Correlation of the sagittal balance with postural analysis of the pelvis and lumbar spine / Correlação do equilíbrio sagital e análise postural de pelve e coluna lombar

ABSTRACT Objective: Evaluate and correlate the sagittal balance parameters with the postural of the pelvis and lumbar spine. Methods: 80 individuals of both sexes, aged between 20 and 35 years, were evaluated. Biophotogrammetry was done with the SAPO software program. Measurements of the sagittal balance parameters were obtained by analyzing a lateral view panoramic radiography of the vertebral column, in which the anatomical points of reference were digitally marked. The calculation of the angles was done automatically by the Keops program. Results: In Keops assessment, 17.5% of the sample had high pelvic incidence angles (> 60°), 31.5% had low pelvic incidence angles (< 45°), and 51.2% had medium pelvic incidence angles (between 46° and 59°). SAPO showed 12,5% lordosis, 40% retroversion, and 47,5% normal curvature. In the right lateral view, pelvic incidence angle had a moderate and positive correlation with vertical alignment of the trunk and with vertical alignment of the body, and a negative and moderate correlation with horizontal alignment of the pelvis. Conclusion: Differences were found between vertical alignment measurements from the postural evaluation system (SAPO). A positive correlation was found between PI from Keops and pelvic anteversion from SAPO. Level of Evidence II; Prospective Study.

RESUMO Objetivo: Avaliar e correlacionar o equilíbrio sagital com parâmetros posturais da pelve e coluna lombar Métodos: Foram avaliados 80 indivíduos de ambos os sexos, com idade entre 20 e 35 anos. A biofotogrametria foi realizada com o software SAPO. As medidas dos parâmetros do equilíbrio sagital foram obtidas pela análise de uma radiografia panorâmica em perfil da coluna vertebral, na qual os pontos anatômicos de referência foram marcados digitalmente. O cálculo dos ângulos foi feito automaticamente pelo programa Keops. Resultados: Na avaliação Keops, 17,5% da amostra apresentavam ângulos de incidência pélvicos altos (> 60°), 31,5% tinham ângulos de incidência pélvicos baixos (< 45°) e 51,2% apresentavam ângulos de incidência pélvicos médios (entre 46° e 59°). O SAPO apresentou 12,5% de lordose, 40% de retroversão e 47,5% de curvatura normal. Na vista lateral direita, o ângulo de incidência da pelve apresentou correlação moderada e positiva com o alinhamento vertical do tronco e com o alinhamento vertical do corpo e negativa e moderada com o alinhamento horizontal da pelve. Conclusão: Foram encontradas diferenças entre as medidas de alinhamento vertical do sistema de avaliação postural (SAPO). Uma correlação positiva foi encontrada entre IP de Keops e anteversão pélvica de SAPO. Nível de Evidência II; Estudo Prospectivo.

Advanced glycation end products consumption and the decline of functional capacity in patients with Parkinson's disease: Cross-sectional study

Abstract Introduction Advanced Glycation End-Products (AGEs) are a diverse group of highly reactive molecules that play a vital role in the development of neurodegenerative disorders, such as Parkinson's Disease (PD), leading to a decline in functional and cognitive capacity. The objective of this study was to assess the intake and quantification of AGEs in individuals with PD and to correlate them with their functional and cognitive abilities. Methods This was a cross-sectional study involving 20 PD patients and 20 non-PD individuals as the Control group (C). The autofluorescence reader was used to evaluate skin AGEs, while food recall was used to quantify AGEs consumed for three different days. The Montreal Cognitive Assessment, Short Physical Performance Battery, and handgrip tests were used. PD patients demonstrated greater impairment in functional capacity compared to the control group. Results Dominant Handgrip (p = 0.02) and motor performance, in the sit and stand test (p = 0.01) and Short Physical Performance Battery (SPPB) (p = 0.01) were inferior in PD patients than the control group. Although PD patients tended to consume less AGEs than the control group, AGE intake was negatively correlated with handgrip strength in individuals with PD (r = -0.59; p < 0.05). Conclusion PD patients had lower strength and functional capacity, suggesting that the effects of AGEs might be exacerbated during chronic diseases like Parkinson's.

Contemporary reflection on the educational levels of high-performance soccer players in Brazil

ABSTRACT Objective As the soccer culture in Brazil is more popular than schooling, this study reflected on the formal education levels of soccer (football) players through descriptive and quantitative analyses. Methods We evaluated 179 national soccer players playing various positions on different teams across six seasons (2012, 2013, 2014, 2015, 2016, and 2022). Data were collected using a questionnaire comprising the following variables: age, position in the pitch, age of professionalization, and education (years of study). The data were distributed according to the pitch position. Results The mean age, length of professional career, and professionalization age were 23±6 years, 7±5 years, and 17±2 years, respectively. In terms of education, 121 athletes (67%) completed high school, equivalent to 11 years of study. Only 5.5% completed higher education, with defensive players (goalkeepers and defenders) being the most educated at 37% (66/179). According to 2017 figures from the Pesquisa Nacional por Amostra de Domicílios Contínua of the Federal Government of Brazil, the schooling rate is 31.7%, wherein 46.1% of Brazilians aged 25 years or over have completed education. In this study of 179 athletes, 67% had completed high school. Thus, players outrank the Brazilian population in terms of achieving a high school education. There were marked disparities in the relative proportions of goalkeepers (85%), defensive players (68%), midfielders (63%), and forward players (64%) in terms of their education. Conclusion Our survey revealed that attending higher education remains a distant reality in Brazil.

Effect of 12-week rehearsal on cardiorespiratory fitness and body composition in Brazilian samba dancers

ABSTRACT Objective To investigate the effect of 12 weeks of rehearsals on cardiorespiratory parameters and body composition in Brazilian samba dancers belonging to a first-league samba school. Methods Twenty-six women were divided into a Samba Group (n=13) and a Control Group (n=13). Cardiorespiratory parameters (cardiopulmonary exercise test) and body composition (skinfold assessment) were assessed before and after the 12 weeks of rehearsals. The Samba Group rehearsed three times per week for 30-60 minutes, and the Control Group participated in no physical activity. A comparison test was performed within and between groups, with p<0.05 indicating statistical significance. Results Compared with the Control Group, the Samba Group showed a significant increase in maximal oxygen uptake (19%), oxygen pulse (13%), and lean body mass (3%) and a decrease in body fat percentage (11%) and fat mass (12%). Conclusion Twelve weeks of samba dance rehearsals improved the cardiorespiratory and body composition parameters in women dancers compared with the Control Group. These findings suggest that dancing samba regularly can increase physical activity levels and positively affect the health parameters of samba dancers.

Evaluation of ankle movements on a sudden inversion platform / Evaluación de los movimientos del tobillo en la plataforma de inversión súbita / Avaliação dos movimentos do tornozelo na plataforma de inversão súbita

ABSTRACT Introduction: Ankle sprains are frequent in sports activities and can lead to joint instability with clinical and performance consequences. Sudden ankle inversion platforms have been used to study the mechanism of ankle sprain. Objectives: To test a static platform that simulates the movement of ankle sprain (sudden inversion) in soccer players. Methods: A platform was developed to perform the sudden movement of an ankle sprain dissociated in three axes: inversion, plantar flexion, and medial rotation. A computer program was also created to read the angular velocity and the time to reach the maximum amplitude of the three axes of movement, synchronized with the platform movements. Thirty soccer players without ankle sprains were evaluated on the sudden inversion platform. Each athlete performed 10 randomly initiated tests, with five per leg. Results: There was no statistical difference in angular velocity or time to reach maximum range of motion of plantar flexion and medial rotation between the tests. During the tests, the angular velocity of the inversion increased. Conclusion: The sudden static platform evaluated the movements performed by the ankle during the sprain reliably in the 10 tests with no difference in the mechanical behavior. Level of evidence I; Therapeutic studies - Investigation of treatment outcomes.

RESUMEN Introducción: El esguince de tobillo es frecuente en las actividades deportivas y puede provocar inestabilidad articular con consecuencias clínicas y de desempeño. Se han utilizado plataformas de inversión súbita del tobillo para estudiar el mecanismo del esguince de tobillo. Objetivos: Probar una plataforma estática que simule el movimiento de esguince de tobillo (inversión súbita) en jugadores de fútbol. Métodos: La plataforma fue desarrollada para realizar el movimiento brusco del esguince de tobillo disociado en tres ejes: inversión, flexión plantar y rotación medial. También se creó un programa informático para leer la velocidad angular y el tiempo para alcanzar la máxima amplitud de los tres ejes de movimiento, sincronizados con los movimientos de la plataforma. Treinta futbolistas sin esguince de tobillo fueron evaluados en la plataforma súbita. Cada atleta realizó 10 pruebas, iniciadas al azar, cinco en cada pierna. Resultados: Entre las pruebas, no hubo diferencias estadísticas en las velocidades angulares y el tiempo para alcanzar la amplitud máxima de los movimientos de flexión plantar y rotación medial. Durante las pruebas, la velocidad angular de la inversión aumentó. Conclusión: La plataforma estática súbita, evaluada en 10 intentos, fue confiable para evaluar los movimientos realizados por el tobillo durante el esguince, y no hubo diferencias en el comportamiento mecánico. Nivel de Evidencia I; Estudios terapéuticos - Investigación de los resultados del tratamiento.

RESUMO Introdução: A entorse do tornozelo é frequente nas atividades esportivas, podendo levar à instabilidade articular com consequências clínicas e de desempenho. As plataformas de inversão súbita do tornozelo têm sido usadas para estudar o mecanismo de entorse do tornozelo. Objetivos: Testar uma plataforma estática que simule o movimento de entorse do tornozelo (inversão súbita) em jogadores de futebol. Métodos: A plataforma foi desenvolvida para realizar o movimento súbito da entorse de tornozelo dissociado em três eixos: inversão, flexão plantar e rotação medial. Também foi criado um programa de computador para leitura da velocidade angular e do tempo para atingir a amplitude máxima dos três eixos de movimento, sincronizados com os movimentos da plataforma. Trinta jogadores de futebol sem entorse de tornozelo foram avaliados na plataforma súbita. Cada atleta fez 10 testes, iniciados de forma aleatória, sendo cinco em cada perna. Resultados: Entre os testes, não houve diferença estatística das velocidades angulares e tempo para atingir a amplitude máxima do movimento de flexão plantar e rotação medial. Durante os testes, a velocidade angular da inversão aumentou. Conclusão: A plataforma estática súbita, avaliada em 10 tentativas, foi confiável para avaliar os movimentos executados pelo tornozelo durante a entorse, e não houve diferença de comportamento mecânico. Nível de evidência I; Estudos terapêuticos - Investigação dos resultados do tratamento.

Adaptation to the driving simulator and prediction of the braking time performance, with and without distraction, in older adults and middle-aged adults

Abstract Context: Many studies show the importance of evaluating the adaptation time of subjects in a virtual driving environment, looking forwards to a response as closest as a possible real vehicle. Objectives: This study aimed to identify and analyze the adaptation to the driving simulator in older adults and middle-aged adults with and without a distraction, and a secondary aim was to identify predictors of safe performance for older adults' drives. Design: Male and female middle-aged adults (n = 62, age = 30.3 ± 7.1 years) and older adults (n = 102, age = 70.4 ± 5.8 years) were evaluated for braking time performance in a driving simulator; cognition performance assessment included the Mini-Mental State Examination; motor evaluation included ankle flexor muscle strength with the isokinetic dynamometer and handgrip strength; the postural balance was evaluated with Timed Up and Go test, with and without a cognitive distraction task. Results: Older adults (men and women) and middle-aged adult women require more time to adapt to the driving simulator. The distractor increases the adaptation time for all groups. The main predictors of braking time for older women are age, muscle strength, and postural balance associated with distraction, and for older men, muscle strength. Conclusions: Age, sex, and distractor interfere in the adaptation of the virtual task of driving in a simulator. The evaluation model developed with multi-domains demonstrated the ability to predict which skills are related to braking time with and without the presence of the distractor.

Effect of concurrent training in unilateral transtibial amputees using Paralympic athletes as a control group

Abstract Context: Transtibial Amputation (TA) predisposes to a sedentary lifestyle. Objectives: To evaluate the efficiency of a short-term (8-week) Concurrent Training (CT) program in Unilateral Transtibial Amputees (UTA) and to compare it with the physical condition of a group of Paralympic athletes in preparation for the Rio de Janeiro Paralympics. Design: This was a longitudinal, prospective and controlled trial study. Methods: Thirty-four male subjects with UTA and using prostheses for six months or more were selected for this study. They were divided into two groups: Group 1 (G1) - 17 non-athlete and untrained UTA and Group 2 (G2) - 17 paralympic athletes with active UTA in the training phase. G1 was evaluated before and after eight weeks of CT and G2 made a single evaluation for control. All were submitted to anamnesis, clinical evaluation (blood pressure, electrocardiogram, and heart rate) and cardiopulmonary exercise testing on a lower limb cycle ergometer, and isokinetic knee dynamometry. The CT of G1 included resistance exercise and aerobic interval training on a stationary bicycle and G2 followed the training of the Paralympic teams. Results: Patients were retested by the same methods after CT. The two most important central dependent variables (maximal oxygen uptake and muscular strength) increased by 22% and knee extensor and flexor strength by 106% and 97%, respectively. Conclusion: After eight weeks of CT, there was an improvement in general functional condition, muscle strength, and cardiorespiratory performance improving protection against chronic diseases and quality of life.

Is 12 months enough to reach function after athletes' ACL reconstruction: a prospective longitudinal study

Abstract Context: Anterior Cruciate Ligament (ACL) injury is disabling in several sports because it causes knee instability and functional deficit. Usually, surgical treatments produce the best functional outcomes, however, sometimes they are not always able to fully restore stability and function. Objective: The objective of this study was to evaluate postural balance, muscle strength, and functional performance of young athletes with an ACL injury before and after ACL reconstruction. Design: This was a longitudinal observational prospective study. Method: 74 athletes, 60 men, and 14 women, aged between 16 and 45, divided into two groups: the Group-Lesion of ACL with 34 athletes (24.1 years) and the Group-Control with 40 athletes without ACL lesion (27.7 years old). All volunteers performed posturography, isokinetic dynamometry, and the Hop-Test. The ACL-Group was evaluated before and 12 months after the reconstruction and the control group was evaluated once. Results: The Postoperative ACL Group presented greater limb symmetry, 0.96 (± 0.12), than the preoperative ACL Group, 0.87 (± 0.17), p < 0.01 in the Hop-Test. In the posturography, the displacement area was smaller in the postoperative ACL Group, 19.85 (± 5.74), compared to the preoperative ACL Group, 24.20 (± 8.97), p < 0.01. In isokinetic dynamometry the torque peak was greater in the postoperative ACL Group, 0.91 (± 0.14), than in the preoperative ACL Group, 0.74 (± 0.15), p < 0.01. Conclusion: The functional outcomes increased in ACL reconstruction athletes after 12 months, but not at the same level as in the Control Group. The result indicates an incomplete functional recovery, adaptive changes in postural control after injury, reconstruction, and return to sport.

Influence of invertor and evertor muscle fatigue on functional jump tests and postural control: A prospective cross-sectional study

ABSTRACT Objective: Fatigue of the ankle's stabilizing muscles may influence the performance of functional activities and postural control. The purpose of this study was to evaluate the performance of healthy young adults using functional jump tests and static posturography control under pre- and post-fatigue conditions of the ankle invertor and evertor muscles. Methods: Thirty physically active healthy male and female (15 male and 15 female) volunteers (24.3 years) were enrolled in this prospective cross-sectional study. Participants performed tests on one day under a non-fatigued state of invertor and evertor muscles and on the second day in a fatigued state. Tests included static posturography on a force platform in a bipedal stance with eyes open and closed and in one-legged support with eyes open and functional jump tests (figure-of-8, side hop, 6-m crossover hop, and square hop). Fatigue of the ankle invertor and evertor muscles was induced using isokinetic dynamometry with 30 repetitions at 120°/s. Results: Participants had an average age of 24.3 years (SD ± 2.08), the height of 1.73 m (SD ± 0.08), and a weight of 68.63 kg (SD ± 10.29). The average Body Mass Index (BMI) was 22.88 (SD ± 2.46). A decrease in performance was observed in functional activities and postural control under all conditions after the induction of muscle fatigue, except for the speed at a bipedal stance with eyes open. Conclusions: Functional jump tests are low cost and useful for clinical practice and evaluation of the effects of muscle fatigue and could be used in clinical practice.

The variability of isokinetic ankle strength is different in healthy older men and women

Abstract Context In the elderly, weak lower limb muscles impair functional tasks' performance. Objective To evaluate the healthy elderly's ankle dorsiflexion and plantarflexion maximum torque and its variability in two sets of 5 RM isokinetics evaluation. Method 50 women (68.0 ± 4.6 years old) and 50 men (72.7 ± 8.5 years old) did two sets of ankle plantar flexor and dorsiflexor isokinetic tests at 30°/s. Peak torque, total work, and coefficient of variation were analyzed. Results Men did the strongest plantarflexion torque (p < 0.05) and dorsiflexion torque (p < 0.05); their highest peak torque occurred at set 2 (p < 0.05), while the largest plantarflexion torque variability (p < 0.05), dorsiflexion torque variability (p < 0.05), and the largest plantarflexion torque variability occurred at set 1 (p < 0.05). Men did the highest plantarflexion and dorsiflexion total work (p < 0.05) at set 2 (p < 0.05). Conclusion Older men are stronger than older women. The torque variability, in men, was higher during the first set, suggesting an adaptation to the isokinetics evaluation. Clinicians and researchers should consider that different muscles might need different numbers of sets and trials to measure their maximal muscle strength.

Changes in postural balance associated with a woman's aging process

Abstract Context Aging causes a progressive worsening in postural balance, affecting functional independence and increasing the risk of falls. Objective The aim of the study was to evaluate the effect of aging on the static balance in women from 50-years to 89-years of age. Design This was a cross-sectional study, with 400 irregularly active women were evaluated and grouped by age: Group 6thdecade (age 50 to 59) ‒ 58 participants; Group 7thdecade (age 60 to 69) ‒ 214 participants; Group 8thdecade (age 70 to 79) ‒ 92 participants; Group 9thdecade (age 80 to 89) ‒ 36 participants. Postural balance was evaluated using a portable force platform in a standard standing position, with Eyes Open (EO) and Eyes Closed (EC). Results In the two measurement conditions, the elderly women in Group 9thdecade presented mediolateral displacement and range, and mean velocity greater than the women's values in Groups 6thand 7thdecade. In the EO e EC situation, the displacement was higher in the elderly Group 9thdecade compared to younger groups. Group 8thhas a mean velocity greater than Group 6thdecade in the EO situation. Conclusions Posturography showed a decline in postural balance with advancing age, suggesting that the 9thdecade of life is a borderline age to this detriment due to an increase in postural instability.

Effects of resistance training on postural control in Parkinson's disease: a randomized controlled trial / Efeitos de um treinamento de resistência muscular no controle postural em indivíduos com doença de Parkinson: um estudo aleatorizado controlado

ABSTRACT Background: Postural instability affects Parkinson's disease (PD) patients' postural control right from the early stages of the disease. The benefits of resistance training (RT) for balance and functional capacity have been described in the literature, but few studies have been conducted showing its effects on PD patients' postural control. Objective: To investigate the effects of a three-month RT intervention on static posturography (SP) measurements and clinical functional balance assessment among PD patients. Methods: Seventy-four patients were randomly assigned to a three-month RT intervention consisting of using weightlifting machines at a gym (gym group) or RT consisting of using free weights and elastic bands (freew group), or to a control group. The participants were evaluated at baseline, three months and six months. We evaluated changes of SP measurements under eyes-open, eyes-closed and dual-task conditions (primary endpoint), along with motor performance and balance effects by means of clinical scales, dynamic posturography and perceptions of quality of life (secondary endpoints). Results: There were no significant interactions in SP measurements among the groups. Unified Parkinson Disease Rating Scale (UPDRS-III) motor scores decreased in both RT groups (p<0.05). Better perceived quality of life for the mobility domain was reported in the gym group while functional balance scores improved in the freew group, which were maintained at the six-month follow-up (p<0.05). Conclusions: This study was not able to detect changes in SP measurements following a three-month RT intervention. Both RT groups of PD patients showed improved motor performance, with positive balance effects in the freew group and better perceived quality of life in the gym group.

RESUMO Introdução: A instabilidade postural afeta o controle postural desde os estágios iniciais da doença de Parkinson (DP). A literatura descreve benefícios do programa de fortalecimento muscular no equilíbrio, na capacidade funcional, porém poucos estudos investigaram seus efeitos no controle postural na DP. Objetivo: Investigar os efeitos de um programa de três meses de fortalecimento nas medidas da posturografia estática (PE) e nos testes clínicos na DP. Métodos: Participaram do ensaio aleatório controlado 74 pacientes, designados em um dos seguintes grupos: fortalecimento utilizando aparelhos de musculação (gmusc); fortalecimento com pesos livres e elásticos (gpeso); e grupo controle. As avaliações ocorreram antes da intervenção, 3 e 6 meses após intervenção. Foram avaliados alterações nas medidas da PE nas condições de olhos abertos, olhos fechados e dupla tarefa (desfecho primário), efeitos sobre sintomas motores, equilíbrio por meio de escalas clínicas, posturografia dinâmica e percepção da qualidade de vida (desfechos secundários). Resultados: Não houve interações significativas nas medidas da PE entre os grupos. As pontuações motoras da Escala Unificada de Avaliação da Doença de Parkinson (UPDRS-III) diminuíram em ambos os grupos de fortalecimento (p<0,05). Houve melhora da percepção da qualidade de vida para o domínio mobilidade no gmusc, assim como ganhos nas pontuações dos testes funcionais no gpeso, mantido no seguimento após seis meses (p<0,05). Conclusões: O programa de fortalecimento não altera o controle postural medida pela PE. Apesar disso, ambos os grupos de fortalecimento apresentaram melhor desempenho motor, efeitos positivos a médio prazo no equilíbrio no gpeso e melhor desempenho na qualidade de vida no gmusc.

Biomechanical evaluation in runners with Achilles tendinopathy

OBJECTIVES: To evaluate the clinical characteristics, ground reaction force (GRF), and function of the plantar muscles and dorsiflexors of the ankle in runners with and without Achilles tendinopathy (AT) and in non-runners. METHODS: Seventy-two participants (42 men, 30 women; mean age: 37.3±9.9 years) were enrolled in this cross-sectional study and divided into three groups: AT group (ATG, n=24), healthy runners' group (HRG, n=24), and non-runners' group (NRG, n=24). Both ankles were evaluated in each group. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale was used for clinical and functional evaluation. GRF was evaluated using force plates and muscle strength was evaluated using an isokinetic dynamometer. RESULTS: The AOFAS scores were lower in the ATG. The strike impulse was higher in the ATG than in the HRG and NRG. However, GRF was similar among the groups. The ATG exhibited lower total work at 120°/s speed than the HRG. The peak torque in concentric dorsiflexion was lower in the NRG than in the ATG and HRG. The peak torque and total work in concentric plantar flexion were lower in the NRG than in the ATG. The peak torque and total work in eccentric plantar flexion were lower in the NRG than in the ATG and HRG. CONCLUSION: Runners with AT showed higher strike impulse, lower muscle strength of the plantar flexors, and higher clinical and functional damage.

Physical and pulmonary capacities of individuals with severe coronavirus disease after hospital discharge: A preliminary cross-sectional study based on cluster analysis

OBJECTIVE: This study aimed to analyze the physical and pulmonary capacities of hospitalized patients with severe coronavirus disease and its correlation with the time of hospitalization and complications involved. METHODS: A total of 54 patients, aged ≥18 years of both sexes, were evaluated 2-4 months after hospital discharge in São Paulo, Brazil. The physical characteristics analyzed were muscle strength, balance, flexibility, and pulmonary function. The K-means cluster algorithm was used to identify patients with similar physical and pulmonary capacities, related to the time of hospitalization. RESULTS: Two clusters were derived using the K-means algorithm. Patients allocated in cluster 1 had fewer days of hospitalization, intensive care, and intubation than those in cluster 2, which reflected a better physical performance, strength, balance, and pulmonary condition, even 2-4 months after discharge. Days of hospitalization were inversely related to muscle strength, physical performance, and lung function: hand grip D (r=−0.28, p=0.04), Short Physical Performance Battery score (r=−0.28, p=0.03), and forced vital capacity (r=−0.29, p=0.03). CONCLUSION: Patients with a longer hospitalization time and complications progressed with greater loss of physical and pulmonary capacities.

During the coronavirus (covid-19) pandemic, does wearing a mask improve or worsen physical performance? / Durante a pandemia de coronavírus (covid 19), o uso de máscara melhora ou piora o desempenho físico? / ¿durante la pandemia de coronavirus (covid 19) el uso de la máscara mejora o empeora el desempeño físico?

ABSTRACT A mask is a simple device yet it provides high levels of protection. As the virus affects mainly the respiratory tract - the nose, mouth, and lungs - it is highly contagious when people sneeze or cough, or exchange respiratory droplets with other people. This exchange is also promoted when a person is performing physical exercise. Although a mask provides some protection, it does not eliminate the need for social distancing. Around 25% of people infected with the new coronavirus may show no symptoms, yet still transmit the virus. One of the main problems with wearing a mask is that it hinders breathing, with the mask gradually becoming damp, increasing its resistance to air intake. Wearing a mask while performing physical activity requires a period of adaptation, as the flow of air to the lungs is reduced, requiring a reduction in the normal rhythm until the wearer has managed to adapt to it. Vigorous and intense exercise can cause inflammatory activity to increase, and should be minimized in order to protect the immune system. Secretory immunoglobulin A (IgA) is an antibody protein used by the immune system to neutralize pathogens, including viruses, and decreases with intense exercise. Exercise is considered intense when it is necessary to breathe through the mouth to eliminate the higher concentrations of CO2, but mouth breathing is associated with infections of the upper respiratory tract. Preference should be given to light to moderate exercise, around three times a week. Wearing a mask, and training in nasal breathing are the best and safest ways to reduce the entry of particles, and should be encouraged during this COVID-19 pandemic. Level of evidence V; Opinion of the specialist.

RESUMO A máscara é um dispositivo simples, mas oferece altos níveis de proteção. Como o vírus afeta principalmente o trato respiratório - nariz, boca e pulmões - é altamente contagioso quando as pessoas espirram, tossem ou trocam gotículas respiratórias com outras pessoas. Essa troca também é promovida quando a pessoa está realizando exercícios físicos. Embora a máscara forneça alguma proteção, ela não elimina a necessidade de distanciamento social. Cerca de 25% das pessoas infectadas com o novo coronavírus podem não apresentar sintomas, mas mesmo assim, transmitem o vírus. Um dos principais problemas do uso de máscara é que ela dificulta a respiração, pois gradualmente fica úmida e aumenta a resistência à entrada de ar. É necessário um período de adaptação para a atividade física com máscara, pois o fluxo de ar para os pulmões é reduzido, exigindo a diminuição do ritmo normal até que a adaptação ocorra. Exercícios vigorosos e intensos podem aumentam a atividade inflamatória e devem ser minimizados para proteger o sistema imunológico. A imunoglobulina secretora A (IgA) é uma proteína anticorpo usada pelo sistema imunológico para neutralizar patógenos, incluindo vírus, e diminui com exercícios intensos. O exercício é considerado intenso quando é necessário respirar pela boca para eliminar a maior concentração de CO2, mas a respiração bucal está associada a infecções do trato respiratório superior. A preferência deve ser pelos exercícios leves a moderados, realizados cerca de três vezes por semana. Usar a máscara e treinar a respiração nasal são os modos melhores e mais seguros de reduzir a entrada de partículas e precisam ser incentivados durante a pandemia de COVID-19. Nível de evidência V; Opinião do especialista.

RESUMEN La máscara es un dispositivo simple, pero ofrece altos niveles de protección. Debido a que el virus afecta principalmente el tracto respiratorio (nariz, boca y pulmones) es muy contagioso cuando las personas estornudan, tosen o intercambian gotitas respiratorias con otros. Aunque la máscara proporciona cierta protección, no elimina la necesidad del distanciamiento social. Alrededor del 25% de las personas infectadas con el nuevo coronavirus pueden no tener síntomas, pero aun así transmiten el virus. Uno de los principales problemas de la máscara es que dificulta la respiración, ya que gradualmente se humedece y aumenta la resistencia a la entrada del aire. Es necesario un período de adaptación para la actividad física con una máscara, ya que reduce el flujo de aire a los pulmones, lo que requiere una disminución del ritmo normal hasta que se produzca la adaptación. El ejercicio vigoroso e intenso puede aumentar la actividad inflamatoria y debe minimizarse para proteger el sistema inmunitario. La inmunoglobulina secretora A (IgA) es una proteína anticuerpo utilizada por el sistema inmunitario para neutralizar los patógenos, incluidos los virus, y disminuye con el ejercicio intenso. El ejercicio se considera intenso cuando es necesario respirar por la boca debido la mayor concentración de CO2, pero la respiración bucal se asocia con infecciones del tracto respiratorio superior. La preferencia debe ser para la realización de ejercicios leves a moderados aproximadamente tres veces por semana. Usar la máscara y entrenar la respiración nasal es mejor y más seguro para reducir la entrada de partículas y deben estimularse durante la pandemia de COVID-19. Nivel de evidencia V; Opinión de expertos.

Effects of treadmill training on gait of elders with Parkinson's disease: a literature review / Efeitos do treinamento de marcha em esteira em idosos com doença de Parkinson: uma revisão da literatura

ABSTRACT Parkinson's disease is the second most common neurodegenerative disorder in old age. Aging process for elders with Parkinson's disease can induce gait disturbances with more functional disabilities than for elders without the disease. Treadmill training as a therapy has resulted in notable effects on the gait of patients with Parkinson's disease and may be a resource for geriatric neurological rehabilitation. This review aimed to study the effects on gait after treadmill training in elderly patients with Parkinson's disease. The search was performed in the databases PubMed®, LILACS, PEDro and EMBASE, with the following keywords: "Parkinson's disease", "elderly", "treadmill training" and "gait evaluation". The quality of the studies included was assessed by PEDro Scale. Eleven studies met the inclusion and exclusion criteria. Eight studies were randomized, and only one did a follow-up. One can observe in this review that treadmill training with or without weight support (at least 20 minutes, two to three times a week, with progressive increase of loads, for minimum of 6 weeks) in elderly patients with the Parkinson's disease was effective to improve gait. In addition, both were considered safe (since some studies described the use of belts, even in unsupported training) and can be associated with therapies complementary to gait, such as repetitive transcranial magnetic stimulation, visual cues or anodal transcranial direct current stimulation. Treadmill training in elderly patients with Parkinson's disease is an intervention that improves gait outcomes, but further studies are required for better proofs.

RESUMO A doença de Parkinson é o segundo distúrbio neurodegenerativo mais comum na velhice. O processo de envelhecimento de idosos com doença de Parkinson pode levar a distúrbios de marcha com mais incapacidades funcionais do que para idosos sem a doença. O treinamento em esteira como terapia pode resultar em efeitos notáveis na marcha de pacientes com Parkinson e ser um recurso para a reabilitação neurológica geriátrica. Esta revisão teve como objetivo estudar os efeitos da marcha após o treinamento em esteira na doença de Parkinson em idosos. A pesquisa foi realizada nas bases de dados PubMed®, LILACS, PEDro e EMBASE, com os seguintes descritores: "doença de Parkinson", "idosos", "treinamento em esteira" e "avaliação da marcha". A qualidade dos estudos incluídos foi avaliada pela escala de PEDro. Atenderam aos critérios de inclusão e exclusão 11 estudos. Oito estudos foram randomizados, e apenas um fez follow-up . Foi possível observar que treinamento em esteira com ou sem suporte de peso (por pelo menos 20 minutos, duas a três vezes por semana, com aumento progressivo de cargas, por, no mínimo, 6 semanas) em idosos com doença de Parkinson foi efetivo para melhorar a marcha. Além disso, ambos os treinamentos foram considerados seguros (pois alguns estudos relataram o uso de cintos, mesmo no treinamento sem suporte de peso) e podem ser associados a terapias complementares à marcha, como estimulação magnética transcraniana repetitiva, estímulos visuais ou estimulação transcraniana direta anódica. O treinamento em esteira em pacientes idosos com doença de Parkinson é uma intervenção que melhora os resultados da marcha, mas requer mais estudos para melhor comprovação.

Response to fatigue observed through magnetic resonance imaging on the quadriceps muscle in postmenopausal women

OBJECTIVES: Menopause marks the end of women's reproductive period and can lead to sarcopenia and osteoporosis (OP), increasing the risk of falls and fractures. The aim of this study is to evaluate the influence of normal and low bone mineral density (BMD) on muscular activity, observed through inflammatory edema when mapping using magnetic resonance imaging (MRI) on the quadriceps muscle of postmenopausal women. METHODS: This was a cross-sectional study involving 16 older women, who were divided into two groups: osteoporosis group (OG), older women with OP, and control group (CG), older women without OP. The groups were evaluated in terms of nuclear MRI exam before and after carrying out fatigue protocol exercises using an isokinetic dynamometer and squatting exercises. RESULTS: The results of the present study showed that in intragroup comparisons, for both groups, there was a significant increase (p<0.05) in the T2 signal of the nuclear MRI in the quadriceps muscle after carrying out exercises using both thighs. In the intergroup comparison, no statistically significant difference was observed between the OG and CG, pre- (p=0.343) and postexercise (p=0.874). CONCLUSION: The acute muscular activation of the quadriceps evaluated by T2 mapping on nuclear MRI equipment is equal in women with and without OP in the postmenopausal phase. BMD did not interfere with muscle response to exercise when muscle fatigue was reached.

Posturographic measures did not improve the predictive power to identify recurrent falls in community-dwelling elderly fallers

OBJECTIVE: This study aimed to evaluate if posturography can be considered a recurrent fall predictor in elderly individuals. METHODS: This was a cross-sectional study. A total of 124 subjects aged 60 to 88 years were evaluated and divided into two groups—the recurrent fallers (89) and single fallers (35) groups. Patients' sociodemographic characteristics were assessed, and clinical testing was performed. The functional test assessment instruments used were timed up and go test (TUGT), Berg Balance Scale (BBS), five times sit-to-stand test, and Falls Efficacy Scale (to measure fear of falling). Static posturography was performed in a force platform in the following three different situations—eyes open (EO), eyes closed (EC), and EO dual task. RESULTS: There were significant differences between the single and recurrent fallers groups regarding the fear of falling, the Geriatric Depression Scale score, the mean speed calculated from the total displacement of the center point of pressure (COP) in all directions with EO, and the root mean square of the displacement from the COP in the mediolateral axis with EC. Based on the hierarchical logistic regression model, none of the studied posturographic variables was capable of significantly increasing the power of differentiation between the recurrent and single fallers groups. Only TUGT with a cognitive distractor (p<0.05) and the BBS (p<0.01) presented with significant independent predictive power. CONCLUSION: TUGT with a cognitive distractor and the BBS were considered recurrent fall predictors in elderly fallers.

Bone mineral density and body composition in elderly runners: six-year follow-up / Densidade mineral óssea e composição corporal de idosos corredores: follow-up de seis anos

ABSTRACT Objective: To evaluate bone mineral density (BMD) and body composition over a six-year period in elderly long-distance runners. Methods: We analyzed the medical records of elderly athletes who were long-distance runners, were participants of the IOT-HCFMUSP Orthogeriatric Group, and had their BMD evaluated between 2001 and 2007; of these athletes, 11 were included in the study. Inclusion criteria: athletes should be long-distance runners, should not stop long-distance running during the six-year period, and should have undergone BMD and body composition evaluations. Body composition was evaluated using bone densitometry with dual-energy X-ray absorptiometry with a Lunar-DPX device. Results: Over the six-year period, body composition remained stable, but there was a significant increase only in the fat percentage (p = 0.003). Conclusion: Long-distance running may maintain BMD but may lead to an increase in the fat percentage in elderly runners. Level of Evidence II; Prognostic Study - Investigating the Effect of Patient Characteristics on Disease Outcome.

RESUMO Objetivo: Acompanhar a densidade mineral óssea (DMO) e a composição corporal, ao longo de seis anos, em idosos corredores de longa distância. Métodos: analisamos os prontuários médicos de um grupo de atletas idosos, corredores de longa distância, participantes do Grupo de Ortogeriatria do IOT-HC-FMUSP, e reunimos todos os atletas que tiveram a DMO avaliada no ano de 2001 e de 2007, sendo destes, 11 prontuários selecionados. Critérios de inclusão: ser corredor de longa distância; não parar de correr ao longo dos seis anos e ter os dois exames de DMO e composição corporal avaliados. A composição corporal foi avaliada por meio de densitometria óssea, com uma dupla energia de absorção de raios-X (DEXA), em um aparelho LUNAR-DPX. Resultados: Ao longo dos seis anos, a composição corpórea se manteve estável, havendo apenas um aumento significante na gordura expressa em (%) (p=0,003). Conclusão: A corrida de longa distância parece conservar a DMO de idosos corredores, porém com aumento de gordura. Nível do Evidência II; Estudos prognósticos - Investigação do efeito de características de um paciente sobre o desfecho da doença.

Confiabilidade das mensurações de testes isocinéticos para articulação do tornozelo / Reliability of isokinetic test measurements for ankle joint

O teste isocinético do tornozelo tem uma grande relevância, já que é possível estabelecer protocolos com velocidades e modos de contração semelhantes aos das atividades funcionais e esportivas. Desta forma, são necessários estudos que mostram a confiabilidade desta ferramenta para auxiliarem na prevenção de lesões do tornozelo. Objetivo: Elaborar uma revisão de literatura sobre estudos que abordaram a confiabilidade de testes isocinéticos da articulação do tornozelo. Métodos: A busca na literatura foi realizada nas bases de dados Pubmed, Lilacs, Pedro, Scielo, Scopus e Cochrane com os descritores científicos ankle e isokinetic e reliability. Foram identificados 34 artigos, 4 foram excluídos por não estudarem humanos e 27 foram incluídos (10 referentes à confiabilidade de testes isocinéticos para inversores e eversores do tornozelo e 17 referentes à confiabilidade de testes para flexores-plantares e dorsiflexores). Resultados: A confiabilidade da avaliação isocinética dos flexores-plantares e dorsiflexores tem sido descrita para diferentes dinamômetros, posições, modos e populações. Os valores de coeficientes de correlação intraclasse variam de 0,55-0,98; e a de eversores e inversores, variam de 0,54-0,99, classificados na faixa de satisfatório a excelente. Conclusão: Os protocolos isocinéticos da articulação do tornozelo devem ser elaborados de acordo com a musculatura recrutada e com a população (com presença ou não de patologia).

Ankle isokinetic tests are importance because establish protocols with velocities and modes of contraction similar to functional and sport activities. Thus, studies that show the reliability of this tool are needed to help the ankle injury prevention. Objective: To develop a literature review about studies that show the reliability of ankle isokinetic test. Methods: The literature search was conducted in Pubmed, Lilacs, Peter, Scielo, Scopus and Cochrane with key words: isokinetic and ankle and reliability. 34 articles were identified, 4 were excluded because they did not study humans and 27 were included (10 about the reliability of ankle inverters and everter isokinetic tests and 17 about the reliability of tests for ankle flexor-plantar and dorsiflexors). Results: The reliability of isokinetic test has been described for different dynamometers, positions, modes and populations. The values of intraclass correlation coefficients ranged from 0.54 to 0.99, which were considered satisfactory to excellent. Conclusion: Ankle isokinetic protocols must be prepared in accordance with the recruited muscles and the population (with or without pathology).