Long-term living in unfavorable socioeconomic conditions impairs late-life gait performance.

BACKGROUND: Low socioeconomic status has been associated with individual health-related problems; however, no study has specifically investigated the impact of socioeconomic disparities on gait performance using an index that considers the population aggregation, as the Human Development Index (HDI). Thus, the aim of the present study was to assess gait parameters of older people living in cities with differences in socioeconomic conditions, identified by HDI. METHODS: Cross-sectional design study conducted with a sample of 233 older people from two Brazilians regions: Coari, state of Amazonas, Brazil (n= 124, low-HDI-Bra) and Ribeirão Preto, state of São Paulo, Brazil (n= 109, very high-HDI-Bra). The gait performance was assessed by an electronic walkway, and the interest variables were gait speed, cadence, stride time, step length and stride width. RESULTS: Low-HDI-Bra group presented worse gait performance as identified by slower gait speed (p = < .001), slower cadence (p = < .001), higher stride time (p = < .001), shorter step length (p = < .001), compared with the very high-HDI-Bra group. There was a positive association between HDI, and gait spend, cadence and step length, and there was a negative association between HDI and stride time and stride width. CONCLUSIONS: Long-term exposure to socioeconomic inequalities found in low HDI cities may impair gait performance in late life. Such information may be relevant to create public politics that use the gait parameter based on the region where the people live.

Effect of Aging on Trunk Muscle Function and Its Influence on Falls Among Older Adults.

The objective was to determine whether trunk muscle function is influenced by the aging process and to identify if the trunk can be an important factor in older people's falls over a period of 1 year. The peak torque, rate of torque development, and torque steadiness of the trunk extensors and flexors were compared between a young group, older group (older adults with no episodes of falls), and older faller group (older adults who had suffered at least one fall episode over a period of 1 year) by one-way analysis of variance, followed by the post hoc Tukey test. The adjusted multivariate linear regression was applied to verify the association between the number of falls and the trunk parameters in older adults. The young group showed higher extensors and flexors peak torque and rate of torque development, and lower extensor torque steadiness at 10% when compared with older groups. Only trunk flexor peak torque showed a negative association with the number of future falls (p = .042), but there was no difference in trunk muscle function between the older group and the older faller group.

Effects of the Use of Anchor Systems in the Rehabilitation of Dynamic Balance and Gait in Individuals With Chronic Dizziness of Peripheral Vestibular Origin: A Single-Blinded, Randomized, Controlled Clinical Trial.

OBJECTIVE: To assess the effectiveness of the anchors in the balance rehabilitation of participants with chronic peripheral vestibulopathy who failed to respond positively to conventional rehabilitation for dynamic balance and gait. DESIGN: Assessor-blind, randomized controlled trial. SETTING: Department of Otoneurology and Laboratory of Assessment and Rehabilitation of Equilibrium. PARTICIPANTS: Women with chronic dizziness of peripheral vestibular origin (N=42), who continued to show otoneurologic symptoms for more than 6 months after starting classic vestibular rehabilitation, with no clinical improvement observed. INTERVENTIONS: Participants were randomly assigned to receive a clinical intervention with the anchor system, a clinical intervention without the anchor system, or no intervention or anchor system. The intervention was based on multi-sensory exercises for 6 weeks, twice a week, totaling 12 sessions, in groups of up to 4 participants, with an average time of 40 minutes per session. MAIN OUTCOME MEASURES: The primary outcome was functional balance as assessed by the short version of the Balance Evaluation Systems Test. The secondary outcomes were gait parameters of step width in meters, step length in meters, and gait speed in meters per second. The measures were assessed preintervention and postintervention, and after a 3-month follow-up period. RESULTS: The proposed intervention was beneficial for dizziness, balance, and gait for both groups studied. At the 3-month follow-up, only the group that used anchors retained the benefits related to the physical aspects of dizziness, balance, and gait. CONCLUSIONS: The present study found that the proposed intervention protocol, with or without the use of anchors, was beneficial for improving the dizziness, balance, and gait. However, retention of the benefits achieved through the exercise protocol was observed only for those using the anchor system, which promotes the use of haptic information. The use of anchors was effective, in short protocols (12wk), with maintenance of results after 3 months.

Is there a relationship between complaints of impaired balance and postural control disorder in community-dwelling elderly women? A cross-sectional study with the use of posturography.

BACKGROUND: Risk of falls increases as age advances. Complaints of impaired balance are very common in the elderly age group. OBJECTIVES: The objective of this study was to investigate whether the subjective perception of impaired balance was associated with deficits in postural control (objective analysis) in elderly community-dwelling women. METHOD: Static posturography was used in two groups: elderly women with (WC group) and without (NC group) complaints of impaired balance. The area, mean sway amplitude and mean speed of the center of pressure (COP) in the anterior-posterior (AP) and medial-lateral (ML) directions were analyzed in three stances: single-leg stance, double-leg stance and tandem stance, with eyes open or closed on two different surfaces: stable (firm) and unstable (foam). A digital chronometer was activated to measure the time limit (Tlimit) in the single-leg stance. Kruskal-Wallis tests followed by Mann-Whitney tests, Friedman analyses followed by post hoc Wilcoxon tests and Bonferroni corrections, and Spearman statistical tests were used in the data analysis. Differences of p<0.05 were considered statistically significant. RESULTS: The results of posturography variables revealed no differences between groups. The timed single-leg stance test revealed a shorter Tlimit in the left single-leg stance (p=0.01) in WC group compared to NC group. A negative correlation between posturography variables and Tlimit was detected. CONCLUSIONS: Posturography did not show any differences between the groups; however, the timed single-leg stance allowed the authors to observe differences in postural control performance between elderly women with and those without complaints of impaired balance.

Is there a relationship between complaints of impaired balance and postural control disorder in community-dwelling elderly women? A cross-sectional study with the use of posturography

Background: Risk of falls increases as age advances. Complaints of impaired balance are very common in the elderly age group. Objectives: The objective of this study was to investigate whether the subjective perception of impaired balance was associated with deficits in postural control (objective analysis) in elderly community-dwelling women. Method: Static posturography was used in two groups: elderly women with (WC group) and without (NC group) complaints of impaired balance. The area, mean sway amplitude and mean speed of the center of pressure (COP) in the anterior-posterior (AP) and medial-lateral (ML) directions were analyzed in three stances: single-leg stance, double-leg stance and tandem stance, with eyes open or closed on two different surfaces: stable (firm) and unstable (foam). A digital chronometer was activated to measure the time limit (Tlimit) in the single-leg stance. Kruskal-Wallis tests followed by Mann-Whitney tests, Friedman analyses followed by post hoc Wilcoxon tests and Bonferroni corrections, and Spearman statistical tests were used in the data analysis. Differences of p<0.05 were considered statistically significant. Results: The results of posturography variables revealed no differences between groups. The timed single-leg stance test revealed a shorter Tlimit in the left single-leg stance (p=0.01) in WC group compared to NC group. A negative correlation between posturography variables and Tlimit was detected. Conclusions: Posturography did not show any differences between the groups; however, the timed single-leg stance allowed the authors to observe differences in postural control performance between elderly women with and those without complaints of impaired balance. .

Analysis of postural control and muscular performance in young and elderly women in different age groups.

BACKGROUND: muscle strength and power are two factors affecting balance. The impact of muscle strength and power on postural control has not been fully explored among different age strata over sixty. OBJECTIVES: the aim of the present study was to assess the muscle strength and power of elderly women in different age groups and determine their correlation with postural control. METHOD: eighty women were divided into four groups: the young 18-30 age group (n=20); the 60-64 age group (n=20); the 65-69 age group (n=20); and the 70-74 age group (n=20). The participants underwent maximum strength (one repetition maximum or 1-RM) and muscle power tests to assess the knee extensor and flexor muscles at 40%, 70%, and 90% 1-RM intensity. The time required by participants to recover their balance after disturbing their base of support was also assessed. RESULTS: the elderly women in the 60-64, 65-69, and 70-74 age groups exhibited similar muscle strength, power, and postural control (p>0.05); however, these values were lower than those of the young group (p<0.05) as expected. There was a correlation between muscle strength and power and the postural control performance (p<0.05). CONCLUSION: despite the age difference, elderly women aged 60 to 74 years exhibited similar abilities to generate strength and power with their lower limbs, and this ability could be one factor that explains the similar postural control shown by these women.

Analysis of postural control and muscular performance in young and elderly women in different age groups

BACKGROUND: muscle strength and power are two factors affecting balance. The impact of muscle strength and power on postural control has not been fully explored among different age strata over sixty. OBJECTIVES: the aim of the present study was to assess the muscle strength and power of elderly women in different age groups and determine their correlation with postural control. METHOD: eighty women were divided into four groups: the young 18-30 age group (n=20); the 60-64 age group (n=20); the 65-69 age group (n=20); and the 70-74 age group (n=20). The participants underwent maximum strength (one repetition maximum or 1-RM) and muscle power tests to assess the knee extensor and flexor muscles at 40%, 70%, and 90% 1-RM intensity. The time required by participants to recover their balance after disturbing their base of support was also assessed. RESULTS: the elderly women in the 60-64, 65-69, and 70-74 age groups exhibited similar muscle strength, power, and postural control (p>0.05); however, these values were lower than those of the young group (p<0.05) as expected. There was a correlation between muscle strength and power and the postural control performance (p<0.05). CONCLUSION: despite the age difference, elderly women aged 60 to 74 years exhibited similar abilities to generate strength and power with their lower limbs, and this ability could be one factor that explains the similar postural control shown by these women. .

Morphological aspects and Cox-2 expression after exposure to 780-nm laser therapy in injured skeletal muscle: an in vivo study.

BACKGROUND: The effectiveness of low-level laser therapy in muscle regeneration is still not well known. OBJECTIVE: To investigate the effects of laser irradiation during muscle healing. METHOD: For this purpose, 63 rats were distributed to 3 groups: non-irradiated control group (CG); group irradiated at 10 J/cm(2) (G10); and group irradiated at 50 J/cm(2) (G50). Each group was divided into 3 different subgroups (n=7), and on days 7, 14 and 21 post-injury the rats were sacrificed. RESULTS: Seven days post-surgery, the CG showed destroyed zones and extensive myofibrillar degeneration. For both treated groups, the necrosis area was smaller compared to the CG. On day 14 post-injury, treated groups demonstrated better tissue organization, with newly formed muscle fibers compared to the CG. On the 21(st) day, the irradiated groups showed similar patterns of tissue repair, with improved muscle structure at the site of the injury, resembling uninjured muscle tissue organization. Regarding collagen deposition, the G10 showed an increase in collagen synthesis. In the last period evaluated, both treated groups showed statistically higher values in comparison with the CG. Furthermore, laser irradiation at 10 J/cm(2) produced a down-regulation of cyclooxygenase 2 (Cox-2) immunoexpression on day 7 post-injury. Moreover, Cox-2 immunoexpression was decreased in both treated groups on day 14. CONCLUSIONS: Laser therapy at both fluencies stimulated muscle repair through the formation of new muscle fiber, increase in collagen synthesis, and down-regulation of Cox-2 expression.

Morphological aspects and Cox-2 expression after exposure to 780-nm laser therapy in injured skeletal muscle: an in vivo study

Background: The effectiveness of low-level laser therapy in muscle regeneration is still not well known. Objective: To investigate the effects of laser irradiation during muscle healing. Method: For this purpose, 63 rats were distributed to 3 groups: non-irradiated control group (CG); group irradiated at 10 J/cm² (G10); and group irradiated at 50 J/cm² (G50). Each group was divided into 3 different subgroups (n=7), and on days 7, 14 and 21 post-injury the rats were sacrificed. Results: Seven days post-surgery, the CG showed destroyed zones and extensive myofibrillar degeneration. For both treated groups, the necrosis area was smaller compared to the CG. On day 14 post-injury, treated groups demonstrated better tissue organization, with newly formed muscle fibers compared to the CG. On the 21st day, the irradiated groups showed similar patterns of tissue repair, with improved muscle structure at the site of the injury, resembling uninjured muscle tissue organization. Regarding collagen deposition, the G10 showed an increase in collagen synthesis. In the last period evaluated, both treated groups showed statistically higher values in comparison with the CG. Furthermore, laser irradiation at 10 J/cm2 produced a down-regulation of cyclooxygenase 2 (Cox-2) immunoexpression on day 7 post-injury. Moreover, Cox-2 immunoexpression was decreased in both treated groups on day 14. Conclusions: Laser therapy at both fluencies stimulated muscle repair through the formation of new muscle fiber, increase in collagen synthesis, and down-regulation of Cox-2 expression. .

The effects of 780-nm low-level laser therapy on muscle healing process after cryolesion.

The objective of this study was to assess the effects of 780-nm low-level laser therapy at different periods of 7, 14 and 21 days after cryolesion, including the dose (10 or 50 J/cm(2)), to promote a better muscle repair evidenced by histopathological and immunohistochemical analyses. Fifty-four male rats were divided into three groups: injured control group (CG)-injured animals without any treatment; injured 780-nm laser-treated group, at 10 J/cm(2) (G10); and injured 780-nm laser-treated group, at 50 J/cm(2) (G50). Each group was divided into three subgroups (n = 6): 7, 14 and 21 days post-injury. Histopathological findings revealed better organised muscle fibres in the G10 and G50 during the periods of 7 and 14 days compared to the CG. The G10 and G50 during the 7 days showed a significant reduction (p < 0.05) of lesion area compared to the CG, without differences between groups treated for 14 and 21 days. The G10 showed an increase of the amount of vessels after 14 days compared to the G50, but not in relation to controls. With regard to the immunohistochemical analyses of the MyoD factor, the G10 and G50 during the 7 days showed higher concentrations of immunomarkers than controls. Myogenin immunomarkers were similarly observed at days 7 and 14 in all the three groups analysed, whereas immunomarkers were found in none of the groups after 21 days of laser therapy. The results showed that laser, regardless the applied dose, has positive effects on muscle repair.

Effects of 660 nm low-level laser therapy on muscle healing process after cryolesion.

The aim of this study was to evaluate the effects of 660 nm low-level laser therapy (LLLT) on muscle regeneration after cryolesion in rat tibialis anterior muscle. Sixty-three Wistar rats were divided into a control group, 10 J/cm(2) laser-treated group, and 50 J/cm(2) laser-treated group. Each group formed three subgroups (n = 7 per group), and the animals were sacrificed 7, 14, or 21 d after lesion. Histopathological findings revealed a lower inflammatory process in the laser-treated groups after 7 d. After 14 d, irradiated animals at both fluences showed higher granulation tissue, new muscle fibers, and organized muscle structure. After 21 d, full tissue repair was observed in all groups. Moreover, irradiated animals at both fluences showed smaller necrosis area in the first experimental period evaluated. MyoD immunoexpression was observed in both treated groups 7 d postinjury. Myogenin immunoexpression was detected after 7 and 14 d. The higher fluence increased the number of blood vessels after 14 and 21 d. These results suggest that LLLT, at both fluences, positively affects injured skeletal muscle in rats, accelerating the muscle-regeneration process.

The influence of vision and support base on balance during quiet standing in patients with adolescent idiopathic scoliosis before and after posterior spinal fusion.

BACKGROUND CONTEXT: Scoliosis is the most common postural alteration in adolescence and is characterized by deviations of the spine in three planes. Surgical treatment based on arthrodesis has been developed, but the effects of such restructuring on the systems involved in postural control need to be better understood. PURPOSE: To assess the influence of vision and the support base on balance in the quiet standing position in adolescents awaiting surgical treatment for idiopathic scoliosis. STUDY DESIGN/SETTING: Longitudinal study/Ribeirão Preto Clinics Hospital (HC-FMRP-USP) and Laboratory of Assessment and Rehabilitation of Equilibrium at the FMRP-USP. PATIENT SAMPLE: Adolescent idiopathic scoliosis patients and controls. OUTCOME MEASURES: Center of pressure (CoP) sway area of the 95% confidence ellipse. METHODS: Thirty female adolescents were divided into two groups according to their spinal alignment: control (n=15) and scoliosis groups (SGs) (n=15). The subjects with scoliosis were evaluated before and 7, 30, 60, and 90 days after surgery; the controls were evaluated once. The area of CoP oscillation was measured with the eyes open and closed and with two different support bases (feet apart or together). The force platform was purchased with funding support (US $8,375.00) provided by the Research Foundation of São Paulo (FAPESP). The study sponsors had no involvement in the study. Data were collected from the force platform and then statistically assessed through a linear model analysis of mixed effects. RESULTS: Data reveal that subjects in the SG oscillated more than controls, and postsurgery subjects had more oscillation than presurgery subjects. The results also indicated that both groups (control and scoliosis) showed more oscillation among those subjects with feet apart and eyes closed, but subjects with scoliosis were more affected by vision deprivation than by a reduced support base. CONCLUSIONS: Our results indicate that adolescents with idiopathic scoliosis are more dependent on visual information and that surgical correction does not change this relationship.

Do muscle strengthening exercises improve performance in the 6-minute walk test in postmenopausal women? / O exercício de força muscular é eficiente para melhorar o desempenho no teste de caminhada de 6 minutos em mulheres pós-menopausais?

BACKGROUND: Walking speed seems to be related to aerobic capacity, lower limb strength, and functional mobility, however it is not clear whether there is a direct relationship between improvement in muscle strength and gait performance in early postmenopausal women. OBJECTIVE: To evaluate the effect of muscle strengthening exercises on the performance of the 6-minute walk test in women within 5 years of menopause. METHODS: The women were randomized into control group (n=31), which performed no exercise, and exercise group (n=27), which performed muscle strengthening exercises. The exercises were performed twice a week for 3 months. The exercise protocol consisted of warm-up, stretching, and strengthening of the quadriceps, hamstring, calf, tibialis anterior, gluteus maximus, and abdominal muscles, followed by relaxation. Muscular strength training started with 60% of 1MR (2 series of 10-15 repetitions), reaching 85% until the end of the 3-month period (4 series of 6 repetitions each). RESULTS: The between-group comparisons pre- and post-intervention did not show any difference in distance walked, heart rate or blood pressure (p>0.05), but showed differences in muscle strength post-intervention, with the exercise group showing greater strength (p CONCLUSION: The results suggest that muscle strengthening of the lower limbs did not improve performance in the 6-minute walk test in this population of postmenopausal women.

CONTEXTUALIZAÇÃO: A velocidade de marcha parece estar relacionada com a capacidade aeróbica, força dos músculos dos membros inferiores e mobilidade funcional. Entretanto, não está claro se existe uma relação direta entre a melhora da força muscular e o desempenho da marcha em mulheres pós-menopausais recentes. OBJETIVO: Avaliar o efeito de exercícios de fortalecimento muscular sobre o desempenho no teste de caminhada de 6 minutos em mulheres nos primeiros cinco anos após a menopausa. MÉTODOS: As mulheres foram randomizadas em grupo controle (n=31), que não realizou exercício, e grupo exercício (n=27), que realizou um programa de exercícios. O programa de exercícios foi realizado duas vezes por semana, durante três meses, e consistiu em aquecimento, alongamento, exercícios de fortalecimento muscular para quadríceps, isquiotibiais, tríceps sural, tibial anterior, glúteo máximo e abdominais, finalizando com relaxamento. O treinamento de força iniciou com 60% de 1RM (duas séries de 10-15 repetições) e atingiu 85% (quatro séries de seis repetições) no final dos três meses. RESULTADOS: As comparações entre os grupos pré e pós-três meses não mostraram diferenças para distância percorrida, frequência cardíaca (FC) e pressão arterial (p≥0,05), mas mostraram diferenças para força muscular após três meses, com o grupo exercício apresentando maior força (p≤0,05). Nas comparações antes e após três meses intragrupos, houve diferenças para FC, forças musculares de quadríceps e isquiotibiais para o grupo intervenção. CONCLUSÃO: Os resultados sugerem que o treinamento de força muscular dos membros inferiores não melhora o teste de caminhada de 6 minutos para essa população de mulheres avaliadas.

Do muscle strengthening exercises improve performance in the 6-minute walk test in postmenopausal women?

BACKGROUND: Walking speed seems to be related to aerobic capacity, lower limb strength, and functional mobility, however it is not clear whether there is a direct relationship between improvement in muscle strength and gait performance in early postmenopausal women. OBJECTIVE: To evaluate the effect of muscle strengthening exercises on the performance of the 6-minute walk test in women within 5 years of menopause. METHODS: The women were randomized into control group (n=31), which performed no exercise, and exercise group (n=27), which performed muscle strengthening exercises. The exercises were performed twice a week for 3 months. The exercise protocol consisted of warm-up, stretching, and strengthening of the quadriceps, hamstring, calf, tibialis anterior, gluteus maximus, and abdominal muscles, followed by relaxation. Muscular strength training started with 60% of 1MR (2 series of 10-15 repetitions), reaching 85% until the end of the 3-month period (4 series of 6 repetitions each). RESULTS: The between-group comparisons pre- and post-intervention did not show any difference in distance walked, heart rate or blood pressure (p>0.05), but showed differences in muscle strength post-intervention, with the exercise group showing greater strength (p CONCLUSION: The results suggest that muscle strengthening of the lower limbs did not improve performance in the 6-minute walk test in this population of postmenopausal women.