Dual task effects on functional performance in community-dwelling elderly

The purpose was to assess the effect of six different dual tasks in community dwelling elderly. Thirty-five volunteers (aged 69.6±7.1 years) were submitted to the Timed Up and Go test (TUG) and to further five tasks wherein TUG was associated to two motor tasks - carrying a glass of water (TUGM1) and transferring coins from one pocket to another (TUGM2); to two cognitive tasks - repeating a sentence (TUGC1) and saying weekdays backwards (TUGC2); and to a motor-cognitive task, of carrying a glass of water while repeating a sentence (TUGMC). Time spent, failure and success in each task were counted. Results showed a significant decrease in average time (in seconds) spent in TUG when associated with all tasks; and a significant correlation from moderate (r=0.676) to almost perfect (r=0.953) between the times of each association with TUG. The number of transferred coins in TUGM2 and the number of days of the week correctly said in TUGC2 showed a correlation with the time spent in all the other tasks. These two tasks most affected the time spent to accomplish TUG (pO objetivo deste estudo foi avaliar o efeito de seis diferentes tarefas duplas no desempenho funcional de idosos da comunidade. Em 35 idosos com idade média de 69,6±7,1 anos foi aplicado o teste de levantar e caminhar cronometrado (TLCC, Timed up and go ou TUG) simples (TLCCS) e associado a duas tarefas motoras - carregar um copo com água (TLCCM1) e transferir moedas de um bolso para o outro (TLCCM2) - e duas cognitivas, repetir uma frase (TLCCC1) e falar os dias da semana em ordem inversa (TLCCC2), sendo aferidos os acertos e erros nessas tarefas. Houve piora significativa da média do tempo em segundos no TLCC nas tarefas duplas, independente da tarefa, e correlação significativa, de moderada (r=0,676) a quase perfeita (r=0,953), entre os tempos de cada tipo de TLCC. O número de moedas transferidas no TLCCM2 e o número de dias na semana dito em ordem inversa no TLCCC2 apresentaram correlação com o tempo gasto para realizar todas as outras tarefas. Essas duas tarefas foram as que mais afetaram o tempo do TLCC (

Comparación de la fuerza muscular respiratoria entre los subgrupos de fragilidad en añosas de la comunidad

La fragilidad está compuesta por un trípode constituido por: sarcopenia, disfunción inmunológica y desregulación neuroendócrina. La sarcopenia es definida como una disminución de la fuerza y de la potencia muscular, donde los músculos respiratorios también son afectados. El objetivo fue comparar la fuerza muscular respiratoria (FMR) en añosas residentes en la comunidad, clasificadas como no frágiles (NF), pre-frágiles (PF) y frágiles (F) y correlacionar la FMR con la fuerza de prensión manual (FPM). El estudio fue del tipo transversal, con una muestra de conveniencia compuesta por 106 añosas. Las participantes fueron clasificadas en cuanto al fenotipo de fragilidad. La FMR fue evaluada por medio de la presión inspiratoria máxima (PImáx) y de la presión expiratoria máxima (PEmáx). Fueron encontradas diferencias significativas de la FMR entre los grupos NF y F (PImáx: p=0,001 y PEmáx: pThe fragility consist in a tripod comprising: sarcopenia, immune dysregulation, and neuroendocrine dysfunction. Sarcopenia is defined as a decrease in strength and muscle power, so that the respiratory muscles are also affected. The aim was to compare respiratory muscle strength (RMS) in elderly community residents, classified as nonfrail (NF), pre frail (PF) and frail (F), and correlate RMS with the handgrip strength (HS). The study was cross-sectional, with a convenience sample of 106 elderly women. Participants were classified according to the phenotype of frailty. The RMS was assessed by maximal inspiratory pressure (MIP) and maximum expiratory pressure (MEP). Significant differences were found in RMS between groups NF and F (MIP: p=0.001 and MEP: pA fragilidade é composta por um tripé constituído por: sarcopenia, disfunção imunológica e desregulação neuroendócrina. A sarcopenia é definida como uma diminuição na força e na potência muscular, sendo que os músculos respiratórios também são afetados. O objetivo foi comparar a força muscular respiratória (FMR) em idosas residentes na comunidade, classificadas como não frágeis (NF), pré-frágeis (PF) e frágeis (F) e correlacionar a FMR com a força de preensão manual (FPM). O estudo foi do tipo transversal, com uma amostra de conveniência composta por 106 idosas. As participantes foram classificadas quanto ao fenótipo de fragilidade. A FMR foi avaliada por meio da pressão inspiratória máxima (PImáx) e da pressão expiratória máxima (PEmáx). Foram encontradas diferenças significativas da FMR entre os grupos NF e F (PImáx: p=0,001 e PEmáx:

Efeito de um programa de treinamento funcional no equilíbrio postural de idosas da comunidade

Functional training programs may help reduce elderly disabilities, falls, and emotional and social problems. The aim of this study was to assess the impact of an eight-week functional exercise program on aged women's instrumental activities of daily living (IADL) and one-foot stance balance. Irrespective of race and/or social condition, 7 community-dwelling elderly women (aged 71±8.1) were selected, being excluded those with cognitive impairment, acute or neurological diseases, spine or joint pain, labyrinth inflammatory disease, visual impairment, fractures in the previous year, and use of gait aid. All subjects were assessed by the Lawton IADL scale and the one-foot stance balance test, before and after the program. Exercises were performed three times a week and consisted of gait exercises in plantar flexion, dorsiflexion, alternation of sustained one-foot stance, sideways gait, gait with increased hip flexion, and tandem gait. Results show a functional improvement in IADL (p=0.042) as measured by the Lawton scale, and a trend towards better static one-foot stance balance, though not significant (p>;0.105). The proposed program of functional exercises may thus be said to bring about improvement in older women's functional performance and a trend towards improvement on static balance, suggesting its relevance to increase elderly women's autonomy.Programas de treino funcional podem colaborar na redução de incapacidades, quedas, problemas emocionais e sociais em idosos. O objetivo do estudo foi verificar o efeito de um programa de oito semanas de exercícios funcionais em idosas da comunidade, avaliando o impacto nas atividades instrumentais de vida diária (AIVD) e no equilíbrio unipodálico. Deste estudo quasi-experimental participaram sete idosas da comunidade (71±8,1 anos), sem distinção de raça e/ ou condição social, excluindo-se aquelas com alterações cognitivas, doenças agudizadas ou neurológicas, quadro álgico na coluna ou articulações, labirintite, distúrbios visuais não-compensados, fratura prévia no último ano e utilização de apoio para a marcha. Todas responderam ao questionário de Lawton e se submeteram ao teste de apoio unipodálico antes e depois do programa, administrado três vezes por semana. O programa consistia em exercícios de marcha em flexão plantar, dorsiflexão, permanência em alternância de apoio unipodálico, marcha lateral com flexão de quadril aumentada e marcha tandem. Os resultados indicam melhora (p=0,042) no nível funcional (índice de Lawton) após o programa e uma tendência à melhora no equilíbrio unipodálico, embora não-significante (p>;0,105). O programa de exercícios proposto produziu pois melhora no desempenho das AIVD e uma tendência à melhora do equilíbrio estático, sugerindo ser relevante para aprimorar a autonomia das idosas

Comparison of respiratory muscle strength between fragility subgroups in community elderly

A fragilidade ? composta por um trip? constitu?do por: sarcopenia, disfun??o imunol?gica e desregula??o neuroend?crina. A sarcopenia ? definida como uma diminui??o na for?a e na pot?ncia muscular, sendo que os m?sculos respirat?rios tamb?m s?o afetados. O objetivo foi comparar a for?a muscular respirat?ria (FMR) em idosas residentes na comunidade, classificadas como n?o fr?geis (NF), pr?-fr?geis (PF) e fr?geis (F) e correlacionar a FMR com a for?a de preens?o manual (FPM). O estudo foi do tipo transversal, com uma amostra de conveni?ncia composta por 106 idosas. As participantes foram classificadas quanto ao fen?tipo de fragilidade. A FMR foi avaliada por meio da press?o inspirat?ria m?xima (PIm?x) e da press?o expirat?ria m?xima (PEm?x). Foram encontradas diferen?as significativas da FMR entre os grupos NF e F (PIm?x: p=0,001 e PEm?x: p<0,001) e entre os grupos PF e F (PIm?x: p<0,001 e PEm?x: p<0,001). Em rela??o ? FPM, foram observadas diferen?as significativas entre todos os grupos (p<0,001). Houve correla??o entre FMR e FPM apenas no grupo fr?gil. Desta forma, a FPM pode ser importante na pr?tica cl?nica para diferenciar os subgrupos de fragilidade e identificar a perda de for?a muscular, incluindo a perda da FMR.Funda??o de Amparo ? Pesquisa do Estado de Minas Gerais (FAPEMIG)Empresa de Pesquisa Agropecu?ria de Minas Gerais (EPAMIG)Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq)Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES)The fragility consist in a tripod comprising: sarcopenia, immune dysregulation, and neuroendocrine dysfunction. Sarcopenia is defined as a decrease in strength and muscle power, so that the respiratory muscles are also affected. The aim was to compare respiratory muscle strength (RMS) in elderly community residents, classified as nonfrail (NF), pre frail (PF) and frail (F), and correlate RMS with the handgrip strength (HS). The study was cross-sectional, with a convenience sample of 106 elderly women. Participants were classified according to the phenotype of frailty. The RMS was assessed by maximal inspiratory pressure (MIP) and maximum expiratory pressure (MEP). Significant differences were found in RMS between groups NF and F (MIP: p=0.001 and MEP: p<0.001) and between groups PF and F (MIP: p<0.001 and MEP: p<0.001). In relation to HS, significant differences were observed between all groups (p<0.001). There was correlation between HS and RMS only in the frail group. Thus, the HS may be important in the clinical evaluation to differentiate subgroups of fragility and identify the loss of muscle strength, including the loss of RMS

Influência da circunferência abdominal sobre o desempenho funcional de idosas

O objetivo do estudo foi comparar o desempenho funcional de idosas segundo a medida de suas circunfêrencias abdominais (CA). Foram avaliadas 48 idosas, divididas nos grupos 1, com CA&gt;88 cm, e grupo 2, de CAThe purpose of this study was to compare physical performance of elderly women according to their waist circumference (WC). Forty-eight elderly women were divided into group 1, with WC&gt;88 cm, and group 2, with W

Translation and cultural adaptation of the Minnesota Leisure Time Activities Questionnaire in community-dwelling older people

OBJECTIVE: To execute the process of translation and cultural adaptation of the Minnesota Leisure Time Activities Questionnaire for the Portuguese-Brazil and to verify its intra and inter-rater reliability in community-dwelling elderly. METHODS: Thirty-nine elderly were evaluated (71.2 ± 6.8 y.), irrespective of gender, race and/or social class, being excluded those who had cognitive impairment (Mini-Mental State Exam, the Brazilian version). The process of translation and cultural adaptation followed the criteria proposed by Beaton et al. (2000). The data analysis was done to the intra-class coefficient correlation in the annual and the last two weeks activities. The visual analysis was done for the Bland and Altman graphics'. RESULTS:: There was a strong significant intra and inter-rater concordance for the application concerning the last two weeks (ICC = 0.911, p = 0.000, ICC = 0.777, p = 0.000), and for the information concerning the annual activities (ICC = 0.969, p = 0.000, ICC = 0.791, p = 0.000) performed by the elderly. The validity analyses had a satisfactory result considering the average of differences seen through Bland-Altman graphics, with a little variability between measures. CONCLUSION: The results found allow to state that the Portuguese-Brazil version of the Minnesota Leisure Time Activities Questionnaire can be used as a tool to verify the weekly and/or annual calorie consumption in community-dwelling elders.</p

Dual task in dwelling-elder women: analysis of the Timed Up and Go between fallers and non fallers

OBJECTIVE: Evaluating the functional performance during the accomplishment of Timed Up and Go (TUG) test, first in an isolated way, then associated with motor dual task, and after associated with cognitive dual task in order to compare elderlies with fall history, no fall history and those ones with "cadentis tremble". METHODS: Elderly women from the community, with no distinction of race and social class participated of this study. The ones with cognitive alterations (Meem), dependent march, visual alterations, not compensated hearing, acute muscle-skeletal pain, use of medications that interfere on the balance were excluded. All of them accomplished the TUG, TUG associated with carrying a complete glass of water (motor task), TUG associated with saying animal names (cognitive task). The comparison between groups was made through ANOVA (\u3b1 = 5%). RESULTS: Thirty-six community elderlies (70.17 ± 6.25 years) participated of this study: six of them were classified as fallers, twenty as non fallers and ten with presence of "cadenti tremble" presence. When compared the three groups, in the three different moments of the test, there was not any statistic difference (p&gt; 0.05). In the intra-group comparison, during the three moments of the test, it was observed a statistic difference on the fallers group, being this difference between the simple TUG and the cognitive TUG (p = 0.01). Other analysis were not significant enough. CONCLUSION: Faller elders, non fallers and the ones with the "cadenti tremble" presence were not different in relation to functional performance. Faller elderlies showed a worse performance on the cognitive TUG when compared to the simple TUG, suggesting the necessity of a specific training.</p

Comparação das distâncias previstas e percorridas no incremental shuttle walking test em idosos comunitários

O objetivo deste estudo foi avaliar a validade externa de três equações de referência para o cálculo da distância a ser percorrida no incremental shuttle walking test (ISWT) por idosos comunitários, e, por fim, identificar qual equação prediz melhor a distância nessa faixa etária. Foram selecionados 84 idosos cadastrados nas Unidades Básicas de Saúde de Diamantina, Minas Gerais. Os voluntários foram submetidos ao ISWT e a distância percorrida em metros até a interrupção do teste foi registrada e utilizada para comparação com as equações de predição. Os voluntários apresentaram média de idade de 73,15±5,89 anos e alguns comprometimentos de saúde comuns dessa faixa etária, sendo a maioria mulheres e praticantes de atividade física. A análise estatística demonstrou que houve interação entre os fatores, ou seja, existe diferença entre as distâncias obtidas pelo ISWT e as distâncias obtidas pelas equações. Houve diferença também nas comparações entre os sexos (p&lt;0,05) e a Equação 1 apresentou maior força de correlação (p&lt;0,0001; r=0,414) com a distância real percorrida em relação às outras equações. Portanto, este estudo demonstrou uma diferença na comparação das distâncias real e calculadas por três equações de predição do ISWT, sugerindo que as equações utilizadas podem superestimar a distância percorrida pelos idosos, e que entre essas a Equação 1 apresentou uma predição mais próxima da distância percorrida para a amostra de idosos avaliada.El objetivo de este estudio fue evaluar la validez externa de tres ecuaciones de referencia para calcular la distancia recorrida de la incremental shuttle walking test (ISWT) para ancianos comunitarios, así como identificar la ecuación que mejor predice la distancia en este grupo de edad. Se seleccionaron a 84 ancianos inscritos en las Unidades Básicas de Salud de Diamantina, Minas Gerais (Brasil). Se aplicaron a los voluntarios la ISWT, y la distancia recorrida en metros hasta la interrupción de la prueba se registró y se utilizó para comparar con las ecuaciones de predicción. Los voluntarios tenían un promedio de edad de 73,15±5,89 años y algunos problemas de salud habituales en este grupo de edad, de los cuales la mayoría fue mujeres y practicantes de actividad física. El análisis estadístico mostró que hubo una interacción entre los factores, es decir, existe una diferencia entre las distancias obtenidas por ISWT y las distancias obtenidas por las ecuaciones. También hubo una diferencia en las comparaciones entre los sexos (p&lt;0,05), y la Ecuación 1 mostró una mayor fuerza de correlación (p&lt;0,0001; r=0,414) con la distancia real recorrida en relación con las otras ecuaciones. Por lo tanto, este estudio demostró una diferencia en la comparación de las distancias reales y calculadas por tres ecuaciones de predicción de ISWT, lo que sugiere que las ecuaciones utilizadas pueden sobreestimar la distancia recorrida por los ancianos y que entre estas la Ecuación 1 presentó una predicción más cercana a la distancia recorrida por la muestra evaluada.Our study aimed to evaluate the external validity of three reference equations for estimating the distance to be covered in the incremental shuttle walking test (ISWT) by older adults and to identify which equation best predicts the distance for this age group. In total, 84 older adults registered in the Health Centers of Diamantina, state of Minas Gerais, Brazil, were selected. The volunteers were subjected to the ISWT and the distance covered, in meters, until the interruption of the test was recorded and compared with the prediction equations. The volunteers had a mean age of 73.15±5.89 years and some health problems common to this age group, were mostly women, and physically active. Statistical analysis showed an interaction between the factors, that is, a difference between the distances covered the ISWT and the distances obtained by the equations. The analysis showed a difference between the men and women (p&lt;0.05) and Equation 1 showed a greater correlationstrength (p&lt;0.0001; r=0.414) with the distance covered compared to the other equations. Therefore, our study showed a difference in the comparison of the distances covered and those estimated by three ISWT prediction equations, suggesting that the equations used may overestimate the distance covered by older adults, and that, Equation 1 showed a prediction closer to the distance covered

Adiponectin Is a Contributing Factor of Low Appendicular Lean Mass in Older Community-Dwelling Women: A Cross-Sectional Study

Inflammation is a chronic, sterile, low-grade inflammation that develops with advanced age in the absence of overt infection and may contribute to the pathophysiology of sarcopenia, a progressive and generalized skeletal muscle disorder. Furthermore, a series of biomarkers linked to sarcopenia occurrence have emerged. To aid diagnostic and treatment strategies for low muscle mass in sarcopenia and other related conditions, the objective of this work was to investigate potential biomarkers associated with appendicular lean mass in community-dwelling older women. This is a cross-sectional study with 71 older women (75 ± 7 years). Dual-energy X-ray absorptiometry was used to assess body composition. Plasmatic blood levels of adipokines (i.e., adiponectin, leptin, and resistin), tumor necrosis factor (TNF) and soluble receptors (sTNFr1 and sTNFr2), interferon (INF), brain-derived neurotrophic factor (BDNF), and interleukins (IL-2, IL-4, IL-5, IL-6, IL-8, and IL-10) were determined by enzyme-linked immunosorbent assay. Older women with low muscle mass showed higher plasma levels of adiponectin, sTNFr1, and IL-8 compared to the regular muscle mass group. In addition, higher adiponectin plasma levels explained 14% of the lower appendicular lean mass. High adiponectin plasmatic blood levels can contribute to lower appendicular lean mass in older, community-dwelling women