Evaluation of functional parameters of the foot and ankle in elderly with sarcopenia

SUMMARY OBJECTIVE: With population aging, the prevalence of sarcopenia has increased. It is a pathology often neglected, with the potential to cause great damage if not diagnosed and treated. The objective of this study was to identify sarcopenic elderly people through the SARC-F score and palm grip test and to evaluate foot and ankle functionality parameters: gait speed, plantar sensitivity, and baropodometry. METHODS: This is a descriptive and cross-sectional study. The sample consisted of 20 sarcopenic elderly diagnosed through the SARC-F score and the handgrip strength test, from which demographic data were obtained, and the three functional tests related to the foot and ankle were performed. RESULTS: No individual was aware of the term sarcopenia. Regarding gait speed, 20 (100%) presented values compatible with sarcopenia (average of 0.52 m/s). Regarding plantar sensitivity, five (25%) of the patients showed changes in the exam with the detection of insensitivity. Regarding baropodometry, higher pressure values were observed in the right foot (average of 52.9±7.01%) compared to the left (average of 47.10±7.01%) and in the hindfoot (average of 55.85±16.21%) compared to the forefoot (mean 44.15±15.35%). When correlating the analyzed variables with the SARC-F scores, the only association that showed statistical significance (p<0.05) was the dynamometry on the right. CONCLUSION: The SARC-F score and the handgrip strength test are easy to apply in the screening of sarcopenia, and the functional parameters of the foot and ankle were shown to be altered in the studied group.

Existe correlação entre atividade elétrica muscular e cerebral após treino com terapia de contensão do membro superior e tronco em sujeitos com acidente vascular encefálico? / Is there a correlation between muscle and brain electrical activity after training with upper limb and trunk constraint-induced therapy in subjects with stroke?

Objetivo: Verificar se existe correlação entre excitabilidade central e periférica após o treino com a terapia de restrição induzida do movimento (TRIM) modificada associada a contensão de tronco para o membro superior parético após Acidente Vascular Encefálico (AVE). Métodos: Ensaio clínico controlado onde vinte e dois voluntários foram selecionados e randomizado em dois grupos: Grupo Controle (GC) e Grupo Experimental (GE). Eles foram avaliados por meio do eletroencefalograma (EEG) e da eletromiografia (EMG) de superfície. Os canais EEG analisados foram: Canal Ântero Frontal (AF3/AF4); Canal Frontal região medial (F7/F8); Canal Frontal região lateral (F3/F4); Canal Fronto Central (FC5/FC6); Região temporal (T7/T8); Região occipital (O1/O2). Os músculos analisados com EMG foram bíceps braquial, flexores e extensores de punho. As avaliações foram realizada durante a atividade, por dez minutos. O GE recebeu o treinamento com TRIM modificada uma hora por dia, duas semanas consecutivas. Resultados: O GC (pós-intervenção) apresentou correlação moderada negativa (r= -0,69; p= 0,02) do canal Fa com extensor de punho. O GE apresentou (pré-intervenção) correlação moderada negativa do canal AF (r= -0,68; p= 0,02) e FC (r= -0,71; p= 0,01) com flexor de punho. Na pós intervenção apresentou correlação positiva do canal Fa (r= 0,61; p= 0,04) com o extensor de punho. Conclusão: A TRIM modificada associada à contensão de tronco para o membro superior parético apresentou correlação positiva do canal Fa com o músculo extensor de punho e o grupo não treinado apresentou correlação negativa do canal Fa com extensor de punho.

Objective: Establish the correlation between central and peripheral excitability after training with the modified upper limb constraint-induced movement therapy (CIMT) associated with trunk constraint for patients with stroke. Methods: This study is a randomized clinical trial. Twenty-two volunteers were included and randomized into the Control (CG) and Experimental Groups (EG). They were assessed with electroencephalography (EEG) and surface electromyography (EMG). The EEG channels analyzed were antero-frontal (AF3/AF4), frontal-medial (F7/F8), frontal-lateral (F3/F4), frontal-central (FC5/FC6), temporal (T7/T8), and occipital (O1/O2). The muscles evaluated with EMG were biceps brachii, wrist flexors, and wrist extensors. The evaluations were performed simultaneously with a functional assessment for ten minutes. The EG received the modified CIMT training one hour per day for two consecutive weeks. Results: After the intervention, the CG showed a moderate negative correlation of the Fa channel with the wrist extensor (r= -0.69; p= 0.02), whereas the EG had a moderate negative correlation of the FA channel (r= -0.68; p= 0.02) and FC (r= - 0.71; p= 0.01) with wrist flexor. In the post-intervention, a positive correlation of the FA channel was found with the wrist extensor (r= 0.61; p= 0.04). Conclusion: The modified CIMT associated with the trunk constraint for the paretic upper limb showed a positive correlation between the Fa channel and the wrist extensor muscle, and the control group showed a negative correlation between the Fa channel and the wrist extensor.

Efeito da realidade virtual no recrutamento de fibras musculares e força muscular respiratória em pacientes com doença de Parkinson - estudo piloto / Effect of virtual reality on recruitment of muscle fibers and respiratory muscle strength in patients with Parkinson's disease - pilot study

Introdução: A Doença de Parkinson compromete a mobilidade da caixa torácica, acarretando limitação progressiva da ventilação, devido ao padrão de flexão e rigidez e fraqueza muscular. A realidade virtual propicia interação em tempo real com atividades e ambientes tridimensionais. Objetivo: Avaliar o efeito da realidade virtual no recrutamento de fibras e forças musculares respiratória e postural em pacientes com doença de Parkinson. Métodos: Estudo clínico, piloto, prospectivo, com alocação por conveniência. Dez indivíduos foram selecionados e alocados em grupo estudo (GE n=5) constituídos por idosos com DP e grupo controle (GC n=5) formado por idosos na mesma faixa etária, sem condições clínicas neurológicas e respiratórias. As variáveis mensuradas foram: independência funcional, desempenho motor, força muscular respiratória, recrutamento de fibras musculares respiratórias e posturais, e qualidade de vida. Foram realizadas 16 sessões com realidade virtual. Resultados: As Pressões Inspiratória máxima (PImáx) e Expiratória máxima (PEmáx) melhoraram em alguns momentos da intervenção. O recrutamento de fibras musculares em esternocleidomastóideo diminuiu e o recrutamento de fibras musculares no diafragma aumentou. Conclusão: A PImáx e a PEmáx melhoraram em alguns momentos do tratamento, e houve diminuição do recrutamento de fibras musculares dos músculos respiratórios acessórios nos pacientes com DP. (AU)

Introduction: Parkinson's disease commits the mobility of the rib cage, causing progressive ventilation limitation due to bending and stiffness. Virtual reality provides real-time interaction with activities and three-dimensional environments. Objective: To evaluate the effect of virtual reality on the recruitment of muscle fibers and respiratory and postural muscle strength in patients with Parkinson's disease. Methods: Clinical, pilot, prospective study, with allocation by convenience. Ten individuals were selected and allocated to a study group (EG n = 5) consisting of elderly people with Parkinson and a control group (CG n = 5) formed by elderly people in the same age group, without neurological and respiratory conditions. The measured variables were functional independence, motor performance, respiratory muscle strength, recruitment of respiratory and postural muscle fibers, and quality of life. 16 sessions were held with virtual reality. Results: The maximum inspiratory pressures (MIP) and maximum expiratory pressures (MEP) improved in some moments of the intervention. The recruitment of muscle fibers in the sternocleidomastoid decreased and the recruitment of muscle fibers in the diaphragm increased. Conclusion: MIP and MEP improved in some moments of treatment, and there was a decrease in the recruitment of muscle fibers from accessory respiratory muscles in patients with PD. (AU)

Existe associação entre α -amilase salivar, escala hospitalar de ansiedade e depressão e autorrelato em estudantes com sintomas de ansiedade? / Is there an association between salivary α -amylase, hospital scale of anxiety and depression and self-report in students with anxiety symptoms?

Objetivo: Verificar se existe associação entre a α-amilase salivar, a escala hospitalar de ansiedade e a depressão e autorrelato de estudantes universitários com sintomas da ansiedade. Métodos: Estudo observacional, realizado com 67 estudantes de uma universidade pública. Para a coleta de dados, foram utilizada a Escala Hospitalar de Ansiedade e Depressão, o autorrelato de ansiedade e a aferição da α-amilase salivar por meio do dispositivo Cocoro Meter®. Os dados foram analisados por meio do teste de qui-quadrado. Resultados: Não houve associação entre α-amilase salivar e a Escala Hospitalar de Ansiedade e Depressão (p=0,51), nem entre a α-amilase salivar e o autor- relato de ansiedade (p=0,51), o que indica que o biomarcador não produz resposta dessas duas variáveis ao mensurar a ansiedade. Conclusão: O biomarcador α-amilase salivar não possui a mesma capacidade em mensurar a ansiedade quando associado com à Escala Hospitalar de Ansiedade de Depressão e ao autorrelato em estudantes universitários com sintomas de ansiedade.

Objective: Verifying if there is an association between the salivary α-amylase biomarker, the hospital scale of anxiety and depression, and a self-report of university students with anxiety symptoms. Methods: An observational study carried out with 67 students from a public university. For the data collection, the Hospital Anxiety and Depression Scale, the self-reported anxiety, and the salivary α-amylase measurement were carried out with the Cocoro Meter® device. The data were analyzed by using the chi-square test. Results: There is no association between salivary α-amylase and the Hospital Anxiety and Depression Scale (p = 0.51), and neither between the salivary α-amylase and the self-reported anxiety (p = 0.51), which indicates that the biomarker does not produce any response of these two variables when measuring anxiety. Conclusion: The salivary α-amylase biomarker does not have the same ability to measure anxiety when associated with the Hospital Anxiety and Depression Scale and with the self-report in university students with anxiety symptoms.