Translation, transcultural adaptation into Brazilian Portuguese and concurrent validity of the rheumatoid arthritis assessment scale (RAKAS-13/Brazil).

BACKGROUND: Knowledge of patients about Rheumatoid Arthritis (RA) is a necessary aspect to better approach self-management support in a patient-centered manner. The research instrument known as the Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS), consisting of 13 items, is simple, reliable and reproducible, and can be applied in both clinical practice and research protocols. OBJECTIVE: This study aimed to translate and culturally adapt the RAKAS vocabulary into Brazilian Portuguese and to evaluate its concurrent validity. METHODS: The RAKAS was translated into Brazilian Portuguese and administered to 52 elderly women with RA recruited between May 2021 and May 2022. Concurrent validity was assessed using the Spearman's correlation coefficient between RAKAS and Patient Knowledge Questionnaire (PKQ). RESULTS: The participants considered RAKAS-13/BRAZIL easy to understand and did not report any doubts in answering the final version. Concurrent validity of the RAKAS-13/BRAZIL was low compared to the PKQ (ρ = 0.283, p = 0.038). CONCLUSION: The Brazilian Portuguese version of the RAKAS (RAKAS-13/BRASIL) proved to be a questionnaire that was easy and quick to administer to assess patient knowledge about Rheumatoid Arthritis, despite its low correlation with the PKQ in the present study.

Translation, transcultural adaptation into Brazilian Portuguese and concurrent validity of the rheumatoid arthritis assessment scale (RAKAS-13/Brazil)

Abstract Background Knowledge of patients about Rheumatoid Arthritis (RA) is a necessary aspect to better approach self-management support in a patient-centered manner. The research instrument known as the Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS), consisting of 13 items, is simple, reliable and reproducible, and can be applied in both clinical practice and research protocols. Objectives This study aimed to translate and culturally adapt the RAKAS vocabulary into Brazilian Portuguese and to evaluate its concurrent validity. Methods The RAKAS was translated into Brazilian Portuguese and administered to 52 elderly women with RA recruited between May 2021 and May 2022. Concurrent validity was assessed using the Spearman's correlation coefficient between RAKAS and Patient Knowledge Questionnaire (PKQ). Results The participants considered RAKAS-13/BRAZIL easy to understand and did not report any doubts in answering the final version. Concurrent validity of the RAKAS-13/BRAZIL was low compared to the PKQ (ρ = 0.283, p = 0.038). Conclusion The Brazilian Portuguese version of the RAKAS (RAKAS-13/BRASIL) proved to be a questionnaire that was easy and quick to administer to assess patient knowledge about Rheumatoid Arthritis, despite its low correlation with the PKQ in the present study.

Factors that cause women with osteoporosis to fall.

Objective: To analyze and compare intrinsic and extrinsic factors that cause falls among women receiving treatment for osteoporosis. Subjects and methods: A cross-sectional study of women ≥50 years receiving treatment for osteoporosis. Participants filled out questionnaires (demographic characteristics), and researchers took anthropometric measurements of bone mineral density, handgrip strength (HGS), ankle range of motion (ROM), and gait speed (GS). We also evaluated the Timed Up and Go Test (TUGT), Five Times Sit-to-Stand Test (SST), and Falls Efficacy Scale-International (FES-I) and investigated the extrinsic factors for falls. Results: We included 144 participants (71.6 [8.3 years]), who reported 133 falls. We classified participants into a non-faller group (NFG; 0 falls, n=71, 49.5%), a faller group (FG; 1 fall, n=42, 28.9%), and a recurrent-faller group (RFG; more than 1 fall, n=31, 21.5%). Most patients had an increased risk of falling according to the TUGT, SST, reduced ankle ROM, and GS (P<.005 for all). FES-I was associated with sporadic and recurrent falls. For the multivariate analysis, the number of falls was influenced by the presence of ramps (RR 0.48, 95% CI, 0.26-0.87, P=.015), uneven surfaces (RR 1.6, 95% CI. 1.05-2.43, P=.028), and antislippery adhesive on stairs (RR 2.75, 95% CI, 1.77-4.28, P<.001). Conclusion: Patients receiving treatment for osteoporosis are influenced by intrinsic and extrinsic factors that cause falls. Lower-limb strength and power-discriminated participants at a higher risk of falls, but extrinsic factors varied. Only uneven floors and antislippery adhesives on stairs were associated with increased frequency of falls.

Factors that cause women with osteoporosis to fall

ABSTRACT Objectives: To analyze and compare intrinsic and extrinsic factors that cause falls among women receiving treatment for osteoporosis. Subjects and methods: A cross-sectional study of women ≥50 years receiving treatment for osteoporosis. Participants filled out questionnaires (demographic characteristics), and researchers took anthropometric measurements of bone mineral density, handgrip strength (HGS), ankle range of motion (ROM), and gait speed (GS). We also evaluated the Timed Up and Go Test (TUGT), Five Times Sit-to-Stand Test (SST), and Falls Efficacy Scale-International (FES-I) and investigated the extrinsic factors for falls. Results: We included 144 participants (71.6 [8.3 years]), who reported 133 falls. We classified participants into a non-faller group (NFG; 0 falls, n = 71, 49.5%), a faller group (FG; 1 fall, n = 42, 28.9%), and a recurrent-faller group (RFG; more than 1 fall, n = 31, 21.5%). Most patients had an increased risk of falling according to the TUGT, SST, reduced ankle ROM, and GS (P < .005 for all). FES-I was associated with sporadic and recurrent falls. For the multivariate analysis, the number of falls was influenced by the presence of ramps (RR 0.48, 95% CI, 0.26-0.87, P = .015), uneven surfaces (RR 1.6, 95% CI. 1.05-2.43, P = .028), and antislippery adhesive on stairs (RR 2.75, 95% CI, 1.77-4.28, P < .001). Conclusion: Patients receiving treatment for osteoporosis are influenced by intrinsic and extrinsic factors that cause falls. Lower-limb strength and power-discriminated participants at a higher risk of falls, but extrinsic factors varied. Only uneven floors and antislippery adhesives on stairs were associated with increased frequency of falls.

Effects of multidomain interventions on skeletal muscle architecture and function in pre-frail older women: The WiiProtein study.

The aim was to investigate the effects of physical training with exergames and protein supplementation on musculoskeletal function, muscle architecture, and markers of physical frailty in pre-frail older women. Ninety participants were assigned to one of five groups: physical training using exergames (PTG); protein supplementation (PSG); physical training and protein supplementation (PTPSG); physical training and isoenergetic supplementation (PTISG); and control group (CG). We evaluated: strength and power of lower limbs; functional mobility; gait speed; handgrip strength; and muscle architecture. The PTPSG increased knee extensor and flexor strength (8.4% and 10.2% respectively), and knee extensor power (17.1%), reduced exhaustion (100%), and also reversed pre-frailty (43.8%). There were no significant differences among groups in all outcomes analyzed. Physical training using exergames with protein supplementation increased musculoskeletal function, reduced exhaustion, and reversed pre-frailty in older women.

Accuracy of Tools to Differentiate Single From Recurrent Fallers Pre-Frail Older Women.

Objectives: The objectives of this study were to analyze and compare musculoskeletal and functional performance and present cutoff points to differentiate pre-frail community-dwelling older women regarding their fall history: non fallers (0 falls), fallers (single fall), and recurrent fallers (≥2 falls). Method: This is a cross-sectional, retrospective study on 90 pre-frail community-dwelling older women (71.2 ± 4.49 years) according to Fried criteria. We assessed peak torque (PT) (isokinetic dynamometer), muscle architecture/mass (ultrasound/dual-energy X-ray absorptometry), and the following functional performance: usual gait speed (UGS), fast gait speed (FGS), walking speed reserve (WSR), cadence and step length, and timed up and go. Results: The recurrent fallers presented lower UGS (1.12 ± 0.18 vs. 1.29 ± 0.28 m/s; p = 0.05) and isometric PT of knee extensors than the fallers (89.88 ± 20.99 vs. 115.55 ± 23.09 Nm; p = 0.01), and lower FGS than the fallers (1.35 ± 0.26 vs. 1.5 ± 0.29 m/s; p = 0.03) and non-fallers (1.35 ± 0.26 vs. 1.52 ± 0.26 m/s; p = 0.01). The outcomes that differentiated the fallers from the non-fallers were both WSR calculated as a difference (WSRdiff) (≤0.26 m/s) and WSR calculated as a ratio (WSRratio) (≤1.25 m/s), while to differentiate the recurrent fallers from the non-fallers were FGS (≤1.44 m/s) and step length (≤73 cm). The following cutoff points might be used to differentiate recurrent fallers and fallers: UGS (≤1.12 m/s), FGS (≤1.34m/s), step length (≤73 cm), PT knee extension (≤114.2 Nm), PT knee flexion (≤46.3 Nm), and PT ankle dorsiflexion (≤22.1 Nm). Conclusion: Recurrent fallers community-dwelling pre-frail older women presented a worse musculoskeletal and functional performance when compared to the non-fallers and fallers. Gait speed, step length, PT of both knee extension and flexion, and ankle dorsiflexion can be used to identify both single and recurrent fallers pre-frail older women, contributing to guide interventions and prevent falls and fractures.

Nutrition assistance improves skeletal muscle function and performance in community-dwelling older women / Assistência nutricional melhora o desempenho muscular esquelético de mulheres idosas residentes na comunidade

To analyze the effects of nutritional assistance focusing on protein intake (in the individual's usual diet) in relation to muscle mass, and the muscle strength and functional performance of community-dwelling older women. Methods: This is a non-randomized controlled clinical trial. Forty-three community-dwelling older women, who were allocated to the Control Group (CG; n = 20) or the Nutrition Group (NG; n = 23). The NG received individualized nutrition assistance and participated in group activities that focused on dietary protein intake once a week for 12 weeks. Main outcome measures: protein and energy intake; handgrip strength (HGS); gait speed (GS); quadriceps cross-sectional area (CSA); and intramuscular non-contractile tissue (IMNCT). The Student's t-test for independent samples, the Mann-Whitney U test, and a mixed model ANOVA with two factors (group and time) were adopted, followed by a post hoc Bonferroni test. A Spearman's correlation test was performed on tests for HGS; GS; CSA; IMNCT; age; and protein intake adjusted for weight (g/kg) (p ≤ 0.050). Results: Participants in the NG showed higher CSA values than those in the CG (p < 0.001). NG participants also had higher HGS (p < 0.001) and GS (p = 0.037) when compared to pre-intervention. Correlations were observed between IMNCT and protein intake adjusted for weight (g/kg) (r = -0.517; p = 0.020); HGS, and CSA (r = 0.827; p = 0.000); and CSA and age (r = -0.520, p = 0.009).

Analisar os efeitos da assistência nutricional com foco na ingestão proteica (na dieta habitual do indivíduo) em relação a massa muscular, força muscular e desempenho funcional de idosas de uma comunidade. Métodos: Trata-se um ensaio clínico controlado não randomizado. Quarenta e três idosas da comunidade foram alocadas no Grupo Controle (GC; n = 20) ou no Grupo Nutrição (GN; n = 23). O GN recebeu atendimento nutricional individualizado e participou de atividades grupais com foco na ingestão proteica da dieta uma vez por semana, durante 12 semanas. Principais medidas de resultado: ingestão de proteína e energia; força de preensão palmar (FPP); teste de velocidade da marcha (TVM); área de secção transversa do quadríceps (ASTq); e tecido intramuscular não contrátil (TIMNC). Utilizou-se o teste t de Student para amostras independentes, o teste U de Mann-Whitney e um modelo misto de análise de variância (ANOVA) com dois fatores (grupo e tempo), seguido de teste post hoc de Bonferroni. Um teste de correlação de Spearman foi realizado para FPP; TVM; ASTq; TIMNC; idade; e ingestão proteica ajustada para peso (g/kg) (p ≤ 0,050). Resultados: Os participantes do GN apresentaram valores de ASTq superiores aos do GC (p < 0,001). Os participantes do GN também exibiram maior FPP (p < 0,001) e GS (p = 0,037) quando comparados à pré-intervenção. Foram observadas correlações entre TIMNC e ingestão proteica ajustada para peso (g/kg) (r = -0,517; p = 0,020); HGS e ASTq (r = 0,827; p = 0,000); e ASTq e idade (r = -0,520, p = 0,009).

Reliability of HOME FAST BRAZIL-Self-Reported Version for Community-Dwelling Older Adults.

Objective: Verify the intra- and inter-rater reliability of the HOME FAST BRAZIL-Self-reported version and correlate household environmental risks with the history of falls by community-dwelling older adults. Method: Cross sectional study with 50 community-dwelling older adults who were screened by the cut-off point of the Mini Mental State Exam and replied to the HOME FAST BRAZIL-Self-reported version using two evaluators, on three occasions. The reliability analysis was determined by the Intra-class Correlation Coefficient (ICC), considering ICC > 0.70 as adequate. To test the correlations, the Spearman test was used. Results: The mean age of the participants was 73.2 ± 5.8 years. The inter- rater reliability of HOME FAST BRAZIL-Self-reported version was ICC 0.83 (IC95%, 0.70-0.90) and the Intra- reliability ICC 0.85 (IC95%, 0.74-0.91). A risk of falls was verified in 88% of the sample and four environmental risks presented significant correlations with the history of falls. Conclusions: The HOME FAST BRAZIL-Self-reported version presented adequate reliability for the evaluation of household environmental risks for community-dwelling older adults. Risks such as inadequate armchairs/ sofas, the absence of anti-slip mats in the shower recess, the presence of pets and inadequate beds require attention in the evaluation of household risks, due to their correlation with the occurrence of falls.

Effects of Exergames and Protein Supplementation on Body Composition and Musculoskeletal Function of Prefrail Community-Dwelling Older Women: A Randomized, Controlled Clinical Trial.

This study aimed to investigate the effects of exergames and protein supplementation on the body composition and musculoskeletal function of pre-frail older women. Methods: A randomized controlled clinical trial was conducted with 90 pre-frail older women (71.2 ± 4.5 years old) divided into five groups: control (CG); exergames training (ETG); protein supplementation (PSG); exergames combined with protein supplementation (ETPSG); exergames combined with isoenergetic supplementation (ETISG). The primary outcomes were pre-frailty status, body composition (appendicular muscle mass (ASM); appendicular muscle mass index (ASMI)) assessed by dual energy X-ray absorptiometry and gastrocnemius muscle architecture via ultrasound. Secondary outcomes were protein intake, plasma levels of interleukin (IL)-6, plantar and dorsiflexion isokinetic peak torque, and handgrip strength (HS). Data were analyzed using an ANOVA mixed model test and Bonferroni post hoc test (p < 0.05). The ETG showed a reduction of ASM (16.7 ± 3.4 vs. 16.1 ± 3.3 kg; Δ = -0.5; p = 0.02; d = 0.26) and ASMI (6.8 ± 0.9 vs. 6.5 ± 0.9 kg; Δ = -0.2; p = 0.03; d = 0.35), without changing ASM in other groups. The average protein intake in the supplemented groups (PSG and ETPSG) was 1.1 ± 0.2 g/kg/day. The dorsiflexion peak torque increased 11.4% in ETPSG (16.3 ± 2.5 vs. 18.4 ± 4.2 Nm; p = 0.021; d = -0.58). The HS increased by 13.7% in ETG (20.1 ± 7.2 vs. 23.3 ± 6.2 kg, Δ = 3.2 ± 4.9, p = 0.004, d = -0.48). The fatigue/exhaustion reduced by 100% in ETG, 75% in PSG, and 100% in ETPSG. Physical training with exergames associated with protein supplementation reversed pre-frailty status, improved the ankle dorsiflexors torque, and ameliorated fatigue/exhaustion in pre-frail older women.

Does Physical Dance Training with Virtual Games Change Muscle Quality of Community-Dwelling Older Women?

Objective: The aim of the study is to analyze the effects of physical dance training with a virtual game on muscle quality (MQ) of community-dwelling older women. Materials and Methods: In total, 46 older women participated in the study and were assigned to either a control group (CG, n = 25, 71 ± 5 years) or training group (TG, n = 21, 69 ± 4 years). The following assessments were performed at baseline and after 12 weeks: quadriceps, ankle plantar flexor, and dorsiflexor isokinetic peak torque (PT) (Biodex System 4 Dynamometer); quadriceps cross-sectional area (CSA) measured using magnetic resonance imaging; intramuscular noncontractile tissue (IMNCT) (Image-Pro Plus 4.5.0.29 for Windows); and MQ (ratio of quadriceps PT to CSA). Each week for 12 weeks, the TG undertook three 40-minute sessions of physical training with the "Dance Central" game for Xbox 360® with Kinect, while the CG was instructed to maintain usual activities of daily living. Results: The TG increased quadriceps eccentric PT at 60°/s (P = 0.04) and ankle plantar flexor concentric PT at 60°/s (P = 0.02) when compared with the CG. No significant difference in quadriceps CSA, IMNCT, and MQ was observed. Conclusion: Physical dance training with virtual games can increase quadriceps and ankle plantar flexor strength without changing IMNCT and MQ of community-dwelling older women. Trial number: RBR-8xkwyp (ensaiosclinicos.gov.br-Brazilian Clinical Trials Registry).

Translation and transcultural adaptation of the injury report form for rugby union / Tradução e adaptação transcultural do injury report form for rugby union

ABSTRACT Objective: To translate into Brazilian Portuguese and conduct the cross-cultural adaptation of the "Injury Report Form for Rugby Union" questionnaire. Methods: This is a cross-sectional study, level of evidence II, with following the steps: translation; synthesis; back-translation; review by a committee of experts and pre-final version; pre-test to verify comprehension; elaboration of the final version of the instrument and clinical application. Results: The two versions resulting from the translation and adaptation process did not show great differences. The pre-final version was filled by 23 male rugby players; three questions were not understood by 40%, 27% and 82.5% of the players, respectively, which required a new meeting with a multidisciplinary committee of experts. The modifications were made, requiring then a new application. The new version was filled by 25 male rugby players, aged 29.44 ± 5.90 years; of which 56% had complete higher education; finalizing the process of cross-cultural adaptation. Conclusion: The questionnaire "Formulário para Notificação/Avaliação de Lesão em Jogadores de Rugby" was translated and transculturally adapted into Brazilian Portuguese. Level of Evidence II, Diagnostic Studies - Investigating a Diagnostic Test.

RESUMO Objetivo: Traduzir para o português brasileiro e realizar adaptação transcultural do questionário "Injury Report Form for Rugby Union". Métodos: Estudo transversal, nível de evidência II, etapas seguidas: tradução; síntese; retrotradução; revisão pelo comitê de especialistas e versão pré-final; pré-teste para verificar a compreensão; elaboração da versão final do instrumento e aplicação clínica. Resultados: No processo de tradução e adaptação as duas versões não apresentaram grandes diferenças entre si. A versão pré-final foi preenchida por 23 jogadores de rugby do sexo masculino, três questões não foram compreendidas por 40%, 27% e 82,5% dos jogadores, respectivamente, convocando-se nova reunião com o comitê multidisciplinar de especialistas. As modificações foram realizadas, sendo necessária nova aplicação. A nova versão foi preenchida por 25 jogadores de rugby do sexo masculino, com idade entre 29,44± 5,90 anos; sendo que 56% possuíam nível de escolaridade superior completo; finalizando o processo de adaptação transcultural. Conclusão: O questionário "Formulário para Notificação/Avaliação de Lesão em Jogadores de Rugby" foi traduzido e adaptado transculturalmente para o português brasileiro. Nível de Evidência II, Estudos diagnósticos - Investigação de um exame para diagnóstico.

TRANSLATION AND TRANSCULTURAL ADAPTATION OF THE INJURY REPORT FORM FOR RUGBY UNION.

OBJECTIVE: To translate into Brazilian Portuguese and conduct the cross-cultural adaptation of the "Injury Report Form for Rugby Union" questionnaire. METHODS: This is a cross-sectional study, level of evidence II, with following the steps: translation; synthesis; back-translation; review by a committee of experts and pre-final version; pre-test to verify comprehension; elaboration of the final version of the instrument and clinical application. RESULTS: The two versions resulting from the translation and adaptation process did not show great differences. The pre-final version was filled by 23 male rugby players; three questions were not understood by 40%, 27% and 82.5% of the players, respectively, which required a new meeting with a multidisciplinary committee of experts. The modifications were made, requiring then a new application. The new version was filled by 25 male rugby players, aged 29.44 ± 5.90 years; of which 56% had complete higher education; finalizing the process of cross-cultural adaptation. CONCLUSION: The questionnaire "Formulário para Notificação/Avaliação de Lesão em Jogadores de Rugby" was translated and transculturally adapted into Brazilian Portuguese. Level of Evidence II, Diagnostic Studies - Investigating a Diagnostic Test.

OBJETIVO: Traduzir para o português brasileiro e realizar adaptação transcultural do questionário "Injury Report Form for Rugby Union". MÉTODOS: Estudo transversal, nível de evidência II, etapas seguidas: tradução; síntese; retrotradução; revisão pelo comitê de especialistas e versão pré-final; pré-teste para verificar a compreensão; elaboração da versão final do instrumento e aplicação clínica. RESULTADOS: No processo de tradução e adaptação as duas versões não apresentaram grandes diferenças entre si. A versão pré-final foi preenchida por 23 jogadores de rugby do sexo masculino, três questões não foram compreendidas por 40%, 27% e 82,5% dos jogadores, respectivamente, convocando-se nova reunião com o comitê multidisciplinar de especialistas. As modificações foram realizadas, sendo necessária nova aplicação. A nova versão foi preenchida por 25 jogadores de rugby do sexo masculino, com idade entre 29,44± 5,90 anos; sendo que 56% possuíam nível de escolaridade superior completo; finalizando o processo de adaptação transcultural. CONCLUSÃO: O questionário "Formulário para Notificação/Avaliação de Lesão em Jogadores de Rugby" foi traduzido e adaptado transculturalmente para o português brasileiro. Nível de Evidência II, Estudos diagnósticos - Investigação de um exame para diagnóstico.

Morphometric and Molecular Muscle Remodeling after Passive Stretching in Elderly Female Rats.

OBJECTIVES: To determine the effects of three sessions of a passive stretching exercise protocol on the muscles of elderly female rats. METHODS: The effects of the stretching exercises on the soleus muscle were analyzed using immunohistochemistry [tissue inhibitors of matrix metalloproteinases (TIMP), the tumor necrosis factor-alpha (TNF-α), and the gene expression levels using real-time PCR of the transforming growth factor-beta 1 (TGF-ß1), collagen type 1 (COL1), and collagen type 3 (COL3)]. Fifteen 26-month-old female Wistar rats were randomly divided into two groups, namely, Stretching (SG, n=8) and Control (CG, n=7). The passive mechanical stretching protocol consisted of a set of 4 1-minute repetitions, with 30 seconds between each repetition (total treatment of 4 minutes), three times a week for 1 week. RESULTS: Immunohistochemical analysis revealed an increase of 71.4% in the TNF-α (p=0.04) gene expression levels for the SG and a 58% decrease in the TGF-ß1 gene expression levels (p=0.005) in the SG compared to that in the CG. No significant differences were observed between the groups for the immunostaining of TIMP-1 or the gene expression levels of COL1 and COL3. CONCLUSION: Three sessions of static stretching reduced the gene expression level of TGF-ß1, which, owing to its anti-fibrotic role, might contribute to the remodeling of the intramuscular connective tissue of the aging muscle. In addition, immunostaining revealed that TNF-α levels increased in the aging muscle tissue in response to stretching, indicating its effect on stimulating extracellular matrix degradation. These outcomes have important clinical implications in reinforcing the use of stretching exercises in the elderly, considering that the aging muscle presents an infiltration of connective tissue.

Effects of ultrasound and stretching on skeletal muscle contusion in rats: immunohistochemistry analysis / Efectos de ultrasonido y estiramiento en la contusión muscular esqueletal en ratas: análisis inmunohistoquímico

SUMMARY: The aim of this study was to evaluate the effects of stretching and therapeutic ultrasound (TUS) on desmin and laminin contents of rat muscle after contusion. Male Wistar rats (n = 35, 8-9 weeks of age, 271 ± 14g body weight) were divided into five groups: Control group (CG) (n= 03); Injured group (IG) (n= 8); Injured + ultrasound group (IUSG) (n= 8); Injured+stretching group (ISG) (n= 8); Injured +ultrasound + stretching group (IUSSG) (n= 8). The application of ultrasound started 72 hours after the contusion, using the 50 % pulsed mode, 0.5 W/cm2, 5 min, once a day, for five consecutive days. Passive manual stretching was started on the tenth day after injury, with four repetitions of 30 s each and 30 s rest between repetitions, once a day, five times per week, for a total of ten applications. After 22 days, the rats were euthanazied and the gastrocnemius of both limbs removed for desmin and laminin immunohistochemistry morphometric measurement. Analysis was conducted using ANOVA one way post-hoc Tukey to parametric data and Kruskall-Wallis for non-parametric data. The IUSSG animals showed a larger area of desmin than ISG (p<0.05). It was found a decrease in laminin comparing IUSG to IG. However, laminin area was higher in ISG than all groups (p<0.05). UST isolated or in combination with stretching influenced gastrocnemius regeneration in different manners. While stretching applied isolated enhanced gastrocnemius regeneration noticed by the increase in laminin area, in combination with TUS strengthened the muscle healing rising desmin area.

RESUMEN: El objetivo de este estudio fue evaluar los efectos del estiramiento y la ecografía en los contenidos de desmina y laminina del músculo de rata después de la lesión. Ratas Wistar macho (n = 35, 8-9 semanas de edad, 271 ± 14 g de peso corporal) se dividieron en cinco grupos: grupo de control (CG) (n = 03); Grupo lesionado (GL) (n = 8); Lesionado + grupo de ultrasonido (LGU) (n= 8); Lesionado + grupo de estiramiento (LGE) (n = 8); Lesionado + ultrasonido + grupo de estiramiento (LUGE) (n = 8). La aplicación de ultrasonido comenzó 72 horas después de la lesión, usando el modo pulsado al 50 %, 0,5W / cm2, 5 min, una vez al día, durante cinco días consecutivos. El estiramiento manual pasivo se inició el décimo día después de la lesión, con cuatro repeticiones de 30 seg cada una y 30 seg de descanso entre repeticiones, una vez al día, cinco veces por semana, para un total de diez aplicaciones. Las ratas fueron sacrificadas después de 22 días, y se extrajo el músculo gastrocnemio de ambos miembros para la medición morfométrica de desmina y laminina a través de inmunohistoquímica. El análisis se realizó utilizando ANOVA unidireccional Tukey post-hoc para datos paramétricos y Kruskall-Wallis para datos no paramétricos. Los animales LUGE mostraron un área mayor de desmina que LGE (p <0,05). Se encontró una disminución en la laminina comparando LGU con GL. Sin embargo, el área de laminina fue mayor en LGE que en todos los grupos (p <0,05). El tratamiento con ultrasonido aislado o en combinación con estiramiento influyó en la regeneración del músculo gastrocnemio de diferentes maneras. Si bien el estiramiento aplicado, en combinación con tratamiento de ultrasonido, fortaleció el área de desmina, la regeneración del músculo gastrocnemio mejoró por el aumento en el área de laminina aumentando la curación muscular.

Frailty prevalence and related factors in older adults from southern Brazil: A cross-sectional observational study.

OBJECTIVES: To determine the prevalence of frailty and the association of sociodemographic characteristics, clinical aspects, and functional capacity with the frailty status of community-dwelling older adults from Curitiba, Southern Brazil. METHODS: This cross-sectional observational study included 1,716 participants aged ≥60 years. Frailty was assessed using the Fried phenotype indicators of weakness, exhaustion, low activity, slowness, and weight loss. Sociodemographic characteristics, clinical aspects, and functional capacity and functionality were evaluated and compared between the sexes and the different frailty statuses (non-frail, prefrail, and frail). Multinomial logistic regression models were used to identify associations (p<0.05). RESULTS: A high prevalence of frailty (15.8%) and prefrailty (65.3%) were observed, and both were higher in female than in male individuals. The most predominant frailty criterion was weakness, followed by exhaustion. Compared with the non-frail elderly, the prefrail and frail elderly were older in age and presented more health problems, greater dependency for basic and instrumental activities of daily living, and reduced lower extremity strength performance and functional mobility. The highest proportion of illiterate individuals, individuals with 1-4 years of education, widowed individuals, polypharmacy, and possible cognition problems and diseases were seen in the frail elderly group. Moreover, the risk of being prefrail and frail was higher in those who were older and had more health problems, higher body mass index, and reduced lower extremity strength performance. Greater calf circumference and independence in activities of daily living were protective factors for prefrailty and frailty. Furthermore, lower functional mobility increased the chances of being frail. CONCLUSIONS: The prevalence of frailty was more pronounced in female than in male individuals, mainly because of a decline in force. Prefrailty was 4 times more prevalent than frailty, and the presence of health problems and reduced functional capacity increased the chances of being prefrail and frail.

Effects of chronic stretching on soleus muscle of Wistar female rats / Efectos del estiramiento crónico en el músculo sóleo de ratas hembras Wistar

The purpose of this study was to evaluate the chronic effects of stretching exercise on soleus muscle histomorphology and histomorphometry of young and aged rats. Thirty-eight female rats were divided into young control group (YCG, n=10;274±50 g); young stretching group (YSG, n=8;274±12 g); aged control group (ACG, n=10;335±39 g); and aged stretching group (ASG, n=10;321±32g). A mechanical apparatus was used to stretch muscle in 4 repetitions, 60 s each, 30 s interval between repetitions in each session, 3 times a week for 3 weeks. Twenty-four hours after the last stretching session, soleus muscle was removed for micromorphology and immunostaining analysis. Data analyses were performed with one-way ANOVA, post-hoc Tukey, or Kruskal-Wallis tests for parametric and nonparametric, respectively (p≤0.05). Muscle fiber cross-sectional area (MFCSA) of ACG was lower (18 %) compared to the YCG. Stretching increased MFCSA comparing YSG to YCG (5,681.15± 1,943.61 µm2 vs 5,119.84±1,857.73 µm2, p=0.00), but decreased comparing ASG to ACG (3,919.54± 1,694.65 µm2 vs 4,172.82±1,446.08 µm2, p=0.00). More serial sarcomere numbers were found in the YSG than YCG (12,062.91±1,564.68 vs 10,070.39±1,072.38, p=0.03). Collagen I and collagen III were higher in YSG than ASG (7.44±7.18 % vs 0.07±0.09 %, p=0.04) and (14.37 %± 9.54 % vs 5.51 %±5.52 %, p=0.00), respectively. TNF-a was greater in ASG than YSG (43.42 %±40.19 % vs 1.72 ± 2.02 %, p=0.00). Epimysium was larger in the YSG compared to YCG (201.83±132.07 % vs 181.09±147.04 %, p=0.00). After 3-week stretching the soleus muscles from aged rats were smaller than their younger counter-parts. Interestingly, while stretching appeared to positively affect young soleus muscle, the opposite was detected in the muscle of the aged rats.

El propósito de este estudio fue evaluar los efectos crónicos del ejercicio de estiramiento sobre la histomorfología e histomorfometría del músculo sóleo de ratas jóvenes y envejecidas. Se dividieron 38 ratas hembras en un grupo control joven (YCG, n = 10; 274 ± 50 g); grupo de estiramiento joven (YSG, n = 8; 274 ± 12 g); grupo control de edad (ACG, n = 10; 335 ± 39 g); y grupo estiramiento envejecido (ASG, n = 10; 321 ± 32 g). Se usó un aparato mecánico para estirar el músculo en 4 repeticiones, 60 s cada una, intervalo de 30 s entre repeticiones en cada sesión, 3 veces por semana, durante 3 semanas. Veinticuatro horas después de la última sesión de estiramiento, se extrajo el músculo sóleo para análisis de micromorfología e inmunotinción. Los análisis de datos se realizaron con pruebas ANOVA de una vía, Tukey post-hoc o Kruskal-Wallis para pruebas paramétricas y no paramétricas, respectivamente (p≤0,05). El área de la sección transversal de fibra muscular (MFCSA) de GCE fue menor (18 %) en comparación con el GCJ. El estiramiento aumentó ASTFM comparando GEJ con GCJ (5.681,15 ± 1.943,61 µm2 vs 5.119,84 ± 1.857,73 µm2, p = 0,00), pero disminuyó comparando GEE con GCE (3.919,54 ± 1.694,65 µm2 vs 4.172,82 ± 1.446,08 µm2, p = 0,00). Se encontraron más sarcómeros en serie en el GEJ que en el GCJ (12.062,91 ± 1.564,68 vs 10.070,39 ± 1,072.38, p = 0,03). El colágeno I y el colágeno III fueron más numerosos en GEJ que en GEE (7,44 ± 7.18 % vs 0,07 ± 0,09 %, p = 0,04) y (14,37 % ± 9,54 % vs 5,51 % ± 5,52 %, p = 0,00), respectivamente. TNF-α fue mayor en GEE que GEJ (43,42 % ± 40,19 % vs 1,72 ± 2,02 %, p = 0,00). El epimisio fue mayor en el GEJ en comparación con el GCJ (201,83 ± 132,07 % vs 181,09 ± 147,04 %, p = 0,00). Después de 3 semanas de estiramiento, los músculos sóleo de las ratas envejecidas eran más pequeños que sus contrapartes más jóvenes. Curiosamente, si bien el estiramiento pareció afectar positivamente el músculo sóleo joven, se detectó lo contrario en el músculo de las ratas envejecidas.

The HOME FAST BRAZIL self-report version: translation and transcultural adaptation into Brazilian Portuguese.

OBJECTIVE: To translate and cross-culturally adapt the Home Falls and Accidents Screening Tool Self-report into Brazilian Portuguese and to correlate with the history of falls. METHODS: The translation and transcultural adaptation process followed international parameters. The Home Falls and Accidents Screening Tool Brazil Self-report, the Mini-Mental State Examination and the history of falls were applied to 10 elderly in the pre-test and to 41 in the final. Demographic and anthropometric data were also evaluated. Spearman correlation coefficient was performed. RESULTS: The participants considered the questionnaire easy to understand and did not report any doubts to answer the final version. There was significant correlation between: Home Falls and Accidents Screening Tool Brazil Self-report score and number of falls (ρ = 0.31, p = 0.02) and the lighting and bathroom domains with presence of falls at home (ρ = 0.44, p = 0.00 and ρ = 0.33, p = 0.02, respectively). The questionnaire indicated fall's risk scoring, 10(±2). CONCLUSION: The Home Falls and Accidents Screening Tool Brazil Self-report showed to be comprehensible and feasible tool for self-assessment of domiciliary falls risk in Brazilian older people. The scores indicated fall's risk and were associated with the history of falls.

The effects of stretching on muscle morphometry of ovariectomized rats / Efeitos do alongamento na morfometria do músculo em ratas ovarectomizadas / Los efectos del ejercicio de estiramiento en la morfometria muscular de las ratas ovariectomizadas

Abstract Introduction: Ageing is responsible for structural alterations, declining of all physiological variables, including range of motion and skeletal muscle function, known as sarcopenia. Objective: The aim of the study was to evaluate the effects of stretching on muscle morphometry in ovariectomized rats. Method: 21 female Wistar rats (12 weeks, 218 ± 22 g) were divided into 4 groups: control (CONTROL, n = 3) intact; ovariectomized and hysterectomized (OH, n = 6); Stretching (STRET, n = 6); ovariectomized and hysterectomized and stretching (OHS, n = 6). The rats were subjected to ovariectomy and hysterectomy. The stretching protocol of the soleus muscle lasted 10 repetitions of 1 minute with 45s interval between each repetition performed 3 times a week for 3 weeks. After 3 weeks, the rats were weighed and the muscles of both hind limbs were removed weighed and analyzed at muscle length; serial sarcomere number; sarcomere length; muscle fiber cross-sectional area (MFCSA) and percentage of connective tissue. Results: The final body weight increased in all groups. The serial sarcomere number of STRET was greater than the OH. The muscle fibers' cross-sectional area of OHS was higher than CONTROL. Conclusion: It can be concluded that ovariectomy and hysterectomy prevented sarcomerogenesis even when stretching was applied. However, the stretching protocol enhanced muscle trophismof ovariectomized and hysterectomized rats. It might be suggested that longitudinal growth (serial sarcomeres) and radial (ASTFM) are differently regulated by stretching in intact and/or estrogen depleted (ovariectomy and hysterectomy) skeletal muscle.

Resumo Introdução: O envelhecimento é responsável por alterações estruturais, com declínio de todas as variáveis fisiológicas, incluindo amplitude de movimento e função muscular esquelética. Objetivo: O objetivo do estudo foi avaliar os efeitos do alongamento na morfometria muscular de ratas ovariectomizadas. Método: Assim, 21 ratas Wistar (12 semanas, 218 ± 22 g) foram divididas em 4 grupos: Controle (CONTROL, n = 3) intacto; Ovariectomizadas e histerectomizadas (OH, n = 6); Alongamento (ALONG, n = 6); Ovariectomizadas e histerectomizadas e Alongamento (OHA, n = 6). As ratas foram submetidas a ovariectomia e histerectomia. O alongamento do músculo sóleo foi composto de 10 repetições de 1 minuto com intervalo de 45s entre cada repetição, realizado 3 vezes por semana, durante 3 semanas. Após 3 semanas, as ratas foram pesadas e os músculos sóleos de ambas as patas foram retirados, pesados e analisados: comprimento do músculo; número de sarcômeros em série; comprimento do sarcômero; área da seção transversal das fibras musculares (ASTFM) e porcentagem de tecido conjuntivo. Resultados: O peso corporal final aumentou em todos os grupos. O número de sarcômeros em série do ALONG foi maior que o OH. A área de secção transversa das fibras musculares do OHA foi superior ao CONTROL. Conclusão: Conclui-se que a ovariectomia e histerectomia impediram a sarcomerogênese mesmo quando realizado alongamento. Porém, o protocolo de alongamento incrementou o trofismo muscular em ratas ovarietomizadas e histerectomizadas. Sugere-se que o crescimento longitudinal (número sarcômeros em série) e radial (ASTFM) respondem diferentemente ao alongamento em músculo esquelético intacto e/ou com depleção estrogênio (ovarietomia e histerectomia).

Resumen Introducción: El envejecimiento es responsable de cambios estructurales del organismo, con disminución de todas las variables fisiológicas, incluyendo la amplitud de movimiento y función muscular esquelética, conocida como sarcopenia. Objetivo: El objetivo del estudio fue evaluar los efectos de los ejercicios de estiramiento en la morfometria muscular de ratas ovarectomizadas. Método: Fueron seleccionadas 21 ratas Wistar (12 semanas, 218 ± 22g) que fueron divididas en 4 grupos: control (CONTROL, n = 3) intacto; ovarectomizadas y histerectomizadas (OH, n = 6); estiramiento (ALONG, n = 6); ovarectomizadas y histerectomizadas y estiramiento (OHA, n = 6). Las ratas han sido sometidas a ovariectomía y histerectomía. El protocolo de estiramiento del músculo sóleo fue realizado en 10 repeticiones de 1 minuto con intervalos de 45 segundos entre cada repetición, realizada 3 veces por semana, durante 3 semanas. Después de 3 semanas, las ratas fueron pesadas y los músculos de ambas patas fueron retirados para analizar el peso muscular; la longitud del músculo; número de sarcómera en serie; longitud de sarcómera; área de la sección transversal de las fibras musculares (ASTFM) y porcentaje del tejido conjuntivo. Resultado: El peso corporal final aumentó en todos los grupos. El número de sarcómera en serie de ALONG fue mayor que el OH. El área de la sección transversal de las fibras musculares del OHA fue superior al de CONTROL. Conclusión: En conclusión, ovariectomía y histerectomía impiedieron la sarcomerogénesis mismo cuando se realizó el estiramiento. Sin embago, el estiramiento aumentó el trofismo muscular de las ratas ovarectomizadas y histerectomizadas. Sugiere que el crescimiento longitudinal (número sarcômeros) y radial (área de sección transversal) responden diferentemente al estiramiento en músculo esqueletico intacto y/o con depleción estrógeno (ovariectomía y histerectomía).

Morphometric and molecular muscle remodeling after passive stretching in elderly female rats

OBJECTIVES: To determine the effects of three sessions of a passive stretching exercise protocol on the muscles of elderly female rats. METHODS: The effects of the stretching exercises on the soleus muscle were analyzed using immunohistochemistry [tissue inhibitors of matrix metalloproteinases (TIMP), the tumor necrosis factor-alpha (TNF-α), and the gene expression levels using real-time PCR of the transforming growth factor-beta 1 (TGF-β1), collagen type 1 (COL1), and collagen type 3 (COL3)]. Fifteen 26-month-old female Wistar rats were randomly divided into two groups, namely, Stretching (SG, n=8) and Control (CG, n=7). The passive mechanical stretching protocol consisted of a set of 4 1-minute repetitions, with 30 seconds between each repetition (total treatment of 4 minutes), three times a week for 1 week. RESULTS: Immunohistochemical analysis revealed an increase of 71.4% in the TNF-α (p=0.04) gene expression levels for the SG and a 58% decrease in the TGF-β1 gene expression levels (p=0.005) in the SG compared to that in the CG. No significant differences were observed between the groups for the immunostaining of TIMP-1 or the gene expression levels of COL1 and COL3. CONCLUSION: Three sessions of static stretching reduced the gene expression level of TGF-β1, which, owing to its anti-fibrotic role, might contribute to the remodeling of the intramuscular connective tissue of the aging muscle. In addition, immunostaining revealed that TNF-α levels increased in the aging muscle tissue in response to stretching, indicating its effect on stimulating extracellular matrix degradation. These outcomes have important clinical implications in reinforcing the use of stretching exercises in the elderly, considering that the aging muscle presents an infiltration of connective tissue.

The HOME FAST BRAZIL self-report version: translation and transcultural adaptation into Brazilian Portuguese

Abstract Objective: To translate and cross-culturally adapt the Home Falls and Accidents Screening Tool Self-report Into Brazilian Portuguese and to correlate with the history of falls. Methods: The translation and transcultural adaptation process followed international parameters. The Home Falls and Accidents Screening Tool Brazil Self-report, the Mini-Mental State Examination and the history of falls were applied to 10 elderly in the pre-test and to 41 in the final. Demographic and anthropometric data were also evaluated. Spearman correlation coefficient was performed. Results: The participants considered the questionnaire easy to understand and did not report any doubts to answer the final version. There was significant correlation between: Home Falls and Accidents Screening Tool Brazil Self-report score and number of falls (p = 0.31, p = 0.02) and the lighting and bathroom domains with presence of falls at home (p = 0.44, p = 0.00 and p = 0.33, p = 0.02, respectively). The questionnaire indicated fall's risk scoring, 10(±2). Conclusion: The Home Falls and Accidents Screening Tool Brazil Self-report showed to be comprehensible and feasible tool for self-assessment of domiciliary falls risk in Brazilian older people. The scores indicated fall's risk and were associated with the history of falls.(AU)