Sarcopenic obesity does not impair lower limb strength and physical performance in sufficiently active older adults: a cross-sectional study.

This study investigated the associations of sarcopenic obesity (SO) with muscle strength and physical performance in sufficiently active older adults. Data from 72 older sarcopenic obese adults classified as sufficiently active were analyzed. Participants were categorized into four groups based on sex and SO status. Muscle strength/physical performance tests were compared using independent sample t-tests. Multiple linear regression and binary logistic regression were performed to examine the associations between SO and muscle strength and physical performance, adjusting for confounding variables. Only handgrip strength showed differences between SO groups, regardless of sex (p < 0.05). SO negatively explained the variability of handgrip strength (p < 0.05). An increase in handgrip strength values was associated with a decrease in the chances of older adults being classified as SO (p < 0.05). The findings suggest that even with SO, sufficiently active older adults did not present a significant reduction in muscle strength in the lower limbs and physical performance.

Static and dynamic postural control assessment in schoolchildren: Reliability and reference values of the Modified Flamingo Test and Bar Test.

INTRODUCTION: Single-leg stance tests have been widely used to evaluate static balance, like the Modified Flamingo Test. The evaluation of dynamic balance on small support surfaces is the objective of some tests like the Bar Test. RESEARCH QUESTION: How is the performance of postural control during the performance of these tests in schoolchildren between 6 and 11 years of age in both sexes? What are the reference values of these tests in this population? METHOD: A cross-sectional study in which a total of 282 children. The evaluation included both tests. RESULTS: The relative reliability was excellent (Intraclass Correlation Coefficient = 0.84-0.98), and the absolute reliability ranged between 4.5% and 7.1% for coefficient variation and between 0.5 and 1.5 for the standard error of measurement. The average results were 3.8 ± 2.7 floor touches for the Modified Flamingo Test and 5 ± 3.5 m for the Bar Test. The results of both tests improve progressively with the increase of age. DISCUSSION: It can be asserted that children of different ages, as well as boys and girls of the same age, perform differently in these tests. Particularly, according to the analysis based on age subgroups, there were greater improvements in the performance of both tests between 8 and 11 years of age. CONCLUSIONS: The girls obtained in both tests better results, although between 6 and 7 years of age the differences between sexes are not significant.

Motor Competence and Body Mass Index in the Preschool Years: A Pooled Cross-Sectional Analysis of 5545 Children from Eight Countries.

BACKGROUND AND OBJECTIVE: One in five preschool children are overweight/obese, and increased weight status over time increases the risks of poorer future health. Motor skill competence may be a protective factor, giving children the ability to participate in health-enhancing physical activity. Yet, we do not know when the relationship between motor competence and weight status first emerges or whether it is evident across the body mass index (BMI) spectrum. This study examined the association between motor skill competence and BMI in a multi-country sample of 5545 preschoolers (54.36 ± 9.15 months of age; 50.5% boys) from eight countries. METHODS: Quantile regression analyses were used to explore the associations between motor skill competence (assessed using the Test of Gross Motor Development, Second/Third Edition) and quantiles of BMI (15th; 50th; 85th; and 97th percentiles), adjusted for sex, age in months, and country. RESULTS: Negative associations of locomotor skills, ball skills, and overall motor skill competence with BMI percentiles (p < 0.005) were seen, which became stronger at the higher end of the BMI distribution (97th percentile). Regardless of sex, for each raw score point increase in locomotor skills, ball skills, and overall motor skill competence scores, BMI is reduced by 8.9%, 6.8%, and 5.1%, respectively, for those preschoolers at the 97th BMI percentile onwards. CONCLUSIONS: Public health policies should position motor skill competence as critical for children's obesity prevention from early childhood onwards. Robust longitudinal and experimental designs are encouraged to explore a possible causal pathway between motor skill competence and BMI from early childhood.

Learning of Basic Life Support through the Flipped Classroom in Secondary Schoolchildren: A Quasi-Experimental Study with 12-Month Follow-Up.

Background and Objectives: International institutions together with the World Health Organisation recommend the teaching of BLS in schools. Therefore, the objective of this research was to study the feasibility of teaching CPR and AED through the flipped classroom, exploring the medium- and long-term retention of knowledge and practical skills among high school students. Materials and Methods: The sample consisted of 260 secondary schoolchildren (137 in the experimental group (EG) and 123 in the control group (CG)) between 12 and 14 years old (M = 12.75 ± 1.02). Results: The data revealed that the EG obtained better post-course results in the correct position of the hands (p = 0.011), the depth of external cardiac compression (p > 0.001), and the mean time to apply an effective shock with the AED (p = 0.013). The CG obtained better results in compressions with complete chest re-expansion (p = 0.025). These differences disappeared at 6 months (p > 0.05) and 12 months (p > 0.05). Conclusions: A training program based on the flipped classroom is as effective and viable as traditional training, although more efficient since it is applied in less time, in the sequence of action in BLS, CPR skills, and the application of an effective shock with an AED.

Accelerometric analysis of trunk acceleration during gait analysis in children between 6 and 11 years old: A cross-sectional study.

Background: Gait analysis in children with accelerometers is of special interest in daily clinical practice, as it eliminates possible biases related to the assessor and is not very sensitivity of visual analysis. The sensitivity of data collection by these instruments makes it possible to evaluate the efficiency of body movements during gait and to better understand the degree of motor development in childhood, assessing progress within normal developmental parameters or detecting possible deficits. Research question: What are the accelerations of the center of mass during normal gait in children aged 6-11 years? Methods: Descriptive cross-sectional study conducted with a total of 283 school children (girls = 142). The analyzed variables were the mean and maximum values obtained in each of the three body axes and their root mean square during normal gait 10 m out, turn and 10 m back over firm ground in a straight line three times. Results: The accelerometric data obtained showed similar values between sexes in each of the age sub-groups analyzed. Except for the medial-lateral axis in children aged 10-11 years where differences between sexes were detected (being significantly lower in girls). A reduction in medial-lateral axis average values over the years was also identified in both sexes. The regression models generated for the average accelerometric values showed significant values only in the average value of the medial-lateral axis. However, the maximum values were significant in all cases. Significance: The preferred motor strategies of boys and girls during gait include developing mainly control and adjustment movements in the frontal plane (hence the high magnitudes recorded there). Flexion-extension movements are the most reduced over the six years of age analyzed, particularly in girls. Conversely, rotational movements are the most constant in speed in both sexes and all age subgroups.

Postural balance under sensory manipulation predicted fine and gross motor skills in children from 5 to 6 years of age.

AIM: Our aim was to identify predictors of fine and gross motor skills at 5-6 years of age using postural balance under sensory manipulation. METHODS: This study was conducted during the 2021-2022 academic year and focused on 112 children from three preschools in Tunisia, with roughly the same socio-economic status. Postural balance was assessed with their eyes open and closed on both firm and foam surfaces and motor skills were measured using the short version of Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (Bot-2). Multiple linear regression analysis with stepwise backward selection was used to find a simplified model that best explained the data. RESULTS: Postural balance accounted for 11% of the total variation in fine motor skills, except for the eyes open firm condition, 10% of the gross motor skills and about 14% of the total Bot-2 score. The eyes open foam condition was the only significant contributor to the gross motor skills model and the overall motor score. CONCLUSION: Assessing postural balance assessment at 5-6 years of age may predict motor skills. It may be useful for monitoring early child development and designing physical activity programmes for this age group.

Multicompartment body composition analysis in older adults: a cross-sectional study.

BACKGROUND: During aging, changes occur in the proportions of muscle, fat, and bone. Body composition (BC) alterations have a great impact on health, quality of life, and functional capacity. Several equations to predict BC using anthropometric measurements have been developed from a bi-compartmental (2-C) approach that determines only fat mass (FM) and fat-free mass (FFM). However, these models have several limitations, when considering constant density, progressive bone demineralization, and changes in the hydration of the FFM, as typical changes during senescence. Thus, the main purpose of this study was to propose and validate a new multi-compartmental anthropometric model to predict fat, bone, and musculature components in older adults of both sexes. METHODS: This cross-sectional study included 100 older adults of both sexes. To determine the dependent variables (fat mass [FM], bone mineral content [BMC], and appendicular lean soft tissue [ALST]) whole total and regional dual-energy X-ray absorptiometry (DXA) body scans were performed. Twenty-nine anthropometric measures and sex were appointed as independent variables. Models were developed through multivariate linear regression. Finally, the predicted residual error sum of squares (PRESS) statistic was used to measure the effectiveness of the predicted value for each dependent variable. RESULTS: An equation was developed to simultaneously predict FM, BMC, and ALST from only four variables: weight, half-arm span (HAS), triceps skinfold (TriSK), and sex. This model showed high coefficients of determination and low estimation errors (FM: R2adj: 0.83 and SEE: 3.16; BMC: R2adj: 0.61 and SEE: 0.30; ALST: R2adj: 0.85 and SEE: 1.65). CONCLUSION: The equations provide a reliable, practical, and low-cost instrument to monitor changes in body components during the aging process. The internal cross-validation method PRESS presented sufficient reliability in the model as an inexpensive alternative for clinical field use.

The Effects of an Intervention Based on the Flipped Classroom on the Learning of Basic Life Support in Schoolchildren Aged 10-13 Years: A Quasi-Experimental Study.

Most out-of-hospital cardiac arrests are attended first by bystanders who are usually friends and/or relatives of the victim. Therefore, the objective of this research was to analyse the impact of a training process based on the flipped classroom on basic life support skills in primary education students. The sample consisted of 308 children (148 experimental group (EG) and 160 control group (CG)) between 10 and 13 years old (M = 10.68 ± 0.64) from 2 schools in Galicia, Spain. The data reveal that the quality parameters are obtained in the number of total compressions in 2 min (CG = 213 and EG = 217; p = 0.024) and in the percentage of correct compressions (CG = 87.23% and EG = 91.6%; p = 0.013) except for the mean depth and the percentage of correct compressions, which were not reached in any case. Regarding the application of an effective discharge with the Automated external defibrillator (AED), there were no significant differences in the time used by schoolchildren between both methods (p = 0.795), but 97.5% (n = 156) of the CG and 100% (n = 148) of the EG are able to do it in just over 1 min. Based on the results obtained, we can conclude that a training program based on the flipped classroom is as effective and viable as traditional training in psychomotricity on CPR techniques and the application of an effective discharge using an AED.

Effects of an Eccentric Training Protocol Using Gliding Discs on Balance and Lower Body Strength in Healthy Adults.

Impaired balance and lower body weakness are the main causes of falls, which are considered to be the major cause of fractures and head injuries in the elderly and are recognised as a serious health problem. The aim of this study is to observe the effect of eccentric training, introducing new technologies (gliding discs), on body composition, lower body strength, balance and quality of life. A quasi-experimental study was carried out with 56 healthy participants who were divided into an experimental group (n = 31) who underwent the protocol consisting of 12 training sessions and a control group (n = 25) who did not undergo the training. Before and after the intervention, all participants underwent a measurement of body composition, the SJ jump, balance with accelerometry and quality of life with the Short Form 12 Health Survey. In the experimental group, statistically significant improvements were found in the variables balance and lower body strength. The application of this training protocol improves lower body strength and the ability to control balance in the adult population.

Prevention of Low Back Pain in Adults with a Back School-Based Intervention.

BACKGROUND: Low back pain is highly prevalent and has a major socio-economic impact worldwide. Among the rehabilitation options is the Back School, which consists of programmes that include exercise and educational interventions to treat and prevent back pain. The effects of this type of programme are usually evaluated in patients with low back pain. The aim of this study was to evaluate the effects on low back functionality and the prevention of medical visits due to low back pain during one year of follow-up in a healthy adult population. METHODS: A quasi-experimental study was conducted with 56 healthy participants who were divided into an experimental group (n = 30), who underwent the programme consisting of a total of 16 sessions, and a control group (n = 26), who did not undergo the intervention. All participants were administered the Partial Curl-up Test, Biering Sorense Test, Modified Schöber Test, and Toe Touch Test, and they completed the Short Form 36 Health Survey before and after the intervention. In addition, a telephone call was made to ask whether they attended a doctor for low back pain in the following year post-intervention. RESULTS: In the experimental group, statistically significant improvements were observed in trunk muscle strength, spinal flexion joint range of motion, and hamstring flexibility, and they had fewer visits to the doctor for low back pain in the following year. CONCLUSIONS: The theoretical-practical programme based on the Back School seems to have beneficial effects on low back functionality by increasing its strength and flexibility in an adult population. In addition, this programme reduced the number of medical visits due to low back pain during the following year after the intervention.

Sex differences in postural control under unstable conditions in schoolchildren with accelerometric assessment.

BACKGROUND: Although the effects of balance training on unstable surfaces have been widely studied, the impact of exposure to an unstable surface in static balance throughout childhood has not been described to date. RESEARCH QUESTION: How does postural stability vary between sexes in children 6-12 years of age during single leg static support on unstable surface? What are the normative values of centre of mass acceleration in the mentioned age range during such test? Is the postural stability on an unstable surface in the postural control of children aged 6-12 years during static single-leg stance. Secondarily, the normative acceleration values of the gravity centre, recorded during such tests and throughout the mentioned age range, were also provided. METHODS: Descriptive, transversal study conducted with a total of 316 school children (girls = 158). The analysed variables were the mean and maximum values obtained in each of the three body axes and their root mean square during static single-leg support test on an unstable surface (a mat). FINDINGS: Accelerations decreased in magnitude with the increasing age of the participants. The highest accelerometric values were recorded in the medio-lateral axis in both sexes and throughout the entire age range studied. Between sexes, the greatest differences were obtained between 8 and 11 year-olds. The regression models revealed significant values about the influence of sex on the accelerometric variables (girls were more likely to obtain less accelerations in postural adjustments with increasing age). INTERPRETATION: Boys depend more on somatoaesthetic information, whereas girls would use more visual and vestibular information. In the age range of 8-11 years, the postural control system is significantly different between sexes regarding the hierarchy of the efferent information of the available postural control subsystems. Moreover, the reactions of straightening and postural control on single-leg stance are, fundamentally, flexion-extension movements.

Validity and Reliability of a Tool for Accelerometric Assessment of Balance in Scholar Children.

In Pediatrics, balance is assessed through low-sensitivity clinical tests which identify developmental alterations at already advanced stages that cannot be detected at earlier stages. Therefore, the aim of this study was to develop an easily applicable quantitative tool that can be used to evaluate postural control. Consequently, a cross-sectional study was carried out with 91 healthy children. All of them performed a series of six accelerometric functional tests and four clinical tests of balance (Modified Flamingo Test, Bar Test, Babinski-Weil Test, and Fukuda Stepping Test). The Bar Test obtained mild inverse correlations with accelerations produced in the mediolateral axis and the root mean square of all the tests in monopodal support. The Flamingo Test obtained direct correlations with the root mean square of the tests in monopodal support and with the mediolateral axis of the monopodal tests and gait. The pediatric balance assessment scale consists of three factors and eleven items extracted from five accelerometric functional tests: the monopodal balance test with six items, normal gait test with three items, and bipodal balance test with two items. This tool is easy to apply and allows analysis in the evaluation of the balance state based on the accelerations of the center of mass.

Accelerometric Assessment of Postural Balance in Children: A Systematic Review.

The correct development of postural control in children is fundamental to ensure that they fully reach their psychomotor capacities. However, this capacity is one of the least studied in the clinical and academic scope regarding children. The objective of this study was to analyze the degree of implementation of accelerometry as an evaluation technique for postural control in children and how it is being used. METHODS: A systematic search was conducted in PubMed, SpringerLink, SportsDiscus, Medline, Scopus, and Web of Science with the following terms: balance, postural control, children, kids, accelerometry, and accelerometer. RESULTS: The search generated a total of 18 articles. Two groups of studies were differentiated: those which exclusively included healthy individuals (n = 5) and those which included children with pathologies (n = 13). Accelerometry is being used in children mainly to assess the gait and static balance, as well as to identify the differences between healthy children and children with developmental disorders. CONCLUSIONS: Accelerometry has a discrete degree of implementation as an evaluation tool to assess postural control. It is necessary to define a systematic method for the evaluation of postural control in pediatrics, in order to delve into the development of this capacity and its alterations in different neurodevelopmental disorders.

Evolution of the Habits of Physical Activity and Television Viewing in Spanish Children and Pre-Adolescents between 1997 and 2017.

BACKGROUND: Promoting healthy lifestyles in children, has become a priority for public health institutions. However, electronic devices with screens encourage sedentary behaviors. The aim of this study was to analyze the evolution of the habits of physical activity practice and television watching in a cohort of 20 years of research in Spanish children. METHODS: A cross-sectional, observational study was based on data from the Spain National Health Surveys between 1997 and 2017 (N = 11,444). The dependent variables considered were the frequency with which the minor practiced physical activity (PA) in his/her spare time, the daily TV viewing habit, and the daily hours of TV viewing. RESULTS: The children who practiced physical activity daily has decreased 7.3% throughout the study period. The proportion of children who watched the television daily for more hours increased significantly (6.3%). Such increase was constant throughout the years, and the analysis by sex showed that the proportion of boys who watched television for more than three hours per day increased three percent, and that of girls increased fourfold. CONCLUSIONS: The habits of physical activity practice and television viewing have changed towards sedentary lifestyle. Particularly, the girls and the children between 12 and 14 years showed the most sedentary behavior. Public health policies must consider the differences between sexes in order for such interventions to be effective in the population of pre-adolescents, in general, and girls, in particular.

Percentiles and Reference Values for the Accelerometric Assessment of Static Balance in Women Aged 50-80 Years.

The identification of factors that alter postural stability is fundamental in the design of interventions to maintain independence and mobility. This is especially important for women because of their longer life expectancy and higher incidence of falls compared to men. The objective of this study was to construct the percentile box charts and determine the values of reference for the accelerometric assessment of the static balance in women. For this, an observational and cross-sectional study with a sample composed of 496 women (68.8 ± 10.4 years old) was conducted. The measurement of accelerations used a triaxial accelerometer during three tests: two tests on the ground in monopodal support and a test on a mat with monopodal support for 30 s each. In all of the variables, an increase in the magnitude of the accelerations was detected as the age advanced. The box charts of the percentiles of the tests show the amplitude of the interquartile ranges, which increased as the age advanced. The values obtained can be used to assess changes in static balance due to aging, trauma and orthopaedic and neurodegenerative alterations that may alter postural stability and increase the risk of falling.

Analyzing the Use of Accelerometers as a Method of Early Diagnosis of Alterations in Balance in Elderly People: A Systematic Review.

Alterations of balance are a growing public health problem as they affect one in three adults over the age of 65, and one in two over the age of 80. Identifying the factors that affect postural stability is essential in designing specific interventions to maintain the independence and mobility of older people. The aim of this review was to understand the use of accelerometers in order to assess the balance in older people. Analyzing the most appropriate evaluation methodology and protocolizing it will optimize the processes of early identification of balance alterations. However, quantitative assessment methods of balance are usually limited to a laboratory environment, a factor that can be overcome by accelerometers. A systematic search was carried out across eight databases where accelerometers were employed to assess balance in older people. Articles were excluded if they focused on sensor design and did not measure balance or apply the technology on targeted participants. A total of 19 articles were included for full-text analysis, where participants took part in the balance evaluation monitored by accelerometers. The analysis of spatio-temporal parameters and the magnitude of the accelerations recorded by the devices were the most common study variables. Accelerometer usage has potential to positively influence interventions based on physical exercise to improve balance and prevent falls in older people.

A comparison of three physical activity programs for health and fitness tested with older women: Benefits of aerobic activity, aqua fitness, and strength training.

Inactivity has been associated with decreased quality of life of older people, and many physical activity programs are encouraged. However, the heterogeneity of the different exercise programs available is well recognized. The objective was to compare three physical activity programs (strength training, aqua fitness, and aerobic exercise) to discern the differences in the benefits achieved by each of them in older women over a period of 6 months. For that, a double-blind randomized trial sorted 347 women over 50 years old into three groups of exercise programs; they completed three sessions of evaluation that included the measurement of weight and body mass index and used the Senior Fitness Test (SFT) and SF-12 questionnaire. A t-test for related samples compared the evolution of each group, and ANOVA statistic was used to compare the effect of the different exercise programs. The results showed that women should consider performing aerobic activity up to age 60. After that age, aerobic activity or strength training can provide greater benefits.

Sedentary behavior as a predictor of functional disability in older adults / Comportamento sedentário como preditor de incapacidade funcional em adultos idosos

The aim of this study was to identify the amount of time spent in sedentary behavior that may be critically related to functional disability in older adults. A cross-sectional study was conducted with a random sample of 624 older adults (65.1% women) aged 60 to 96 years. Perceived limitations in instrumental activities of daily living were used as indication of functional disability. Time spent in sedentary behavior was assessed using the International Physical Activity Questionnaire (IPAQ). The prevalence of functional disability was 29.4%. The mean total time spent in sedentary behavior was 576.51 ± 5.14 min/day. Receiver Operating Characteristic (ROC) curves were used to identify cut-points for time spent in sedentary behavior that could discriminate functional disability in older adults. The results suggested that spending > 600.00 min/day and > 614.00 min/day in sedentary behavior, for men and women, respectively, was a discriminator for functional disability in the current study. These cut-points can be used to identify older adults who are most vulnerable to functional disability in future studies

O objetivo deste estudo foi identificar pontos de corte para o tempo gasto em comportamento sedentário que podem potencialmente discriminar a presença de incapacidade funcional em idosos. Um estudo transversal foi realizado com uma amostra aleatória de 624 idosos (65,1% mulheres) com idade entre 60 e 96 anos. As limitações percebidas nas atividades instrumentais da vida diária foram utilizadas como indicação de incapacidade funcional. O tempo gasto no comportamento sedentário foi avaliado usando o Questionário Internacional de Atividade Física (IPAQ). A prevalência de incapacidade funcional foi de 29,4%. A média do tempo total despendido em comportamento sedentário foi de 576,51 ± 5,14 minutos/dia. As curvas de ca-racterística operativa do receptor (ROC) foram usadas para identificar pontos de corte para o tempo gasto em comportamento sedentário que discriminassem a incapacidade funcional em idosos. Os resultados sugeriram que despender > 600,00 min/dia e > 614,00 min/dia em comportamento sedentário, para homens e mulheres, respectivamente, foram discriminadores de incapacidade funcional no presente estudo. Esses pontos de corte podem ser usados para identificar os idosos que estão em maior vulnerabilidade à incapacidade funcional em estudos futuros

Walking, body mass index, and self-rated health in a representative sample of Spanish adults.

Obesity and physical inactivity (PI) are risk factors for chronic diseases and are associated with lifestyle and environmental factors. The study tested the association between PI, body mass index (BMI), and self-rated health in a representative sample of the Spanish adult population (N = 21,486). The sample included 41.5% men, with mean age 52.3 years (± 18.03), and age range 20-82 years. Prevalence of overweight/obesity was 34.2%/12.7% in women and 52.1%/12.7% in men (p < 0.001 for obesity in both sexes). 53% of women and 57.5% of men met recommended levels of physical activity by walking (≥ 150 minutes/week). According to logistic regression analysis, individuals that walked less had higher risk of overweight or obesity. Data from the population-based surveillance study support suggestions that regular walking by adults is associated with positive self-rated health and better BMI profile. Obesity and low/very low self-rated health have low prevalence rates to meet the recommendations.

A Cross-Sectional Study of the Relationship of Physical Activity with Depression and Cognitive Deficit in Older Adults.

The aim of this study was to examine the association of physical activity with depression and cognition deficit, separately and combined, in Brazilian older adults. We analyzed data from 622 older adults. Physical activity was assessed using the International Physical Activity Questionnaire. Depressive symptoms were assessed using the Geriatric Depression Scale, while cognitive deficit was assessed using the Mini-Mental State Examination. Multinomial logistic regressions were used to assess associations of depression and cognitive deficit with sociodemographic, health, and behavioral variables. Prevalence of physical inactivity (< 150 min of moderate-to-vigorous physical activity/ week), depression, and cognitive deficit were 35.7%, 37.4%, and 16.7%. Physical inactivity was associated with depression (OR: 1.83, 95% CI: 1.14-2.94) and with depression and cognitive deficit combined (OR: 4.23, 95% CI: 2.01-8.91). Physically inactive participants were also more likely to present limitations in orientation and language functions. Physical inactivity was associated with depression and also with depression and cognitive deficit combined in older adults.