Analysis of postural control and muscle function performance of older adults participating in a multicomponent exercise program in primary health care / Análise do desempenho do controle postural e da função muscular de idosos participantes de um programa de exercício multicomponente na Atenção Primária à Saúde

Objectives: This cross-sectional study aimed to investigate (1) postural control performance in different postural tasks and (2) muscle strength and power of the hip, knee, and ankle of active vs inactive older adults. Methods: The sample consisted of 61 healthy community-dwelling older adults, classified into 2 groups: active, consisting of participants of a multicomponent exercise program offered through the Exercise Orientation Service; and inactive. Participants were considered physically active/inactive in the past 3 months. Postural control was assessed using a force plate in 8 postural tasks. Muscle function was evaluated using an isokinetic dynamometer. T-tests were used to compare clinical characteristics between the groups. ANCOVA and MANCOVA were used to compare differences in variables of postural control and muscle function. Results: Active participants had higher levels of physical activity, clinical balance, and quality of life than inactive participants. The active group had lower values for area (center of pressure) than the inactive group under the following conditions: bipedal stance on an unstable surface with eyes open and with eyes closed, and semi-tandem stance on an unstable surface with eyes open. The active group showed greater muscle power, with higher mean power values for hip abduction and adduction, knee extension, and knee flexion and shorter time to peak torque for hip adduction and ankle dorsiflexion than the inactive group. Conclusions: Multicomponent exercise programs delivered in primary health care settings contributed to improving postural control and muscle power in this sample of older adults, which can potentially help prevent falls and improve quality of life.

Objetivo: Este estudo transversal visou investigar: (1) o desempenho no controle postural em diferentes tarefas e (2) a força e a potência musculares de quadril, joelho e tornozelo de idosos ativos vs. inativos. Metodologia: A amostra foi composta de 61 idosos comunitários saudáveis, classificados em dois grupos: os ativos, participantes do programa de exercício multicomponente ofertado pelo Serviço de Orientação ao Exercício, e os inativos. Os participantes foram considerados fisicamente ativos/inativos nos três meses anteriores. O controle postural foi avaliado em oito tarefas usando-se uma plataforma de força. A função muscular foi mensurada com um dinamômetro isocinético. Foram utilizados testes t para comparar as características clínicas entre os grupos. Análise de covariância e análise multivariada de covariância foram utilizadas para comparar diferenças nas variáveis de controle postural e função muscular. Resultados: Os participantes ativos apresentaram maiores níveis de atividade física, equilíbrio e qualidade de vida que os inativos. O grupo ativo apresentou menores valores de área (centro de pressão) que o inativo nas seguintes condições: base bipodal em superfície instável com olhos abertos e fechados e base semitandem em superfície instável com olhos abertos. O grupo ativo apresentou maior potência que o inativo, com maior valor de potência média para abdução e adução de quadril, extensão e flexão de joelho, e menor tempo de pico de torque para adução de quadril e dorsiflexão de tornozelo. Conclusão: Programas de exercício multicomponente ofertados na Atenção Primária à Saúde contribuíram para melhorar o controle postural e a potência muscular nesta a

The value of calcaneal bone mass measurement using a dual X-ray laser calscan device in risk screening for osteoporosis

OBJECTIVE: To evaluate how bone mineral density in the calcaneus measured by a dual energy X-ray laser (DXL) correlates with bone mineral density in the spine and hip in Turkish women over 40 years of age and to determine whether calcaneal dual energy X-ray laser variables are associated with clinical risk factors to the same extent as axial bone mineral density measurements obtained using dual energy x-ray absorbtiometry (DXA). MATERIALS AND METHODS: A total of 2,884 Turkish women, aged 40-90 years, living in Ankara were randomly selected. Calcaneal bone mineral density was evaluated using a dual energy X-ray laser Calscan device. Subjects exhibiting a calcaneal dual energy X-ray laser T- score <-2.5 received a referral for DXA of the spine and hip. Besides dual energy X-ray laser measurements, all subjects were questioned about their medical history and the most relevant risk factors for osteoporosis. RESULTS: Using a T-score threshold of -2.5, which is recommended by the World Health Organization (WHO), dual energy X-ray laser calcaneal measurements showed that 13 percent of the subjects had osteoporosis, while another 56 percent had osteopenia. The mean calcaneal dual energy X-ray laser T-score of postmenopausal subjects who were smokers with a positive history of fracture, hormone replacement therapy (HRT), covered dressing style, lower educational level, no regular exercise habits, and low tea consumption was significantly lower than that obtained for the other group (p<0.05). A significant correlation was observed between the calcaneal dual energy X-ray laser T-score and age (r=-0.465, p=0.001), body mass index (BMI) (r=0.223, p=0.001), number of live births (r=-0.229, p=0.001), breast feeding time (r=-0.064, p=0.001), and age at menarche (r=-0.050, p=0.008). The correlations between calcaneal DXL and DXA T-scores (r=0.340, p=0.001) and calcaneal DXL and DXA Z-scores (r=0.360, p=0.001) at the spine, and calcaneal DXL and DXA T- ...