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Introduction : La gonarthrose est une pathologie très fréquente chez les personnes âgées. Elle entraine des déficiences et des limitations d'activités qui réduisent l'autonomie des patients. La rééducation contribue à améliorer l'autonomie et la qualité de vie de ces patients. L'objectif de l'étude était d'évaluer l'intérêt de la rééducation dans la prise en charge de la gonarthrose de la personne âgée à la Clinique Universitaire de Médecine Physique et de Réadaptation du CNHU- HKM de Cotonou. Méthodes : Il s'est agi d'une étude rétrospective, descriptive et analytique, concernant les dossiers des patients de 65 ans et plus, souffrant de gonarthrose, de 2011 à 2021. Les bilans de début et de fin ont été relevés et comparés selon la douleur, la force musculaire et la limitation fonctionnelle pour obtenir le résultat de la rééducation. Résultats : Cent trente et un patients (131) ont été retenus. L'âge moyen était 70, 90 ± 5,72 ans avec un sex-ratio 0,32. L'évolution a été chronique chez la majorité des sujets (91,00%). La douleur a été d'intensité sévère à l'échelle visuelle analogique dans 71,75% des cas. On notait une faiblesse musculaire périarticulaire du genou dans 60,31% et une limitation des capacités fonctionnelles chez tous les patients à l'indice algo fonctionnel de Lequesne. Après la rééducation, les résultats étaient globalement satisfaisants dans 84,98% concernant la douleur, la force musculaire et les capacités fonctionnelles. Ces résultats ont été très bons et bons respectivement chez 17,30% et 67,68% des patients. L'évolution chronique (p = 0,002 ; OR=0,14 [0,04-0,50]) et l'absence de diabète (p = 0,014 ; OR=3,71[1,04-13,23]) étaient associées à une évolution satisfaisante après la prise en charge rééducative. Conclusion : La rééducation est un moyen thérapeutique efficace pour réduire les déficiences et limitations d'activités et améliorer l'autonomie dans notre contexte où l'arthroplastie n'est pas encore très accessible.

Introduction: Gonarthrosis is a very common pathology among the elderly. It leads to deficiencies and activity limitations which weaken the autonomy of patients. Rehabilitation helps to improve the autonomy and quality of life of these patients. The objective of the study was to evaluate the contribution of rehabilitation in the management of knee osteoarthritis in the elderly at the University Clinic of Physical Medicine and Rehabilitation of the CNHU-HKM of Cotonou in 2022. Methods: This was a retrospective descriptive and analytical study record of patients aged 65 and over, suffering from knee osteoarthritis from 2011 to 2021. The beginning and end assessments were recorded and compared according to pain, muscle strength and functional limitation to obtain the result of the rehabilitation. Results: One hundred and thirty-one patients (131) were included. The average age was 70.90 ± 5.72 years with a sex ratio 0.32. The evolution was chronic in the majority of subjects (91.00%). The pain was of severe intensity on the visual analog scale in 71.75% of cases. Periarticular knee muscle weakness was noted in60,31% and functional capacity was limited in all patients using the Lequesne functional algo index. After rehabilitation, the results were globally satisfactory in 84.98% regarding pain, muscle strength and functional abilities. These results were very good and good respectively in 17.30% and 67.68% of patients. Chronic evolution (p = 0,002; OR=0,14 [0,04-0,50]) and the absence of diabetes (p = 0,014; OR=3,71[1,04-13,23]) were associated with a satisfactory evolution after rehabilitation. Conclusion: Rehabilitation is an effective therapeutic means to reduce deficiencies and activity limitations and improve autonomy in our context where arthroplasty is not yet very accessible.

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Purpose: To assess the frequency of dysmobility syndrome (DS) in a group of postmenopausal women, to determine the frequency of fragility fractures in these patients, and to compare the frequency of fragility fractures and other clinical, biochemical, densitometric, and muscle health characteristics between patients with and without DS. Methods: Postmenopausal women aged ≥ 60 years were invited to participate in a muscle health study program in our bone clinic. The diagnosis of DS was considered when at least three of the following factors were present: osteoporosis, ≥1 fall in the preceding year, low muscle mass, slow gait speed, low grip strength, and high-fat mass. The cohort was divided into patients with DS and without DS. Results: The mean age in the study cohort (n = 250) was 70.36± 7.72 years. DS was diagnosed in 77 patients (30.8 %). A history of falls in the preceding year and the prevalence of fragility fractures were more frequent in patients with DS in comparison with the control group (60% vs. 19%, p <0.001 and 42% vs 17%, p <0.001, respectively). Furthermore, the history of fragility fractures was significantly associated with the presence of DS (OR 4.92, 95% CI 2.3-10.4, p <0.001). Discussion: A significant association was found between DS and a history of fragility fractures. Although this new concept needs further investigation, it seems that the identification of various compartments affected by the aging process results in an opportunity to better predict major adverse events in the elderly. (AU)

Propósito: Evaluar la frecuencia del síndrome de dismovilidad (SD) en un grupo de mujeres posmenopáusicas, determinar la frecuencia de fracturas por fragilidad en estas pacientes y comparar la frecuencia de fracturas por fra-gilidad y otras características clínicas, bioquímicas, densitométricas y de salud muscular entre pacientes con y sin SD. Métodos: Se invitó a mujeres posmenopáusicas de edad ≥60 años a participar en un pro-grama de estudio de la salud muscular en nuestra clínica ósea. Se consideró el diagnóstico de SD cuando estaban presentes al menos tres de los siguientes factores: osteoporosis, ≥1 caída en el año anterior, baja masa muscular, velocidad de marcha lenta, baja fuerza de prensión y masa grasa elevada. La cohorte se dividió en pacientes con SD y sin SD. Resultados: La edad media de la cohorte de estudio (n = 250) fue de 70,36± 7,72 años. Se diagnosticó SD en 77 pacientes (30,8%). Los antecedentes de caídas en el año anterior y la prevalencia de fracturas por fragilidad fue-ron más frecuentes en los pacientes con SD en comparación con el grupo de control (60% frente a 19%, p <0,001 y 42% frente a 17%, p <0,001, respectivamente). Además, el ante-cedente de fracturas por fragilidad se asoció significativamente con la presencia de SD (OR 4,92; IC 95% 2,3-10,4; p <0,001). Discusión: Se encontró una asociación significativa entre el SD y los antecedentes de frac-turas por fragilidad. Aunque este nuevo concepto requiere más investigación, parece que la identificación de diversos compartimentos afectados por el proceso de envejecimiento brinda la oportunidad de predecir mejor los principales acontecimientos adversos en los ancianos. (AU)

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Las miopatías inducidas por medicamentos son una causa relativamente frecuente de debilidad muscular aguda. En muchos casos, los síntomas comienzan poco después del inicio de la medicación causante; sin embargo, el diagnóstico puede ser difícil debido a la polifarmacia o a la asociación inicial de los síntomas con otras patologías. Esto puede provocar un retraso en la retirada del medicamento, lo cual es fundamental para el tratamiento. Se presenta el caso de un paciente de 62 años de edad con antecedentes de hepatocarcinoma, quien presentó debilidad muscular aguda en el posoperatorio de un trasplante hepático temprano. Se documentó una asociación excepcional con miopatía inducida por micofenolato. Tras suspender este fármaco, el paciente recuperó completamente la fuerza muscular, confirmando así el diagnóstico. De hecho, este caso es el segundo reportado en la literatura médica sobre miopatía inducida por micofenolato.

Drug-induced myopathies are a relatively common cause of acute muscle weakness. In many cases, symptoms begin shortly after initiating the causative medication; however, diagnosis can be challenging due to polypharmacy or the initial association of symptoms with other pathologies. This can lead to a delay in withdrawing the medication, which is essential for treatment. We present the case of a 62-year-old patient with a history of hepatocellular carcinoma who developed acute muscle weakness in the early postoperative period following liver transplantation. An exceptional association with mycophenolate-induced myopathy was documented. Upon discontinuation of this medication, the patient regained full muscle strength, confirming the diagnosis. In fact, this case is the second reported in the medical literature of mycophenolate-induced myopathy.

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Introduction: Low muscle strength is a risk factor for various health conditions such as cardiometabolic diseases, neurodegenerative syndromes and mortality. Objective: Evaluate the knowledge of muscle strength in health professionals in Colombia. Materials and Methods: An analytical cross-sectional study was conducted in health professionals attending two continuing medical education events. Three components were evaluated through a questionnaire: identification of muscle strength as a risk factor for health conditions, measurement of muscle strength and education in muscle strength. Results: 501 participants (52.49% women) were evaluated. Of these, 53.89% (n=270) were general practitioners, 18.16% (n=91) specialists and 6.18% (n=31) nurses. The association between low muscle strength and cardiometabolic diseases was identified by 56.67% (n=153) of general practitioners and 41.94% (n=13) of nurses. The indication for measuring muscle strength in older adults was recognized by 86.81% (n=79) of specialist physicians and 41.94% (n=13) of nurses. 32.93% (n=165) of the participants were aware of some method for measurement. Physiotherapists were the group that mostly reported measuring muscle strength by 83.33% (n=20). Only 29.03% (n=9) of the nurses had received academic information on muscle strength. Discussion and Conclusions: This study demonstrates the lack of knowledge on low muscle strength, its association with health conditions and measurement methods, and the lack of information about published literature on the subject. Educational interventions are needed to incorporate muscular strength evaluation into the clinical practice.

Introducción: La baja fuerza muscular es un factor de riesgo para diversas condiciones de salud como enfermedades cardiometabólicas, síndromes neurodegenerativos y mortalidad. Objetivo: Evaluar el conocimiento sobre fuerza muscular en profesionales de salud en Colombia. Materiales y Métodos: Se realizó un estudio analítico de tipo corte transversal en profesionales de salud asistentes a dos eventos de educación médica continuada. A través de un cuestionario se evaluaron tres componentes: identificación de la fuerza muscular como factor de riesgo para condiciones de salud, medición de la fuerza muscular y formación en fuerza muscular. Resultados: Se evaluaron 501 participantes (52,49% mujeres). 53,89% (n=270) eran médicos generales, 18,16% (n=91) especialistas y 6,18% (n=31). enfermeros . La asociación entre baja fuerza muscular con enfermedades cardiometabólicas fue identificada por el 56,67% (n=153) de médicos generales y 41,94% (n=13) de enfermeros. El 86,81% (n=79) de médicos especialistas y el 41,93% (n=13) de enfermeros reconocía la indicación de medir la fuerza muscular en adultos mayores. El 32,93% (n=165) de los participantes conocía de algún método de medición. Los fisioterapeutas fueron el grupo que más reportó realizar mediciones 83,33% (n=20). Sólo el 29,03% (n=9) de los enfermeros había recibido información académica sobre fuerza muscular. Discusión y Conclusión: Este estudio muestra el bajo conocimiento sobre la importancia de la fuerza muscular, su asociación a condiciones de salud, los métodos de medición y la falta de información sobre la literatura publicada al respecto. Son necesarias intervenciones educativas sobre fuerza muscular con el fin de incorporarla en la práctica clínica.

Introdução: A diminuição na força muscular é um fator de risco para diferentes condições de saúde, tais como doenças cardiometabólicas, síndromes neurodegenerativas e mortalidade. Objetivo: Avaliar o conhecimento sobre força muscular em profissionais da saúde na Colômbia. Materiais e Métodos: Realizou-se um estudo analítico de tipo transversal em profissionais da saúde que assistiram a dois eventos de educação médica continuada. Um questionário foi usado para avaliar três componentes: identificação da força muscular como fator de risco para condições de saúde, medição da força muscular e treinamento da força muscular. Resultados: Foram avaliados 501 participantes (52,49% mulheres). O 53,89% (n=270) eram médicos generalistas, 18,16% (n=91) médicos especialistas e 6,18% (n=31) enfermeiras. A associação entre força muscular diminuída com doenças cardiometabólicas foi identificada pelo 56,67% (n=153) dos médicos generalistas y 41,9% (n=13) dos enfermeiros. O 86,81% (n=79) dos médicos especialistas e o 41,94% (n=13) dos enfermeiros reconheceram a indicação de mensurar força muscular em idosos. O 32,93% (n=165) dos participantes conheciam algum método para mensuração de força muscular. Os fisioterapeutas foram o grupo que reportou realizar mensurações com maior frequência 83,33% (n=20). A principal causa para não realizar mensurações de força muscular foi a falta de equipamentos. Somente o 29,03% (n=9) dos enfermeiros tinham recebido informação acadêmica sobre força muscular. Discussão e Conclusão: Este estudo demostra o baixo conhecimento sobre força muscular diminuída e sua associação com condições de saúde, métodos de mensuração, e falta de informação sobre a literatura publicada. São necessárias intervenções educacionais para influenciar a prática clínica.

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Introducción: la fuerza muscular es fundamental para la movilidad y el mantenimiento de la postura, y su estudio es esencial para comprender los mecanismos que rigen la contracción muscular. Sin embargo, los cambios en los volúmenes y formas musculares pueden influir significativamente en su función. Durante el embarazo, los cambios hormonales pueden tener un impacto notable en la fisiología muscular, especialmente en los músculos abdominales. Por lo tanto, es importante investigar la fuerza muscular central en relación con el embarazo para comprender mejor los capacitamientos ME que subyacen a la contracción. El objetivo principal de este estudio fue determinar si existe una asociación entre haber tenido un embarazo y el tipo de parto con respecto a la fuerza muscular central. Población y métodos: este estudio se llevó a cabo en una ciudad del Departamento de Dierman-TE, utilizando un diseño metodológico descriptivo, observacional y transversal. La muestra consistió en mujeres nulíparas y multiparias entre las edades de 20 y 45 años. La prueba Sahrmann se usó como un instrumento para evaluar la fuerza muscular del núcleo. Resultados: Se encontró una asociación entre el tipo de entrega y la fuerza muscular abdominal (P = 0.030). 45.45% de las mujeres con parto por cesárea y 56.52% de las mujeres con parto vaginal alcanzaron el nivel 5; Estos resultados indican que las mujeres con entrega vaginal obtuvieron más fuerza muscular abdominal. No se encontraron resultados significativos entre el embarazo y la fuerza muscular abdominal (P = 0.361). Conclusiones: se encontró una asociación entre el tipo de entrega y la fuerza del núcleo abdominal en las mujeres

Introduction: Muscle strength is fundamental for mobility and maintaining posture, and its study is essential to understand the mechanisms that govern muscle contraction. However, changes in muscle volumes and shapes can significantly influence their function. During pregnancy, hormonal changes can have a notable impact on muscle physiology, especially on the abdominal muscles. Therefore, it is important to investigate core muscle strength in relation to pregnancy to better understand the mechanisms underlying contraction. The main objective of this study was to determine whether there is an association between having had a pregnancy and the type of delivery with respect to core muscle strength. Population and methods: This study was carried out in a town in the department of Diamante, using a descriptive, observational and cross-sectional methodological design. The sample consisted of nulliparous and multiparous women between the ages of 20 and 45 years. The Sahrmann test was used as an instrument to assess core muscle strength. Results: An association was found between the type of delivery and abdominal muscle strength (p=0.030). 45.45% of women with cesarean delivery and 56.52% of women with vaginal delivery reached level 5; these results indicate that women with vaginal delivery obtained more abdominal muscle strength. No significant results were found between pregnancy and abdominal muscle strength (p=0.361). Conclusions: An association was found between the type of delivery and abdominal core strength in women.

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SUMMARY: The objective was measure quadricep strength after Total Hip Arthroplasty (THA) and kinetic treatment and then determine its impact on the functional recovery of patients with hip osteoarthritis. A total of 79 (25 were male and 54 were female) patients with THA. Exclusion criteria were previous extra-system kinetic treatment, operated on for hip fracture, not completing the treatment. Maximum Isometric Strength (MIS), Time Up and Go (TUG), Modified Harris Hip Score. There was a significant increase in the MIS of the post-treatment operated knee extension in both men and women (p < 0.0001 SE = 0.43; p < 0.0001 SE = 1.22, respectively). In the TUG, the execution time was significantly lower post-treatment in both men and women (p < 0.0001 SE = 0.77; p < 0.0001 SE = 0.94, respectively). The final Harris score increased significantly post-treatment in male and female (p < 0.0001 SE = 2.90; p < 0.0001 SE = 1.96, respectively). the association between MIS and the Harris score, it was noted that, for a 1 kg increase in this measure compared to the initial assessment, the Harris score, after 12 weeks of treatment, increased by 0.179 points (β = 0.179; p = 0.050). The conclusions were Indicate an increase in knee extension MIS of the operated hip after treatment in both sexes. At the same time, functionality increased post-treatment in both male and female.

El objetivo del estudio fue medir la fuerza del músculo cuádriceps femoral después de la artroplastia total de cadera (THA, por sus siglas en inglés) y el tratamiento kinésico, para determinar su impacto en la recuperación funcional de pacientes con osteoartritis de cadera. En el estudio participaron 79 pacientes con THA (25 hombres y 54 mujeres). Se excluyeron quienes tuvieron tratamiento Kinésico previo fuera del hospital, operación por fractura de cadera y no completar el tratamiento. Las principales medidas tomadas fueron: Fuerza Máxima Isométrica (MIS), Time UP and GO (TUG), Puntuación Modificada de Harris de Cadera. Hubo un aumento significativo en la MIS de la extensión de rodilla del lado operado después del tratamiento tanto en hombres (p<0,0001, EE=0,43) como en mujeres (p<0,0001, EE=1,22). En el TUG, el tiempo de ejecución fue significativamente menor después del tratamiento en hombres (p<0,0001, EE=0,77) y mujeres (p<0,0001, EE=0,94). La puntuación final de Harris aumentó significativamente después del tratamiento en hombres (p<0,0001, EE=2,90) y mujeres (p<0,0001, EE=1,96). En cuanto a la asociación entre MIS y la puntuación de Harris, se observó que por cada aumento de 1 kg en esta medida en comparación con la evaluación inicial, la puntuación de Harris aumentó en 0,179 puntos después de 12 semanas de tratamiento (β=0,179; p=0,050). En conclusión se observó un aumento en la MIS de la extensión de rodilla del lado operado después del tratamiento en ambos sexos. Al mismo tiempo, la funcionalidad aumentó después del tratamiento tanto en hombres como en mujeres.

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INTRODUCTION: Uncaria tomentosa (Willd. ex Roem. & Schult.) DC. (Rubiaceae) or UT is a medicinal plant with antiviral, antimutagenic, anti-inflammatory and antioxidant properties. Duchenne muscular dystrophy (DMD) is a severe muscle wasting disease caused by mutations in the dystrophin gene; this deficiency leads to sarcolemma instability, inflammation, muscle degeneration and fibrosis. OBJECTIVE: Considering the importance of inflammation to dystrophy progression and the anti-inflammatory activity of UT, in the present study we evaluated whether oral administration of UT extract would ameliorate dystrophy in the mdx mice, a DMD model. METHODS: Eight-week-old male mdx mice were submitted to 200 mg/kg body weight daily UT oral administration for 6 weeks. General histopathology was analysed, and muscle tumor necrosis factor α, transforming growth factor-ß, myostatin and osteopontin transcript levels were assessed. The ability of mice to sustain limb tension to oppose their gravitational force was measured. Data were analysed with the unpaired Student's t-test. RESULTS: Morphologically, both untreated and UT-treated animals exhibited internalised nuclei, increased endomysial connective tissue and variations in muscle fibre diameters. Body weight and muscle strength were significantly reduced in the UT-treated animals. Blood creatine kinase was higher in UT-treated compared to untreated animals. In tibialis anterior, myostatin, transcript was more highly expressed in the UT-treated while in the diaphragm muscle, transforming growth factor-ß transcripts were less expressed in the UT-treated. CONCLUSION: While previous studies identified anti-inflammatory, antiproliferative and anticarcinogenic UT effects, the extract indicates worsening of dystrophic muscles phenotype after short-term treatment in mdx mice.

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La percepción de la condición física en estudiantes universitarios se refiere a cómo se ven a sí mismos en términos de su estado físico y salud. En esta etapa, las variables antropométricas pueden verse afectadas por estrés, cambios en hábitos de sueño y alimentación, y menor participación en actividades físicas, impactando el desempeño académico y salud general. El objetivo fue relacionar la percepción de la condición física con medidas antropométricas auto reportadas en estudiantes universitarios Esta Investigación es de tipo descriptivo-correlacional, de diseño observacional y corte transversal. Fueron evaluados 46 estudiantes universitarios de la ciudad de Talca. La condición física se midió por medio del International Fitness Scale (IFIS) y las medidas antropométricas por medio de auto reporte. La condición física general se relacionó de manera inversa con la circunferencia de cintura (r=-0,32; p=0,028), la circunferencia de cintura(r=-0,44; p=0,002) y el ICE (r=-0,43; p=0,003). Se observaron correlaciones inversas entre la condición cardiorrespiratoria con el IMC (p=0,008; r=-0,38), circunferencia de cintura e ICE (p=0,008; r=-0,38). La velocidad/agilidad se correlacionó de forma inversa con el índice de masa corporal (IMC) (p=0,001; r=-0,46), circunferencia de cintura (p=0,019; r=-0,34), cadera (p= 0,004; r= -0,40) y el ICE (p=0,004; r=-0,41). La flexibilidad se correlaciono de forma inversa con el IMC (p=0,041; r=-0,30), circunferencia de cintura (p=0,023; r=-0,33), índice cintura cadera (ICC) (p= 0,001; r=-0,45)). Por último, la fuera muscular no se correlaciono con las variables antropométricas. Se concluye que existe correlación inversa entre la percepción de la condición física y algunos autore portes de las medidas antropométricas.

The physical fitness perception of college students refers to how they see themselves in terms of their physical condition and health. In this stage, anthropometric variables may be affected by stress, changes in sleep and eating habits, and decreased participation in physical activities, impacting academic performance and general health. The objective of this study is to relate the perception of physical condition with self-reported anthropometric measures in university students. This is a descriptive-correlational, observational, cross-sectional research. Forty-six university students from the city of Talca were evaluated. Physical condition was measured by means of the International Fitness Scale (IFIS) and anthropometric measures by means of self-report. General physical condition was inversely related to waist circumference (r=-0.32; p=0.028), waist circumference (r=-0.44; p=0.002) and IFIS (r=-0.43; p=0.003). Inverse correlations were observed between cardiorespiratory fitness with BMI (p=0.008; r=-0.38), waist circumference and ECI (p=0.008; r=-0.38). Speed/agility was inversely correlated with body mass index (BMI) (p=0.001; r=-0.46), waist circumference (p=0.019; r=-0.34), hip (p= 0.004; r= -0.40) and ECI (p=0.004; r=-0.41). Flexibility was inversely correlated with BMI (p=0.041; r=-0.30), waist circumference (p=0.023; r=-0.33), waist hip index (WHI) (p= 0.001; r=-0.45)). Lastly, muscle was not correlated with the anthropometric variables. It is concluded that there is an inverse correlation between the perception of physical condition and some anthropometric measures.

A percepção da aptidão física em estudantes universitários refere-se a como eles se veem em termos de sua condição física e saúde. Nessa fase, as variáveis antropométricas podem ser afetadas pelo estresse, por mudanças nos hábitos de sono e alimentação e pela diminuição da participação em atividades físicas, o que afeta o desempenho acadêmico e a saúde em geral. O objetivo foi relacionar a percepção da aptidão física com medidas antropométricas autorreferidas em estudantes universitários. Trata-se de uma pesquisa descritiva, correlacional, transversal e observacional. Foram avaliados 46 estudantes universitários da cidade de Talca. A condição física foi medida por meio da Escala Internacional de Aptidão Física (IFIS) e as medidas antropométricas por meio de autorrelato. A aptidão física geral foi inversamente relacionada à circunferência da cintura (r=-0,32; p=0,028), circunferência da cintura (r=-0,44; p=0,002) e IFIS (r=-0,43; p=0,003). Foram observadas correlações inversas entre a aptidão cardiorrespiratória com o IMC (p=0,008; r=-0,38), a circunferência da cintura e o ECI (p=0,008; r=-0,38). A velocidade/agilidade foi inversamente correlacionada com o índice de massa corporal (IMC) (p=0,001; r=-0,46), circunferência da cintura (p=0,019; r=-0,34), quadril (p= 0,004; r= -0,40) e ECI (p=0,004; r=-0,41). A flexibilidade foi inversamente correlacionada com o IMC (p=0,041; r=-0,30), a circunferência da cintura (p=0,023; r=-0,33), o índice cintura-quadril (WHI) (p= 0,001; r=-0,45). Por fim, a musculatura não foi correlacionada com as variáveis antropométricas. Concluise que há uma correlação inversa entre a percepção da condição física e algumas medidas antropométricas.

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INTRODUCTION: Older adults, who are considered to be at higher risk of contracting the COVID-19 virus, have been adversely affected by the pandemic. OBJECTIVE: This prospective longitudinal study aimed to verify changes in the physical fitness of older adults during the period of the COVID-19 pandemic, considering gender and age group. METHODS: Seventy-six older individuals (aged 72.6±6.47 years) who were part of a university extension program participated in the study. Their physical fitness was assessed using the Senior Fitness Test (SFT), which was administered by trained researchers before the pandemic (November 2019) and during the pandemic (April 2022). RESULTS: The results showed a significant decline in physical fitness in all tests, except for the Arm Curl Test. The greatest decline was observed in the 6-minute walk test. Both men and women exhibited greater declines in aerobic endurance and lower limb strength. Older adults aged 80 years or older were the most affected, exhibiting the greatest declines, particularly in aerobic endurance and lower limb strength. CONCLUSION: The study concludes that the COVID-19 pandemic had a significant negative impact on the physical fitness of older adults, especially women and those aged 80 years or older. Therefore, physical activity programs should be implemented for these populations to minimize or even reverse the negative impacts caused by COVID-19 on their physical fitness.

INTRODUÇÃO: A COVID-19 impactou negativamente a vida dos idosos, considerados como grupo de risco para o vírus. OBJETIVO: Este estudo longitudinal prospectivo teve como objetivo verificar as alterações na aptidão física de idosos durante o período da pandemia COVID-19, levando em consideração o sexo e a faixa etária. MÉTODOS: Participaram do estudo 76 idosos (72,6 ± 6,47 anos), que faziam parte de um programa de extensão universitário. A aptidão física foi avaliada por meio da bateria de testes Senior Fitness Test (SFT). Os pesquisadores, devidamente treinados, aplicaram a SFT antes da pandemia (novembro de 2019) e durante a pandemia (abril de 2022). RESULTADOS: Os resultados indicaram uma piora significativa na aptidão física dos idosos em todos os testes, exceto no teste de flexão de cotovelo. A maior redução na aptidão física foi observada no teste de caminhada de 6 minutos. Em relação ao sexo, tanto homens quanto mulheres apresentaram maiores reduções na resistência aeróbia e na força dos membros inferiores. Quanto à faixa etária, os idosos com 80 anos ou mais foram os mais afetados, apresentando as maiores reduções, especialmente na resistência aeróbia e na força dos membros inferiores. CONCLUSÃO: O estudo conclui que o período da pandemia de COVID-19 teve um impacto negativo significativo na aptidão física dos idosos, especialmente nas mulheres e nos idosos com 80 anos ou mais. Portanto, recomenda-se a implementação de atividades físicas para essas populações, com o objetivo de minimizar ou até reverter os impactos negativos causados pela COVID-19 na aptidão física dos idosos.

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INTRODUCTION: The intravaginal examination is an important part of the pelvic floor muscle (PFM) functional assessment. However, women sometimes refuse to submit to this procedure due to being embarrassed. This justifies the investigation of other alternatives of evaluation that could contribute to the treatment of pelvic floor disorders. Handgrip strength (HGS) provides an approximation of overall muscle strength, strongly associated with functionality, and this could be indirectly linked to the pelvic floor musculature. OBJECTIVE: To verify whether there is a correlation between PFM strength and HGS. METHODS: This is an observational study that evaluated 51 young women who filled out a clinical evaluation form and were submitted to pelvic floor evaluation, using the Modified Oxford Scale, Peritron® perineometer, and HGS (Saehan® dynamometer). For the perineometer and handgrip strength test, three repetitions of the maximum contraction were performed, considering the average of the attempts for analysis. Student's t-test and Pearson's coefficient were used to determine the correlation between variables, considering significance <0.05. RESULTS: The participants were normotrophic, with a mean age of 23.14 ± 3.14 years, most were undergraduate students and physically active. The correlation coefficient between handgrip and pelvic floor musculature strength was 0.21 with a confidence interval of -0.07 to 0.46 and a significant value of 0.137. CONCLUSION: Pelvic floor muscle strength had a weak positive association with HGS. Therefore, it is not possible to state that women who have satisfactory HGS have a strong pelvic floor.

INTRODUÇÃO: O exame intravaginal é importante na avaliação funcional dos músculos do assoalho pélvico (MAP). No entanto, algumas mulheres se recusam a esse procedimento por constrangimento. Isso justifica a investigação de alternativas de avaliação que possam contribuir para o tratamento das disfunções do assoalho pélvico. A força de preensão palmar (FPM) fornece uma aproximação da força muscular global, fortemente associada à funcionalidade, podendo estar indiretamente ligada à musculatura do assoalho pélvico. OBJETIVO: Foi verificar se existe correlação entre a força dos MAP e a FPM. MÉTODOS: Trata-se de um estudo observacional que avaliou 51 mulheres jovens que preencheram uma ficha de avaliação clínica e foram submetidas à avaliação do assoalho pélvico, por meio da Escala de Oxford Modificada, perineômetro Peritron® e FPM (dinamômetro Saehan®). Para a perineometria e teste de força de preensão manual foram realizadas três repetições da contração máxima, considerando a média das tentativas para análise. Foram utilizados o teste t de Student e o coeficiente de Pearson para determinar a correlação entre as variáveis, considerando significância <0,05. RESULTADOS: As participantes eram normotróficas, com idade média de 23,14 ± 3,14 anos, a maioria universitárias e fisicamente ativas. O coeficiente de correlação entre preensão palmar e força da musculatura do assoalho pélvico foi de 0,21 com intervalo de confiança de -0,07 a 0,46 e valor de significância de 0,137. CONCLUSÃO: A força muscular do assoalho pélvico teve uma associação positiva fraca com a FPM. Portanto, não é possível afirmar que mulheres com FPM satisfatória tenham assoalho pélvico forte.

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SUMMARY: The angiotensin converting enzyme gene (ACE) has been associated with endurance and strength performance through its I/D polymorphism. Nevertheless, contradictory results exist between different populations. In this context, the purpose of this research was to determine the influence of the I/D polymorphism of the ACE gene on muscle strength in a sedentary Chilean sample. In this study 102 healthy male students (21.3 ± 2.2 years) completed the assessment. I/D genotyping, cardiovascular, anthropometric, grip strength and knee extensor peak strength were evaluated. The ACE polymorphism frequency was: II, 33.3 %; ID, 46.1 %; DD, 20.6 %. The results showed significant differences and large effect size in maximum (p = 0.004; d = 0.85) and relative handgrip strength (p = 0.004; d = 0.9) between genotype II vs DD. No difference was found for maximal or relative knee extensor strength between groups (p = 0.74), showing a low effect size (d = 0.20). In conclusion, this study provides insights into the role of the ACE gene in muscle strength and highlights the importance of investigating genetic variants in sedentary populations to better understand strength performance.

El gen de la enzima convertidora de angiotensina (ACE) se ha asociado con el rendimiento de resistencia y fuerza a través de su polimorfismo I/D. Sin embargo, existen resultados contradictorios entre diferentes poblaciones. En este contexto, el propósito de esta investigación fue determinar la influencia del polimorfismo I/D del gen ACE sobre la fuerza muscular en una muestra chilena sedentaria. En este estudio, fueron evaluados 102 estudiantes varones sanos (21,3 ± 2,2 años). Se realizaron aplicaron las siguientes evaluaciones: genotipado del polimorfismo I/D, cardiovascular, antropométrica, fuerza de prensión y fuerza máxima de extensión de rodilla. La frecuencia del polimorfismo I/D de ACE fue: II, 33,3 %; DNI, 46,1 %; DD, 20,6 %. Los resultados mostraron diferencias significativas y un gran tamaño del efecto en la fuerza máxima (p = 0,004; d = 0,85) y relativa de prensión manual (p = 0,004; d = 0,9) entre el genotipo II y el DD. No se encontraron diferencias en la fuerza máxima o relativa de los extensores de rodilla entre los grupos (p = 0,74), lo que muestra un tamaño de efecto bajo (d = 0,20). En conclusión, este estudio proporciona información sobre el papel del gen ACE en la fuerza muscular y destaca la importancia de investigar variantes genéticas en poblaciones sedentarias para comprender mejor el rendimiento de la fuerza.

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SUMMARY: Frailty affects the functional autonomy (FA) of older adults and could manifest itself in muscle imbalances in the limbs, resulting in a disparity in size and strength between them. In Chile, information on the relationship between muscle strength (MS) levels and FA asymmetries in older women is limited. This study related the levels of MS, anthropometric parameters, and asymmetries of the lower and upper limbs, with the FA of a group of older Chilean women. The study included 39 women who participated, and their FA was evaluated using the GDLAM index (IG). Based on the score obtained in the IG, they were classified by percentiles as Group 1 with favorable FA (P ≤ 50) and Group 2 with low FA (P > 50). Anthropometric parameters were BMI, fat percentage, bone mass, circumferences (arm, thigh, calf), diameters (humerus, femur) and upper/lower limb strength was evaluated to determine asymmetries. The differences between the covariates of both groups were evaluated using the student's t test and the Mann-Whitney test for independent samples. G1 presented less asymmetry (p > 0.05) in the lower limbs and greater calf circumference than G2 (p < 0.05). G1 presented greater bilateral strength (dominant and non-dominant limb) compared to G2 (p < 0.05). The covariates of age, anthropometry, MS, and lower/upper limb asymmetries influence FA in older women.

La fragilidad afecta la autonomía funcional (AF) de las personas mayores y podría manifestarse en desequilibrios musculares en los miembros, dando lugar a una disparidad de tamaño y fuerza entre ellos. En Chile, la información que relaciona los niveles de fuerza muscular (FM) y las asimetrías con la AF en mujeres mayores es limitada. Este estudio relacionó los niveles de FM, parámetros antropométricos y asimetrías de los miembros inferiores y superiores, con la AF de un grupo de mujeres mayores chilenas. Participaron 39 mujeres, cuya AF se evaluó mediante el índice GDLAM (IG). En función de la puntuación obtenida en el IG, se clasificaron por percentiles en Grupo 1 con AF favorable (P ≤ 50) y Grupo 2 con AF baja (P > 50). Los parámetros antropométricos fueron IMC, porcentaje de grasa, masa ósea, circunferencias (brazo, muslo, pantorrilla), diámetros (húmero, fémur) y se evaluó la fuerza de los miembros superiores/ inferiores para determinar asimetrías. Las diferencias entre las covariables de ambos grupos se evaluaron mediante la prueba t de student y la prueba de Mann-Whitney para muestras independientes. G1 presentó menor asimetría (p > 0,05) en los miembros inferiores y mayor perímetro de pantorrilla que G2 (p < 0,05). G1 presentó mayor fuerza bilateral (miembro dominante y no dominante) en comparación con G2 (p < 0,05). Las covariables de antropometría, FM y asimetrías de extremidades inferiores/superiores influyen en la AF en mujeres mayores.

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SUMMARY: The aim of this study was to determine the sensitivity of different methods of partialization, in terms of different body component indices in relation to indicators of strength and explosiveness. The research involved 187 subjects who were divided into two groups based on sex. This research consisted of measuring body composition characteristics by multichannel bioimpedance analysis (BIA) InBody 720, as well as contractile characteristics of different muscle groups with tenziometric Dinamometry method. Based on the results of the factor analysis we found that regardless of the sex the most sensitive variable for partialization of absolute body isometric strength variable (ABiS) is partialization by allometric scaling (0.964 for females and 0.947 for males explained factor variance). However, in the case of absolute body isometric explosiveness (ABiE), the results of this study have demonstrated that partialization relative to skeletal muscle mass according to the body longitudinality - skeletal muscle mass index (SMMI) is the methodological choice disregarding the sex (0.982 for females and 0.980 for males explained factor variance). The results of the study have shown that for the purpose of scaling the maximal strength relative to body composition, the allometric method can be considered as a choice, while for the partialization of maximal isometric explosiveness skeletal muscle mass index is the best choice insensitive of the sex.

El objetivo de este estudio fue determinar la sensibilidad de distintos métodos de parcialización, en términos de diferentes índices de componentes corporales en relación a los indicadores de fuerza y explosividad. En la investigación participaron 187 sujetos que se dividieron según el sexo en dos grupos. Esta investigación consistió en medir las características de composición corporal mediante análisis de bioimpedancia multicanal (BIA) InBody 720, así como las características contráctiles de diferentes grupos musculares con el método de Dinamometría tenciométrica. Con base en los resultados del análisis factorial, encontramos que, independientemente del sexo, la variable más sensible para la parcialización de la variable de fuerza isométrica corporal absoluta (ABiS) fue la parcialización mediante escala alométrica (0,964 para las mujeres y 0,947 para los hombres). Sin embargo, en el caso de la explosividad isométrica corporal absoluta (ABiE), los resultados de este estudio han demostrado que la parcialización relativa a la masa del músculo esquelético según la longitudinalidad del cuerpo - índice de masa del músculo esquelético (SMMI) es la opción metodológica sin tener en cuenta el sexo (0,982 para las mujeres y 0,980 para los hombres). Los resultados del estudio han demostrado que para escalar la fuerza máxima en relación con la composición corporal, el método alométrico puede considerarse como una opción, mientras que para la parcialización de la explosividad isométrica máxima, el índice de masa del músculo esquelético es la mejor opción independiente del sexo.

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Objective: Adapt functional mobility and muscle strength tests for older people with dementia to be performed remotely in the home environment; determine intra-rater and inter-rater reliability of functional mobility and strength tests for older people with dementia; and correlate the performance on the physical tests executed remotely and the Timed Up and Go (TUG) test, which was validated remotely in healthy older people. Methods: We included 43 people with dementia. The Short Physical Performance Battery (SPPB), TUG, TUG Dual Task (TUG-DT), and 30-Second Sit-to-Stand Test (SST30s) were performed through videocalls. Test performance was documented to facilitate the subsequent determination of inter- and intra-rater reliability. The intra-rater reliability was determined at a 2-week interval from the real-time videocall to analysis of the recording. Results: Intra-rater reliability ranged from good to excellent for all tests performed (ICC 0.862­1.000). Inter-rater reliability values were fair for gait speed (ICC = 0.223), moderate for some of the SPPB items (ICC = 0.706­0.801), good for the SPPB two-foot balance (ICC = 0.860) and the SPPB total score (ICC = 0.831), and excellent for the rest of the tests. Conclusion: Functional mobility and muscle strength tests proved reliable and feasible for remote, at-home assessments of older people with dementia when assisted by their respective caregivers, providing an additional alternative for assessment of this patient population. (AU)

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INTRODUCTION: Chronic obstructive pulmonary disease is a systemic disease characterized not only by respiratory symptoms but also by physical deconditioning and muscle weakness. One prominent manifestation of this disease is the decline in respiratory muscle strength. Previous studies have linked the genotypes of insulin-like growth factor 1 and 2 (IGF-1 and IGF-2) to muscle weakness in other populations without this disease. However, there is a notable knowledge gap regarding the biological mechanisms underlying respiratory muscle weakness, particularly the role of IGF-1 and IGF-2 genotypes in this pulmonary disease. Therefore, this study aimed to investigate, for the first time, the association between IGF-1 and IGF-2 genotypes with respiratory muscle strength in individuals with chronic obstructive pulmonary disease. In addition, we analyzed the relationship between oxidative stress, chronic inflammation, and vitamin D with respiratory muscle strength. METHODS: A cross sectional study with 61 individuals with chronic obstructive pulmonary disease. Polymerase chain reaction of gene polymorphisms IGF-1 (rs35767) and IGF-2 (rs3213221) was analyzed. Other variables, related to oxidative stress, inflammation and Vitamin D were dosed from peripheral blood. Maximal inspiratory and expiratory pressure were measured. RESULTS: The genetic polymorphisms were associated with respiratory muscle strength ( 3.0 and 3.5; = 0.57). Specific genotypes of IGF-1 and IGF-2 presented lower maximal inspiratory and expiratory pressure (<0.05 for all). Oxidative stress, inflammatory biomarkers, and vitamin D were not associated with respiratory muscle strength. CONCLUSION: The polymorphisms of IGF-1 and IGF-2 displayed stronger correlations with respiratory muscle strength compared to blood biomarkers in patients with chronic obstructive pulmonary disease. Specific genotypes of IGF-1 and IGF-2 were associated with reduced respiratory muscle strength in this population.

INTRODUCCIÓN: La enfermedad pulmonar obstructiva crónica es una enfermedad sistémica caracterizada no solo por síntomas respiratorios, sino también por el deterioro físico y la debilidad muscular. Una manifestación destacada de esta enfermedad es el declive en la fuerza de los músculos respiratorios. Estudios previos han vinculado los genotipos de factor de crecimiento insulínico 1 y 2 (IGF-1 e IGF-2) con la debilidad muscular en poblaciones sin esta enfermedad. Sin embargo, existe un vacío de conocimiento con respecto a los mecanismos biológicos subyacentes a la debilidad de los músculos respiratorios, en particular el papel de los genotipos IGF-1 e IGF-2 en esta enfermedad pulmonar. Por lo tanto, este estudio tuvo como objetivo investigar, por primera vez, la asociación de los genotipos IGF-1 e IGF-2 con la fuerza de los músculos respiratorios en individuos con enfermedad pulmonar obstructiva crónica. Además, analizamos la relación entre el estrés oxidativo, la inflamación crónica y la vitamina D con la fuerza de los músculos respiratorios. MÉTODOS: Un estudio transversal con 61 individuos con enfermedad pulmonar obstructiva crónica. Se analizó la reacción en cadena de la polimerasa de los polimorfismos genéticos IGF-1 (rs35767) e IGF-2 (rs3213221). Otras variables relacionadas con el estrés oxidativo, la inflamación y la vitamina D se dosificaron a partir de muestras de sangre periférica. Se midieron las presiones inspiratorias y espiratorias máximas. RESULTADOS: Los polimorfismos genéticos están asociados con la fuerza de los músculos respiratorios (F: 3.0 y 3.5; R2= 0.57). Genotipos específicos de IGF-1 e IGF-2 presentaron bajos valores en las presiones inspiratorias y espiratorias (p<0.05 en todos los casos). El estrés oxidativo, los biomarcadores inflamatorios y la vitamina D no se asociaron con la fuerza de los músculos respiratorios. CONCLUSIÓN: Los polimorfismos de IGF-1 e IGF-2 mostraron correlaciones más sólidas con la fuerza de los músculos respiratorios en pacientes con enfermedad pulmonar obstructiva crónica en comparación con los biomarcadores sanguíneos. Genotipos específicos de IGF-1 e IGF-2 se asociaron con una disminución de la fuerza de los músculos respiratorios en esta población.

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Objectives: To screen hospitalized older adults for sarcopenia and ascertain whether correlations exist between heart rate variability (HRV), peripheral muscle strength, functional ability, independence, and nutritional aspects in this population. Methods: Observational study of hospitalized adults aged > 60 years who were clinically stable and able to complete the study assessments. HRV, functionality, peripheral muscle strength, independence, level of physical activity, nutritional aspects, and risk of death were assessed. The Shapiro-Wilk, Kruskal-Wallis, and Mann-Whitney tests and Spearman correlations were used for statistical analysis; significance was accepted at p < 0.05. Results: The sample comprised 40 older adults, of whom only nine (22.50%) did not meet criteria for sarcopenia. HRV in participants with sarcopenia correlated positively with level of physical activity (rs 0.92, p = 0.001) and nutritional condition (rs 0.79, p = 0.001), and negatively with mortality (rs -0.59, p = 0.04) (rs 0.79, p = 0.001). In older adults without sarcopenia, HRV correlated positively with independence (rs 0.83, p = 0.001) and muscle strength (rs 0.67, p = 0.04). Conclusion: Most hospitalized older adults meet criteria for sarcopenia. In this population, better autonomic control of the heart is associated with greater independence, muscle strength, physical activity level, and better nutritional status, while worse HRV is associated with a higher risk of mortality. (AU)

Objetivos: Avaliar a sarcopenia e verificar correlações entre VFC, força muscular periférica, funcionalidade, independência e aspectos nutricionais em pessoas idosas hospitalizadas. Metodologia: Estudo observacional com população > 60 anos capaz de realizar as avaliações e estável clinicamente. Foi avaliada a VFC, a funcionalidade, a força muscular periférica, a independência, o nível de atividade física, os aspectos nutricionais e o risco de morte. Foram aplicados os testes de Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney e correlação de Spearman, sendo adotado um p < 0,05. Resultados: A amostra foi composta por 40 pessoas idosas, das quais apenas nove (22,50%) não possuíam critérios de sarcopenia. A VFC em pessoas com sarcopenia apresentou correlação positiva entre o nível de atividade física (rs 0,92; p = 0,001) e a condição nutricional (rs 0,79; p = 0,001) e correlação negativa com a mortalidade (rs -0,59, p = 0,04) (rs 0,79, p = 0,001). Em idosos não diagnosticados com a doença, houve correlação positiva da VFC com a independência (rs 0,83; p = 0,001) e a força muscular (rs 0,67, p = 0,04). Conclusão: Pessoas idosas hospitalizadas, em sua maioria, apresentam sarcopenia. Melhor controle autonômico cardíaco está associado com maior independência, força muscular, nível de atividade física e condição nutricional, enquanto piores índices de VFC estão associados a maior risco de mortalidade. (AU)

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Objective: To analyze hemodynamic parameters, kidney and cognitive function, and physical performance of institutionalized older adults with high- and low-strength. Method: Cross-sectional study. Twenty-one older adults (11 women, 10 men) participated in this study. Blood samples were collected for analysis of biochemical parameters. Cognitive function was evaluated using the mini-mental state examination (MMSE), clock drawing test (CDT), and verbal fluency test, while physical performance was assessed using the Short Physical Performance Battery (SPPB) and, blood pressure, heart rate, and Framingham Risk Score were evaluated. Result: Based on the median value, participants were divided into low-strength (81.63 ± 3.03 years) and high-strength (82.10 ± 2.11 years). The high-strength group showed significantly lower systolic (138.8 ± 3.6 vs. 116.5 ± 3.1; p<0.05), diastolic (84.9 ± 2.14 vs. 72.9 ± 2.2; p<0.05), mean blood pressure (102.2 ± 2.4 vs. 87.4 ± 2.4; p<0.05), and cardiovascular risk (39.7 ± 4.6 vs. 26.0 ± 3.5; p<0.05) than the low-strength group. In addition, the high-strength group had better HDL-c levels (27.4 ± 1.7 vs. 35.6 ± 3.4; p<0.05), higher estimated glomerular filtration rate (51.5 ± 4.9 vs. 86.2 ± 5.5; p<0.05), and lower creatinine (0.94 ± 0.1 vs 0.57 ± 0.1; p<0.05) than the low-strength group. For cognitive data (MMSE and CDT p<0.05) and physical performance (semi-tandem, tandem and walking speed p<0.05), the high-strength group had better scores compared to the low-strength group. Conclusion: Institutionalized older adults with high-strength has better hemodynamic parameters, physical performance, kidney and cognitive function than those with low-strength levels

Objetivo: Analisar os parâmetros hemodinâmicos, a função física, cognitiva e renal de idosos institucionalizados com alta e baixa força. Método: Estudo transversal. Vinte e um idosos (11 mulheres, 10 homens) participaram do estudo. Foram coletadas amostras de sangue para análise de parâmetros bioquímicos. A função cognitiva foi avaliada por meio do miniexame do estado mental (MEEM), do teste de desenho do relógio (TDR) e do teste de fluência verbal, enquanto o desempenho físico foi avaliado por meio da Short Physical Performance Battery (SPPB) e foram aferidas a pressão arterial, a frequência cardíaca e o escore de risco de Framingham. Resultado: Com base no valor da mediana, os participantes foram divididos em baixa força (81,63 ± 3,03 anos) e alta força (82,10 ± 2,11 anos). O grupo de alta força apresentou pressão arterial sistólica (138,8 ± 3,6 vs. 116,5 ± 3,1; p<0,05), diastólica (84,9 ± 2,14 vs. 72,9 ± 2,2; p<0,05), média (102,2 ± 2,4 vs. 87,4 ± 2,4; p<0,05) e risco cardiovascular (39,7 ± 4,6 vs. 26,0 ± 3,5; p<0,05) significativamente menores do que o grupo de baixa força. Além disso, o grupo de alta força apresentou melhores níveis de HDL-c (27,4 ± 1,7 vs. 35,6 ± 3,4; p<0,05), maior taxa de filtração glomerular estimada (51,5 ± 4,9 vs. 86,2 ± 5,5; p<0,05) e menor creatinina (0,94 ± 0,1 vs. 0,57 ± 0,1; p<0,05) do que o grupo de baixa força. Em relação aos dados cognitivos (MEEM e TDR, p<0,05) e ao desempenho físico (semi-tandem, tandem e velocidade de caminhada, p<0,05), o grupo de alta força apresentou melhores escores em comparação com o grupo de baixa força. Conclusão: Os idosos institucionalizados com altos níveis de força têm melhores parâmetros hemodinâmicos, desempenho físico, função renal e cognitiva do que aqueles com baixos níveis de força.PALAVRAS-CHAVEAvaliação GeriátricaCardiovascularDesempenho CognitivoFunção RenalForça Muscular

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Objective: Multicomponent physical training, carried out via tele-exercise, can contribute to a healthier lifestyle in the elderly. The objective is to present the intervention protocol of the "Idoso Ativo" (Active Older Adult) program via tele-exercise, synchronously and asynchronously. Method: This is a randomized clinical trial with two groups performing tele-exercise. Participant recruitment will be done via digital platforms, social media pages and printed leaflets distributed in the different regions of Distrito Federal. Both groups will perform exercises three times a week, lasting 50 min, and the intervention period will be 12 weeks. Discussion: The hypothesis is that the multicomponent exercise program offered online will provide improvements in muscular strength, balance and mobility in both groups. A higher adherence rate is expected in relation to the asynchronous group, and it is believed that the positive effects on physical health, minimizing the negative outcomes caused by inactivity, are present in participants in both groups.

Objetivo: O treinamento físico multicomponente, realizado via tele-exercício, pode contribuir para um estilo de vida mais saudável em pessoas idosas. O objetivo é apresentar o protocolo de intervenção do programa "Idoso Ativo" via tele-exercício, de forma síncrona e assíncrona. Método: Trata-se de um ensaio clínico randomizado com dois grupos realizando tele-exercício. O recrutamento dos participantes será feito via plataformas digitais, páginas de redes sociais e folhetos impressos distribuídos nas diferentes regiões do Distrito Federal. Ambos os grupos realizarão os exercícios três vezes por semana, com duração de 50 min, e o período de intervenção será de 12 semanas. Discussão: A hipótese é que o programa de exercícios multicomponentes, oferecido on-line, proporcionará melhora na força muscular, equilíbrio e mobilidade em ambos os grupos. Espera-se maior taxa de adesão em relação ao grupo síncrono, e acredita-se que os efeitos positivos na saúde física, minimizando os desfechos negativos causados pela inatividade, estejam presentes nos participantes de ambos os grupos

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Abstract Objective: To compare the function and muscle strength of the limb between patients undergoing knee arthroplasties using primary implants with posterior stabilization (control group) and patients with rotating hinge implants (Hinge group). Methods: Function assessment was performed using the Knee Society Score (KSS) and muscle strength using an isokinetic dynamometer using a speed of 60°/s. Results: 43 patients were analyzed, who underwent 51 surgeries, with the Hinge group comprising 25 surgeries and the control group comprising 26 primary surgeries. We did not observe significant differences between the Hinge and control groups in the values of functional KSS (p = 0.54), objective KSS (p = 0.91), peak flexor torque (p = 0.25) and peak extensor torque (p = 0.08). Patients in the Hinge group who underwent primary arthroplasties had a higher peak flexor torque (0.76 Nm/kg) than those who used the implant in revision after septic failure (0.33 Nm/kg) (p <0.05). The constrained implant was indicated in arthroplasty revision surgeries with severe ligament instability and in cases of complex primary arthroplasties with bone destruction or severe coronal deformity in the coronal plane. Conclusion: The use of constrained implants enables joint function and muscle strength comparable to patients who underwent primary arthroplasty using conventional implants with posterior stabilization. Patients undergoing septic revision with a rotating Hinge prosthesis exhibit lower flexor muscle strength compared to those undergoing primary arthroplasty with a constrained implant.

Resumo Objetivo: Comparar a função e a força muscular do membro entre pacientes submetidos a artroplastias do joelho que utilizaram implantes primários com estabilização posterior (grupo controle) e pacientes com implantes constritos rotatórios (grupo Hinge). Métodos: A avaliação da função foi feita por meio do Knee Society Score (KSS) e da força muscular por um dinamômetro isocinético utilizando a velocidade de 60°/s. Resultados: Foram analisados 43 pacientes, que realizaram 51 cirurgias, sendo o grupo Hinge composto por 25 cirurgias e o grupo controle por 26 cirurgias primárias. Não observamos diferenças significativas entre os grupos Hinge e controle nos valores do KSS funcional (p = 0,54), KSS objetivo (p = 0,91), pico de torque flexor (p = 0,25) e pico de torque extensor (p =0,08). Os pacientes do grupo Hinge que realizaram artro-plastias primárias apresentaram um pico de torque flexor maior (0,76 Nm/kg) que aqueles que utilizaram o implante em revisão após falha séptica (0,33 Nm/kg) (p < 0,05). O implante constrito foi indicado em cirurgias de revisão de artroplastia com instabilidade ligamentar grave e em casos de artroplastias primárias complexas com destruição óssea ou deformidade coronal grave no plano coronal. Conclusão: O uso de implantes bloqueados possibilita função articular e força muscular comparáveis a dos pacientes que realizaram artroplastia primária utilizando implantes convencionais com estabilização posterior. Pacientes submetidos à revisão séptica com prótese Hinge rotatória apresentam menor força da musculatura flexora em relação àqueles submetidos a artroplastia primária com implante constrito.

ABSTRACT

Purpose: To evaluate the influence of patients' serum vitamin D levels on muscle strength characteristics and whether it impacts the durability of botulinum toxin (BT) treatment. Methods: The muscle strength of the frontal and corrugator muscles was evaluated before and after the application of TB with pre- and post-application control measurements, and at weeks 2, 5 and 12. The effect of vitamin D on muscle strength and its interaction with BT were investigated in 20 patients. The muscle contraction force was measured by surface electromyography. Results: The results revealed statistically significant differences between the frontal measurement groups at weeks 2 and 5, as well as for the corrugator in the same weeks and at week 12. Regarding vitamin D, significant differences were observed only in the initial group with vitamin D > 30 ng/mL compared to < 30 ng/mL for the frontal muscles. Patients with higher levels of vitamin D had higher average muscle strength compared to those with lower levels in all evaluations. Conclusions: It was observed that vitamin D influences muscle strength and the necessary dosage of BT.