Programa de exercícios multicomponentes domiciliar (VIVIFRAIL®) para longevos durante a pandemia da covid-19 / Acceptability of a home-based multicomponent exercise program (Vivifrail®) for the oldest-old via videoconferencing during the Covid-19 pandemic

Resumo Objetivo Investigar a aceitação e adequação de um programa de exercícios multicomponentes por videoconferência para longevos em Porto Alegre (RS), Brasil. Método Estudo Quase experimental. Os participantes realizaram o protocolo de exercícios multicomponentes ViviFrail® durante 12 semanas, com a aceitação e adequação avaliadas semanalmente por videoconferência. O questionário de aceitação e adequação foi baseado em uma escala Likert (de 0 a 4) de seis barreiras que os participantes enfrentam ao fazer exercício físico, com pontuação máxima de 24 pontos (aceitação máxima). Resultados A aceitação foi de 70%, com 14 participantes concluindo o protocolo (89,07±6,30 anos). A consistência interna, (alfa de Cronbach) para o questionário, foi de 70%, considerada moderada. Os participantes mostraram um aumento geral na aceitação dos 17,8±3,51 pontos iniciais, para 22,0±2,94 pontos no final. Quatro (28.6%) necessitaram de adequação no protocolo de exercício. Conclusão O programa de exercícios multicomponente ViviFrail®, com acompanhamento através de videoconferência, foi bem aceito e adequado, podendo ser uma importante ferramenta para a promoção da qualidade de vida, principalmente em longevos com dificuldade de sair de casa, tanto por problemas de mobilidade, quanto por ambientes sociais desfavoráveis (violência urbana e situações sanitárias). O questionário de aceitação e adequação, que necessitou ser criado, foi capaz de detectar barreiras do

Abstract Objective To investigate the acceptability and adequacy of a multicomponent exercise program via videoconferencing for the oldest-old in Porto Alegre, a city in southern Brazil. Method This is a quasi-experimental study. Fourteen participants were enrolled in the multicomponent exercise program Vivifrail® for 12 weeks, 5 days a week, with weekly video calls for assessment of acceptability and adequacy. The acceptability and adequacy questionnaire was based on 6 barriers that older adults face when engaging in physical exercise. Responses were measured using a 5-point Likert scale ranging from 0 to 4 points, with a maximum score of 24 points (maximum acceptability). Results Fourteen participants (89.07±6.30 years) concluded the protocol, with an acceptability rate of 70%. Internal consistency was moderate, with a Cronbach's coefficient alpha of 0.7. Participants showed an overall increase in acceptability and adequacy (from 17.8±3.51 points in the first week to 22.0±2.94 in the 12th week). Four participants (28.6%) required some modification to the exercise protocol. Conclusion The Vivifrail® protocol, together with weekly follow-up via videoconferencing, was well accepted and adequate. It could be an important tool for promoting quality of life, especially in the oldest-old with difficulty leaving home. The acceptability questionnaire was able to detect exercise barriers and suggest possible modifications to the training program and could be presented as a suggestion for the evaluation of intervention protocols in the oldest-old population. Therefore, the Vivifrail® protocol, with weekly follow-up via videoconferencing, could be a new field of intervention for health professionals.

Anthropometric Characteristics, Handgrip Strength, and Upper Limb Asymmetries in Highly Trained Chilean Shot Put Para-Athletes / Características Antropométricas, Fuerza de Prensión Manual y Asimetrías de Miembros Superiores en Para-Atletas Chilenos de Lanzamiento de Bala Altamente Entrenados

SUMMARY: Anthropometric characteristics, including body size, shape, and composition, can have a significant impact on sports performance due to their influence on various physiological and biomechanical factors. However, limited research has been conducted on the anthropometric characteristics of highly trained throwing para-athletes. The purpose of this study was to describe the anthropometric characteristics, handgrip strength, and upper limb bilateral asymmetries of highly trained Chilean shot put para-throwers. Five male Chilean shot put para-athletes (average age of 38.8 ± 7.7 years) were assessed for their anthropometric characteristics, including skinfold thickness at six anatomical sites, girth at five sites, and bone breadth at two sites. Handgrip strength and bilateral asymmetries were also measured. The body mass and height of the athletes were found to be 90.5 ± 5.1 kg and 179.1 ± 8.9 cm, respectively. The athletes were found to have an endo-mesomorph somatotype (4.4-6.9-1.0) with high levels of fat mass (25.7 ± 2.8 %) and skeletal muscle mass (39.1 ± 3.7 %). The handgrip strength of the athletes was found to be 66.4 ± 6.7 kg with a bilateral asymmetry of 6.5 ± 6.2 %, with the dominant hand showing greater strength. The results indicate that the shot put para-athletes have a somatotype characterized by increased muscularity and body fat, along with a considerable stature. Although handgrip strength was found to be high, the athletes showed bilateral asymmetry, which requires further investigation to determine the cause and implications.

Las características antropométricas, incluido el tamaño, forma y composición del cuerpo, pueden tener un impacto significativo en el rendimiento deportivo debido a su influencia en diversos factores fisiológicos y biomecánicos. Sin embargo, las investigaciones sobre las características antropométricas para-atletas de lanzamiento altamente entrenados son limitadas. El propósito de este estudio fue describir las características antropométricas, la fuerza de prensión manual y las asimetrías bilaterales de miembros superiores de paralanzadores chilenos altamente entrenados en lanzamiento de la bala. Se evaluaron las características antropométricas de cinco atletas masculinos chilenos de lanzamiento de bala (edad promedio de 38,8 ± 7,7 años), incluido el grosor de los pliegues cutáneos en seis sitios anatómicos, la circunferencia en cinco sitios y la anchura de los huesos en dos sitios. También se midieron la fuerza de prensión manual y las asimetrías bilaterales. Se encontró que la masa corporal y la altura de los atletas eran 90,5 ± 5,1 kg y 179,1 ± 8,9 cm, respectivamente. Los atletas tenían un somatotipo endo-mesomorfo (4.4-6.9-1.0) con altos niveles de masa grasa (25.7 ± 2.8 %) y masa muscular esquelética (39.1 ± 3.7 %). Se encontró además que la fuerza de prensión manual de los atletas era de 66,4 ± 6,7 kg con una asimetría bilateral de 6,5 ± 6,2 %, mostrando mayor fuerza la mano dominante. Los resultados indican que los atletas de lanzamiento de bala tienen un somatotipo caracterizado por una mayor musculatura y grasa corporal, junto con una estatura considerable. Aunque se encontró que la fuerza de agarre era alta, los atletas mostraron asimetría bilateral, lo que requiere de más investigaciones para determinar las causa e implicaciones.

Effects of multicomponent exercise training on the intrinsic capacity in frail older adults: review of clinical trials

Abstract Aim: To review the effects of multicomponent exercise training on the domains of the intrinsic capacity of physically frail older adults: locomotion, vitality, cognition, psychological outcomes, and sensory function. Methods: The search for the studies was carried out in the MEDLINE, Cochrane CENTRAL, and PEDro databases, along with manual search, delimiting the period of publication as the last 10 years. The initial search identified 338 studies and 18 among them were analyzed qualitatively. Results: From the analysis of the included studies, great variability was evidenced between the intervention protocols, as well as between the results. As for the effectiveness of multicomponent exercise training, it has been shown to induce a positive effect on most of the analyzed outcomes. Conclusion: In summary, the present review suggests that multicomponent physical training can be effective to improve aspects of locomotion, cognition, and psychological aspects in frail older populations. Nevertheless, more studies are needed to specify the time needed to achieve such adaptations, the magnitude of these adaptations, and the design of the most appropriate training program for each outcome related to intrinsic capabilities.

Dynamic circadian fluctuations of glycemia in patients with type 2 diabetes mellitus

BACKGROUND: Diabetes mellitus (DM) has glucose variability that is of such relevance that the appearance of vascular complications in patients with DM has been attributed to hyperglycemic and dysglycemic events. It is known that T1D patients mainly have glycemic variability with a specific oscillatory pattern with specific circadian characteristics for each patient. However, it has not yet been determined whether an oscillation pattern represents the variability of glycemic in T2D. This is why our objective is to determine the characteristics of glycemic oscillations in T2D and generate a robust predictive model. RESULTS: Showed that glycosylated hemoglobin, glycemia, and body mass index were all higher in patients with T2D than in controls (all p < 0.05). In addition, time in hyperglycemia and euglycemia was markedly higher and lower in the T2D group (p < 0.05), without significant differences for time in hypoglycemia. Standard deviation, coefficient of variation, and total power of glycemia were significantly higher in the T2D group than Control group (all p < 0.05). The oscillatory patterns were significantly different between groups (p = 0.032): the control group was mainly distributed at 2-3 and 6 days, whereas the T2D group showed a more homogeneous distribution across 2-3-to-6 days. CONCLUSIONS: The predictive model of glycemia showed that it is possible to accurately predict hyper- and hypo-glycemia events. Thus, T2D patients exhibit specific oscillatory patterns of glycemic control, which are possible to predict. These findings may help to improve the treatment of DM by considering the individual oscillatory patterns of patients.

Comparison of the electromyographic activity of different zones of the abductor digiti minimi manus muscle in search of a functional compartmentalisation / Comparación de la actividad electromiográfica de diferentes zonas del músculo abductor digiti minimi manus en busca de una compartimentación funcional

SUMMARY: There is evidence demonstrating the presence of functional compartmentalisation (FC) in some skeletal muscles. This means that the motor units (MU), grouped in certain areas of the muscle, show different levels of activation in comparison to those located in other zones. This has only been described in large muscles whose morphology proves the existence of a FC. However, there is no background information about small muscles, such as the Abductor digiti minimi manus (ADM). The objective of this study was to compare the activation of the MU in different zones of the ADM to support the hypothesis of the existence of a FC in the ADM. By using a cross- sectional, analytical, observational study, the activity of the MUs in the ADM was assessed in 12 volunteers (age 21 ± 1.6 years old; weight 75.3 ± 8 kg; height 176.2 ± 7.3 cm; average ± standard deviation). The activity of MUs was evaluated using high-density surface electromyography (HD-sEMG) with an array of 64 electrodes arranged two-dimensionally. This allowed us to record the activity of the MUs in three zones of the ADM (Z1: dorsal zone; Z2: dorsal-palmar zone and Z3: palmar zone). Electromyographic recordings were obtained during voluntary isometric contractions of the ADM at 20, 40, 60 and 80 % of the maximum voluntary contraction (MVC). The comparison of the activation levels of MUs between the three zones was carried out using a mixed model analysis of covariance. The results showed a significant difference between the dorsal and palmar zones at 40 % of the MVC (p= 0.03), and between the dorsal and dorsal- palmar zone at 80 % of the MVC (p= 0.03). The results obtained in the evaluated sample support the hypothesis of the existence of FC in the ADM. However, further research is needed to determine with greater certainty the presence of this compartmentalisation in the ADM.

RESUMEN: Existe evidencia que demuestra la presencia de una compartimentalización funcional (CF) en algunos músculos esqueléticos. Aquello se traduce en que las unidades motoras (UM) agrupadas en ciertas zonas del músculo, presentan diferentes niveles de activación a las ubicadas en otras regiones. Esto solo ha sido descrito en músculos grandes, cuya morfología justifica la existencia de una CF. Sin embargo, no existen antecedentes de aquello en músculos pequeños, tales como el abductor digiti minimi manus (ADM). El objetivo de este estudio fue comparar la activación de las UM en distintas zonas del ADM, con la finalidad sostener la hipótesis de la existencia de una CF en el ADM. Mediante un estudio observacional analítico transversal se evaluó la actividad de las UM del ADM en 12 voluntarios (edad 21±1,6 años; peso 75,3±8 kg; altura 176,2 ± 7,3 cm; promedio ± desviación estándar). La actividad de las UM, se evaluó mediante electromiografía de superficie alta densidad usando una matriz de 64 electrodos dispuestos bidimensionalmente. Esta permitió registrar la actividad de las UM en tres zonas del ADM (Z1: zona dorsal; Z2: zona dorso-palmar y Z3: zona palmar). Los registros electromiográficos fueron obtenidos durante contracciones isométricas voluntarias del ADM al 20, 40, 60 y 80 % de la contracción voluntaria máxima (CVM). La comparación de los niveles de activación de las UM entre las tres zonas fue realizada mediante un análisis de modelos mixtos de covarianza. Los resultados indicaron que existió diferencia significativa entre la zona dorsal y palmar al 40 % de la CVM (p=0,03), y entre la zona dorsal y dorso-palmar al 80 % de la CVM (p=0,03). Los resultados obtenidos en la muestra evaluada sostienen la hipótesis de la existencia de una CF en el ADM. Sin embargo, son necesarias más investigaciones para establecer con mayor certeza la presencia de esta compartimentalización en el ADM.

Neuromuscular compartmentalization of the vastus medialis muscle: comparison of the activity of the vastus medialis obliquus and the vastus medialis longus by high density electromyography / Compartimentación neuromuscular del músculo vasto medial: comparación de la actividad del vasto medial oblicuo y del vasto medial largo mediante electromiografía de alta densidad

SUMMARY: Anatomical studies describe the vastus medialis (VM) as being subdivided into two morphologically distinct components, the vastus medialis obliquus (VMO) and the vastus medialis longus (VML). However, there are discrepancies regarding the functional differentiation of these components. The aim of this study was to compare the levels of activation of the VMO and the VML by high density surface electromyography. Twelve healthy young women (age: 21.4 ± 2.0 years; weight: 58.1 ± 7.5 kg; height: 1.6 ± 0.1 m), performed an open kinetic chain knee exercise during which the EMG activity of the VMO and the VML was recorded with two- dimensional matrices of 32 surface electrodes. The exercises were performed with three levels of resistance (5, 10 and 15 % of the body weight (BW)), considering three phases: concentric, isometric and excentric. In the isometric phase the VMO had greater activation than the VML with the three levels of resistance (p<0.05). In the excentric phase, the VMO also showed greater activation than the VML with the 10 and 15 % BW resistance levels, while in the concentric phase, the VMO showed greater activity than the VML with only the 15 % BW resistance. The results indicated significant differences in the activation level of the two components of the VM. This bears importance in the development of exercises intended to achieve a greater or more selective activation of the VMO. In the sample subjected to evaluation, the EMG recordings describe a greater activation of the VMO in comparison to the VML, which is more important in the isometric and excentric phases of the flexion/extension of the knee in an open kinetic chain. These findings suggest a functional compartmentalization of the VM.

RESUMEN: Los estudios anatómicos describen que el músculo vasto medial (VM) se subdivide en dos componentes morfológicamente distintos, el vasto medial obliquus (VMO) y el vasto medial largo (VML). Sin embargo, existen discrepancias con respecto a la diferenciación funcional de estos componentes. El objetivo de este estudio fue comparar los niveles de activación del VMO y el VML mediante electromiografía de superficie de alta densidad. Doce mujeres jóvenes sanas (edad: 21,4 ± 2,0 años; peso: 58,1 ± 7,5 kg; altura: 1,6 ± 0,1 m), realizaron un ejercicio de rodilla de cadena cinética abierta durante el cual se registró la actividad EMG de la VMO y la VML con dos matrices dimensionales de 32 electrodos de superficie. Los ejercicios se realizaron con tres niveles de resistencia (5, 10 y 15% del peso corporal (PC)), considerando tres fases: concéntrica, isométrica y excéntrica. En la fase isométrica el VMO tuvo mayor activación que el VML con los tres niveles de resistencia (p <0,05). En la fase excéntrica, el VMO también mostró mayor activación que el VML con los niveles de resistencia de 10 y 15% BW, mientras que en la fase concéntrica, el VMO mostró mayor actividad que el VML con solo el 15 % de resistencia al BW. Los resultados indicaron diferencias significativas en el nivel de activación de los dos componentes de la VM. Esto tiene importancia en el desarrollo de ejercicios destinados a lograr una activación mayor o más selectiva del VMO. En la muestra sometida a evaluación, los registros EMG describen una mayor activación del VMO en comparación con el VML, que es más importante en las fases isométrica y excéntrica de la flexión / extensión de la rodilla en cadena cinética abierta. Estos hallazgos sugieren una compartimentación funcional de la VM.

Ejercicio físico en pacientes con diabetes e hipertensión: prevalencia de respondedores y no respondedores para mejorar factores de riesgo cardiometabólicos / Effects of a six weeks exercise training program for type 2 diabetes mellitus and hypertensive patients

Background: There is a wide interindividual variability in the response to a period of exercise training. The science have reported that a minimum of participants could be non-responders for improving different health-related outcomes after training. Aim: To compare the effects of a 6-weeks exercise program on body composition, cardiovascular and metabolic outcomes patients with type 2 diabetes and hypertension. Material and Methods: Data from 23 trained subjects were used in a secondary analysis of the response to exercise. Of these, 14 were considered adherent to training and nine as non-adherent. Body mass, height, waist circumference, four skinfolds and their sum, blood pressure and plasma triglyceride levels were assessed before and after the training period. Results: Among adherent participants, significant reductions were observed in the sum of four skinfolds (30 ± 7 to 27 ± 6 mm, p ≤ 0.05), systolic blood pressure (133 ± 18 to 127 ± 20 mmHg; p ≤ 0.05) and plasma triglycerides (125 ± 58 to 102 ± 34 mg/dL; p ≤ 0.05). No changes were observed in weight or diastolic blood pressure. Among non-adherent participants, no changes of measured parameters were observed. Among adherent participants, 57% were considered as non-responders for waist circumference, 7% for the sum of skinfold thickness, 50% for systolic blood pressure, 64% for diastolic blood pressure and 57% for plasma triglycerides. Conclusions: Participants with a good adherence to a 6-weeks exercise training program experienced overall improvement in body composition, blood pressure and plasma triglycerides. The prevalence of non-responders varied considerably among measured outcomes.

Polimorfismo del gen ACTN3 y ECA en seleccionados de gimnasia de Brasil y Japón / Gene polymorphism ACTN3 and ACE in selected gymnasts athletes in Brazil and Japan

En el rendimiento deportivo, el estudio de la genética ha cobrado un papel fundamental al momento de estudiar el rendimiento deportivo. El objetivo del estudio fue analizar la frecuencia de genotipo y alelo de a - actinina 3 (ACTN3) R577X y enzima convertidora de angiotensina (ECA) I/D polimorfismo en un grupo de gimnastas de Brasil y Japón. Se considero una muestra de 73 gimnastas (14 de Japón y 59 de Brasil), todos los sujetos firmaron de consentimiento informado. Para la obtención de ACTN3 y ECA se recogió una muestra la saliva y analizaron los genotipos mediante el empleo de cadena de la polimerasa en tiempo real a partir del iQ5 Thermal Cycler, BioRad. Los resultados muestran una prevalencia del genotipo RX ACTN3, prevalencia del alelo R, prevalencia del genotipo DI ECA y prevalencia de alelo D en el total del grupo. Se concluye que el predominio RX del ACTN3, prevalencia del alelo R y predominio del genotipo DI en ECA pueden ofrecer una ventaja genética en cuanto a niveles de fuerza y potencia muscular, posiblemente facilitando la práctica y el éxito competitivo en gimnastas.

In the field of competitive sport, genetics has gained a fundamental role in the study of sport performance. The aim of this study was to analyze the prevalence of polymorphisms R577X and insertion/deletion (I/D), occurring in a-actinin-3 (ACTN3) and angiotensin converting enzyme (ACE) genes, respectively, in Brazilian and Japanese gymnasts. A suitable non-probabilistic sample of 73 gymnasts (14 from Japan) was recruited and signed an informed consent. To measure ACTN3 and ECA saliva samples were obtained by means of real time polymerase chain reaction (iQ5 Thermal Cycler, BioRad). A high prevalence of RX ACTN3 genotype, R allele, ACE I/D genotype, and D allele were observed in Brazilian and Japanese gymnasts. In conclusion a high prevalence of RX ACTN3 genotype, R allele and ACE I/D genotype would allow a genetic advantage regarding muscle strength and power, possibly facilitating competitive success in gymnastics.