Field-Based Estimates of Muscle Quality Index Determine Timed-Up-and-Go Test Performance in Obese Older Women.

Objective: The muscle quality index (MQI) is associated with numerous health outcomes in adults; however, the effects of distinct MQI on functional capacity in obese older women have not yet been fully investigated. Thus, we investigated the contribution of different muscle quality indices on TUG performance prediction in obese older women. We secondarily evaluated the association between MQI, aerobic capacity performance (Treadmill performance and 6-minute walk test), and obesity indices (BMI, body fat percentage, and neck, waist, and hip circumference). Methods: Participants included 64 obese older women (mean age 67.05 ± 5.46 years, body fat ≥ 35%). General anthropometric, health history, body composition, treadmill exercise, and functional test (Time up and go) measures were collected. A hydraulic dynamometer was used to assess muscle strength, and Dual Energy X-ray Absorptiometry (DXA) to identify body fat percentage. The field MQI was defined as the highest reading divided by the subject's body mass index (BMI), while the laboratory MQI was obtained by the ratio of grip strength to the entire arm muscle in kilograms measured by DXA. A hierarchical multiple regression was performed to predict TUG-test performance. Results: An increase in field MQI of one unit is associated with a decrease of 2.59 seconds in the TUG test (ß = -0.540; p = 0.004). There was no association between laboratory MQI and TUG performance (ß = 0.067; p = 0.712). Furthermore, field MQI displays a positive correlation (p < 0.05) with aerobic capacity performance (6-minute walk test and peak O2 consumption) and a negative correlation (p < 0.05) with diverse obesity indices (neck and waist circumference, body fat, and BMI). Conclusion: MQI displayed an important prediction with TUG-test, a positive correlation with aerobic capacity, and a negative correlation with obesity indices.

New insights for statistical analysis of blood pressure response to resistance training in elderly hypertensive women / Novas perpectivas para a análise estatística da resposta da pressão arterial ao treinamento resistido em mulheres idosas hipertensas

ABSTRACT The main goal was to present statistical procedures for a better data interpretation of responsiveness, explain how to deal with RTM effect, and describe how to determine clinically important changes in BP from significant real difference (SRD). Twenty-seven hypertensive elderly women were included, and RT consisted of a periodized linear model. The RT lasted 10 weeks, with two sessions performed per week. Responders were classified on the basis of SBP differences between time-points T1 (first 3 weeks) and T4 (weeks 9-10). Statistical analyses were performed using One-Way Repeated Measures ANOVA, an analysis of covariance (ANCOVA), the linear mixed model (LMM) was used in the present study, and SRD was also calculated. In conclusion, when one-way repeated measure ANOVA was conducted to determine whether there was a statistically significant difference in SBP levels over the course of 10-week RT, results showed a non-significant reduction of -2.24 mmHg, while classifying subjects by responsiveness provides a different perspective of the results. Furthermore, initial SBP was the more powerful predictor of post-exercise SBP response, as analyzed by the regression to the mean effect. Finally, the reductions of -2.24 mmHg was not statistically significant nor clinically meaningful, but fell within the measurement error of the SBP measurements.

RESUMO O objetivo principal do estudo foi apresentar procedimentos estatísticos para uma melhor interpretação dos dados sobre a responsividade, explicar como lidar com o efeito da regressão a média (RM) e descrever como determinar alterações clinicamente importantes na pressão arterial (PA) pelo cálculo da diferença clínica (DC). Vinte e sete mulheres idosas hipertensas foram incluídas e o treinamento resistido (TR) consistiu em um modelo linear periodizado. O TR durou 10 semanas, com duas sessões realizadas por semana. Os responsivos foram classificados com base nas diferenças da pressão arterial sistólica (PAS) entre os momentos T1 (primeiras 3 semanas) e T4 (semanas 9-10). As análises estatísticas no presente estudo foram realizadas utilizando a ANOVA de medidas repetidas, análise de covariância (ANCOVA) e modelo linear misto (MLM). Conclui-se que quando uma ANOVA de medidas repetidas é aplicada, os resultados mostram uma redução não significativa de -2,24 mmHg, mas a classificação dos participantes por responsividade fornece uma interpretação diferente dos resultados. Além disso, a PAS inicial foi o preditor mais potente da resposta pós-exercício da PAS, conforme analisado pela RM. Finalmente, as reduções de -2,24 mmHg não foram estatisticamente significativas e nem clinicamente importantes, mas caíram dentro do erro de medida.

Sarcopenic obesity negatively affects muscle strength, physical function and quality of life in obese elderly women / Obesidade sarcopênica negativamente afeta força muscular, função física e a qualidade de vida em mulheres idosas obesas

ABSTRACT We evaluated the negative effect of sarcopenic obesity (SO) on muscle strength, physical function and quality of life in obese elderly women using the appendicular lean mass (aLM) adjusted for BMI, and aLM adjusted for height and fat mass residuals approach. Participated fifty-eight obese elderly women aged 60 to 70 years separated by two groups (SO) and non-sarcopenic (NSO) in two different approaches. The prevalence of SO was also verified between methods and its effects on handgrip strength, lean body mass, chair-stand test, time-up-and-go test, six-minute-walk test, peak O2 consumption, heart rate recovery and quality of life. The SO group presented significantly lower lean body mass, lower handgrip strength, inferior scores in the functional tests, inferior aerobic fitness, an impaired heart rate recovery, and an inferior aspect of quality of life as compared with the NSO group. Furthermore, no elderly woman was classified with SO by the aLM adjusted for height and fat mass residuals method. The cutoff-point addressed by the aLM/BMI represents a tool in clinical geriatric practice to identify and prevent this obesity/muscle syndrome in elderly women.

RESUMO Avaliamos o efeito negativo da obesidade sarcopênica (OS) sobre a força muscular, função física e qualidade de vida em idosas obesas usando o índice de massa magra apendicular (IMMA) ajustada para o IMC, e aLM ajustado pela estatura e massa gorda residual. Participaram cinquenta e oito mulheres idosas obesas com idade entre 60 a 70 anos de idade separadas por dois grupos: OS e não sarcopênica (NS) em duas abordagens diferentes. A prevalência de OS também foi verificada entre os métodos e seus efeitos sobre a força de preensão manual, massa magra, teste de sentar e levantar, time-up-and-go e caminhada de seis minutos, pico O2, recuperação de frequência cardíaca e qualidade da vida. O grupo de OS apresentou significativamente menor massa magra, menor força de preensão manual, pontuação inferior nos testes funcionais, baixa aptidão física, menor redução da frequência cardíaca durante a recuperação e aspecto inferior da qualidade de vida em comparação com o grupo NS. Além disso, nenhuma idosa foi classificada com OS pelo aLM ajustado pela estatura e massa gorda residual. O ponto de corte abordado pelo aLM/IMC representa uma ferramenta importante na prática clínica geriátrica para identificar e prevenir os efeitos deletérios da OS em mulheres idosas.

Blood pressure response to resistance training in hypertensive and normotensive older women.

PURPOSE: The purpose of the present study was to identify the variability of blood pressure response to a 10-week resistance training (RT) program in hypertensive and normotensive elderly women. PARTICIPANTS AND METHODS: Twenty-seven untrained hypertensive and 12 normotensive elderly women participated in the present study. A whole-body RT program was performed on two nonconsecutive days per week for 10 weeks. The responsiveness of resting systolic blood pressure (SBP) was determined based on the percent decline between the pre- and post-training time points T1 and T4. The term responders were used to describe subjects who exhibited a percent SBP decline ≥-2.58% and the term nonresponders for subjects who exhibited a percent SBP decline <-2.58%, respectively. RESULTS: Both the responders and nonresponders in the hypertensive group presented significant changes in SBP (-7.83 ± 5.70 mmHg vs 3.78 ± 7.42 mmHg), respectively. Moreover, the responders and nonresponders in the normotensive group presented significant changes in SBP as well (-8.58 ± 5.52 mmHg vs 5.71 ± 3.84 mmHg). CONCLUSION: SBP presents a heterogeneous response to a controlled RT program in hypertensive and normotensive elderly women. A different modality of training and additional therapies should be used for nonresponders in order to decrease resting SBP.

Relationship between adiposity and heart rate recovery following an exercise stress test in obese older women / Relação entre a adiposidade e a recuperação da frequência cardíaca após teste de esforço em mulheres idosas obesas

Abstract The aim of the present study was to compare differences in heart rate (HR) response during and following exercise in obese older women with different percent body fat levels. Ninety older, obese women aged 60-87 years participated in the study, were categorized, and enrolled to one of two groups based on a lower percent body fat (LPBF ≤ 41.10 %) or higher percent body fat (HPBF > 41.10 %) as measured by dual-energy x-ray absorptiometry. The peak HR during exercise and in the first and second minutes of recovery period were compared between groups. The HPBF group presented a lower peak HR during exercise (p =.001) and an impaired HR recovery (p =.001) when compared to LPBF group. The present study demonstrated that older women who were in exceedingly obese level have an impaired heart rate response during exercise and in the recovery period, indicating possible autonomic dysfunction.

Resumo O objetivo do presente estudo foi comparar a reposta da frequência cardíaca (FC) durante e após um teste de esforço entre mulheres idosas obesas com diferentes níveis de percentual de gordura corporal. Noventa idosas obesas com idade entre 60-87 anos participaram desse estudo e foram separadas em dois grupos com base no baixo percentual (LPBF ≤ 41.10 %) e alto percentual de gordura corporal (HPBF > 41.10 %) medido por absorciometria de raio-x de dupla energia. A FC pico durante o teste e no primeiro e segundo minuto de recuperação foram comparadas entre os grupos. O grupo HPBF apresentou FC pico inferior durante o teste (p = 0.001) e também após o período de recuperação (p = 0.001) quando comparado com o grupo LPBF. Os dados desse estudo demonstraram que mulheres idosas com alto percentual de gordura corporal apresentaram FC pico inferior e menor recuperação da FC durante o período de recuperação, indicando possivelmente uma disfunção autonômica.