FGF23 levels as a marker of physical performance and falls in community-dwelling very old individuals

ABSTRACT Objective: The fibroblast growth factor 23 (FGF23) has been related to biological aging, but data in elderly individuals are scant. We determined the profile of serum FGF23 levels in a population of very-old individuals and studied their correlations with parameters of bone metabolism and health markers, as functional performance. Materials and methods: This cross-sectional study was performed on 182 community dwellers aged ≥ 80 years. Serum levels of FGF23, PTH, calcium, albumin, phosphorus, creatinine, bone markers, and bone mineral density data were analyzed. Physical performance was evaluated with the stationary march (Step), Flamingo, and functional reach tests, along with questionnaires to assess falls and fractures in the previous year, energy expenditure (MET), and the Charlson index (CI). Physical activity was evaluated with the International Physical Activity Questionnaire (IPAQ). Results: Most participants (75%) had FGF23 levels between 30-120 RU/mL (range: 6.0-3,170.0 RU/mL). FGF23 levels correlated with estimated glomerular filtration rate (eGFR; r = -0.335; p = 0.001) and PTH (r = 0.318; p < 0.0001). Individuals with FGF23 in the highest tertile had more falls in the previous year (p = 0.032), worse performance in the Flamingo (p = 0.009) and Step (p < 0.001) tests, worse CI (p = 0.009) and a trend toward sedentary lifestyle (p = 0.056). On multiple regression, FGF23 tertiles remained significant, independently of eGFR, for falls in the previous year, performance in the Flamingo and stationary march tests, lean mass index, and IPAQ classification. Conclusion: In a population of very elderly individuals, FGF23 levels were inversely associated with neuromuscular and functional performances. Higher concentrations were related to more falls, lower muscle strength and aerobic capacity, and poorer balance, regardless of renal function, suggesting a potentially deleterious role of high FGF23 concentrations in musculoskeletal health.

Efeitos de oito semanas de canoagem no equilíbrio corporal dinâmico de crianças e adolescentes com Síndrome de Down / Effects of eight weeks of canoeing on the dynamic body balance of children and adolescents with Down Syndrome

O objetivo dessa pesquisa foi analisar os efeitos de oito semanas de treinamento de canoagem no equilíbrio corporal dinâmico de crianças e adolescentes com síndrome de Down. Sete sujeitos, sendo 4 meninos e 3 meninas (10,8±2 anos) participaram da pesquisa durante oito semanas de canoagem, com duas sessões semanais. Para mensurar o equilíbrio corporal dinâmico adotou-se o Four Square Step Test (FSST) que compreende em completar um percurso com obstáculos o mais rápido possível. O teste de Wilcoxon foi utilizado para comparar os valores de equilíbrio corporal dinâmico obtidos no pré e pós. Para comparar os valores entre meninos e meninas, foi utilizado o teste de Mann-Whitney, sendo o tamanho do efeito da intervenção calculada pela escala de Cohen. Pode se afirmar que oito semanas de aulas de canoagem são suficientes para produzir efeitos positivos no equilíbrio corporal dinâmico de crianças e adolescentes com síndrome de Down.

The objective herein was to analyse the effects of eight weeks of canoe training on the dynamic body balance of children and adolescents with Down syndrome. Seven subjects, four boys and three girls (10.8 ± 2 years), participated in this study, attending eight weeks of canoe training (two weekly sessions). The Four Square Step Test was used to measure dynamic body balance; this test involves completing a course with obstacles as quickly as possible. The Wilcoxon test was used to compare the values of dynamic body balance obtained in the pre- and post-tests. To compare the values between the boys and girls, the Mann­Whitney test was used, and the size of the effect of the intervention was calculated using the Cohen scale. It was concluded that eight weeks of canoeing was sufficient to produce positive effects on the dynamic body balance of children and adolescents with Down syndrome.

Sensory assessment of balance regulation of physically active women, 60-79 years old / Avaliação sensorial da regulação do equilíbrio de mulheres fisicamente ativas, 60-79 anos

OBJECTIVE: To evaluate the performance of sensory regulation of static and dynamic balance in older women, and to verify the sensitivity and specificity levels of the Body Balance Test (Teste de Equilíbrio Corporal, TEC) in relation to its reference standard, determining the best cutoff point for identifying risk of falling. METHODS: 74 women (age 67.59 ± 5.26 years) participated in the study, divided into fallers (n = 18) and non-fallers (n = 56). RESULTS: Comparatively, non-fallers had higher performance scores on static balance exteroceptive regulation (SBER), dynamic balance exteroceptive regulation (DBER), and dynamic balance interoceptive regulation (DBIR). Statistically significant differences were found in DBER (p = ≤0.001) and DBIR (p = 0.031). The area under the ROC curve was 0.73 (95%CI 0.58 ­ 0.88; p = 0.003), with a sensitivity level of 42.30% and specificity of 84.80%. CONCLUSIONS: The greatest chance of falling was found for dynamic balance in situations of exteroceptive and interoceptive regulation for older women with and without a history of falls. Deficits in sensory regulation of body balance are common in older women, both fallers and non-fallers

OBJETIVO: Avaliar o desempenho da regulação sensorial do equilíbrio estático e dinâmico de mulheres idosas e verificar os níveis de sensibilidade e especificidade do Teste de Equilíbrio Corporal (TEC) em relação ao seu padrão de referência, determinando o melhor ponto de corte para a identificação do risco de queda. METODOLOGIA: participaram do estudo 74 mulheres (67,59 ± 5,26 anos), divididas em caidoras (n = 18) e não-caidoras (n = 56). RESULTADOS: Comparativamente, não-caidoras indicaram escores de desempenho mais elevados para equilíbrio estático regulação exteroceptiva (EERE), equilíbrio dinâmico regulação exteroceptiva (EDRE) e equilíbrio dinâmico regulação interoceptiva (EDRI). Diferenças estatisticamente significativas foram encontradas na regulação EDRE (p = ≤0,001) e EDRI (p = 0,031). A área verificada sob a curva ROC foi de 0,73 (IC95% 0,58 ­ 0,88; p = 0,003) e nível de sensibilidade de 42,30% e especificidade de 84,80%. CONCLUSÕES: A maior chance de queda foi encontrada para o equilíbrio dinâmico em situação de regulação exteroceptivo e interoceptivo para mulheres idosas com e sem histórico de queda. Déficits na regulação sensorial do equilíbrio corporal são comuns em mulheres idosas caidoras e não-caidoras

Postural Control of People in treatment for substance use disorder

Abstract Aims: One of the common sequelae of chronic abuse of alcohol and/or illicit drugs is the impairment of body balance control, caused by long-term neurological damage. This study aimed to investigate the postural control of individuals hospitalized for the treatment of substance use disorder (initial phase) and to compare the results obtained by a control group. Method: For this, One-hundred fourteen individuals hospitalized for the treatment of substance use disorder and eighty-eight healthy controls, all males, were analyzed. Body mass, height, and waist circumference were measured. Were performed a balance test in a static upright position with feet side by side using a plantar pressure platform. Results: Individuals with substance use disorder have shown significantly lower results on body balance compared with controls. Individuals with chemical dependence showed balance results open-eyes, similar/lower than control subjects with close-eyes. Still, those who used only alcohol or alcohol combined with other illicit drugs presented worse results. Finally, impairments in body balance variables showed a significant correlation with age and substance time of use. Conclusion: Even in the early stage of treatment, substance use disorder considerably impairs the balance of the investigated men. The worst results were found in alcohol-dependents (alcohol alone or alcohol combined with other drugs).

Avaliação da regulação exteroceptiva e interoceptiva do equilíbrio corporal de idosas ativas / Evaluation of exteroceptive and interoceptive regulation of body balance of active seniors

O processo do envelhecimento humano traz consigo um conjunto de alterações para o organismo, dentre elas há a diminuição da eficácia das estratégias motoras do equilíbrio corporal e o aumento do tempo de reação muscular, o que torna o indivíduo mais suscetível à queda. O objetivo deste estudo foi avaliar o desempenho do equilíbrio de um grupo de idosas fisicamente ativas, com ênfase na regulação do sistema visual, vestibular e somatossensorial do equilíbrio estático e dinâmico, bem como sua performance em testes de marcha e flexibilidade. Trata-se de um estudo transversal analítico, realizado com 32 mulheres (67,48±4,88 anos), praticantes regulares de Pilates e hidroginástica. Os instrumentos utilizados foram: Escala do Equilíbrio de Berg (EEB), Timed Up and Go Test (TUG), Teste de Alcance Funcional (TAF) e o Teste de Equilíbrio Corporal (TEC). As idosas foram estratificadas em grupos: G1 (60-64 anos), G2 (65-69 anos), G3 (70-74 anos) e G4 (75-79 anos). A EEB atestou para um equilíbrio conservado [F(3,29)=1,766, p≥0,50], o TUG para independência funcional preservada [F(3,29)=0,418; p≥0,50] e o TAF sem risco para quedas [F(3,20)=2,228; p≥0,50]. O TEC identificou déficit da regulação interoceptiva do equilíbrio para todas as idades e comprometimento regulação interoceptiva do equilíbrio dinâmico para septuagenárias [F(3,29)= 0,301; p≥0,50]. Observou-se correlação moderada entre EEB-TEC (r=0,416; p=0,018), TEC-TUG (r=-345; p=0,013) e negativa entre EEB-TUG (r=-0,427; p=0,013). Sendo que, o TAF não se mostrou equivalente aos demais instrumentos. Conclui-se que mulheres sexagenárias e septuagenárias, praticantes regulares de exercícios físicos, apesar de indicarem bom desempenho nos testes de equilíbrio, marcha e flexibilidade, apresentaram comprometimento dos sistemas de regulação sensorial do equilíbrio estático e dinâmico...(AU)

The process of human aging brings with it a number of alterations to the organism, among them there is a decrease in the effectiveness of the motor strategies of the body balance and the increase of the time of muscular reaction, which makes the individual more susceptible to fall. The aim of this study was to evaluate the balance performance of a group of physically active elderly women, with emphasis on the regulation of the visual, vestibular and somatosensory systems of the static and dynamic balance, as well as their performance in gait tests and flexibility. This is a cross-sectional, analytical study of 32 women (67.48 ± 4.88 years), regular Pilates practitioners, and water aerobics. The instruments used were: Berg Balance Scale (BBS), Timed Up and Go Test (TUG), Functional Reach Test (TAF) and Body Balance Test (TEC). The elderly were stratified into groups: G1 (60-64 years), G2 (65-69 years), G3 (70- 74 years) and G4 (75-79 years). BBS attained a conserved equilibrium [F(3.29)=1.766, p≥0.50], the TUG for preserved functional independence [F(3.29)=0.418; p≥0.50] and TAF without risk of falls [F(3,20)=2,228; p≥0.50]. The TEC identified deficit of interoceptive regulation of balance for all ages and compromise interoceptive regulation of dynamic balance for septuagenarians [F(3,29)=0.301; p≥0.50]. It was observed a moderate correlation between BBS-TEC (r=0.416, p=0.018), TEC-TUG (r=-345, p=0.013) and negative between BBS-TUG (r=-0.427, p=0.013). The TAF did not prove to be equivalent to the other instruments. It was concluded that sexagenarian and septuagenarian women, regular physical exercise practitioners, despite indicating good performance in tests of balance, gait and flexibility, presented impairment of the systems of sensorial regulation of the static and dynamic balance...(AU)

Effect of dominant eye on balance function in age-related cataract patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the effects of improving the dominant and non-dominant eye vision on the balance function of age-related cataract patients with a 3mo follow-up.<p>METHODS: Totally 106 patients with age-related cataract underwent monocular surgery were recruited. According to whether the surgical eyes were dominant, cases were divided into two groups: the dominant eye group(50 cases)and the non-dominant eyes(56 cases). Balance function(Berg balance scale, timed “up and go”)were tested 1d before surgery and 3mo after surgery.<p>RESULTS: The preoperative and postoperative Berg balance scale score changes were as followes: 50.08±4.92, 51.60±4.96, 1.52±1.14, in dominant eye group and 50.73±3.08, 51.67±2.65, 0.94±1.35 in the non-dominant eye group, there were no statistically differences in the first two items, and the amount of changes were statistically different(<i>P</i>=0.02). The preoperative and postoperative timed “up and go”were changed as these, 11.91±4.08s, 10.96±3.66s, 0.95±1.54s in dominant eye group, and 11.80±3.87s, 10.69±3.16s and 1.11±1.75s in non-dominant eye group, there were no statistically differences in the above three items(all <i>P</i>>0.05).<p>CONCLUSION: There was no effect on the balance function between the improvement of the visual acuity on dominant and the non-dominant eye in the age-related cataract with a 3mo follow-up.

Functional reach and lateral reach tests adapted for aquatic physical therapy / Testes de alcance funcional e alcance lateral adaptados para fisioterapia aquática

Abstract Introduction: Functional reach (FR) and lateral reach (LR) tests are widely used in scientific research and clinical practice. Assessment tools are useful in assessing subjects with greater accuracy and are usually adapted according to the limitations of each condition. Objective: To adapt FR and LR tests for use in an aquatic environment and assess the performance of healthy young adults. Methods: We collected anthropometric data and information on whether the participant exercised regularly or not. The FR and LR tests were adapted for use in an aquatic environment and administered to 47 healthy subjects aged 20-30 years. Each test was repeated three times. Results: Forty-one females and six males were assessed. The mean FR test score for men was 24.06 cm, whereas the mean value for right lateral reach (RLR) was 10.94 cm and for left lateral reach (LLR) was 9.78 cm. For females, the mean FR score was 17.57 cm, while the mean values for RLR was 8.84cm and for LLR was 7.76 cm. Men performed better in the FR (p < 0.001) and RLR tests than women (p = 0.037). Individuals who exercised regularly showed no differences in performance level when compared with their counterparts. Conclusion: The FR and LR tests were adapted for use in an aquatic environment. Males performed better on the FR and RLR tests, when compared to females. There was no correlation between the FR and LR tests and weight, height, Body Mass Index (BMI), foot length or length of the dominant upper limb.

Resumo Introdução: Os testes de alcance funcional (AF) e Alcance Lateral (AL) são comumente utilizados em pesquisas científicas e na prática clínica. Os instrumentos de avaliação promovem maior segurança para avaliar cada indivíduo com maior acurasse nos resultados e são adaptados de acordo com as limitações de cada doença. Objetivo: Adaptar os testes de AF e AL para o ambiente aquático e verificar o desempenho de jovens saudáveis. Métodos: Foram coletados os dados antropométricos, e os jovens foram questionados se realizavam atividade física. Os testes de AF e AL foram adaptados para o ambiente aquático e aplicados em 47 sujeitos saudáveis com idade entre 20 e 30 anos. Repetiu-se três vezes cada teste. Resultados: 41 mulheres e seis homens foram avaliados. A média do teste de AF para os homens foi de 24,06cm, alcance lateral direito (ALD) foi 10,94cm, alcance lateral esquerdo (ALE) foi 9,78cm para os homens. No grupo das mulheres, o AF foi de 17,57cm, para ALD 8,84cm e ALE 7,76cm. Homens apresentaram melhor desempenho no AF (p < 0.001) e no ALD do que as mulheres (p = 0.037). Os indivíduos que praticavam atividade física não apresentaram diferenças de desempenho nos testes. Conclusão: Os testes de AF e AL foram adaptados para o meio aquático. Homens apresentaram um melhor desempenho no teste de AF e ALD comparado com as mulheres. Os testes de AF e AL não apresentaram correlação com peso, altura, Índice de Massa Corpórea (IMC) e comprimento do pé e do MS dominante.

Idosos caidores e não caidores: programa de exercício multicomponente e prevalência de quedas / Elderly fallers and non-fallers: physical fitness and falls prevalence

Introdução: O episódio de queda esta presente em 40% da população idosa. A atividade física regular apresenta-se como uma estratégia de melhoria das capacidades da aptidão física e prevenção de quedas para idosos. Objetivo: analisar a aptidão física de idosos caidores e não caidores antes e após a participação em programa de exercício multicomponente, verificar se ocorre a redução de quedas. Métodos: Estudo de coorte, 156 idosos participantes de um programa de extensão universitária; classificados em dois grupos: caidores (n=25) e não caidores (n=131). Aplicou-se a bateria de avaliação de Rikli e Jones. Utilizou-se o método de Equações de Estimativas Generalizadas, adotando-se como fatores tempo e grupo, com post hoc de Bonferroni. Resultados: A análise indicou diferença estatística significante em algumas das relações dos fatores tempo e grupo. Conclusão: Aptidão física indicou melhores resultados, destacando-se a capacidade força. Houve diminuição da prevalência de quedas no grupo caidores. (AU)

Introduction: The incident of fall is present in 40% of the elderly population. Regular physical activity is a strategy for improving physical fitness capacity and to prevent falls in elderly. Objective: To analyze the physical fitness of elderly fallers and non-fallers before and after participation in a multicomponent exercise program, to verify if fall reduction occurs. Methods: A cohort study, 156 elderly participants of a university extension program; divided in two groups: fallers (n = 25) and non-fallers (n = 131). Applied to assessment battery of physical fitness Rikli and Jones. We used the Generalized Estimation Equation method (GHG), adopting as factors time and group and the Bonferroni test. Results: The analysis indicated a statistically significant difference in some of the relations of time and group factors. Conclusion: Physical fitness indicated better results, highlight strength capacity. Decrease in the prevalence of falls in the fallers group. (AU)

Balance in seniors who exercise, considering different levels of fear of falling / Equilíbrio em idosos praticantes de atividade física com diferentes níveis de medo de cair

The aging process brings changes to one's body balance and may trigger a fear of falling. The aim of this study was to compare and verify correlation between different methods that assess body balance among elderly individuals who exercise, according to different levels of fear of falling. The sample was composed of 186 individuals (68.28±6.years) who exercise. Balance assessment used Timed Up and Go, Unipedal Stance, Sitting-Rising and Functional Reach tests. A question about fear of falling was applied in the form of an interview. Statistical analysis used Spearman and Kruskall Wallis correlation. In results, Timed Up and Go (7.13±1.6s), Unipedal Stance (20.52±9.9s), Sitting-Rising (12.43s±3.2s) and Functional Reach (29.51±6.5) showed significant correlation with fear of falling. Individuals less afraid of falling showed better balance performance when compared to those not afraid of falling. In conclusion, better balance performance can contribute to decreasing fear of falling.

Com o envelhecimento há alterações no equilíbrio, podendo desencadear o medo de cair. O objetivo desse estudo foi comparar e verificar a relação de distintos métodos de avaliação do equilíbrio corporal em idosos praticantes de atividade física, segundo os diferentes níveis de medo de cair. A amostra foi composta por 186 indivíduos (68,28±6,7anos) praticantes de atividade física. Para avaliar o equilíbrio, utilizou-se o Timed Up and Go, Apoio Unipodal, Sentar e Levantar e Alcance Funcional. Foi aplicado, em forma de entrevista, questão sobre o medo de cair. Na análise estatística utilizou-se correlação de Spearman e Kruskall Wallis. Nos resultados, o Timed Up and Go (7,13±1,6s), Apoio Unipodal (20,52±9,9s), Sentar e Levantar (12,43s±3,2s) e Alcance Funcional (29,51±6,5) apresentaram relação significativa com o medo de cair. Os indivíduos com menos medo de cair apresentaram melhor desempenho de equilíbrio quando comparados com indivíduos sem medo de cair. Dessa forma, o melhor desempenho no equilíbrio pode contribuir para uma diminuição do medo de cair.

AGREEMENT BETWEEN INSTRUMENTS FOR ASSESSMENT OF BODY BALANCE IN ACTIVE ELDERLY INDIVIDUALS / Concordância entre instrumentos para avaliação do equilíbrio corporal em idosos ativos

ABSTRACT The aim of this study was to analyze the correlation between the instruments used to assess body balance and prediction of the risk of falls of active seniors. Cross-sectional, observational study involving 41 women (69.24 ± 5.24 years) practitioners of physical exercises, in Petrolina-PE. The instruments used were the Berg Balance Scale (BBS), the Dynamic Gait Index (DGI), the "Timed Up and Go" simple (TUG), the "Timed Up and Go" motor (TUGm), the "Timed up and Go "cognitive (TUGc) and Body Balance Test (CET). Significant correlation was observed between TEC-DGI (r = 0.469; p = 0.032), BSE-DGI (r = 0.513; p = 0.021), a significant negative correlation between DGI-TUG (r = -0.454; ˂0,017), DGI -TUGm (r = -0.516; p˂0,006), DGI-TUGc (r = -0.547; ˂0,003), MMSE-TUG (r = -, 470; p = 0.055), MMSE-TUGm (r = - 470; p = 0.057) and a significant and moderate correlation between TUG-TUGm (r = 0.701; p = 0.000), TUG-TUGc (r = 0.713; p = 0.000) and TUGm-TUGc (r = 0.761; p = 0.000). It is concluded that the instruments are complementary. It is recommended their joint application to the evaluation of the body balance and to predict the risk of falls in elderly active.

RESUMO O objetivo do estudo foi analisar a correlação entre instrumentos utilizados à avaliação do equilíbrio corporal e a predição do risco de quedas de idosos ativos. Estudo transversal, observacional, realizado com 41 mulheres (69,24±5,24 anos) praticantes de exercícios físicos, em Petrolina-PE. Os instrumentos utilizados foram a Escala de Equilíbrio de Berg (EEB), o Índice de Marcha Dinâmica (DGI), o “Timed Up and Go” simples (TUG), o “Timed Up and Go” motor (TUGm), o “Timed Up and Go” cognitivo (TUGc) e o Teste de Equilíbrio Corporal (TEC). Foi observada correlação significativa entre TEC-DGI (r=0,469; p=0,032), EEB-DGI (r= 0,513; p=0,021), correlação significativa negativa entre DGI-TUG (r= -0,454; p˂0,017), DGI-TUGm (r= -0,516; p˂0,006), DGI-TUGc (r= -0,547; p˂0,003), MEEM-TUG (r= -,470; p=0,055), MEEM-TUGm (r= -,470; p=0,057) e correlação significativa e moderada entre TUG-TUGm (r=0,701; p=0,000), TUG-TUGc (r=0,713; <0,000) e TUGm-TUGc (r=0,761; <0,000). Conclui-se que os instrumentos são complementares. Recomenda-se sua aplicação conjunta à avaliação do equilíbrio corporal e à predição do risco de quedas em idosos ativos.

Effect of a single session of ear acupuncture on pain intensity and postural control in individuals with chronic low back pain: a randomized controlled trial

ABSTRACT Background Ear Acupuncture (EA) is a form of acupuncture in which needles are applied to the external ear and has been used in multiple painful conditions. Low back pain (LBP) is highly prevalent in active individuals and causes high economic burden to health systems worldwide. LBP affects the person’s ability to keep balance, especially in challenging conditions. Objective The aim of the study was to examine the effects of a single session of EA on pain intensity and body sway during postural tasks. Method Eighty adults with LBP and pain intensity equal to or greater than 4 (0-10 scale) were randomly allocated (1:1) to EA group (EAG) or placebo group (PG). Initially, the level of pain intensity was assessed. Next, participants stood still on a force plate either with feet in parallel or in semi-tandem and with eyes open or closed. Then, the EAG was treated with EA for 20 min and the PG was treated with detuned ultrasound. After the treatment, pain intensity was assessed again and the postural test was repeated. Pain intensity was the primary outcome and center of pressure sway area and speed were the secondary outcomes measured. Results Results revealed that pain intensity decreased in both groups after treatment, but decreased more in the EAG. For postural control, no effect of treatment and no interaction between treatment and postural condition on body sway were found. Conclusion Those findings indicate that EA is better than placebo to reduce pain, but neither treatment has any effect on postural control.

Análise do equilíbrio corporal em idosos classificados em diferentes faixas etárias através da posturografia dinâmica computadorizada (PDC) / Body balance analysis in elderly classified into different age groups using computerized dynamic posturography (CDP) / Análisis del equilibrio corporal en personas de edad avanzada clasificadas en diferentes grupos de edad utilizando la posturografía dinámica computarizada (PDC)

O presente estudo teve como objetivo avaliar o equilíbrio corporal entre idosos categorizados em três faixas etárias, idosos jovens (60-69 anos), idosos (70-79 anos), e idosos mais velhos (acima de 80 anos). A avaliação constou de variáveis antropométricas e posturografia dinâmica computadorizada (PDC) com uma amostra total de 105 sujeitos. Para a análise das variáveis quantitativas utilizou-se a estatística descritiva de média e desvio-padrão e o teste de Kruskal Wallis com intervalo de confiança de 95%. Os resultados demonstraram que idosos acima de 80 anos obtiveram melhor resultado no tempo de latência (99,111mseg) quando comparados aos mais jovens (133,403mseg para idosos entre 60-69 anos e 135,282msg entre 70-79 anos). No entanto, os idosos mais jovens conseguiram preservar melhor o equilíbrio corporal geral no teste de organização sensorial (percentual de 71,368 para idosos entre 60-69 anos; 67,950 entre 70-79 anos e 68,555 para idosos com mais de 80).

The objective of this study was to evaluate the body balance among the elderly categorized in three age groups: young elderly (60-69 years), elderly (70-79 years) and the older elderly (80 years and older). The evaluation consisted of anthropometric variables and computerized dynamic posturography (CDP) with a total sample of 105 subjects. For the analysis of the quantitative variables, we used the descriptive statistics of mean and standard deviation and the Kruskal Wallis test with 95% confidence interval. The results showed that older elderly had a better latency time (99.111 msec) when compared to younger ones (133,403 msec for the elderly between 60-69 years and 135,282 msec between 70-79 years). However, younger elderly were able to better preserve the general body balance in the sensory organization test (71.368 percent for the elderly between 60-69 years, 67.950 between 70-79 years and 68.555 for the elderly with more than 80).

Este estudio tuvo como objetivo evaluar el equilibrio entre el cuerpo de los ancianos categorizados en tres grupos de edad: jóvenes de edad (60-69 años de edad), los de edad avanzada (70-79 años) y las personas mayores de edad avanzada (mayores de 80 años). La evaluación consistió en variables antropométricas y se calculó posturografía dinámica (PDC) con una muestra total de 105 sujetos. Para el análisis de las variables cuantitativas se utilizó la estadística descriptiva de la media y la desviación estándar y la prueba de Kruskal Wallis, con un intervalo de confianza del 95%. Los resultados mostraron que los ancianos mayores de 80 tenían mejores resultados en el tiempo de latencia (99,111mseg) en comparación con los más jóvenes (60-69 133,403mseg para las personas mayores y 135,282msg em edades comprendidas entre los 70-79 años). Sin embargo, las personas mayores más jóvenes fueron capaces de conservar mejor el equilibrio general del cuerpo en la prueba de organización sensorial (porcentaje de 71,368 para el de 60-69 años, 70-79 años entre 67.950 y 68.555 para las personas mayores de 80).

Análise da concordância entre instrumentos de avaliação do equilíbrio corporal em idosos / Analysis of agreement of assessment tools of body balance in the elderly

CONTEXTUALIZAÇÃO: Diagnosticar os parâmetros clínicos associados com as quedas em idosos tornou-se um grande desafio para a comunidade científica. Apesar da existência de diversos instrumentos direcionados à avaliação do equilíbrio corporal em idosos, ainda é escasso o número de trabalhos que investigaram e discutiram a concordância entre os diversos métodos. OBJETIVO: Analisar a correlação entre alguns testes usados para avaliar o equilíbrio corporal no idoso. MÉTODOS: Tratou-se de um estudo transversal, observacional, realizado com 30 voluntárias idosas comunitárias, hígidas, com diferentes níveis de condicionamento físico. Foram utilizados o Teste de Alcance Funcional Anterior (TAF), a Escala de Equilíbrio de Berg (EEB), o teste Timed Up and Go (TUG) e o Teste de Equilíbrio de Tinetti (Performance Oriented Mobility Assessment - POMA). A correlação dos dados foi realizada por meio da aplicação do Coeficiente de Correlação de Spearman, com nível de significância de 5 por cento (p<0,05). RESULTADOS: Observou-se correlação positiva e moderada entre o TAF e a EEB (r=0,4845; p=0,0067), entre o TAF e a POMA (r=0,4136; p= 0,0231), entre a EEB e a POMA (r=0,6088; p=0,0004). CONCLUSÃO: Os testes são complementares, dado que se mostraram com particularidades e limitações distintas. Torna-se razoável, portanto, a aplicação conjunta desses instrumentos para melhor avaliar o equilíbrio de idosas.

BACKGROUND: The diagnosis of clinical parameters associated with falls in the elderly has become a major challenge for the scientific community. Despite the existence of several tools aiming to assess body balance in the elderly, it is still scarce the number of studies that have investigated and discussed the agreement between different methods. OBJECTIVE: To analyze the correlation between tests used to assess the body balance in the elderly. METHODS: This was a cross-sectional, observational study conducted with 30 healthy female community-dwelling elderly volunteers with different levels of physical conditioning. The Functional Reach Test (FRT), the Berg Balance Scale (BBS), the Timed Up and Go (TUG) and the Performance-Oriented Mobility Assessment of Balance (POMA) were used. The data analysis was performed by using the Spearmam's rank correlation coefficient, with a significance level of 5 percent (p<0.05). RESULTS: There was positive and moderate correlation between the FRT and BBS (r=0.4845, p=0.0067), between FRT and POMA (r=0.4136, p=0.0231), and between BBS and POMA (r=0.6088, p=0.0004). CONCLUSION: The tests are complementary since they showed specific and distinct limitations. It is reasonable, therefore, to use these instruments together to get better assessment of elderly body balance.

Efeitos do treinamento resistido sobre variáveis relacionadas com a baixa densidade óssea de mulheres menopausadas tratadas com alendronato / Effects of resistance training on low bone density-related variables in menopausal women taking alendronate

A osteoporose é uma doença crônica que atinge o esqueleto humano. OBJETIVO: Verificar os efeitos do treinamento resistido sobre a densidade mineral óssea (DMO), força muscular, equilíbrio e qualidade de vida em mulheres menopausadas em tratamento com alendronato. MÉTODOS: Participaram do estudo 16 voluntárias. Elas foram separadas em dois grupos: que praticaram o treino resistido (n = 9, 49,7 ± 4,2 idade) e que constituíram o grupo controle (n = 7, 53,8 ± 4,4 idade). Os instrumentos de avaliação seguintes foram usados: a absorciometria de dupla energia por raios X -DXA (que mediu a coluna lombar L2-L4, colo do fêmur, triângulo de Wards e trocanter maior), o Osteoporosis Assessment Questionnaire (OPAQ) e um teste de equilíbrio. O treinamento foi periodizado em 12 meses, divididos em seis ciclos com intensidade de 70-90 por cento da carga máxima (10RM). Testes paramétricos (t ou Wilcoxon), para análise intragrupo e (Anova) para intergrupos, foram usados. RESULTADOS: Foram encontradas diferenças significativas favoráveis ao grupo que treinou nos sítios da lombar L2-L4 (6,8 por cento, p = 0,001), colo do fêmur (4,8 por cento, p = 0,005) e trocanter (0,76 por cento, p = 0,005). Além de diferenças significativas também para o equilíbrio corporal (21,4 por cento, p = 0,001), qualidade de vida (9,1 por cento, p = 0,001) e todas as medidas de força como na pressão de pernas 45º (49,3 por cento, p < 0,001). CONCLUSÃO: Os resultados sugerem que a metodologia aplicada ao treino resistido pode ser recomendada a mulheres menopausadas com baixa DMO.

Osteoporosis is a chronic disease of the human skeleton. OBJECTIVE: To verify the effects of resistance training on bone mineral density (BMD), muscular strength, balance and quality of life in menopausal women taking Alendronate. MATERIALS AND METHODS: Sixteen female volunteers participated in the study. The volunteers were separated into two groups: resistance training participants (n=9; 49.7±4.2 years) and control group (n=7; 53.8±4.4 years). The following evaluation instruments were used: absorptiometry-DXA (which measured the lumbar spine L2-L4, neck femur, Wards triangle and major trochanter), the Osteoporosis Assessment Questionnaire (OPAQ) and a balance test. The training was applied in 12 months, divided in six cycles with intensity of 70-90 percent of the maximum load (10RM). Parametric tests for intra-group analysis (t or Wilcoxon) and (Anova) for inter-groups, were used. RESULTS: Significant differences in the resistance training group were found in the bones variables: lumbar L2-L4 (6.8 percent, p=0.001), neck femur (4.8 percent, p=0.005) and trochanter (0.76 percent, p=0.005). In addition, significant differences were also found for body balance (21.4 percent, p=0.001), quality of life (9.1 percent, p=0.001) and all muscular strength measurements, such as in leg press 45º (49.3 percent, p<0.001). CONCLUSION: The results suggest that the methodology applied to resistance training can be recommended for menopausal women with low BMD.

La dimensión vertical restaurada en la prótesis dental parcial removible: [revisión] / Restored vertical dimension for the removable partial denture: [review]

Para establecer consideraciones importantes sobre el diseño de las prótesis dentales parciales removibles se presentan algunos criterios respecto a la necesidad de considerar lo que sucede en las articulaciones temporo-mandibulares (ATM), cuando el caso por resolver es unilateral o cuando es bilateral. Se debe recordar que el sistema estomatognático cumple con 32 funciones dentro de las cuales las ligadas con la masticación, la digestión oral y la fonoarticulación cambian rotundamente si hay la carencia de los dientes posteriores. Pero esta carencia también compromete dos funciones generales de mucha importancia para la persona: el equilibrio y la alteración auditiva. Por ello formular y confeccionar las prótesis dentales removibles no es algo tan simple que lo pueda hacer un simple dentista y menos un mecánico dental sin la dirección de un profesional. Como la tarea es muy compleja, este es el primero de varios artículos mediante los cuales se tratará de reorientar el tratamiento rehabilitador del subsistema masticatorio como parte del sistema estomatognático.

Partial dental prosthesis is a very important field of dental rehabilitation process that usually is not well understood, mainly because it involves the repercussion on more than 10 of the 32 functions performed by the stomatognatic system. In order to fit several very important considerations about partial removable dental prosthesis design, some discernment about the need to consider factors that could affect the temporomandibular joint (TMJ) are presented, particularly when the lack of teeth is unilateral or bilateral. It is necessary to take on account that stomatognatic system performs the mastication, the oral carbohydrate digestion, the vocalization and other functions that could change drastically when there are no sufficient posterior teeth. But this lack also affects two general functions: the dynamic balance and the listening capability. All of those factors are very important to formulate and to produce high quality removable dental prosthesis; therefore, this kind of work couldn’t be performed by a simple dentist or by a dental prosthetic technician without a professional guidance. Since this is a very important and complex assignment, this paper is the first of a four assay being oriented to improve the rehabilitation treatment of the masticatory system as a part of the stomatognatic system.