Association of chronic pain with strength, levels of stress, sleep and quality of life in women over 50 years

La literatura presenta la necesidad de investigar los dolores osteoarticulares crónicos en ancianos, ya que estos dolores influencian negativamente parámetros biopsicosociales. Entender la relación entre las dimensiones del dolor y los parámetros de salud de los individuos afectados es necesario para un mejor enfoque preventivo y terapéutico. Este trabajo tiene el objetivo de identificar relaciones entre niveles de dolores crónicos y fuerza, calidad de vida, estrés y sueño en mujeres (las más acometidas por los dolores osteoarticulares crónicos). Se reclutaron participantes de un programa de educación física para ancianos, con edad entre 50 y 70 años. El dolor fue evaluado por medio de un instrumento multidimensional. Se evaluaron también el estado cognitivo global, el nivel de actividad física, la calidad de vida, el estrés y el sueño de las participantes. La fuerza muscular fue analizada por medio de la prueba de sentarse y levantarse y de la prueba de flexo-extensión de codos. Participaron de la investigación 56 mujeres, con media de edad de 63,7±7,7 anos, y 28,7±4,7kg/m2 de índice de masa corporal (IMC). La mayoría de las participantes relató sentir dolor (89,2%); el 21,4% relató dolor en los miembros inferiores y el 67,8% relató dolor en los miembros superiores. La dimensión sensorial del dolor se asoció al estrés, pero no a las demás variables, que no se relacionaron a ninguno de los aspectos del dolor. Además, puede haber influencia de la edad en la interpretación del dolor evaluativo.The literature presents the need for investigations related to the chronic osteoarticular pains of older adults, which are more prevalent in women, since they negatively influence biopsychosocial parameters. To understand the relationship between pain dimensions and health parameters of these individuals is necessary for a better preventive and therapeutic approach. This study aims to identify associations between levels of chronic pain and levels of strength, quality of life, stress and sleep in women. Participants were recruited from a physical education program for older adults, aged between 50 and 70 years. Pain was assessed using a multidimensional instrument on pain parameters. Global cognitive status, physical activity level, quality of life, stress and sleep were also assessed. The muscular strength of the participants was analyzed using the sit up test and the elbow flexion and extension test. The participants were 56 women, mean age 63.7±7.7 years, and 28.7±4.7 kg/m2 body mass index (BMI). Most participants reported feeling pain (89.2%), 21.4% reported lower limb pain, and 67.8% reported experiencing upper limb pain. The sensory dimension of pain was associated with stress, but not with the other variables, which were not related to any aspects of pain. In addition, there may be an influence of age in the interpretation of evaluative pain.A literatura apresenta a necessidade de investigar as dores osteoarticulares crônicas em idosos, uma vez que essas influenciam negativamente parâmetros biopsicossociais. Entender a relação entre as dimensões da dor e parâmetros de saúde dos indivíduos acometidos é necessário para melhor abordagem preventiva e terapêutica. Este trabalho tem o objetivo de identificar relações entre níveis de dores crônicas e força, qualidade de vida, estresse e sono em mulheres (as mais acometidas pelas dores osteoarticulares crônicas). Foram recrutadas participantes de um programa de educação física para idosos, com idade entre 50 e 70 anos. A dor foi avaliada por meio de um instrumento multidimensional. Foram avaliados também estado cognitivo global, nível de atividade física, qualidade de vida, estresse e sono. A força muscular das participantes foi analisada por meio do teste de sentar e levantar e do teste de flexão e extensão de cotovelo. Participaram 56 mulheres, com média de idade de 63,7±7,7 anos, e 28,7±4,7kg/m2 de índice de massa corporal (IMC). A maior parte das participantes relatou sentir dor (89,2%); 21,4% relataram dor nos membros inferiores e 67,8% relataram dor nos membros superiores. A dimensão sensorial de dor foi associada ao estresse, mas não às demais variáveis, que não se relacionaram a nenhum dos aspectos da dor. Além disso, pode haver influência da idade na interpretação da dor avaliativa

Influence of fluid ingestion on heart rate, cardiac autonomic modulation and blood pressure in response to physical exercise : a systematic review with meta-analysis and meta-regression

A systematic review was undertaken to investigate the involvement of hydration in heart rate (HR), HR variability (HRV) and diastolic (DBP) and systolic (SBP) blood pressure in response to exercise. Data synthesis: The EMBASE, MEDLINE, Cochrane Library, CINAHL, LILACS and Web of Science databases were searched. In total, 977 studies were recognized, but only 36 were included after final screening (33 studies in meta-analysis). This study includes randomized controlled trials (RCTs) and non-RCTs with subjects > 18 years old. The hydration group consumed water or isotonic drinks, while the control group did not ingest liquids. For the hydration protocol (before, during and after exercise), the HR values during the exercise were lower compared to the controls (−6.20 bpm, 95%CI: −8.69; −3.71). In the subgroup analysis, “water ingested before and during exercise” showed lower increases in HR during exercise (−6.20, 95%CI: 11.70 to −0.71), as did “water was ingested only during exercise” (−6.12, 95%CI: −9.35 to −2.89). Water intake during exercise only revealed a trend of avoiding greater increases in HR during exercise (−4,60, 95%CI: −9.41 to 0.22), although these values were not significantly different (p = 0.06) from those of the control. “Isotonic intake during exercise” showed lower HRs than the control (−7.23 bpm, 95% CI: −11.68 to −2.79). The HRV values following the exercise were higher in the hydration protocol (SMD = 0.48, 95%CI: 0.30 to 0.67). The values of the SBP were higher than those of the controls (2.25 mmHg, 95%CI: 0.08 to 4.42). Conclusions: Hydration-attenuated exercise-induced increases in HR during exercise, improved autonomic recovery via the acceleration of cardiac vagal modulation in response to exercise and caused a modest increase in SBP values, but did not exert effects on DBP following exercise

Older postmenopausal women with lower lean mass have hypermethylated sites in the PI3K-Akt pathway

Introduction: The decrease in lean mass is directly related to the loss of independence, muscle strength, and worse quality of life over the years. Although the genetic determinants of muscle mass were well recognized, recent literature has been uncovering new epigenetic factors affecting the state of muscular tissue. This study aimed to verify differences in the DNA methylation profile among Brazilian postmenopausal women aged 50–70 years according to the lean mass evaluation.Methods: A cross-sectional study comprised 40 women aged 50–70 years. After K-means cluster analysis the 40 participants were divided into two groups, the Lower Lean Mass group with 20 participants (61.1 ± 4.6 years) and the Higher Lean Mass group with 20 participants (60.7 ± 3.2 years). Lean mass was measured by dual-energy X-ray emission densitometry (DEXA). The participants' DNA was extracted using the Salting Out technique and subsequently, the Illumina 850k EPIC Infinium Methylation BeadChip was performed to obtain methylation data.Results: We obtained 1,913 differentially methylated sites (p ≤ 0.005 of β > 5% and β < −5%) in a total of 979 genes between groups (p ≤ 0.005; −5% > β > 5%). In addition, the PI3K-Akt pathway had the greatest power of significance with an FDR of 4.6 × 10–3.Conclusion: Our results demonstrate a differentiation between specific sites of different genes, which have essential functions in body composition and energy metabolism, supporting future studies that aim to relate lean mass with epigenetics

Postural imbalances, cognition, flexibility, quality of movement and effects of different physical training programs in physically inactive women aged 60 to 70 years

Introdução: O envelhecimento é marcado por um progressivo declínio nas funções fisiológicas e morfológicas, podendo levar ao desenvolvimento das alterações posturais, e perda na qualidade de movimento que podem estar envolvidos com a redução da flexibilidade e declínio cognitivo, que vem com o processo de envelhecer. Todos esses fatores contribuem para as principais causas que se associam com as dores crônicas, quedas e gastos no serviço de saúde pública. A prática regular de exercício físico tem sido recomendada neste contexto, porém qual a melhor intervenção e seus benefícios, variam de pessoa para pessoa, além da escassez na literatura sobre a flexibilidade, seus reais benefícios sobre a inatividade física e sobre exercícios que colaboraram para a manutenção postural. Objetivo: Comparar o efeito do treinamento multicomponente com e sem ênfase em um programa individualizado de flexibilidade em aspectos posturais, amplitude e qualidade de movimento, e nas demais capacidades físicas, além de observar associação entre qualidade de movimento e aspectos cognitivos em mulheres idosas. Sua relevância justifica-se porque não há na literatura análises da eficácia de intervenções deste grupo neste contexto. Método: Foram selecionadas 142 mulheres, entre 60 e 70 anos, para participar de um programa de treinamento físico na EEFERP-USP, randomizadas em 3 grupos: Grupo de Treinamento Multicomponente (TM) (n=52), Grupo de Treinamento Multicomponente com Ênfase em Flexibilidade (TMF) (n=43) e Grupo Controle (GC) (n=47), durante 3 meses, sendo os treinamentos duas vezes por semana e com duração de 90 minutos cada sessão, a intensidade de 5 a 10 na escala de Borg (um pouco moderado a intenso). Este projeto foi submetido e aprovado pelo Comitê de Ética em Pesquisa da EEFERP-USP (CAAE: 63681517.3.0000.5659, REBEC: RBR-8hqwmx). Para caracterização da amostra, utilizamos o Critério de Classificação Socioeconômica Brasil (CCEB). Foram realizadas medidas antropométricas e pressão arterial. O nível de atividade física foi avaliado por meio do Questionário de Baecke Modificado para Idosos (QBMI) e por meio de acelerometria. A cognição foi avaliada por meio do Montreal Cognitive Assessment (MoCA). O nível de flexibilidade foi avaliado por meio dos testes Mãos nas Costas (MNC) e Sentar e Alcançar (SEA); a função cardiorrespiratória por meio do Teste de Caminhada de 6 Minutos; o padrão postural pela fotogrametria (SAPO); a qualidade de movimento pelo Functional Movement Screen (FMS); e a amplitude de movimento articular por meio da goniometria. Teste de aptidão física de Rikli e Jones para as demais capacidades funcionais. A análise estatística considerou os grupos, utilizando o Anova de medidas repetidas, teste t, regressões lineares e magnitude do efeito de D Cohen (TE). Resultados: em relação à cognição e qualidade do movimento na análise de regressão mostrou-se uma associação entre idade (β: -0,11; IC: -0,10- 0,30; p = 0,03), habilidades visuoespaciais (β: 0,36; IC: 0,24-1,23; p 0.5 na maioria das variaveis estudadas em relação aos demais grupos. Por fim, o grupo TMF apresentou melhoras posturais e flexibilidade (TE > 0.5 em 24 variáveis) maiores do que o grupo TM (TE > 0.5 em nove variáveis). O GC apresentou TE > 0.5 em apenas oito das 31 variáveis analisadas na biofotogrametria. Ambas as intervenções melhoraram a qualidade do movimento. Quando observamos as demais capacidades físicas, os dois tipos de treinamento, multicomponente e multicomponente com flexibilidade, se mostraram efetivos. No entanto, o treinamento multicomponente com flexibilidade apresentou tamanho do efeito muito grande nas variáveis de força, agilidade e aptidão aeróbia, enquanto o treinamento multicomponente apresentou tamanho do efeito médio na agilidade e grande/muito grande nas variáveis de força. Conclusões: A qualidade do movimento foi relacionada à idade e ao desempenho cognitivo em idosas fisicamente inativas, principalmente nos domínios das habilidades visuoespaciais, linguagem e orientação. Além disso, 14 semanas de treinamento multicomponente e flexibilidade em uma intervenção em grupo podem melhorar os níveis de flexibilidade e posturais em idosas fisicamente inativas. Por fim, podemos notar que o treinamento multicomponente com flexibilidade é um potencializador para o desenvolvimento de outras capacidades físicas.Introduction: Aging is marked by a progressive decline in physiological and morphological functions, which can lead to the development of postural changes, and loss in the quality of movement that may be involved with the reduction of flexibility and cognitive decline, which comes with the process of aging. All of these factors contribute to the main causes that are associated with chronic pain, falls and expenses in the public health service. The regular practice of physical exercise has been recommended in this context, but which is the best intervention and its benefits, vary from person to person, in addition to the scarcity in the literature on flexibility, its real benefits on physical inactivity and on exercises that contributed to the postural maintenance. Objective: To compare the effect of multicomponent training with and without emphasis on an individualized program of flexibility in postural aspects, range and quality of movement, and in other physical capacities, in addition to observing an association between quality of movement and cognitive aspects in elderly women. Its relevance is justified because there is no analysis in the literature of the effectiveness of interventions by this group in this context. Methods: 142 women, between 60 and 70 years old, were selected to participate in a physical training program at EEFERP-USP, randomized into 3 groups: Multicomponent Training Group (TM) (n = 52), Multicomponent Training Group with Emphasis in Flexibility (MPT) (n = 43) and Control Group (CG) (n = 47), for 3 months, with training twice a week and lasting 90 minutes each session, the intensity of 5 to 10 on the scale of Borg (a little moderate to intense). This project was submitted to and approved by the Research Ethics Committee of EEFERP-USP (CAAE: 63681517.3.0000.5659, REBEC: RBR-8hqwmx). To characterize the sample, we used the Brazil Socioeconomic Classification Criterion (CCEB). Anthropometric measurements and blood pressure were performed. The level of physical activity was assessed using the Modified Baecke Questionnaire for the Elderly (QBMI) and through accelerometry. Cognition was assessed using the Montreal Cognitive Assessment (MoCA). The level of flexibility was assessed using the Hands on Back (MNC) and Sit and Reach (SEA) tests; cardiorespiratory function through the 6-minute walk test; the postural pattern by photogrammetry (SAPO); the quality of movement by the Functional Movement Screen (FMS); and the range of articular movement through goniometry. Physical fitness test by Rikli and Jones for other functional capacities. The statistical analysis considered the groups, using the ANOVA of repeated measures, t test, linear regressions and magnitude of the D Cohen effect (TE). Results: in relation to cognition and quality of movement in the regression analysis, there was an association between age (β: -0.11; CI: -0.10-0.30; p = 0.03), visuospatial skills (β: 0.36; CI: 0.24-1.23; p 0.5 in most of the variables studied in relation to the other groups. Finally, the TMF group showed greater postural and flexibility improvements (TE> 0.5 in 24 variables) than the TM group (TE> 0.5 in nine variables). The CG presented TE> 0.5 in only eight of the 31 variables analyzed in biophotogrammetry. Both interventions improved the quality of the movement. When we look at the other physical capacities, the two types of training, multicomponent and multicomponent with flexibility, proved effective. However, multicomponent training with flexibility had a very large effect size on the variables of strength, agility and aerobic fitness, while multicomponent training had a medium effect size on agility and large / very large on strength variables. Conclusions: The quality of the movement was related to age and cognitive performance in physically inactive elderly women, mainly in the domains of visuospatial skills, language and orientation. In addition, 14 weeks of multicomponent training and flexibility in a group intervention can improve the levels of flexibility and posture in physically inactive elderly women. Finally, we can notice that multicomponent training with flexibility is an enhancer for the development of other physical abilities

14-Week exercise training modifies the DNA methylation levels at gene sites in non-Alzheimer's disease women aged 50 to 70 years

Exercise training emerges as a key strategy in lifestyle modification, capable of reducing the risk of developing Alzheimer's disease (AD) due to risk factors such as age, family history, genetics and low level of education associated with AD. We aim to analyze the effect of a 14-week combined exercise training (CT) on the methylation of genes associated with AD in non-alzheimer's disease women. CT sessions lasted 60 min, occurring three times a week for 14 weeks. Forty non-Alzheimer's disease women aged 50 to 70 years (60.7 ± 4.1 years) with a mean height of 1.6 ± 0.1 m, mean weight of 73.12 ± 9.0 kg and a mean body mass index of 29.69 ± 3.5 kg/m2, underwent two physical assessments: pre and post the 14 weeks. DNA methylation assays utilized the EPIC Infinium Methylation BeadChip from Illumina. We observed that 14 weeks of CT led to reductions in systolic (p = 0.001) and diastolic (p = 0.017) blood pressure and improved motor skills post-intervention. Among 25 genes linked to AD, CT induced differentially methylated sites in 12 genes, predominantly showing hypomethylated sites (negative β values). Interestingly, despite hypomethylated sites, some genes exhibited hypermethylated sites (positive β values), such as ABCA7, BDNF, and WWOX. A 14-week CT regimen was adequate to induce differential methylation in 12 CE-related genes in healthy older women, alongside improvements in motor skills and blood pressure. In conclusion, this study suggest that combined training can be a strategy to improve physical fitness in older individuals, especially able to induce methylation alterations in genes sites related to development of AD. It is important to highlight that training should act as protective factor in older adults.</p