Handgrip strength, functional capacity and cognitive status of centenarians / Força de preensão manual, capacidade functional e estado cognitivo em centenários

Objective: To compare and correlate handgrip strength (HGS) with functional capacity and cognitive status in centenarians. Method: This is a cross-sectional study. The study population consisted of 127 centenarians, of which 78 met the inclusion criteria, with a mean age of 101.7 ± 2.52 years. Cognitive status was assessed using the Mini-Mental State Examination (MMSE) and functional capacity using the Katz Scale. To investigate HGS, we used a manual dynamometer. The level of significance was 5%. Results: Centenarian men have higher right (p= 0.005) and left (p<0.001) HGS compared to women. About functional capacity, centenarians more functional present higher right and left HGS (p<0.001) when compared to intermediate and less functional. Furthermore, when analyzing cognition, centenarians with preserved cognitive status have higher right and left HGS (p<0.001) than cognitively impaired elderly. In the relationship analysis, it was possible to verify that the lower the MMSE score, the higher the right (rho= 0.59; p<0.001) and left (rho= 0.57; p<0.001) HGS. Furthermore, the lower the Katz Scale score, the higher the right (rho= -0.53; p<0.001) and left (rho= -0.57; p<0.001) HGS. Conclusion: Our results show that male centenarians, more functional and with preserved cognitive status have higher HGS in both hands. Moreover, we found a moderate negative relationship between HGS and functional capacity and a moderate positive relationship between HGS and cognitive status of centenarians.

Objetivo: Comparar e correlacionar a força de preensão manual (HGS) com a capacidade funcional e o estado cognitivo em centenários. Método: Este é um estudo de corte transversal. A população do estudo consistiu em 127 centenários, dos quais 78 preenchiam os critérios de inclusão, com uma idade média de 101,7 ± 2,52 anos. O estado cognitivo foi avaliado utilizando o Mini-Mental State Examination (MMSE) e a capacidade funcional utilizando a Escala Katz. Para investigar o HGS, utilizamos um dinamômetro manual. O nível de significância foi de 5%. Resultados: Os homens centenários têm o HGS mais alto à direita (p= 0,005) e à esquerda (p<0,001) em comparação com as mulheres. Quanto à capacidade funcional, os centenários mais funcionais apresentam HGS mais altos à direita e à esquerda (p<0,001) quando comparados com os intermediários e menos funcionais. Além disso, ao analisar a cognição, os centenários com estado cognitivo preservado têm HGS direito e esquerdo mais elevados (p<0,001) do que os idosos com deficiência cognitiva. Na análise da relação, foi possível verificar que quanto mais baixa a pontuação MMSE, mais alta a direita (rho= 0,59; p<0,001) e esquerda (rho= 0,57; p<0,001) HGS. Além disso, quanto mais baixa a pontuação da Escala Katz, mais alta a direita (rho= -0,53; p<0,001) e esquerda (rho= -0,57; p<0,001) HGS. Conclusão: Os nossos resultados mostram que os centenários masculinos, mais funcionais e com estatuto cognitivo preservado, têm HGS mais elevado em ambas as mãos. Além disso, encontramos uma relação negativa moderada entre HGS e capacidade funcional e uma relação positiva moderada entre HGS e estado cognitivo dos centenários.

Frailty and physical activity in centenarians: a systematic review

There is a lack of studies evaluating frailty and physical activity in people aged 100 years or older. This review aimed to synthesize the evidence on frailty and physical activity in centenarians. A systematic review was conducted according to the PRISMA guidelines. We searched the PubMed, CINAHL, SCOPUS, Web of Science, and Lilacs databases for articles published until 18 June 2020. This review was registered with PROSPERO (CRD42020162913). Five studies were included in this review according to the eligibility and exclusion criteria. In summary, the reviewed studies show that centenarians are fragile and that frailty increases with age; however, women are frailer than men. The most common frailty criteria were low physical activity level (78% to 72.5%), muscle weakness (84.2% to 66%), and slow walking speed (77.6% to 48.4%). Most centenarians perform less exercise than younger older adults, have a low physical activity level, live in nursing homes, and exhibit functional disability. Regarding the methodological quality of the studies, one article was classified as regular and the other four as poor. Frailty and a low physical activity level are common in centenarians. Experimental studies with better methodological quality are necessary to better understand the causal relationship between variables.

Factors associated with urinary incontinence in volleyball athletes: a cross-sectional study

The article has the purpose of identify the factors associated with the occurrence of urinary incontinence (UI) among volleyball athletes. This is a cross-sectional study conducted with female athletes of court volleyball. An interview was conducted to identify the factors associated with UI. The presence of urinary loss was identified using the Urinary Distress Inventory 6 (UDI-6). The associated factors found were divided into those related to sociodemographic (education and marital status), behavioral (constipation occurrence), obstetric (previous pregnancies), hereditary (skin color), and sports practice variables (sports level, volleyball position, time of sports practice in years, physical and tactical training routine, and daily water intake). The Chi-square test or Fisher's exact test, Mann-Whitney U test, and binary logistic regression model were used. This study included 83 volleyball athletes with a mean age of 26.6 (± 7.2) years. It was found that 25.3% of the volleyball athletes presented UI and those that reported symptoms of constipation were 10 times more likely to develop UIthan those without constipation.Women who practice high-impact sports in a professional manner, such as volleyball, should be aware of the symptoms of pelvic floor dysfunction, since they will be predisposed to urine leakage. The finding that a considerable number of athletes report UI and that long-term sports practice exposes athletes to a higher risk of UI indicates that pelvic exercises should be proposed in order to reduce these symptoms.

Força de preensão manual e velocidade máxima da caminhada de acordo com o nível de atividade física e o sexo de centenários / Handgrip strenght and maximum walking speed according to the physical activity and sex of centenarians

Objetivo: comparar a força de preensão manual (FPM) e a velocidade máxima da caminhada de acordo com o nível de atividade física (NAF) e o sexo em idosos centenários. Método: participaram do estudo 48 centenários (101,73±2,52 anos), sendo 29 mulheres e19 homens. Dados sociodemográficos, de saúde e hábitos de vida foram analisados por meio do Protocolo de Avaliação Multidimensional do Idoso Centenário ­ PAMIC. A FPM foi mensurada por meio de dinamômetro, o NAF por meio de pedômetro e a velocidade máxima da caminhada por meio de teste físico. Foram classificados como centenários ativos os que atingiram no mínimo 1.000 passos/semana e como insuficientemente ativos aqueles abaixo deste valor. O nível de significância adotado foi de 5%. Resultados: centenários do sexo masculino apresentaram maior FPM direita (17,47±6,94kgf) e esquerda (16,63±6,28kgf) quando comparados ao sexo feminino (11,90±4,84kgf; 10,48±5,00kgf) (p<0,05). Quando analisados de acordo com o NAF, centenários ativos apresentaram maior FPM direita (22,86±8,01 kgf) e esquerda (22,14±5,55kgf) em comparação aos insuficientemente ativos (14,33±3,82kgf; 13,42±4,14kgf) (p<0,05). Para o sexo feminino, a FPM direita foi maior nas centenárias ativas (15,75±4,68kgf) quando comparadas às insuficientemente ativas (10,43±4,12kgf) (p=0,006). Na FPM esquerda, o grupo ativo apresentou maior valor médio (14,00±4,63 kgf) em comparação ao grupo insuficientemente ativo (9,14±4,55kgf) (p=0,017). A velocidade máxima da caminhada não apresentou diferença significativa de acordo com o NAF ou o sexo dos idosos. Conclusão: o estudo evidencia que a atividade física está intimamente relacionada a melhores valores de FPM, indicando que idosos centenários ativos possuem melhor força corporal global.(AU)

Aim: to compare the handgrip strength (HGS) and the maximum walking speed according to the level of physical activity (PA) and sex in elderly centenarians. Method: 48 centenarians (101.73 ± 2.52 years old) participated in the study, 29 women and 19 men. Sociodemographic, health, and lifestyle data were analyzed using the Multidimensional Assessment Protocol for the Elderly Centenary ­ PAMIC. HGS was measured using a dynamometer, PA utilizing a pedometer, and the maximum gait speed through a physical test. Those who reached at least 1,000 steps/week were classified as active centenarians and those below this value as insufficiently active. The level of significance adopted was 5%. Results: centenarians of the male sex had higher HGS on the right (17.47 ± 6.94kgf) and left (16.63 ± 6.28kgf) when compared to the female sex (11.90 ± 4.84kgf; 10.48 ± 5, 00kgf) (p<0.05). When analyzed according to PA, active centenarians had a higher right (22.86 ± 8.01 kgf) and left (22.14 ± 5.55kgf) HGS compared to insufficiently active (14.33 ± 3.82kgf; 13, 42 ± 4.14 kgf) (p <0.05). For females, the right HGS was higher in active centenarians (15.75 ± 4.68kgf) when compared to insufficiently active women (10.43 ± 4.12kgf) (p = 0.006). In the left HGS, the active group had a higher mean value (14.00 ± 4.63 kgf) compared to the insufficiently active group (9.14 ± 4.55kgf) (p = 0.017). The maximum gait speed did not show any significant difference according to PA or the gender of the elderly. Conclusion: the study shows that physical activity is closely related to better values of HGS, indicating that active elderly centenarians have better overall body strength.(AU)

Treinamento dos músculos do assoalho pélvico em mulheres com dispareunia: um ensaio clínico randomizado / Pelvic floor muscles training in women with dyspareunia: randomized clinical trial

Introdução: A dispareunia afeta a função sexual feminina, bem como a qualidade de vida. Deste modo, o treinamento do assoalho pélvico gera consciência da região vaginal, bem como melhora da função sexual. Objetivo: Analisar o efeito do treinamento dos músculos do assoalho pélvico (TMAP) na qualidade de vida de mulheres com dispareunia. Métodos: Trata-se de um ensaio clínico randomizado em mulheres sexualmente ativas com sintomas de dispareunia que foram aleatoriamente distribuídas em Grupo Intervenção (GI; n = 6) e Grupo Controle (GC; n = 7). A função sexual foi verificada através do Female Sexual Function Index (FSFI). A interferência da dispareunia na qualidade de vida foi verificada por uma escala visual analógica (0= nenhuma interferência; 10= máxima interferência). O GI foi submetido ao TMAP por oito semanas, sendo dois encontros semanais com e duração de 40 minutos, e o GC não recebeu nenhum treinamento. Para análise dos dados, utilizou-se estatística descritiva e inferencial, com nível de significância de 5%. Resultados: Observou-se que os domínios desejo, excitação, lubrificação, orgasmo e satisfação não apresentaram diferença significativa em ambos os grupos. No entanto, houve diminuição dos valores encontrados no domínio dor (p = 0,043; d = 1,24) no GI. Quanto à interferência da dispareunia na qualidade de vida, os valores foram significativamente melhores no GI (p = 0,022; d = 1,95). Conclusão: Após intervenção fisioterapêutica de treino dos músculos do assoalho pélvico, há melhora da dor em mulheres. (AU)

Introduction: Dyspareunia affects female sexual function as well as quality of life. In this mode, pelvic floor training generates awareness of the vaginal region as well as enhances sexual function. Aim: To analyze the effect of pelvic floor muscle training (PFMT) on the quality of life of women with dyspareunia. Methods: This was a randomized clinical trial in sexually active women with symptoms of dyspareunia that were randomly assigned to Intervention Group (GI; n = 6) and Control Group (CG; n = 7). Sexual function was verified through the Female Sexual Function Index (FSFI). Dyspareunia interference on quality of life was verified by a visual analog scale (0 = no interference; 10 = maximum interference). The GI was submitted to the PFMT for eight weeks, two weekly meetings lasting 40 minutes, and the CG received no training. For data analysis, descriptive and inferential statistics were used, with a significance level of 5%. Results: The domains desire, arousal, lubrication, orgasm and satisfaction did not present significant difference in both groups. However, there was a decrease in the values found in the pain domain (p = 0.043; d = 1.24) in the GI. Regarding the interference of dyspareunia in quality of life, values were significantly better in GI (p = 0.022; d = 1.95). Conclusion: After physical therapy intervention of pelvic floor muscles training there is pain improvement in women. (AU)