Proceso de envejecimiento: cambios en la composición corporal y uso terapéutico de los exergames en la rehabilitación del adulto mayor institucionalizado

El proceso de envejecimiento cursa con limitaciones funcionales que, sin programas de prevención y rehabilitación desencadenan en dependencia e institucionalización. El objetivo fue detectar alteraciones en la composición corporal en el proceso de envejecimiento, así como analizar el impacto de un programa de rehabilitación basado en el uso de exergames como método para mejorar el estado físico, cognitivo, psicológico y funcional de las personas mayores. Los resultados mostraron que disminuyeron los niveles de fragilidad, depresión, ansiedad, apatía y el riesgo de caída y aumentaron la velocidad de la marcha, el equilibrio estático, los niveles de atención y la memoria. En conclusión, este estudio permite la identificación de alteraciones en la composición corporal demostrando que, mediante un programa de rehabilitación con videoconsola Wii mejoran áreas alteradas durante el proceso de envejecimiento, haciendo de la fragilidad una situación reversible

Influence of Teaching Style on Physical Education Adolescents’ Motivation and Health-Related Lifestyle

According to various WHO reports in 2018, a large number of adolescents worldwide are either overweight or obese. This situation is the result of not following a healthy and balanced diet, combined with a lack of practice of physical activity. In this sense, Physical Education classes could help to solve the problem. The present study seeks to analyze the relationship between the role of the teacher in relation to the structural dimensions of the PE teaching environment and the basic psychological needs and self-motivation of adolescents as determinants of their behaviors related to eating habits and the practice of physical activity. A total of 1127 secondary school adolescents between the ages of 13 and 18 participated in this study. Questionnaires were used: Perceived Autonomy Support Scale, Psychologically Controlling Teaching Scale, Basic Psychological Needs in Physical Education, Frustration of Psychological Needs in PE context, Physical Activity Class Satisfaction Questionnaire, Perceived Locus of Causality Revised, and WHO’s Global school-based student health survey. A structural equations model was elaborated to explain the causal relationships between the variables. The results showed that autonomy support positively predicted the three structural dimensions of PE classes, while, in contrast, they were negatively predicted by psychological control. The three structural dimensions positively predicted the satisfaction of psychological needs and negatively predicted the thwarting of psychological needs. Self-determined motivation was positively predicted by the satisfaction of psychological needs and negatively predicted by the thwarting of psychological needs. Finally, self-determined motivation positively predicted healthy eating habits and the practice of physical activity and negatively predicted unhealthy eating habits. Certainly, the results obtained in this study support the postulates of the self-determination theory, demonstrating the predictability of PE class context towards the adoption of healthy lifestyle habits, such as a proper diet and the regular practice of physical activity

Influence of the use of Wii games on physical frailty components in institutionalized older adults

Producción CientíficaAging is a multifactorial physiological phenomenon in which cellular and molecular changes occur. These changes lead to poor locomotion, poor balance, and an increased falling risk. This study aimed to determine the impact and effectiveness of the use of the Wii® game console on improving walking speed and balance, as well as its influence on frailty levels and falling risk, in older adults. A longitudinal study was designed with a pretest/post-test structure. The study population comprised people over 75 years of age who lived in a nursing home or attended a day care center (n = 80; 45 women; 84.2 ± 8.7 years). Forty of them were included in the Wii group (20 rehabilitation sessions during 8 consecutive weeks), and the other 40 were in the control group. Falling risk and frailty were evaluated using the Downton scale and Fried scale; balance and walking speed were assessed with the Berg Balance scale and the Gait Speed Test, respectively, as well as the Short Physical Performance Battery (SPPB). The results showed that there was no significant association between Frailty Phenotype and study groups in baseline. However, there was significant association between Frailty Phenotype and study groups at the end of study. Moreover, a significantly higher and negative percentage change (Δ) in the Wii group with respect to the control group on the in falling risk (−20.05 ± 35.14% vs. 7.92 ± 24.53%) and in walking speed (−6.42 ± 8.83% vs. −0.12 ± 4.51%) during study, while there was a higher and positive significant percent change in static balance (6.07 ± 5.74% vs. 2.13 ± 4.64%) and on the SPPB (20.28 ± 20.05% vs. 0.71 ± 7.99%) after 8 weeks of study. The main conclusion of this study was that the use of the Wii® video console for 8 weeks positively influenced walking speed, falling risk, static balance, and frailty levels in older adults. Through a rehabilitation program with the Wii® game console in the older adults, frailty levels are reduced, accompanied by a reduction in falling risk and an increase in static balance and walking speed

Impact of an intervention with Wii video games on the autonomy of activities of daily living and psychological–cognitive components in the Institutionalized elderly

Producción CientíficaAs people age, the risk of disease increases and deterioration becomes more noticeable. These changes can increase the risk of cognitive impairment, with negative consequences for the quality of life and the ability to perform activities of daily living (ADLs) in older people, which translate into greater dependence and loss of wellness. This study aimed to determine the impact and effectiveness of the use of the Wii® game console (Nintendo Company Limited, Kyoto, Japan) on improving performance of basic and instrumental ADLs, as well as its relationship with cognitive impairment levels and mood in institutionalized older people. A longitudinal study was designed, whose study population consisted of people over 75 years of age who lived in a nursing-home or attended a day care center (n = 80; 45 women). Cognitive status was assessed using Lobo’s Mini-Cognitive Examination (MCE) and Global Deterioration Scale (FAST-GDS), while the psychological assessment used the Dementia Apathy Interview and Rating (DAIR), Yesavage scale for Geriatric Depression (EGD-15), and Goldberg Anxiety and Depression Scale (EADG). Differences from T1 to T2 in the control group (control; n = 40; 23 women; 83.25 ± 8.78 years; 76.35 ± 13.54 kg) and in the experimental group (Wii; n = 40; 22 women; 85.05 ± 8.63 years; 74.60 ± 13.01 kg) were evaluated using a paired Student’s t-test or Wilcoxon’s signed rank test, and a two-way repeated measures analysis of variance (ANOVA) test. Differences in Δ (%) and other tests at T1 and T2 were compared using the independent t-test or Mann–Whitney U test, with the treatment category as a fixed factor. The results showed that the Wii® video console had a positive influence for older people, increasing cognitive status and levels of ADLs, and psychological status. In addition, a positive correlation between performance of ADLs and cognitive status was observed, as well as a negative correlation with the psychological status. Through a rehabilitation program with a Wii® game console in the elderly, depression, anxiety and apathy levels were reduced, accompanied by an increase in memory and attention, as well as in performance of basic and instrumental ADLs

Previous falls and risk of falls in relation to fragility

Esta investigación descriptiva transversal estudia la relación entre el número de caídas durante el último mes y el riesgo de caídas de una parte; y la situación de fragilidad en adultos mayores de otra parte; en una muestra de 194 personas mayores institucionalizadas. La fragilidad se mide con la herramienta Short Physical Performance Battery, las caídas previas durante el último mes se recogen de manera numérica y el riesgo de caídas se mide mediante la escala Downton. Los resultados no muestran diferencias significativas entre los grupos de fragilidad en relación al número de caídas previas durante el último mes. Sin embargo, sí que existen diferencias significativas entre los grupos de fragilidad que establece el SPPB y el riesgo de caídas; así, ya desde los resultados descriptivos se observa como las medias obtenidas en riesgo de caídas aumentan según el continumm robusto-prefrágil-frágil-dependiente avanza hacia la dependencia. En relación a las diferencias entre grupos, se encuentra que el grupo dependiente tiene diferencias significativas con todos los demás (p=,001); además, existen diferencias significativas entre frágil y robusto (p=,003). Por el contrario en las relaciones frágil-prefrágil y prefrágil-robusto las diferencias no son significativas. Los resultados obtenidos permiten la detección de la población con mayor riesgo de caídas, lo que posibilitaría implementar intervenciones precoces encaminadas a la prevención de caídas en base a las diferencias encontradas entre los grupos.This descriptive transversal research studies the relationship between number of falls in the last month and fall risk on one side; and frailty situation in older adults on the other side; through a 194 old institutionalized people sample. Frailty is measured with the Short Physical Performance Battery; previous falls in the last month are measured with the number of events, and fall risk with Downton scale. The results do not show any significant differences in frailty groups related to the number of previous falls in the last month. However, significant differences do exist between frailty groups established in SPPB and fall risk; then, since descriptive results, they show how the arithmetical averages in fall risk increase as the continuum robust-prefrail-frail-dependent advances towards dependency. Concerning differences between groups, it is found that dependent group has got significant differences with all other (p=,001), there are significant differences also in frail-robust (p=,003). In opposition, the relation frail-prefrail and frail-robust do not show any significant differences Results allow the detection of high level fall risk population, which enables early intervention implementations aimed to falls prevention based on differences found between groups.peerReviewe

Basic and instrumental activities in relation to the situation of fragility

Esta investigación descriptiva transversal estudia la relación de la situación de fragilidad en adultos mayores y la existencia o no de dependencia para las actividades de la vida diaria divididas en básicas e instrumentales con una muestra de 194 personas mayores institucionalizadas. La fragilidad se mide con la herramienta Short Physical Performance Battery, las actividades básicas de la vida diaria mediante el Índice de Barthel y las actividades instrumentales de la vida diaria con la escala de Lawton y Brody. Los resultados descriptivos muestran como las medias obtenidas en ambas actividades de la vida diaria disminuyen según el continumm robusto-prefrágil-frágil-dependiente avanza hacia la dependencia. Las diferencias en todas las subescalas de la Short Phisical Performance Battery son significativas, al igual que en Barthel y Lawton y Brody (p<,001). En relación al Barthel y los grupos del SPPB se encuentra que todos los grupos obtienen diferencias significativas entre sí (,007>p>,001) excepto en la relación robusto-frágil, en el que las diferencias no son significativas. En cuanto Lawton y Brody las diferencias son significativas (,041>p>,001); exceptuando el caso de los grupos frágil y prefrágil. Las diferencias encontradas entre los grupos permiten un diagnóstico precoz e intervenciones encaminadas a la prevenir o revertir el avance hacia una situación de dependencia.This descriptive transversal research studies frailty situation in older adults and basic and instrumental activities of daily living relationship through a 194 old institucionalized people sample. Frailty is measured with the Short Physical Performance Battery; basic activities of daily living with Barthel Index and instrumental activities of daily living with Lawton and Brody scale. Descriptive results show how the arithmetical averages in both activities of daily living decrease as the continuum robust-prefrail-frail-dependent advances towards dependency. There are significant differences in all subscales of Short Physical Performance Battery, as well as in Barthel and Lawton and Brody (p<,001). Regarding to Barthel and SPPB groups, significant differences among all of them were found (,007>p>,001), except in the robust-prefrail relation, where differences are not meaningful. Concerning Lawton and Brody, differences are significant (,041>p>,001); except in fragil-prefrail relation. The differences found between groups allow an early diagnosis and interventions aimed to prevent or reverse the progress towards a dependency situation.peerReviewe

Ansiedad, depresión y apatía en relación a la situación de fragilidad

This descriptive, transversal research studies the relationship between frailty in institutionalized old people and anxiety, depression and apathy in a 193 old people sample institutionalized in four old people’s homes.Frailty is measured with Short Physical Performance Battery; anxiety and depression with Goldberg scale; and apathy with Dementhia Apathy Interview and Rating.It is about a descriptive and transversal research that does not make any intervention on people participating and aims to establish if there is or there is not a relationship between variables, but not a causality relationship.It is shown that the three variables correlate with total punctuation in frailty scale and with all its subscales; so that, a higher frailty and/or dependency, corresponds to higher levels of anxiety, depression and apathy.There are also significant differences between frail and prefrail people groups in relation to apathy; and between dependent and prefrail groups in relation to anxiety and depression.Esta investigación descriptiva transversal estudia la relación de la situación de fragilidad en adultos mayores institucionalizados y la ansiedad, depresión y apatía en los mismos con una muestra de 193 personas mayores institucionalizadas en cuatro residencias para personas mayores.La fragilidad se mide con la herramienta Short Physical Performance Battery; la ansiedad y la depresión con la escala Goldberg; y la apatía con la escala Dementhia Apathy Interview and Rating.Se trata de un estudio transversal y descriptivo que no realiza ningún tipo de intervención sobre las personas participantes y pretende establecer si existe o no relación entre las variables, pero no una relación de causalidad entre ellas.Se observa que las tres variables correlacionan con la puntuación total de la escala de fragilidad y con cada una de sus subescalas; de manera que, a mayor situación de fragilidad y/o dependencia, mayores niveles de ansiedad, depresión y apatía.Aparecen además diferencias significativas entre el grupo de personas frágiles y prefrágiles en lo referente a la apatía; y entre los grupos dependiente y prefrágil en relación a la ansiedad y la depresión

Relationship of Body Composition with the Strength and Functional Capacity of People over 70 Years

Producción CientíficaBackground: Aging is a multifactorial physiological phenomenon, in which a series of changes in the body composition occur, such as a decrease in muscle mass and bone mineral density and an increase in fat mass. This study aimed to determine the relationship of muscle mass, osteoporosis, and obesity with the strength and functional capacity of non-dependent people over 70 years of age. Methods: A cross-sectional study was designed, whose study population was all people aged over 70 years, living independently and attending academic and recreational programs. Muscle strength and functional capacity of the participants were assessed by isometric exercises of lower and upper limbs and by four tests taken from the Senior Fitness Test, respectively. Bone mineral density, total mass, fat mass, total lean mass, arms lean mass, legs lean mass, and appendicular lean mass (ALM) was calculated by dual energy X-ray absorptiometry. Differences in muscle strength and functional capacity, according to the sex, muscle mass, mineral bone density and fat mass, were measured by &chi;2 test, independent samples Student&rsquo;s t-test, analysis of covariance and a 2-factor analysis of covariance; Results: 143 subjects were included in the study group. Men and women with an adequate amount of ALM adjusted for body mass index (BMI) had a maximal dynamic biceps strength in a single repetition, a maximal isometric leg extension strength, a maximal dynamic leg extension strength in a single repetition, a maximum right hand grip strength and maximum hand grip strength (the highest). Significantly higher values were observed in the maximal isometric biceps&rsquo; strength in men with osteoporosis. Obese men had less isometric strength in the biceps and took longer to perform the chair stand test; Conclusions: Men and women with an adequate amount of ALM adjusted for BMI obtained better results in tests of muscle strength and functional capacity. However, osteoporosis and obesity are not related to these parameters

Factores de riesgo en el ictus - influencia de la edad

Objective: To analyze the influence of different risk factors on the age at which a stroke occurs. Method: An observational cross-sectional study was conducted including all patients admitted consecutively with ischemic stroke at the University Hospital of Burgos (Spain). Sociodemographic and clinical, parameters were collected, exploring possible association with patient’s age by univariate and multivariate analysis. Results: 436 patients were included, with a mean age of 75.39 years (SD ±12.674). The most frequent risk factors were high blood pressure and cardiovascular disease. In the case of having a personal history of arterial hypertension (Odds Ratio [OR] 2.49; 95% Confidence Interval [CI] 1.49-4.16), having a sedentary lifestyle (OR 3.24; 95%CI 1.97-5.31) was related with a greater probability that the patient is aged 75 years or older. However, being overweight/obese (OR 0.51; 95%CI 0.30-0.88), being an active smoker (OR 0.47; 95%CI 0.02-0.11) or alcohol consumption (OR 0.42; 95%CI 0.26-0.69) increased the probability of stroke occurrence before 75 years. Conclusion: The age of occurrence of a case is related to the occurrence of certain risk factors, which are determined in the planning of future education campaigns.Objetivo: Analizar la influencia que los distintos factores de riesgo ejercen sobre la edad a la que se produce un ictus. Método: Estudio observacional transversal en el que se incluyeron a todos los pacientes con ictus ingresados de forma consecutiva en el Hospital Universitario de Burgos (España). Se recogieron parámetros sociodemográficos y clínicos, estudiándose su posible relación con la edad mediante análisis univariante y multivariante. Resultados: Se incluyeron 436 pacientes, siendo la edad media de 75,39 años (DE ±12,674). Los factores de riesgo más frecuentes fueron la hipertensión arterial y la enfermedad cardiovascular. Se observó que el tener antecedentes personales de hipertensión arterial (OR 2,49; IC95% 1,49-4,16) ó el no tener un estilo de vida sedentario (OR 3,24; 1,97-5,31) se relacionó con una mayor probabilidad de que el paciente tuviera una edad igual o superior a 75 años. Sin embargo, el tener sobrepeso/obesidad (OR 0,51; IC95% 0,30-0,88), el ser fumador activo (OR 0,47; 0,02-0,11) ó el consumir alcohol (OR 0,42; 0,26-0,69) aumentó la probabilidad de que el ictus ocurriera antes de 75 años. Conclusión: La edad de aparición de un ictus se relaciona con la ocurrencia de determinados factores de riesgo, los cuales deberían ser considerados en la planificación de futuras campañas educacionales