adapts itself to the various areas and types of terrain where you walk and is directly related to balance and stability. Manipulative techniques were used to treat disorders and restore the joint movements, and may influence the postural control system. The study’s goal was to evaluate the immediate changes in stability generated by the application of thrust technique. Twenty men, 22±2 years old, were separated into two groups: G1 (n=10) manipulated group, and G2 (n=10) control group. The technique used was the talocrural thrust in the dominant leg. The data was collected by the stabilometric platform Cibex Reactor before and five minutes after the application of the technique in G1. The group G2 performed only the stabilometric test at the same time, without receiving the thrust. The values obtained were statistically signifi cant for G1 after the manipulation (P<0,05), the stabilometric values before the technique was 8.169 points, and after was a decline of 14.35% (6,996 points), indicating that there was a change in the stability when compared to the control group, which there were no differences between the results. The results of this study suggest that the manipulation can be effective in improving balance and stability.