Un análisis crítico sobre las recomendaciones de actividad física en España

ResumenObjetivoIdentificar los documentos oficiales de las comunidades autónomas en España que contengan recomendaciones sobre actividad física, para evaluar el grado de conformidad con las recomendaciones sobre actividad física para la salud de la Organización Mundial de la Salud (OMS).MétodosSe realizó un análisis de contenido sobre 55 documentos de las consejerías de sanidad de los distintos gobiernos autonómicos que contienen recomendaciones sobre actividad física.ResultadosEl 84% de las comunidades autónomas en España hacen algún tipo de recomendación sobre actividad física aeróbica y el 37% sobre fortalecimiento muscular. Sin embargo, las que tienen documentos en consonancia con los criterios de la OMS son: actividad física aeróbica (n=11, 58%), personas adultas (n=10, 53%), personas mayores (n=5, 26%), infancia/adolescentes (n=1, 5%); fortalecimiento muscular, personas adultas (n=6, 32%), personas mayores (n=3, 16%), infancia/adolescentes (n=1, 5%); equilibrio (n=5, 26%); al menos 10 minutos continuados de actividad física (n=6, 32%); recomiendan hasta 300 minutos semanales (n=10, 53%); intensidad de la actividad física (n=2, 11%).ConclusionesLas recomendaciones hacen referencia a la actividad física aeróbica y apenas tienen en cuenta el fortalecimiento muscular. Una comunidad autónoma se ajusta a las recomendaciones de la OMS. Las comunidades con mayores índices de envejecimiento y mayor porcentaje de infancia/adolescentes casi no hacen recomendaciones sobre actividad física de acuerdo con las directrices de la OMS.AbstractObjectiveTo identify official documents with recommendations on physical activity published by the autonomous regions of Spain with the goal of evaluating their compliance with the physical activity recommendations of the World Health Organization (WHO).MethodsWe conducted a content analysis of 55 documents of the ministries of health of several regional governments containing recommendations on physical activity.ResultsEighty-four percent of the autonomous regions in Spain made recommendations on aerobic physical activity and 37% made recommendations on strength training. However, the number of documents consistent with the WHO criteria was as follows: aerobic activity (n=11, 58%), adults (n=10, 53%), the elderly (n=5, 26%), children/adolescents (n=1, 5%); strength training, adults (n=6, 32%), the elderly (n=3, 16%), children/adolescents (n=1, 5%); balance (n=5, 26%); at least 10minutes continuous physical activity (n=6, 32%); recommendation of up to 300minutes per week (n=10, 53%); intensity of physical activity (n=2, 11%).ConclusionsThe recommendations of the autonomous regions tend to focus on aerobic physical activity and to under-represent strength training. Moreover, only one autonomous region conforms to the WHO recommendations for physical activity. The regions with higher rates of population aging and a higher percentage of children and adolescents fail to make recommendations on physical activity consistent with the WHO guidelines

Determinants of sedentary behavior, motivation, barriers and strategies to reduce sitting time in older women: a qualitative investigation

Abstract: Sedentary behavior defined as time spent non-exercising seated or reclining posture has been identified has a health risk and associated with frailty and disablement for older adults. Older adults are the most sedentary segment of society. To date no study has investigated the determinants of sedentary behavior in older adults. This study reports a qualitative investigation of the determinants of sedentary behavior, strategies and motivator to reduce sitting time by structured interviews in a group of community dwelling older women (N = 11, age 65 and over). Older women expressed the view that their sedentary behavior is mostly determined by pain which acts both as an incentive to sit and a motivator to stand up, lack of energy in the afternoon, pressure from direct social circle to sit and rest, societal and environmental typecasting that older adult are meant to sit, lack of environmental facilities to allow activity pacing. This qualitative investigation highlighted some factors that older adults consider determinants of their sedentary behavior. Some are identical to those affecting physical activity (self-efficacy, functional limitations, ageist stereotyping) but some appear specific to sedentary behavior (locus of control, pain) and should be further investigated and considered during intervention design. Tailore

Effects of a pulmonary rehabilitation program with balance training on patients with COPD

PURPOSE: Patients with chronic obstructive pulmonary disease (COPD) have balance impairments. However, pulmonary rehabilitation (PR) is associated with only minor improvements in functional balance. Therefore, there is a need to explore the role of balance training within PR. This study aimed at assessing the effects of a PR program, with a specific component of balance training, on functional balance of patients with COPD. METHODS: Outpatients with COPD (N = 22, age = 68.0 ± 11.8 years; forced expiratory volume in 1 second = 72.2 ± 22.3% predicted) participated in a 12-week PR program including exercise training and psychosocial support and education. Exercise training sessions comprised endurance, strength, and a specific component of balance training. The Timed Up and Go (TUG) test was used to assess functional balance before and after the PR. Health-related quality of life (St George's Respiratory Questionnaire), quadriceps muscle strength (10 repetition maximum), and exercise tolerance (6-minute walk test) were also assessed. RESULTS: Patients demonstrated significant improvements in TUG scores after PR (mean change-1.7 ± 1.4 seconds; P =.001; effect size = 1.249). Before PR, 9 (41%) participants and after PR only 1 (4.5%) participant had a TUG performance worse than the average performance of age-matched healthy peers (P =.008). The St George's Respiratory Questionnaire symptoms score (P =.012), quadriceps muscle strength (P =.001), and exercise tolerance (P =.001) were also improved. CONCLUSIONS: Pulmonary rehabilitation with a specific component of balance training had a large effect on functional balance in patients with COPD. Findings highlight the value of including balance training in PR programs. Further research is needed to determine the optimal intervention to improve balance and its specific components among patients with COPD.publishe

Effect of Resistance Training on Neuromuscular Junctions of Young and Aged Muscles Featuring Different Recruitment Patterns

To examine the effects of aging on neuromuscular adaptations to resistance training (i.e., weight lifting), young (9 months of age) and aged (20 months of age) male rats either participated in a 7-week ladder climbing protocol with additional weight attached to their tails or served as controls (n=10/group). At the conclusion, rats were euthanized and hindlimb muscles were quickly removed and frozen for later analysis. Longitudinal sections of the soleus and plantaris muscles were collected, and pre- and postsynaptic features of neuromuscular junctions (NMJs) were visualized with immunofluorescence staining procedures. Cross-sections of the same muscles were histochemically stained to determine myofiber profiles (fiber type and size). Statistical analysis was by two-way ANOVA (main effects of age and treatment) with significance set at P0.05. Results revealed that training-induced remodeling of NMJs was evident only at the postsynaptic endplate region of soleus fast-twitch myofibers. In contrast, aging was associated with pre- and postsynaptic remodeling in fast- and slow-twitch myofibers of the plantaris. Although both the soleus and the plantaris muscles failed to display either training or aging-related alterations in myofiber size, aged plantaris muscles exhibited an increased expression of type I (slow-twitch) myofibers in conjunction with a reduced percentage of type II (fast-twitch) myofibers, suggesting early stages of sarcopenia. These data demonstrate the high degree of specificity of synaptic modifications made in response to exercise and aging and that the sparsely recruited plantaris is more vulnerable to the effects of aging than the more frequently recruited soleus muscle. (c) 2014 Wiley Periodicals, Inc

How are falls and fear of falling associated with objectively measured physical activity in a cohort of community-dwelling older men?

BACKGROUND: Falls affect approximately one third of community-dwelling older adults each year and have serious health and social consequences. Fear of falling (FOF) (lack of confidence in maintaining balance during normal activities) affects many older adults, irrespective of whether they have actually experienced falls. Both falls and fear of falls may result in restrictions of physical activity, which in turn have health consequences. To date the relation between (i) falls and (ii) fear of falling with physical activity have not been investigated using objectively measured activity data which permits examination of different intensities of activity and sedentary behaviour. METHODS: Cross-sectional study of 1680 men aged 71-92 years recruited from primary care practices who were part of an on-going population-based cohort. Men reported falls history in previous 12 months, FOF, health status and demographic characteristics. Men wore a GT3x accelerometer over the hip for 7 days. RESULTS: Among the 12% of men who had recurrent falls, daily activity levels were lower than among non-fallers; 942 (95% CI 503, 1381) fewer steps/day, 12(95% CI 2, 22) minutes less in light activity, 10(95% CI 5, 15) minutes less in moderate to vigorous PA [MVPA] and 22(95% CI 9, 35) minutes more in sedentary behaviour. 16% (n = 254) of men reported FOF, of whom 52% (n = 133) had fallen in the past year. Physical activity deficits were even greater in the men who reported that they were fearful of falling than in men who had fallen. Men who were fearful of falling took 1766(95% CI 1391, 2142) fewer steps/day than men who were not fearful, and spent 27(95% CI 18, 36) minutes less in light PA, 18(95% CI 13, 22) minutes less in MVPA, and 45(95% CI 34, 56) minutes more in sedentary behaviour. The significant differences in activity levels between (i) fallers and non-fallers and (ii) men who were fearful of falling or not fearful, were mediated by similar variables; lower exercise self-efficacy, fewer excursions from home and more mobility difficulties. CONCLUSIONS: Falls and in particular fear of falling are important barriers to older people gaining health benefits of walking and MVPA. Future studies should assess the longitudinal associations between falls and physical activity

High intensity interval training (HIIT) improves resting blood pressure, metabolic (MET) capacity and heart rate reserve without compromising cardiac function in sedentary aging men

Background: This study examined a programme of pre-conditioning exercise with subsequent high intensity interval training (HIIT) on blood pressure, echocardiography, cardiac strain mechanics and maximal metabolic (MET) capacity in sedentary (SED) aging men compared with age matched masters athletes (LEX). Methods: Using a STROBE compliant observational design, 39 aging male participants (SED; n=22, aged 62.7± 5.2 yrs) (LEX; n = 17, aged= 61.1 ± 5.4 yrs) were recruited to a study that necessitated three distinct assessment phases; enrolment (Phase A), following pre-conditioning exercise in SED (Phase B), then following 6 weeks of HIIT performed once every five days by both groups before reassessment (Phase C). Hemodynamic, echocardiographic and cardiac strain mechanics were obtained at rest and maximal cardiorespiratory and chronotropic responses were obtained at each measurement phase. Results: The training intervention improved systolic, mean arterial blood pressure, rate pressure product and heart rate reserve (each P b 0.05) in SED and increased MET capacity in both SED and LEX (P b 0.01) which was amplified by HIIT. Echocardiography and cardiac strain measures were unremarkable apart from trivial increase to intra-ventricular septum diastole (IVSd) (P b 0.05) and decrease to left ventricular internal dimension diastole (LVId) (P b 0.05) in LEX following HIIT. Conclusions: A programme of preconditioning exercise with HIIT induces clinically relevant improvements in blood pressure, rate pressure product and encourages recovery of heart rate reserve in SED, while improving maximal MET capacity in both SED and LEX without inducing any pathological cardiovascular remodeling. These data add to the emerging repute of HIIT as a safe and promising exercise prescription to improve cardiovascular function and metabolic capacity in sedentary aging