The role of ankle and knee muscle characteristics in spatiotemporal gait parameters at different walking speeds: A cross-sectional study.

BACKGROUND: Understanding the intricate interplay between ankle and knee muscle characteristics and their impact on gait parameters is crucial for enhancing our comprehension of human locomotion, particularly in the context of varying walking speeds among healthy young adults. RESEARCH QUESTION: The study aimed to identify the relative importance of ankle and knee flexor and extensor muscle characteristics (e.g., strength estimated by peak torque [PT] and rate of torque development [RTD]) in the spatiotemporal gait parameters and variability in self-selected (SSWS) and fast walking speeds (FWS) in healthy young adults. METHODS: One hundred and thirty-nine adults (75 men - 54% and 64 women - 46%; 29.04 ± 9.55 years) were assessed about their muscle characteristics (PT and RTD by an isokinetic dynamometer) and spatiotemporal gait parameters at different walking speeds (SSWS and FWS by an instrumented walkway). RESULTS: Data analysis indicated a weak relationship between the PT and RTD of the ankle and knee and spatiotemporal gait parameters and variability in both walking conditions (SSWS: R2 0.14-0.05; FWS: R2 0.40-0.05). The strength of the knee muscles was more relevant when walking at a self-selected speed, while the strength of the ankle muscles played a more prominent role when walking at a fast pace. SIGNIFICANCE: The findings underscore the critical role of ankle muscles (plantar and dorsiflexors) at fast walking speeds. Therefore, targeted interventions for strength and optimization of these muscles are paramount.

Combined ultrasound and electric field stimulations improve pain and functional capacity in immediate cesarean delivery: a randomized clinical trial, double-blind, and placebo-controlled / Terapia combinada de estimulação elétrica por meio do ultrassom melhora a dor e a capacidade funcional no pós-parto imediato de cesariana: ensaio clínico randomizado, duplo-cego e placebo

ABSTRACT BACKGROUND AND OBJECTIVES: Wound complications and pharmacological pain relief methods used at the skin surgical site after cesarean delivery may result in women's physical and emotional burden. Thus, nonpharmacological treatments must be explored to avoid these complications and side effects on maternal health. The objective of this study was to investigate the effects of Combined Ultrasound and Electric Field Stimulation (CUSEFS) on cicatricial pain and functional capacity in immediate cesarean delivery. METHODS: This study has a randomized clinical trial, double-blind, and placebo-controlled design. Thirty women (25.7±5.0 years) in immediate postpartum were randomly assigned to three groups: Control (CG, n:9), CUSEFS (TG, n:11), and Placebo (PG, n:10). CUSEFS was performed once for 20 minutes. Cicatricial pain (McGill Pain Questionnaire) and functional capacity (Functional Capacity Check) was assessed at baseline, after the intervention, and after 30 minutes. Cohen's (d) and Mixed-design analysis of variance were used to compare groups. RESULTS: Immediately after the intervention, TG showed a decrease in cicatricial pain compared with CG in sensory (d:3.8 to 4.0), affective (d:4.0), and total categories (d:3.9). In functional capacity, TG had less difficulty than CG at walking (d:0.6) and lying down (d:1.1), and PG at rest (d: 0.9). CONCLUSION: CUSEFS might be a resource for managing cicatricial pain and functional capacity in immediate cesarean delivery. Further studies with longer duration and different CUSEFS doses/parameters are required.

RESUMO JUSTIFICATIVA E OBJETIVOS: As complicações na ferida e o uso de métodos farmacológicos de alívio da dor no local cirúrgico após a cesariana podem resultar em sobrecarga física e emocional para a mulher. Assim, tratamentos não farmacológicos devem ser explorados para evitar essas complicações e efeitos adversos à saúde materna. O objetivo deste estudo foi investigar os efeitos da terapia combinada de estimulação elétrica por meio do ultrassom (CUSEFS) na dor cicatricial e na capacidade funcional no pós-parto imediato de cesariana. MÉTODOS: Este estudo possui um desenho de ensaio clínico randomizado, duplo-cego e controlado por placebo. Trinta mulheres (25,7±5,0 anos) em pós-parto imediato de cesariana foram distribuídas aleatoriamente em três grupos: Controle (CG, n:9), CUSEFS (TG:11) e Placebo (PG, n:10). O CUSEFS foi realizado uma vez por 20 minutos. A dor cicatricial (Questionário de Dor McGill) e a capacidade funcional (Functional Capacity Check) foram avaliadas no início, após a intervenção e após 30 minutos. As análises de variância de design misto e Cohen (d) foram usadas para comparar os grupos. RESULTADOS: Imediatamente após a intervenção, o TG apresentou diminuição na dor cicatricial em relação ao CG nas categorias sensorial (d:3,8 a 4,0), afetiva (d:4,0) e total (d:3,9). Na capacidade funcional, o TG apresentou menor dificuldade que o CG na marcha (d:0,6) e deitado (d:1,1), e que o PG em repouso (d:0,9). CONCLUSÃO: O CUSEFS pode ser um recurso para o manejo da dor cicatricial e da capacidade funcional imediatamente após a cesariana. Além disso, são necessários mais estudos com maior duração e diferentes doses/parâmetros de CUSEFS.

The Brazilian Portuguese version of the Pregnancy Mobility Index: Cross-cultural adaptation and psychometric evaluation - a validation study.

BACKGROUND: The Pregnancy Mobility Index (PMI) was developed to assess mobility in pregnant women in the Netherlands. At present, no similar questionnaire is available in Brazil. OBJECTIVE: The present study aimed to translate, cross-culturally adapt, and evaluate the psychometric properties of a Brazilian PMI. DESIGN AND SETTING: The present study was a validation study conducted at the Universidade Federal do Paraná and a public maternity ward in Curitiba, Brazil. METHODS: Text translation and cross-cultural adaptation followed international guidelines. Construct validity, internal consistency, and inter- and intra-rater reliability tests included 97 women. The Pelvic Girdle Questionnaire, Multidimensional Pain Evaluation Scale, Schober's test, and lumbar spine range of motion assessment were administered on the first day. Intra-rater reliability (n = 19) was measured after 15 days. Exploratory factor analysis was performed, and the correlation matrix was analyzed using Pearson's coefficient. RESULTS: Pregnant women (88%) understood the cultural adaptation process. The internal consistency was high (Cronbach's alpha > 0.90), construct validity was moderate, with significant correlation between lumbar spine range of motion (r = 0.283-0.369) and Schober's test (r = -0.314), and high correlation between the Multidimensional Pain Evaluation Scale (r = -0.650 and -0.499) and Pelvic Girdle Questionnaire (r = -0.737). Intra- and inter-rater reliabilities were excellent (intraclass correlation coefficient = 0.932 and 0.990, respectively). CONCLUSION: The Brazilian version of the PMI was successfully translated with excellent reliability and moderate-to-high construct validity. It is an important tool for assessing mobility in pregnant women. CLINICAL TRIAL: RBR-789tps (Validation study), https://ensaiosclinicos.gov.br/rg/RBR-789tps.

Are the spatiotemporal gait parameters at different walking speeds capable of predicting variations in cognitive status by the mini-mental state examination?

BACKGROUND: Several studies have reported the association between cognition and gait; however, most are limited to investigating gait in just one speed, usually the self-selected one, and commonly, only the general score of cognitive tests is used. AIMS: Investigate the relationship between the spatiotemporal gait parameters at different speeds (self-selected and fast walking speeds) and cognitive status in older adults. METHODS: Cross-sectional study. Two hundred and ninety-five older adults (70.9 ± 7.2 years; 82.3% women) were evaluated according to cognitive status (Mini-Mental State Examination, MMSE) and spatiotemporal gait parameters. RESULTS: Data analysis indicates that the spatiotemporal gait parameters (stride length, step time, and single support time) were able to predict cognitive status, assessed by the MMSE general score and its subdomain (temporal and spatial orientation) at both walking speeds. CONCLUSIONS: The spatiotemporal gait parameters were associated with cognitive status, assessed by the MMSE (general score and temporal and spatial orientation), regardless of the walking conditions. The model's variance was significant and with a large effect size. Stride length and step time were identified as the variables with the best explanatory factors. Therefore, it is concluded that greater cognitive performance is associated with longer stride lengths and faster step times.

The Brazilian Portuguese version of the Pregnancy Mobility Index: Cross-cultural adaptation and psychometric evaluation - a validation study

ABSTRACT BACKGROUND: The Pregnancy Mobility Index (PMI) was developed to assess mobility in pregnant women in the Netherlands. At present, no similar questionnaire is available in Brazil. OBJECTIVE: The present study aimed to translate, cross-culturally adapt, and evaluate the psychometric properties of a Brazilian PMI. DESIGN AND SETTING: The present study was a validation study conducted at the Universidade Federal do Paraná and a public maternity ward in Curitiba, Brazil. METHODS: Text translation and cross-cultural adaptation followed international guidelines. Construct validity, internal consistency, and inter- and intra-rater reliability tests included 97 women. The Pelvic Girdle Questionnaire, Multidimensional Pain Evaluation Scale, Schober's test, and lumbar spine range of motion assessment were administered on the first day. Intra-rater reliability (n = 19) was measured after 15 days. Exploratory factor analysis was performed, and the correlation matrix was analyzed using Pearson's coefficient. RESULTS: Pregnant women (88%) understood the cultural adaptation process. The internal consistency was high (Cronbach's alpha > 0.90), construct validity was moderate, with significant correlation between lumbar spine range of motion (r = 0.283-0.369) and Schober's test (r = -0.314), and high correlation between the Multidimensional Pain Evaluation Scale (r = -0.650 and -0.499) and Pelvic Girdle Questionnaire (r = -0.737). Intra- and inter-rater reliabilities were excellent (intraclass correlation coefficient = 0.932 and 0.990, respectively). CONCLUSION: The Brazilian version of the PMI was successfully translated with excellent reliability and moderate-to-high construct validity. It is an important tool for assessing mobility in pregnant women. CLINICAL TRIAL: RBR-789tps (Validation study), https://ensaiosclinicos.gov.br/rg/RBR-789tps.

Clinical-Functional Vulnerability, Functional Capacity, and Falls in Octogenarians with Different Physical Activity Levels-A Cross-Sectional Study.

AIM: To compare differences between frailty, functional capacity, and fall prevalence among community-dwelling oldest-old adults regarding their physical activity levels. METHODS: Two hundred and thirty-nine octogenarians (80+ years) were allocated according to their physical activity as insufficiently active (<150 min week-1; n = 98; 84.4 ± 3.7 years), active (150 to 300 min week-1, n = 81, 83.9 ± 3.1 years), and very active (>300 min week-1, n = 60; 83.8 ± 3.4 years). Frailty (CFVI-20 questionnaire), functional capacity (Five Times Sit-to-Stand Test, Timed Up and Go, Balance, and handgrip strength), fall history, and physical activity were assessed. RESULTS: The insufficiently active group was the frailest and presented the worst functional performance compared to the other groups. The fall prevalence was higher in the insufficiently active (60.9%) compared to the active (26.4%) and very active (12.7%) groups. CONCLUSIONS: The group of insufficiently active octogenarians showed the greatest frailty, worst functional capacity, and higher fall prevalence than the active and very active groups. The engagement in physical activity of at least 300 min week-1 is essential to reverse or minimize the deleterious effects of aging on frailty, functional capacity, and falls in octogenarians.

Effects of Auriculotherapy on treatment of women with premenstrual syndrome symptoms: A randomized, placebo-controlled clinical trial.

OBJECTIVE: This study aimed to investigate the effect of auriculotherapy on the intensity of physical and mood Premenstrual syndrome (PMS) symptoms. DESIGN: Single-blind randomized, placebo-controlled clinical trial. SETTING: Federal University of Parana, Curitiba, Brazil. INTERVENTION: Ninety-one women were randomly assigned to Auriculotherapy (AG), Placebo (PG), and Control (CG) groups. The intervention was 8 weeks long, done once per week. At each session in AG the microneedles were placed in seven points related to PMS symptoms (Anxiety; Endocrine; Muscle relaxation; Analgesia; Kidney; Shen Men; and Sympathetic). At PG the microneedles also were placed in seven points but unrelated to PMS symptoms (Tonsils; Vocal cords; Teeth; Eyes; Allergy; Mouth; and External nose). MAIN OUTCOME MEASURES: Assessments of PMS symptoms (Premenstrual Syndrome Screening Tool), musculoskeletal pain (Nordic Musculoskeletal Questionnaire), anxiety (Beck Anxiety Inventory), and quality of life (WHOQOL-Bref) were done at baseline, before the 5th session, after program completion, and a month follow-up. RESULTS: The AG and PG showed significantly lower scores of PMS symptoms, musculoskeletal pain, and anxiety. On the quality of life and follow-up analysis, the significance was observed only in PG. CONCLUSION: Auriculotherapy can be used as adjunctive therapy to reduce the physical and mood PMS symptoms.

Exergames Training Effects on Gait During Single and Dual Tasks in Sexagenarian Women.

Objective: This study was designed to analyze the effects of an exergames training program on gait parameters while holding a cellphone conversation at self-selected walking speed (SSWS) and fast walking speed (FWS). Materials and Methods: Twenty-one older women (66.3 ± 4.0 years) practiced exergames for 12 weeks and were assessed for spatiotemporal gait parameters at SSWS and FWS under single task and dual task. The strength of the lower limbs was measured by an isokinetic dynamometer (Byodex System 3). The cognitive function was assessed with the Montreal Cognitive Assessment (MoCA). The tests were assessed 4 weeks before the start of the exergames training (baseline, T0), immediately before (pretraining, T1), and at the end of 12 weeks of the exergame training (post-training, T2), except for the MoCA test that was assessed at T0 and T2. Results: The spatiotemporal gait parameters at SSWS and FWS showed extensive changes when a cellphone conversation was sustained (e.g., 6.5% and 5.8% reduction in walking speed, respectively). Exergames training was not effective in minimizing these changes or improving muscle strength after 12 weeks (<3.0%). Minor cognitive improvements (0.5 points) were observed in response to training. Conclusion: Holding a cellphone conversation while walking changed several gait parameters, irrespective of the walking speed. The spatiotemporal gait parameters and lower limb muscle strength in sexagenarian women remained unchanged after the exergames training program.

Perceptive-Cognitive and Physical Function in Prefrail Older Adults: Exergaming Versus Traditional Multicomponent Training.

Research highlights the benefits of regular traditional multicomponent training in older adults. The potential effect of exergames on perceptive-cognitive and physical function in prefrail older adults is still little explored. The study aimed to compare the effects of two physical exercise training programs (exergaming vs. traditional multicomponent) on perceptive-cognitive and physical functions of prefrail older adults. This study was a randomized controlled trial having 66 prefrail older adults assigned to two groups (exergame group [EG]: n = 32, 70.84 ± 4.53 years; multicomponent group [MG]: n = 34, 70.76 ± 5.60 years). Frailty phenotype, fall history, basic and advanced cognition, perceptual, physical (mobility, gait speed, and balance), and muscle (strength and power) functions were evaluated. Intervention was conducted during 12 weeks. The EG and MG performed similar exercise routines involving the main lower limb muscle groups required in daily activities. A mixed model analysis of variance (ANOVA) and effect size (d) revealed that both programs were effective in postponing frailty status, reducing the fear of falling (EG: d = 1.65; MG: d = 1.40), increasing fall risk awareness (EG: d = 2.14; MG: d = 1.60), improving cognitive status (EG: d = 0.83-2.61; MG: d = 0.86-1.43), muscle (EG: d = 0.54; MG: d = 0.51-0.73), and physical function (EG: d = 0.97-1.55; MG: d = 1.01-2.23). The exergame training might be a better alternative to improve cognition, whereas the multicomponent program may be a better option to provide physical function gains.

Idosos caidores e não caidores: Associação com características sociais, fatores econômicos, aspectos clínicos, nível de atividade física e percepção do risco de quedas: um estudo transversal / Los ancianos que caen y los que no caen y su asociación con características sociales, factores económicos, aspectos clínicos, nivel de actividad física y percepción del ries-go de caídas: un estudio transversal / Older adult fallers and non-fallers: association with social characteristics, economic factors, clinical aspects, physical activity level, and fall risk awareness: a cross-sectional study

RESUMO As quedas em idosos são capazes de impactar negativamente sobre diversos aspectos biopsicossociais. O objetivo deste estudo foi verificar a associação de quedas com características sociais, fatores econômicos, aspectos clínicos, nível de atividade física e percepção do risco de quedas em idosos caidores e não caidores. A amostra foi composta por 520 idosos (71,7±7,4 anos) de ambos os sexos (83,7% feminino) que foram entrevistados em relação às características sociais, fatores econômicos, aspectos clínicos, histórico de quedas, nível de atividade física (Minnesota) e percepção do risco de quedas (falls risk awareness questionnaire, PRQ). Para comparação foram utilizados os testes de Mann-Whitney e qui-quadrado e para associação os testes de regressão logística binária e multivariada. Após a análise de dados, identificamos que idosos caidores apresentaram menor escolaridade, classe econômica e PRQ. A escolaridade (OR: 1,35 a 1,28), classe econômica (OR: 1,62) e PRQ (OR: 1,46) apresentaram associação com as quedas, semelhante foi observado em idosos com duas ou mais quedas (escolaridade, OR: 2,44 a 1,92; PRQ, OR: 0,84). A análise de idosos com apenas uma queda evidenciou associação apenas com a PRQ (OR: 0,87). Conclui-se que idosos caidores apresentaram menor percepção do risco de quedas, nível de escolaridade e classe econômica. A PRQ demonstrou-se uma ferramenta importante para programas de prevenção de quedas, pois foi capaz de identificar fatores perceptuais sobre o risco de quedas que podem ser utilizados para avaliação e acompanhamento, bem como direcionar estes programas em idosos da comunidade.

RESUMEN Las caídas en ancianos pueden afectar negativamente varios aspectos biopsicosociales de esta población. El objetivo de este estudio fue verificar la asociación de caídas con las características sociales, los factores económicos, los aspectos clínicos, el nivel de actividad física y la percepción de riesgo de caídas en ancianos que caen y los que no caen. La muestra estuvo conformada por 520 ancianos (71,7±7,4 años) de ambos sexos (83,7% mujeres) que fueron entrevistados respecto de características sociales, factores económicos, aspectos clínicos, historia de caídas, nivel de actividad física (Minnesota) y percepción del riesgo de caídas (falls risk awareness questionnaire, PRQ). Para comparar los datos se utilizaron la prueba de Mann-Whitney y el test chi-cuadrado, y para asociarlos se emplearon las pruebas de regresión logística binaria y multivariante. El análisis de datos permitió identificar que los ancianos que caen tienen bajos niveles educativo, de clase económica y de PRQ. El nivel educativo (OR: 1,35 a 1,28), la clase económica (OR: 1,62) y la PRQ (OR: 1,46) se asociaron con las caídas de manera similar a lo que se observó en los ancianos con dos o más caídas (nivel educativo, OR: 2,44 a 1,92; PRQ, OR: 0,84). El análisis de ancianos con una sola caída mostró asociación solamente con la PRQ (OR: 0,87). Se concluye que los ancianos que caen tienen una percepción del riesgo de caídas, el nivel educativo y de clase económica bajos. La PRQ demostró ser útil para los programas de prevención de caídas, ya que permite identificar los factores de percepción sobre el riesgo de caídas que pueden utilizarse en la evaluación y seguimiento, así como en la aplicación de estos programas a ancianos de la comunidad.

ABSTRACT Falls in older adults can negatively affect several biopsychosocial aspects. This study aimed to verify the association of falls with social characteristics, economic factors, clinical aspects, physical activity level, and fall risk awareness in older adult fallers and non-fallers. The sample consisted of 520 older adult (71.7±7.4 years) of both sexes (83.7% female) who were interviewed regarding their social characteristics, economic factors, clinical aspects, fall history, physical activity level (Minnesota), and fall risk awareness (Falls Risk Awareness Questionnaire, FRAQ). The Mann-Whitney and Chi-square tests were used for comparison, and binary and multivariate logistic regression tests were used for association. After data analysis, we identified that older adult fallers presented lower education level, economic class, and fall risk awareness (FRAQ). Education level (OR: 1.35 to 1.28), economic class (OR: 1.62), and FRAQ (OR: 1.46) were associated with falls, which was also observed in older adult people with two or more falls (education level, OR: 2.44 to 1.92; FRAQ, OR: 0.84). The analysis of older adult people with only one fall presented an association only with FRAQ (OR: 0.87). We conclude that older adult fallers presented a lower fall risk awareness, education level, and economic class. FRAQ was an important tool for fall prevention programs, since it was able to identify perceptual factors about the risk of falls that can be used for assessment and follow-up, as well as for targeting these programs for older adults in the community.

Aquatic exercise improves functional capacity, perceptual aspects, and quality of life in older adults with musculoskeletal disorders and risk of falling: A randomized controlled trial.

BACKGROUND: This study aimed to determine the effects of an aquatic training program on functional capacity, perceptual aspects, and quality of life (QoL) performed by older adults with musculoskeletal disorders (MSDs) and moderate/high risk of falls. METHODS: This randomized controlled trial included 120 older adults assigned to aquatic exercises (AG; n = 60; 70.62 ± 6.04 years) and a control group (CG; n = 60; 71.86 ± 6.95 years). The risk of falls, perceptual aspects (fall risk awareness and pain), functional capacity (lower and upper body strength, lower and upper body flexibility, functional mobility, and balance) and QoL were assessed at baseline and after the experimental protocol. The AG performed 16 weeks of aquatic exercises (twice per week, 45 min.session-1) with lower and upper body strength, stretching, and balance exercises. Exercise intensity was controlled using the rate of perceived exertion (12-16 on the Borg scale [6-20 points]) and heart rate (progressing from 40% to 60% of the heart-rate reserve). RESULTS: The training program improved the lower (mean difference [95% CI]: 2.7 [2.0 to 3.3]) and upper body strength (3.5 [2.6 to 4.5]), lower (4.6 [3.4 to 5.8]) and upper body flexibility (6.5 [4.3 to 8.6]), functional mobility (-2.5 [-2.9 to -1.9]), and balance (11.2 [10.6 to 11.9]); reduced pain perception (-3.2 [-3.7 to -2.8]); increased the fall risk awareness (9.5 [8.8 to 10.1]) and QoL perception (5.6 to 22.6 [4.6 to 25.1]). CONCLUSIONS: The water-based program may be used as a preventive approach for the older adults with MSDs and at risk of falling to improve physical and usual perceptual aspects (QoL and pain) and fall risk awareness.

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.

Athlete older women and sedentary controls: compairing the incidence of frailty, physical aspects and falls / Idosas atletas e sedentárias: comparação entre incidência de fragilidade, aspectos físicos e quedas

INTRODUCTION: The aging process results in falls, frailty, and functional dependence. However, the practice of physical exercises can prevent negative impacts on the older adult health. OBJECTIVE: To compare the incidence of frailty, physical aspects, and number of falls among older adult women and sedentary controls. METHODS: The study has a cross-sectional design and included 70 community-dwelling older adult women (73.96±7.52 years). The frailty phenotype (Fried Criteria) and the history of falls in the last 12 months were analyzed, followed by the evaluation of muscle power (Five times Sit-to-Stand Test), functional mobility (Time Up and Go), balance (Mini BESTest) and fear of falling (Falls Efficacy Scale). The Mann Whitney and Chi-Square tests were used for statistical analysis. RESULTS: The frailty rate among sedentary women (Pre-frail: 42.9%; Frail: 57.1%) was different from athlete women (Non frail: 100%). The rate of falls was the same in both groups (25.7%), however, sedentary controls fell at home (100%), while older adult athlete women fell in sports activities (88.9%). The athletes showed better scores (p<0.001) in all physical aspects when compared to the sedentary controls in muscle power (11.25 vs 24.10 seconds), functional mobility (10.01 vs. 16.04 seconds), balance (27 vs 19 points) and fear of falling (16 vs 27 points). CONCLUSION: Ahlete older women had lower frailty rates and fear of falling, as well as better physical aspects. The characteristics of falls were different, indicating the need and the importance of contemplating the lifestyle in prevention programs promoting healthy life for older adults.

INTRODUÇÃO: O processo de envelhecimento resulta em quedas, fragilidade e dependência funcional. Contudo, a prática de exercícios físicos pode prevenir impactos negativos na saúde do idoso. OBJETIVO: Comparar a incidência de fragilidade, aspectos físicos e número de quedas entre idosas atletas e sedentárias. MÉTODOS: O estudo possui delineamento transversal, composto por 70 idosas (73,96±7,52 anos) da comunidade. Inicialmente, foi analisado o fenótipo de fragilidade (Critérios de Fried) e histórico de quedas nos últimos 12 meses, seguido pela avaliação da potência muscular (Teste de sentar e levantar 5x), mobilidade funcional (Time Up and Go), equilíbrio (Mini BESTest) e medo de cair (Falls Efficacy Scale). Para análise estatística foram utilizados os testes Mann Whitney e Qui-Quadrado. RESULTADOS: O índice de fragilidade entre as idosas sedentárias (Pré frágeis: 42,9%; Frágeis: 57,1%) foi diferente em relação às atletas (Não frágeis: 100%). O índice de quedas foi o mesmo em ambos os grupos (25,7%), contudo, as sedentárias caíram em casa (100%), enquanto as atletas caíram em atividades esportivas (88,9%). As atletas apresentaram escores melhores (p<0,001) em todos os aspectos físicos, comparadas às sedentárias, a potência muscular (11,25 vs 24,10 s), mobilidade funcional (10,01 vs 16,04 s), equilíbrio (27 vs 19 pontos) e medo de cair (16 vs 27 pontos). CONCLUSÃO: As idosas atletas apresentaram menores índices de fragilidade, medo de cair e melhores aspectos físicos. As características de quedas foram diferentes, indicam necessidade de programas com prevenção de quedas considerando os hábitos do idoso para promover um estilo de vida ativo e saudável.

The Effects of Different Exergame Intensity Training on Walking Speed in Older Women.

Objective: It is not known if the intensity in which exergames are performed can change gait parameters at different walking speeds. This study was designed to determine if a training program based on exergame exercises performed at different intensities (moderate vs. vigorous) influences walking speed and gait parameters in older adult women. Methods: After applying the inclusion criteria, 20 participants (69.5 ± 5.4 years) were randomized into two groups: moderate (11-13 perceived exertion) and vigorous (14-16 perceived exertion). Walking speed and gait parameters at self-selected walking speed (SSWS) and maximal walking speed (MWS) were evaluated before and after 3 months of exergame training. The walking speed and gait parameters were measured with an instrumented walkway. The walking speed reserve (WSR) was calculated as a difference and ratio. Results: There was pre-to-post effect of walking speed at self-selected walking pace (pre = 112.1 ± 16.4 cm.s-1; post = 124.8 ± 16.4 cm.s-1), in WSR calculated as ratio (pre = 1.35 ± 0.08; post = 1.28 ± 0.09), in a number of gait parameters at SSWS (step length, stride length, stride velocity, step time, stride time, swing time, stance time, single support, double support, gait cycle time, and cadence) and at MWS (step time, stride time, swing time, single support, double support, gait cycle time, and cadence). Conclusion: Irrespective of the exercise intensity, exergame training improved walking speed only at a self-selected walking pace and some gait parameters at self-selected and MWS in older women.

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.

Quedas em idosos: aspectos perceptuais sobre o risco de quedas e medo de cair / Falls in elderly: perceptual aspects of fall risk and fear of falling / Caídas en ancianos: aspectos perceptuales de riesgo de caídas y temor de caídas

O envelhecimento é um processo natural e progressivo marcado por alterações musculoesqueléticas, cognitivas e perceptuais que podem levar o idoso a apresentar episódios de quedas. Este estudo teve como objetivo analisar a relação entre o número de quedas, a percepção do risco de quedas, e o medo de cair em idosos, de ambos os sexos, com idade igual ou superior a 60 anos. O estudo possui delineamento transversal e foi composto por 106 idosos (69,64 ± 8,94 anos). A percepção de quedas foi avaliada por meio do Falls Risk Awareness Questionnaire (FRAQ), e o medo de cair pela Falls Efficacy Scale - International (FES-I). Pôde-se concluir que, quanto menor for o número de medicamentos consumidos, o número de quedas e o medo de cair, maior será a percepção do risco de quedas do idoso. Além disso, também foi possível observar que, quanto maior for o consumo de medicamentos, maior será o medo de cair do idoso.

Aging is a natural and progressive process marked by musculoskeletal, cognitive and perceptual changes that can lead the elderly to present episodes of falls. This study aimed to analyze the relationship between the number of falls, the perception of the risk of falls and the fear of falling in the elderly, of both sexes, aged 60 years or over. The study has a cross-sectional design and was composed of 106 elderly people (69.64 ± 8.94 years). The perception of falls was assessed using the Falls Risk Awareness Questionnaire (FRAQ) and the fear of falling using the Falls Efficacy Scale - International (FES-I). It can be concluded that the smaller the number of drugs consumed, the number of falls and the fear of falling, the greater the perception of the risk of falls for the elderly. In addition, it was also possible to observe that the greater the consumption of medications, the greater the fear of falling for the elderly.

El envejecimiento es un proceso natural y progresivo marcado por cambios musculoesqueléticos, cognitivos y perceptivos que pueden llevar a los ancianos a presentar episodios de caídas. Este estudio tuvo como objetivo analizar la relación entre el número de caídas, la percepción del riesgo de caídas y el miedo a las caídas en los ancianos, de ambos sexos, de 60 años o más. El estudio tiene un diseño transversal y estuvo compuesto por 106 personas de edad avanzada (69,64 ± 8,94 años). La percepción de caídas se evaluó mediante el Cuestionario de conciencia de riesgo de caídas (FRAQ) y el miedo a caerse utilizando la Escala de eficacia de caídas - Internacional (FES-I). Se puede concluir que cuanto menor sea la cantidad de medicamentos consumidos, la cantidad de caídas y el miedo a las caídas, mayor será la percepción del riesgo de caídas para los ancianos. Además, también fue posible observar que cuanto mayor es el consumo de medicamentos, mayor es el miedo a enamorarse de los ancianos.

Does functional capacity, fall risk awareness and physical activity level predict falls in older adults in different age groups?

The aims of this study were to examine whether: i) functional capacity and physical activity level differ between fallers and non-fallers older adults, by controlling for fall risk awareness; ii) functional capacity, fall risk awareness and physical activity differ between fallers and non-fallers older adults, by controlling for age; iii) variables and which may predict falls in different age groups. 1826 older adults performed a series of functional tests and reported their fall episodes, fall risk awareness and physical activity level. The overall incidence of falls was high (40.2%), and falls risk awareness scores reduced with age. The older adults with greater falls risk awareness and non-fallers presented better scores in all functional tests and physical activity level (P < .05). Functional tests and falls risk awareness differed among age groups and differed between fallers and non-fallers, irrespective of age group (P < .05). Falls risk awareness predicted falls in all age groups (odds ranging: 1.05-1.09). Handgrip strength and balance scores predicted falls until 79 years (OR = 1.04, 95%CI = 1.01-1.06). The physical activity level predicted falls up to 70 years (OR = 1.09, 95%CI = 1.06-1.12). Functional mobility was able to predict falls up to 80 years (OR = 1.06, 95%CI = 1.01-1.08). Therefore, according to age, functional capacity, physical activity level and falls risk awareness can be a predictor of falls in older adults.

Multisensory exercise programme improves cognition and functionality in institutionalized older adults: A randomized control trial.

AIM: The aim of this study was to verify the effects of a multisensory exercise programme on the cognition and functionality of institutionalized older adults. METHODS: Forty-five volunteers were randomly allocated to 2 groups, the multisensory exercise programme (n = 24) and the control group that received no treatment (n = 21). The programme consisted of 3 50-min sessions of progressive exercises per week for 16 weeks that challenged their strength, balance, coordination, multisensory stimulation, and flexibility in different tasks. Cognition (Montreal Cognitive Assessment), balance (Berg Scale), mobility (Timed Up and Go), and functional performance (Physical Performance Test) were measured preintervention and postintervention. Statistical analyses were performed using Student's t test and 2-way ANOVA. RESULTS: The multisensory exercise programme showed statistically significant improvements (p < .05) on cognition (effect size [ES]: 0.92), balance (ES: 0.77), mobility (ES: 0.51), and functional performance (ES: 0.86) as compared with the control group, which showed no statistical significant differences at the postintervention time point. CONCLUSIONS: The multisensory exercise programme improved the cognition and functionality of institutionalized older adults. The introduction of a motor and multisensory-based approach in care routines may improve residents' health and engagement to the environment.

Associação entre dependência do exercício físico e percepção da qualidade de vida no basquetebol master brasileiro / Impact of physical exercise dependence on quality of life perception in Brazilian master basketball / Impacto negativo de la dependencia del ejercicio físico en la percepción de la calidad de vida en el baloncesto veterano de Brasil

Resumo O objetivo do presente estudo foi verificar a associação entre dependência do exercício físico (DEF) e percepção da qualidade de vida relacionada à saúde (QVRS) em atletas do basquetebol master brasileiro. A amostra foi composta por 410 atletas do sexo masculino. QVRS foi avaliada por meio do Medical Outcomes Study (SF-36). DEF foi avaliada com a Negative Addiction Scale. A Razão de Prevalência (RP) foi usada como medida de associação. Os resultados revelaram a associação negativa da DEF e QVRS, baixos níveis de DEF foram associados a oito domínios da QVRS (RP entre 2,88 e 1,45) e a média DEF a seis domínios da QVRS (RP entre 1,80 e 1,31). Em conclusão, a DEF pode diminuir os níveis de percepção da QVRS dos atletas, tanto em aspectos físicos quanto mentais.

Abstract The current study aimed to investigate the association between physical exercise dependence (PED) and health-related quality of life (HRQoL) perception in Brazilian master basketball athletes. The sample consisted of 410 male athletes. HRQoL was assessed using the Medical Outcomes Study (SF-36). DEF was assessed with the Negative Addiction Scale. Prevalence Ratio (PR) was used as a measure of association. The results exposed a negative association of DEF and HRQOL, and low DEF levels were associated with eight HRQoL domains (PR between 2.88 and 1.45), and the medium DEF with six HRQoL domains (PE between 1.80 and 1.31). In conclusion, DEF can decrease athletes HRQoL perception levels, both physical and mental aspects.

Resumen El objetivo de este estudio fue investigar la relación entre la dependencia del ejercicio físico (DEF) y la percepción de la calidad de vida relacionada con la salud (CVRS) en los jugadores de baloncesto veteranos de Brasil. La muestra estaba compuesta por 410 jugadores masculinos. La CVRS se evaluó mediante el Medical Outcomes Study (SF-36). La DEF se evaluó con la Negative Addiction Scale. La razón de prevalencia (RP) se utilizó como una medida de asociación. Los resultados revelaron una relación negativa de la DEF y la CVRS, y los bajos niveles de DEF se relacionaron con ocho dominios de la CVRS (RP entre 2,88 y 1,45) y la media de DEF con seis dominios de la CVRS (RP entre 1,80 y 1,31). En definitiva, la DEF puede disminuir los niveles de percepción de la CVRS de los jugadores, tanto en los aspectos físicos como en los mentales.

Percepção da qualidade de vida em universitários: comparação entre períodos de graduação / Quality of life perception in college students: comparison between graduation periods

A graduação é um importante período para a formação profissional, contudo, representa uma fase composta por mudanças físicas e mentais, fatores esses que podem afetar a Qualidade de Vida Relacionada a Saúde (QVRS) dos universitários. O objetivo do presente estudo foi comparar a percepção da QVRS entre universitários do primeiro e último ano de graduação do curso de Educação Física. A amostra foi composta por 110 acadêmicos (22,00 ± 3,84 anos). Foram incluídos nesta pesquisa universitários do primeiro e último ano do Curso de Educação Física, de ambos os sexos, com idade entre 18 e 30 anos, previamente matriculados nos respectivos períodos. A coleta de dados foi realizada em uma única sessão, por meio de entrevistas, visando evitar interferências na resposta dos questionários. A QVRS foi avaliada por meio do Medical Outcomes Study (SF-36). Para análise dos dados foi realizado o teste de Mann-Whitney. Em relação a comparação da QVRS entre os ingressantes e concluintes não houve diferença significativa entre a maioria dos domínios (p > 0,05). Com exceção do domínio Aspectos Físicos, em que o primeiro ano apresentou um escore menor da QVRS quando comparado ao último ano (70,50 vs. 80,83, p = 0,038). Os achados deste estudo evidenciam que a percepção da QVRS para os universitários, independente do período, apresentou valores semelhantes. Com exceção do domínio Aspectos Físicos, em que concluintes apresentam uma melhor percepção. Estes resultados tornam evidente a importância dos aspectos psicológicos dos universitários, que podem estar diretamente relacionados ao seu sucesso acadêmico e profissional.

Graduation studies are an important period for vocational training. However, it is also a phase involving many physical and mental changes, factors that may affect the Health Related Quality of Life (HRQoL) of the students. The aim of this study was to compare the HRQoL perception in students in the first and final year of the Physical Education undergraduate course at the Federal University of Paraná. The sample consisted of 110 students (22.00 ± 3.84 years old). The study included Physical Education students of the first and final year of the course, of both genders, aged between 18 and 45 years old, previously registered in the respective periods. Data collection was performed in a single session through interviews in order to avoid interference during the answering of the questionnaires. HRQoL was assessed using the Medical Outcomes Study (SF-36). Data analysis was performed with the Mann-Whitney test. Regarding the comparison of HRQoL between periods, there was no significant difference between most domains (p > 0.05). With the exception of Physical Aspects domain, wherein the second period showed a lower HRQoL score when compared to the eighth period (70.50 vs. 80.83, p = 0.038). The findings of this study showed the importance of the psychological aspects of college students, which can be directly related to their academic and professional success.