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

Denis Cesar Leite Vieira,1 Ramires Alsamir Tibana,1 Vitor Tajra,1 Dahan da Cunha Nascimento,1 Darlan Lopes de Farias,1 Alessandro de Oliveira Silva,1 Tatiane Gomes Teixeira,1 Romulo Maia Carlos Fonseca,2 Ricardo Jacó de Oliveira,2 Felipe Augusto dos Santos Mendes,2 Wagner Rodrigues Martins,2 Silvana Schwerz Funghetto,2 Margo Gomes de Oliveira Karnikowski,2 James Wilfred Navalta,3 Jonato Prestes11Graduate Program on Physical Education, Catholic University of Brasilia, Brasilia, Brazil; 2University of Brasilia, UnB, Brasilia, Brazil; 3Department of Kinesiology and Nutrition Sciences of the University of Nevada, Las Vegas, NV, USAPurpose: 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/m2), 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/m2). 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.Keywords: metabolic syndrome, functional capacity, muscle performance, agin

Ações e possibilidades de prevenção de acidentes com crianças em creches de Fortaleza, Ceará Actions and possibilities of accidents prevention with children in daycare at Fortaleza, Ceará State

Este estudo descreve o cotidiano de professoras da educação infantil, em creches de Fortaleza, Ceará, Brasil, bem como as ações desenvolvidas e as possibilidades de prevenção de acidentes com crianças, nesse espaço educativo e de cuidado à saúde. Trata-se de um estudo descritivo, com abordagem qualitativa, realizado com 17 professoras de Educação Infantil, que trabalhavam em creches da Secretaria Executiva Regional VI, em Fortaleza, Ceará, em 2004. A entrevista semi-estruturada conduziu à coleta de dados e esses foram analisados à luz do Discurso do Sujeito Coletivo (DSC). Os resultados evidenciaram que as professoras concebem esse tipo de acidente como passível de prevenção mediante a orientação à família, alterações físicas no espaço domiciliar e elaboração e cumprimento de leis específicas. Reconhecem que a agilidade e curiosidade da criança favorecem a ocorrência dos acidentes. Em suas práticas, relatam e propõem vigilância, mudanças na estrutura física das creches e educação por meio de orientações às crianças, professores, pais ou responsáveis, estendendo-se à comunidade. Portanto, é preciso que os profissionais de saúde compartilhem sua prática de cuidado com os profissionais do setor da educação, não só prevenindo acidentes e outros agravos à saúde humana, mas, sobretudo, ampliando conceitos que contribuam com a Promoção da Saúde.<br>This paper describes the daily of infantile education teachers in day-cares in the city of Fortaleza, Ceará, Brazil as well as the developed actions and the possibilities of prevention accidents' with children, in this educative space of health care. It is a descriptive study, using a qualitative approach that involved 17 day care teachers working at the 6th Regional Executive Office (Fortaleza, Ceará, Brazil) in the year of 2004. A semi-structured interview was used to collect the data, which was analysed using the Collective Subject Discourse (CSD) technique. The results showed that teachers believe that this type of accident is preventable through family orientation, physical modifications of house spaces and creation and enforcement of specific laws. They recognise children's agility and curiosity, which facilitate the occurrence of accidents. In their practices, they report and suggest vigilance, physical changes at the day care centers, and education, through orientation directed to children, teachers, parents (or care givers), and the community. Therefore, health care professionals should share their 'caring' practice with professionals in the educational area, not only in order to prevent accidents and other human health afflictions, but also to expand concepts that contribute Health Promotion