Stages of sarcopenia, bone mineral density, and the prevalence of osteoporosis in older women.

A better understanding of the relationship between osteoporosis and sarcopenia may help to develop effective preventive and therapeutic strategies. In the present study, the association between different stages of sarcopenia, BMD, and osteoporosis was examined. The salient findings indicate that a dose-response relationship exists between sarcopenia stages and bone-related phenotypes. PURPOSE: To assess the association between sarcopenia stages, bone mineral density (BMD), and the prevalence of osteoporosis in older women. METHODS: Two hundred thirty-four women (68.3 ± 6.3 years) underwent body composition and BMD measurements using dual-energy X-ray absorptiometry. Quadriceps isokinetic torque was evaluated, and the timed up-and-go test was conducted as a measure of function. Sarcopenia stages were classified according to European Working Group on Sarcopenia in Older People (EWGSOP): nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia. Osteoporosis was defined as BMD value (hip or spine) 2.5 standard deviations below a young-adult reference population. Between-group differences were examined using ANOVA for continuous variables and chi-squared for categorical variables. Logistic regression was performed to evaluate the association between sarcopenia stages and osteoporosis. RESULTS: Rates of osteoporosis were 15.8%, 19.2%, 35.3%, and 46.2% for nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia, respectively (P = 0.002). Whole-body and femoral neck BMD values were significantly lower among all sarcopenia stages when compared to nonsarcopenia (all P values < 0.05, η2p 0.113 to 0.109). The severe sarcopenia group also showed significantly lower lumbar spine BMD values and T-scores (both P values < 0.05; η2p 0.035 and 0.037, respectively). When clustered, sarcopenia and severe sarcopenia exhibited lower BMD values for all sites (all P values < 0.01), and presented a significantly higher risk for osteoporosis (odds ratio 3.445; 95% CI 1.521-7.844). CONCLUSION: The observed results provide support for the concept that a dose-response relationship exists between sarcopenia stages, BMD, and the presence of osteoporosis. These findings strengthen the clinical significance of the EWGSOP sarcopenia definition and indicate that severe sarcopenia should be viewed with attention by healthcare professionals.

Normative Values of Knee Extensor Isokinetic Strength for Older Women and Implications for Physical Function.

BACKGROUND AND PURPOSE: Lower-limb strength is required for everyday activities and thus its evaluation has been especially emphasized in older adults. Isokinetic testing is a criterion standard method to assess muscle strength; however, lack of reference values limits its usefulness in geriatric evaluation and rehabilitation. The aim of this study was to develop reference values of knee extensor isokinetic strength for older women. As a secondary aim, functional tests were performed for clinical significance validation. METHODS: A total of 453 older women aged 60 to 84 years participated in this study. Knee extensor isokinetic strength was measured using the Biodex System dynamometer at 60° per second. The Timed Up and Go test and the 5 times Sit-to-Stand test were used for functional performance evaluation. Participants were categorized into age groups of 5 years range. The 20th, 40th, 60th, and 80th percentiles were used for stratification purposes. RESULTS AND DISCUSSION: As expected, mean strength values significantly decreased with advancing age groups. Isokinetic percentile groups are presented according to age. Individuals in the lower percentile strata showed significantly reduced performance in both the Timed Up and Go and 5 times Sit-to-Stand tests (P < .05). CONCLUSION: This study provides normative values of isokinetic knee extensor strength in older women. The association between lower isokinetic knee extensor strength strata and reduced functional capacity supports the potential application of these reference values in clinical and research settings. Future studies should ascertain these findings in different female populations.

Cancer-Related Fatigue and Muscle Quality in Hodgkin's Lymphoma Survivors.

The purpose of this study was to compare fatigue, strength, body composition, muscle thickness, and muscle quality between Hodgkin's lymphoma survivors (HLS) and apparently healthy subjects matched by age, gender, and physical activity levels (CON). Twelve HLS (32.16 ± 8.06) and 36 CON (32.42 ± 7.64) were enrolled in the study. Fatigue was assessed using the 20-item Multidimensional Fatigue Inventory, muscle strength using an isokinetic dynamometer, body composition using dual-energy X-ray absorptiometry, and thickness and muscle quality using B-mode ultrasound. Differences between HLS and CON were analyzed using independent samples t tests. No significant differences were observed between groups for any demographic characteristics: age ( P = .922), weight ( P = .943), height ( P = .511), body mass index ( P = .796), fat mass ( P = .688), fat-free mass ( P = .520), and percent body fat ( P = .446). No significant differences were observed for strength (peak torque; P = .552), relative peak torque ( P = .200), muscle thickness ( P > .05) and muscle quality ( P > .05). However, self-perceived fatigue was significantly higher in HLS than in CON ( P = .009). It appears that when HLS are matched by age and physical activity levels to CON, no significant difference in body composition, muscle thickness, muscle quality, or strength is observed. Self-perceived fatigue, as predicted, is higher in HLS, which may have implications and should be considered when prescribing exercise training to this cancer population.

Effects of Elastic Resistance Exercise on Muscle Strength and Functional Performance in Healthy Adults: A Systematic Review and Meta-Analysis.

BACKGROUND: Elastic Resistance Exercise (ERE) has already demonstrated its effectiveness in older adults and, when combined with the resistance generated by fixed loads, in adults. This review summarizes the effectiveness of ERE performed as isolated method on muscle strength and functional performance in healthy adults. METHODS: A database search was performed (MEDLine, Cochrane Library, PEDro and Web of Knowledge) to identify controlled clinical trials in English language. The mean difference (MD) with 95% confidence intervals (CIs) and overall effect size were calculated for all comparisons. The PEDro scale was used assess the methodological quality. RESULTS: From the 93 articles identified by the search strategy, 5 met the inclusion criteria, in which 3 presented high quality (PEDro > 6). Meta-analyses demonstrated that the effects of ERE were superior when compared with passive control on functional performance and muscle strength. When compared with active controls, the effect of ERE was inferior on function performance and with similar effect on muscle strength. CONCLUSIONS: ERE are effective to improve functional performance and muscle strength when compared with no intervention, in healthy adults. ERE are not superior to other methods of resistance training to improve functional performance and muscle strength in health adults.

Effects of resistance training on sarcopenic obesity index in older women: A randomized controlled trial.

The purpose of this study was to examine the effects of resistance training (RT) on sarcopenic obesity (SO) in older women. 243 older women underwent body composition measurement using dual-energy X-ray absorptiometry, and the SO index was calculated. This randomized controlled trial adopted from the baseline sample, 113 volunteers (67.0±5.2years) were randomly assigned to a control group (CG, n=64) or an experimental group (EG, n=69). The EG took part in a 24-week RT program, conducted three times per week. Body composition measurements were repeated at the end of the training program. RT induced a significant increase in fat-free mass (P<0.01), but not decrease in fat mass in the EG. Moreover, the SO index was also significantly improved in the EG (P<0.01), while it decreased significantly in the CG (P<0.01). It is concluded that RT is an effective approach to promote body composition alterations in older women, and it might improve SO-related phenotypes.

A Randomized Trial Investigating the Influence of Strength Training on Quality of Life in Ischemic Stroke.

BACKGROUND: Strength training post stroke is widely acknowledged as an important part of a rehabilitation program. Muscle strength has been shown to be a significant contributor to physical disability after stroke, which in turn has an immense impact on the reintegration of patients into society, affecting their quality of life. OBJECTIVE: This was a randomized intervention trial to determine the effect of a resistance training program on the quality of life in patients with stroke. METHODS: An experimental group (EG), consisting of 11 subjects aged 51.7 ± 8.0 years, and a control group (CG), consisting of 13 subjects aged 52.5 ± 7.7 years, were studied before and after 12 weeks. EG underwent 12 weeks of strength training three times a week. The CG did not undergo strength training during the 12-week study period. RESULTS: There was a significant increase in quality of life from pre-test to post-test (Δ% = 21.47%; p = 0.021) in EG. There were significant differences in all indicators of quality of life between groups at 12 weeks. There were greater gains in strength in EG than in CG (p ≤ 0.05). There was a negative correlation between the strength gains as determined with the 1RM test and the quality of life, especially in lower limb exercises. CONCLUSION: The results of this study indicate that there was an improvement in the measures of strength in EG, and that there was a correlation between improvements in strength and quality of life in these patients who had previously suffered a stroke at least one year prior to study.

Efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder: A systematic review with meta-analysis.

BACKGROUND: Temporomandibular joint disorder (TMD) requires a complex diagnostic and therapeutic approach, which usually involves a multidisciplinary management. Among these treatments, musculoskeletal manual techniques are used to improve health and healing. OBJECTIVES: To assess the effectiveness of musculoskeletal manual approach in temporomandibular joint disorder patients. DESIGN: A systematic review with meta-analysis. METHODS: During August 2014 a systematic review of relevant databases (PubMed, The Cochrane Library, PEDro and ISI web of knowledge) was performed to identify controlled clinical trials without date restriction and restricted to the English language. Clinical outcomes were pain and range of motion focalized in temporomandibular joint. The mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CIs) and overall effect size were calculated at every post treatment. The PEDro scale was used to demonstrate the quality of the included studies. RESULTS/FINDINGS: From the 308 articles identified by the search strategy, 8 articles met the inclusion criteria. The meta-analysis showed a significant difference (p < 0.0001) and large effect on active mouth opening (SMD, 0.83; 95% CI, 0.42 to 1.25) and on pain during active mouth opening (MD, 1.69; 95% CI, 1.09 to 2.30) in favor of musculoskeletal manual techniques when compared to other conservative treatments for TMD. CONCLUSIONS: Musculoskeletal manual approaches are effective for treating TMD. In the short term, there is a larger effect regarding the latter when compared to other conservative treatments for TMD.

Effects of short term elastic resistance training on muscle mass and strength in untrained older adults: a randomized clinical trial.

BACKGROUND: The current recommendations on resistance training involving older adults have reported an improvement of body composition variables. Despite this, there is a lack of knowledge on how elastic resistance training (ERT) affects the muscle mass in older adults population. The purpose of this study was to determine the effects of a short-term ERT on muscle mass of health and untrained older adults. METHODS: Forty older adults were randomized into two groups of 20 individuals each: Control Group (CG = 66.2 ± 6.6 years) and Training Group (TG = 69.1 ± 6.3 years). TG underwent an ERT twice a week during 8 weeks and control group did not receive any specific intervention. The primary outcome was the upper and lower limbs muscle mass, measured by Dual-energy x-ray absorptiometry. The secondary outcomes were knee isokinetic peak torque (PT) at 60°/s and 120°/s speeds and isometric handgrip strength. A 2×2 mixed model (group [TG and CG] × time [pre and post]) analysis of variance (ANOVA) was applied to determine the effect on primary and secondary outcomes. RESULTS: The results of the ANOVA showed no significant effects in group x time interaction for (1) upper limbs fat free mass (F [1.38] = 1.80, p = 0.19, effect size [ES] = 0.1) and for (2) lower limbs fat free mass (F [1.38] = 0.03, p = 0.88, ES = 0.02). Regarding muscle strength, the ANOVA showed no significant effects in group x time interaction for (3) PT at 60°/s (F [1.38] = 0.33, p = 0.56, ES = 3.0), for (4) PT at 120°/s (F [1.38] = 0.80, p = 0.38, ES = 4.1) and for handgrip strength (F [1.38] = 0.65, p = 0.42-value, ES = 0.9). Analysis of PT in TG showed a significant change of 4.5%, but only at 120°/s (p = 0.01) when comparing pre and post-training (time interaction). CONCLUSIONS: Eight weeks of ERT did not show significant changes in muscle mass and strength of untrained older adults. TRIAL REGISTRATION: NCT02253615 (09/25/14).

Immediate changes in electroencephalography activity in individuals with nonspecific chronic low back pain after cranial osteopathic manipulative treatment: study protocol of a randomized, controlled crossover trial.

BACKGROUND: Osteopathic medicine is based on a diagnostic and therapeutic system to treat tissue mobility/ motility dysfunctions in general, using different approaches (depending on the target tissue) known as osteopathic manipulative treatment. Among the available techniques those ones addressed to the cranial field are the most questioned because of the lack of scientific evidence; but the compression of the 4th ventricle technique has been largely studied in clinical trials. Studies have shown that the technique may affect both central and autonomous nervous system, modulating some reflexes (Traube-Hering baro signal), and modifying brain cortex electrical activity through central sensitization in subjects with chronic low back pain. Thus, investigators hypothesize that the compression of the 4th ventricle may modulate peak alpha frequency (eletroencephalographic assessment) and promote physical relaxation in subjects in vigil. METHODS/DESIGN: A randomized, controlled crossover trial with blinded assessor was designed to test the hypothesis. A total of 81 participants will be assigned to three treatment conditions, with seven days of washout: (I) compression of the 4th ventricle; (II) sham compression of the fourth ventricle; (III) control (no intervention). The (I) power amplitude and the (II) frequencies of the dominant peak in the alpha band will be the primary outcome measures of the study. All participants will be recruited at the Outpatient Rehabilitation Service of the University Hospital of Brasília-University of Brasília. All the electroencephalographic exams will be conducted by a blinded assessor. DISCUSSION: The investigators hypothesize that patients with chronic low back pain submitted to the technique would have the peak alpha frequency modulated and, thus, would experience physical relaxation. TRIAL REGISTRATION: NCT02111382.

Mechanical evaluation of elastic tubes used in physical therapy.

PURPOSE: To quantify the force of elastic tubes at different elongation patterns used in exercises. METHODS: A tensile test of elastic tubes which had seven levels of resistance identified by colors was performed. All samples (n = 105; 15 samples for each color) were 7 cm of length and had two interfaces for fixation. The samples were tested in a tensile testing hydraulic machine, under elongation control, up to 200% of the original length (21 cm). The force values corresponding to an increase of 50%, 100%, 150% and 200% of the samples initial length were recorded. RESULTS: A strong linear association between force and elongation for all colors was found. There were different forces for each elongation investigated for the same tube and between different tubes in almost all percentage of elongation investigated, except for the red and green tubes (all elongations), and for the blue and black tubes at 50% elongation. CONCLUSION: Mechanical tests revealed different elastic forces for different levels of elongation of each tube. The replication of the results in clinical situations is recommended, so the elastic resistance in clinical routine could be evaluated with more propriety.

The exon 3 polymorphism of the growth hormone receptor is a severity-related factor for osteoporosis.

The purpose of this study was to investigate the association between the GHR exon 3 fl/d3 polymorphism and body composition traits in Brazilian cohorts of normal post-menarche adolescent girls and in post-menopausal women with and without osteoporosis. First, multiplex PCR and quantitative PCR (TaqMan) were used with 105 DNA samples from the general Brazilian population to validate the SNP rs6873545 as a surrogate marker for the GHR polymorphism. Subsequently, genotyping was carried out to evaluate associations for this polymorphism in 136 post-menarche adolescents and 175 post-menopausal women, who were evaluated for body composition traits such as bone mineral density and fat-free mass. Statistical analysis used an independent sample t test, one-way ANOVA test and post hoc Tukey HSD test. Significant values were assumed by p < 0.05. Genotyping indicated complete linkage disequilibrium between the GHR polymorphism and the SNP alleles (r(2) = 1.0). Adolescents and healthy post-menopausal women showed no genotype associations for body composition traits or osteoporosis. However, a lower total body bone mineral density was observed in fl/fl post-menopausal women with osteoporosis (p = 0.0004). These results suggest that the SNP rs6873545 can be used as a surrogate for the GHR fl/d3 polymorphism due to linkage disequilibrium in the Brazilian population and that the fl/fl genotype is a severity-related risk factor for osteoporosis, but did not appear to be associated with disease status.

Relationship between Depression and Strength Training in Survivors of the Ischemic Stroke.

The Cerebral Vascular Accident is responsible for a significant increase in the mortality rate in individuals who have suffered this condition, regardless of the level of subsequent disability. This study aimed to analyze the influence of a strength training program on indicators of depression in survivors of the ischemic stroke. The study sample included subjects from both genders who were divided into two groups: an experimental group (EG) consisting of 11 subjects aged 51.7 8.0 years, and a control group (CG) consisting of 13 subjects aged 52.5 7.7 years. The EG underwent 12 weeks of strength training. Assessment was made in the pre-test before training and at the re-test after 12 weeks of training. We used the Beck Depression Inventory and evaluated 1RM. Significant differences in depression were found between post-test and pretest measurements (Δ% = -21.47%, p = 0,021) in the EG; furthermore, there were significant differences in all indicators of depression between the EG and CG after completing 12 weeks of training. There were significant gains in strength of the EG in relation to the CG. There was a negative correlation between the strength gains as determined with the 1RM test and the levels of depression, especially in lower-limb exercises. The results of this study suggest that improvements in strength are negatively correlated with levels of depression. Improvements in strength are therefore associated with a reduction in levels of depression.

Do 12-week yoga program influence respiratory function of elderly women?

Aging produces several respiratory limitations and reduces tolerance to physical efforts, sometimes leading to pulmonary diseases in the elderly. The literature draws attention to the possible benefits of Yoga practice among the elderly, presenting evidence for significant improvements in quality of life. It was hypothesized that yoga practice can improve respiratory function in the elderly. The effects of a yoga program on pulmonary volumes and respiratory muscle strength were verified in 36 elderly women divided into a yoga group [YG] (63.1 ± 13.3 years of age) and a control group (61.0 ± 6.9 years of age). Maximal inspiratory and expiratory pressure (MIP and MEP) were assessed by a manovacuometer and tidal volume (VT), vital capacity (VC) and minute ventilation (VE) were measured by a ventilometer. The program comprised 65 min sessions, 3 times/week during 12 weeks. The heart rate and respiratory rate decreased significantly in the YG (76-39 ± 8-03 vs. 74-61±10.26 bpm and 18.61 ± 3.15 vs. 16.72 ± 3.12 resp/min, respectively). In the YG, VT and VE increased significantly (0.55 ± 0.22 vs. 0.64 ± 0.2 ml and 9.19 ± 2.39 vs. 10.05 ± 2.11 ml, respectively), as well as VC (1.48 ± 0.45 vs. 2.03 ± 0.72 ml). Improvements were also found in MIP and MEP in the YG (62.17 ± 14.77 vs. 73.06 ± 20.16 cmH2O and 80.56 ± 23.94 vs. 86.39 ± 20.16 cmH2O, respectively). It was concluded that a 12-week yoga program significantly improves pulmonary function of aged women.

Decreased functional capacity and muscle strength in elderly women with metabolic syndrome.

PURPOSE: To compare the metabolic parameters, flexibility, muscle strength, functional capacity, and lower limb muscle power of elderly women with and without the metabolic syndrome (MetS). METHODS: This cross-sectional study included 28 older women divided into two groups: with the MetS (n = 14; 67.3 ± 5.5 years; 67.5 ± 16.7 kg; 1.45 ± 0.35 m; 28.0 ± 7.6 kg/m(2)), and without the MetS (n = 14; 68.7 ± 5.3 years; 58.2 ± 9.9 kg; 1.55 ± 0.10 m; 24.3 ± 3.8 kg/m(2)). Body composition was evaluated by dual-energy X-ray absorptiometry and dynamic muscle strength was assessed by one-maximum repetition (1RM) tests in leg press, bench press and biceps curl exercises. Six-minute walk test, Timed Up and Go (TUG); 30-second sitting-rising; arm curl using a 2-kg dumbbell, sit-and-reach (flexibility), and vertical jump tests were performed. RESULTS: There was no difference between groups regarding age (P = 0.49), height (P = 0.46), body fat (%) (P = 0.19), systolic (P = 0.64), diastolic (P = 0.41) and mean blood pressure (P = 0.86), 30-second sitting-rising (P = 0.57), 30-s arm curl (P = 0.73), leg press 1RM (P = 0.51), bench press 1RM (P = 0.77), and biceps curl 1RM (P = 0.85). However, women without the MetS presented lower body mass (P = 0.001), body mass index (BMI) (P = 0.0001), waist circumference (P = 0.02), waist-to-height ratio (P = 0.02), fat body mass (kg) (P = 0.05), lean body mass (kg) (P = 0.02), blood glucose (P = 0.05), triglycerides (P = 0.03), Z-score for the MetS (P = 0.05), higher high-density lipoprotein-cholesterol (HDL-C) (P = 0.002), better performance on TUG (P = 0.01), flexibility (P = 0.03), six-minute walk test (P = 0.04), vertical jump (P = 0.05) and relative muscle strength for leg press (P = 0.03), bench press (P = 0.04) and biceps curl (P = 0.002) exercises as compared to women with the MetS. CONCLUSION: Elderly women with the MetS have higher metabolic risk profile and lower functional capacity, muscle strength, lower limb power and flexibility as compared to women without the MetS. The evaluation of functional capacity may help to determine the degree of physical decline in older persons with the MetS, while exercise interventions should be encouraged.

Elastic resistance training to increase muscle strength in elderly: a systematic review with meta-analysis.

Analyze the efficiency of training programs with progressive elastic resistance on muscle strength in elderly 'healthy' and 'not healthy'. It was performed a systematic review in relevant databases to identify controlled clinical trials with outcomes from parameters of muscle strength. Two independent reviewers decided about the inclusion criteria, data extraction and evaluation of methodological quality of the articles. Standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated for relevant outcomes and pooled using a random effects model. Among the 11 studies whose effect sizes were used in the meta-analysis, there were 834 individuals between the ages of 60 and 79. The resistance training with elastic bands showed strong effects on muscle strength in healthy elderly (SMD=1.30; 95% CI: 0.90, 1.71) and with some functional incapacity (SMD=1.01; 95% CI: 0.82, 1.19), and a moderate effect on muscle strength in elderly patients with pathology (SMD=0.54; 95% CI: 0.12, 0.96). There was little information available about the training intensity. The training with elastic resistance proved to be effective for improving muscle strength in 'healthy' and 'not healthy' elderly. Our results suggest that training with elastic resistance is most effective in 'healthy' subjects and with functional limitations, and less effective in subjects with some kind of disorders. To establish dose-response relations from different intensities of training on muscle strength in the elderly, new studies are needed to identify reliable and objective methods of evaluation of muscle strength using elastic materials directly.

Effects of hippotherapy on mobility, strength and balance in elderly.

OBJECTIVES: To assess the chronic effects of hippotherapy on functional mobility, muscle strength and balance in elderly. METHODS: 28 volunteers, between the age of 60 and 84, were randomly recruited and divided in experimental group (EG), with 12 individuals (8 women and 4 men) and control group (CG), with 16 individuals (14 women and 2 men). The EG group participated in an 8-week hippotherapy program. Before and after the study period functional mobility was assessed and measured by Time Up and Go Test (TUG), muscle strength of the lower limbs was measured by 30s Chair Stand Test (30CST) and performance in balance was measured by the Berg Balance Scale (BBS). A mixed ANOVA model (group×testing time) was applied to establish the effect of the different groups on the functional variables. RESULTS: The functional capacity of the EG group was increased if compared to CG group after the intervention of the BBS (p=0.003) and 30CST (p=0.032), but not of the TUG (p=0.063). CONCLUSION: The results indicated that hippotherapy improves the lower limb strength and balance in elderly.

The influence of resistance exercise training on the levels of anxiety in ischemic stroke.

The aim of this pilot study was to analyze the effect of a strength training program on indicators of trait and state anxiety in patients with ischemic stroke. The subjects were divided into two groups: experimental group (EG) consisting of 11 subjects aged 51.7 ± 8.0 years and a control group (CG) with 13 subjects aged 52.5 ± 7.7 years. EG underwent 12 weeks of strength training, with a frequency of three times a week. For data collection, a State-Trait Anxiety Inventory (STAI) was used. Significant differences were found between pre- and posttest in EG for trait anxiety (43.2 ± 12.5 pretest 39.9 ± 7.3 posttest) and state anxiety (46.9 ± 7.6 pretest 44.9 ± 7.7 posttest) with no differences in CG for trait anxiety (42.9 ± 12.2 pretest 42.6 ± 12.1 posttest) and state anxiety (47.4 ± 8.1 pretest 47.5 ± 8.0 posttest). In the evaluation between the groups, significant differences were found for all indicators of trait anxiety (39.9 ± 7.3 EG; 42.6 ± 12.1 CG) and state anxiety (44.9 ± 7.7 EG; 47.5 ± 8.0 CG). This pilot study indicates that strength training may provide an improvement in trait and state anxiety more than one year after stroke.

[Biological fragility syndrome in the elderly: systematic review]. / Síndrome da fragilidade biológica em idosos: revisão sistemática.

OBJECTIVE: The aim of this study was to identify the prevalence and assessment strategies of Biological Fragility Syndrome in the Elderly. METHODS: For the development of this study was it was done a search in electronic databases (Medline/PubMed) and the reference lists of articles identified using the following key words/terms in English: "frailty" and `frail" in conjunction with the terms "elderly", "aging" and "prevalence". These terms/descriptors were combined using the logical operators available in search engines. The initial electronic search resulted in 1 865 manuscripts. The process of analysis of the studies involved reading titles, abstracts and full texts. After all these phases, 35 manuscripts met the inclusion criteria of the review. RESULTS: The results indicated that women, with rage from 7.3 % to 21.6 %, are frailer than men, with percentages ranging from 4 % to 19.2 %. CONCLUSIONS: Differences in prevalence rates of prefrailty and frailty should be minimized, with stimulus for standardization for the evaluation of human frailty.

Lactate threshold prediction by blood glucose and rating of perceived exertion in people with type 2 diabetes.

The validity of rating of perceived exertion (RPE) in predicting lactate threshold during an incremental test was analyzed in 15 men with type 2 diabetes (M age = 53.4 yr., SD = 12.9). Blood glucose, lactate, and minute ventilation (VE)/VO2 responses identified the lactate, ventilatory, and glucose thresholds. Workloads (W) corresponding to RPEs 12, 13, 14, and 15 were determined. Second-order polynomials fit to VE/W and [lac]/W ratios corresponding to RPEs of 9-10, 12-13, and 16-17 also identified workloads above which there was an overproportional increase in VE and [lac]. These workload breakpoints did not differ, although at RPE 12 underestimated and at RPE 15 overestimated lactate threshold. RPE 13 and 14 and the responses of VE/W and [lac]/W to submaximal exercise accurately predicted lactate threshold.

Cardiorespiratory fitness and quality-of-life analysis posttreatment in breast cancer survivors.

This study compared VO(2peak), treatment frequency and dosage, and QOL between 22 post-treated breast cancer survivors (CATotal) and 22 apparently healthy, age-matched women (CO). The CATotal group included 11 with no history of any other co-morbidities (CA) and 11 with controlled hypertension (CA + H). VO(2peak) was measured using the Bruce Protocol. QOL was measured using the SF-36 survey. Significant differences were observed in VO(2peak) between CATotal and CO (p = 0.014), CA and CA + H (p = 0.001), and CA + H and CO (p = 0.001). Physical, emotional, and mental health domains of the SF-36 were significantly different between CATotal and CO (p = 0.006, 0.001, and 0.05 respectively). These results suggest that breast cancer survivors with controlled hypertension can experience a significant reduction in VO(2peak) when compared to apparently healthy, age-matched controls. Also, treatment frequency and dosage affected QOL in this group of survivors.