Development of Continuous Assessment of Muscle Quality and Frailty in Older Patients Using Multiparametric Combinations of Ultrasound and Blood Biomarkers: Protocol for the ECOFRAIL Study.

BACKGROUND: Frailty resulting from the loss of muscle quality can potentially be delayed through early detection and physical exercise interventions. There is a demand for cost-effective tools for the objective evaluation of muscle quality, in both cross-sectional and longitudinal assessments. Literature suggests that quantitative analysis of ultrasound data captures morphometric, compositional, and microstructural muscle properties, while biological assays derived from blood samples are associated with functional information. OBJECTIVE: This study aims to assess multiparametric combinations of ultrasound and blood-based biomarkers to offer a cross-sectional evaluation of the patient frailty phenotype and to track changes in muscle quality associated with supervised exercise programs. METHODS: This prospective observational multicenter study will include patients aged 70 years and older who are capable of providing informed consent. We aim to recruit 100 patients from hospital environments and 100 from primary care facilities. Each patient will undergo at least two examinations (baseline and follow-up), totaling a minimum of 400 examinations. In hospital environments, 50 patients will be measured before/after a 16-week individualized and supervised exercise program, while another 50 patients will be followed up after the same period without intervention. Primary care patients will undergo a 1-year follow-up evaluation. The primary objective is to compare cross-sectional evaluations of physical performance, functional capacity, body composition, and derived scales of sarcopenia and frailty with biomarker combinations obtained from muscle ultrasound and blood-based assays. We will analyze ultrasound raw data obtained with a point-of-care device, along with a set of biomarkers previously associated with frailty, using quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. Additionally, we will examine the sensitivity of these biomarkers to detect short-term muscle quality changes and functional improvement after a supervised exercise intervention compared with usual care. RESULTS: At the time of manuscript submission, the enrollment of volunteers is ongoing. Recruitment started on March 1, 2022, and ends on June 30, 2024. CONCLUSIONS: The outlined study protocol will integrate portable technologies, using quantitative muscle ultrasound and blood biomarkers, to facilitate an objective cross-sectional assessment of muscle quality in both hospital and primary care settings. The primary objective is to generate data that can be used to explore associations between biomarker combinations and the cross-sectional clinical assessment of frailty and sarcopenia. Additionally, the study aims to investigate musculoskeletal changes following multicomponent physical exercise programs. TRIAL REGISTRATION: ClinicalTrials.gov NCT05294757; https://clinicaltrials.gov/ct2/show/NCT05294757. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50325.

Differences in Functional Capacity between Oncologic and Non-Oncologic Populations: Reference Values.

This study is focused on the fact that in the context of increasing global aging and cancer diagnoses, additional challenges arise in clinical care. Adequate functionality and body composition are key to coping with antineoplastic treatment, which can lead to better treatment tolerance, survival, and quality of life. This is a cross-sectional comparative study focused on the assessment and comparison of body composition and functionality between cancer patients and a reference population, with the aim of establishing meaningful baseline values. Techniques such as manual dynamometry, the Five-Times Sit-to-Stand test, and bioimpedance were used to collect data from 374 oncologic patients and 1244 reference individuals. The results reveal significant disparities in functionality and body composition among participants, and provide age group-specific adjusted baseline values for those diagnosed with cancer. These findings may have crucial clinical implications for applying particular cut-off points designed for this population group, which makes the assessment process faster and more accurate, enhances the capacity of medical personnel to act quickly, and improves the management of frailty in cancer patients.

Diferencias antropométricas y potencia aeróbica máxima entre hombres y mujeres en el remo de traineras / Anthropometric and maximal aerobic power differences between male and female row crews-traineras

En el remo de traineras se han observado diferencias antropométricas, mecánicas y de rendimiento entre remeros de un mismo club que competían en distintas categorías. La potencia aeróbica máxima se ha definido como uno de los mejores predictores del rendimiento en el remo. El objetivo fue observar diferencias entre de remeros y remeras en datos antropométricos, fisiológicos y de potencia aeróbica. Se evaluó el peso (P), la talla (T), el porcentaje graso (G), el sumatorio de siete pliegues (S7) y los vatios (W) absolutos y relativos (W/kg) de 55 sujetos. De los 55 sujetos, 38 fueron hombres (26,95 ±7,0 años) y 17 mujeres (24,82 años ±6,8). Para calcular el tamaño del efecto como diferencia de medias estandarizadas se utilizó la d de Cohen. En los resultados, se obtuvieron medias muestrales en las variables analizadas en los diferentes sexos (M: mujeres y H: hombres). Para H: [P: 77,25 (9,41) – T: 1,80 (0,07) – G: 12,77 (3,04) – S7: 72,23 (28,20) – W: 273,6 (52,88) – W/kg: 3,57 (0,67)] y para M: [P: 61,79 (6,85 - T: 1,67 (0,07) – G: 14,44 (2,47)- S7: 103,83 (28,64) – W: 171,35 (29,19) – W/kg: 2,78 (0,43)]. Finalmente los resultados fueron los siguientes: P: 1,77 – T: 1,87 – G: 0,57 – S7: 1,11 – W: 2,17 – W/kg: 1,28. Mostrando diferencias significativas y un tamaño del efecto grande entre ambos sexos en todas las variables analizadas, exceptuando la variable del porcentaje graso.(AU)

Anthropometric, mechanical and performance differences have been observed in rowing between rowers from the same club competing in different categories. Maximal aerobic power has been defined as one of the best predictors of rowing performance. The aim was to observe differences between male and female rowers in anthropometric, physiological and aerobic power data. Weight (P), height (T), fat percentage (G), sum of seven folds (S7) and absolute and relative watts (W) (W/kg) of 55 subjects were assessed. Of the 55 subjects, 38 were male (26.95 ±7.0 years) and 17 were female (24.82 ±6.8 years). Cohen’s d was used to calculate the effect size as standardised mean difference. In the results, sample means were obtained for the variables analysed in the different sexes (F: females and M: males). For F: [P: 77.25 (9.41) - T: 1.80 (0.07) - G: 12.77 (3.04) - S7: 72.23 (28.20) - W: 273.6 (52.88) - W/kg: 3.57 (0.67)] and for M: [P: 61.79 (6.85 - T: 1.67 (0.07) - G: 14.44 (2.47)- S7: 103.83 (28.64) - W: 171.35 (29.19) - W/kg: 2.78 (0.43)]. Finally, the results were as follows: P: 1.77 - T: 1.87 - G: 0.57 - S7: 1.11 - W: 2.17 - W/kg: 1.28. Showing significant differences and a large effect size between both sexes in all the variables analysed, except for the fat percentage variable.(AU)

Effects of Socioeconomic Environment on Physical Activity Levels and Sleep Quality in Basque Schoolchildren.

The socioeconomic and built environment of an area are interrelated with health data and have a direct influence on children's development. There are facilitators and barriers for schools to promote physical activity depending on the socioeconomic status of the school. The aim of this study was to analyse the relationship between physical activity and sleep and the socioeconomic level of children in the Basque Country. The sample consisted of 1139 schoolchildren between the ages of six and seventeen (566 boys and 573 girls) from 75 schools (43 public and 32 private). Differences between groups were compared using the Mann-Whitney U test (two samples), Kruskal-Wallis one-factor ANOVA (k samples), and Spearman's Rho correlation. There are sex differences in light (200.8 ± 62.5 vs. 215.9 ± 54.7) and moderate (69.0 ± 34.3 vs. 79.9 ± 32.1) physical activity in favour of the female group of higher socioeconomic status compared to male group of higher socioeconomic status. In the case of vigorous physical activity, the female group performed less than the male group across all socioeconomic statuses, which was statistically significant in the groups of high socioeconomic status (11.6 ± 9.3 vs. 6.9 ± 5.7) in group 2 and medium socioeconomic status (11.1 ± 9.3 vs. 7.7 ± 6.1) in group 3. There is an inverse relationship between sedentary behaviour and BMI, total bed time, total sleep time, and night-time awakenings. There is also an inverse relationship between all levels of physical activity performed with respect to BMI and total sleep efficiency. These data point towards notable inequalities in physical activity and daily sleep in Basque schoolchildren, which in turn may be marginalised in our current school system due to the effects of the socioeconomic environment.

Physical Activity Levels and Sleep in Schoolchildren (6-17) with and without School Sport.

There is strong evidence to support the association between daily physical activity and sleep parameters in children and adolescents. Physical activity and outdoor play are favourably associated with most sleep outcomes in school children. The aim is to find out the levels of physical activity and the quality of sleep in Basque schoolchildren aged between six and seventeen and to analyse the possible differences between those who carry out some kind of physical sports activity and those who do not. The sample consisted of 1082 schoolchildren (50.1% male and 49.9% female). Differences between groups were compared using the Mann-Whitney U test (2 samples) and Kruskal-Wallis one-factor ANOVA (k samples). A total of 723 (66.94%) of the participants said they practiced some physical sports activity. The accelerometers obtained significant differences in all levels of physical activity, as well as in sleep efficiency, with higher levels of physical activity (sedentary p = 0.001; light p = 0.017; moderate p = 0.009; vigorous p = 0.001 and moderate-to-vigorous physical activity p = 0.002) and better sleep efficiency (p = 0.002) in those schoolchildren who perform some type of physical sports activity. A significant difference in time spent in sedentary activities was also observed between primary and secondary school pupils of both sexes and regardless of the degree of physical sports activity completion.

Health Benefits and Participation Barriers of Different Level Horseback Riders Age-Wise.

Although horseback riding is not specifically mentioned in the recommendations for different age groups regarding the level of physical activity necessary for good health, its practice continues to grow in popularity throughout the world. Despite being a minority discipline, it has some characteristics that make it an opportunity for its participants to be active people, so it is important to understand what are the perceived health benefits and barriers to participation. The aim of the study is to describe and analyze the perceived health benefits and barriers in horseback riding among riders categorized by level and age, in order to promote physical activity through these benefits and to overcome the barriers. An online version of the EBBS (Exercise Benefits/Barriers Scale) was used to analyze benefits and barriers. The sample consisted of 2,651 participants (95.9% women and 4.1% men) in an equestrian event, distributed in four age groups (79.4% up to 25 years, 11.5% between 26 and 35, 7.9% between 36 and 50, and 1.2 older than 50 years). Perceived benefits and participation barriers to horseback riding were analyzed. The factor analysis identified and confirmed five benefit factors and four barrier factors. Benefit factors were significantly correlated among them but barriers were less interrelated. Higher ages were associated to larger benefits and less barrier effects. Benefit and barrier differences were larger between amateur and professional riders, compared to gender differences.

Level of Physical Activity, Sedentary Behavior, and Sleep in the Child and Adolescent Population in the Autonomous Community of the Basque Country (6-17 Years Old): Protocol for the Mugikertu Study.

BACKGROUND: Physical inactivity and sedentary behavior are increasingly common problems in the general population, which can lead to overweight, obesity, diabetes, cardiovascular disease, and decreased motor and cognitive capacity among children and adolescents. Establishing healthy habits in childhood on the basis of the World Health Organization's 2020 Physical Activity Guidelines is essential for proper physical, motor, and cognitive development. OBJECTIVE: The primary aim of this study is to describe the level of physical activity (PA), sedentary behavior, and sleep of the child and adolescent population from 6 to 17 years of age in the Basque Autonomous Community (BAC). Our secondary aim is to establish a starting point for future research and intervention protocols to improve the existing reality. METHODS: This cross-sectional study aims to recruit 1111 children and adolescents, aged 6 to 17 years from the BAC in a representative random sample. Participants will wear the ActiGraph WGT3X-BT triaxial accelerometer for 7 consecutive days in their nondominant wrist, and fill out a habit diary log of PA, mobility, and sleep routine. PA intensities, sedentary behavior, and sleep parameters (total bedtime, total sleep time, and sleep efficiency) will be calculated from raw accelerometer data using SPSS (IBM Corp). Participants will be randomly selected. RESULTS: The results of this study intend to demonstrate significant differences in PA levels in different age and gender groups since the volume of school PA in the BAC decreases as the age of the schoolchildren increases. The total study sample includes 1111 participants. In April 2021, up to 50% of the sample size was reached, which is expected to increase to 100% by April 2022. This sample will allow us to analyze, discuss, compare, and assess the reality of the school population, in a sensitive period of adherence to behavior patterns, using data from the geographical and administrative area of the BAC. This study will provide a realistic insight into PA levels among children and adolescents in the BAC. It will also offer scientific contributions on the positive relationship between PA levels and sleep quality in this population. CONCLUSIONS: This study might highlight the need for the promotion of cross-sectional policies so that children and adolescents may increase their levels of PA, thus improving both the school environment and positive healthy behavior. TRIAL REGISTRATION: ISRCTN Registry ISRCTN65573865; https://www.isrctn.com/ISRCTN65573865. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/31325.

Effects of a Physical Exercise Intervention on Pain in Workplaces: A Case Study.

Interventions that promote physical activity and healthy habits in workplaces have proven to be effective in reducing risk factors associated with numerous pathologies. This study examines the effects of an individualized physical exercise program that lasts five minutes for 30 working days on the perceived pain of workers, as well as analyzing adherence to it within workplaces. Data were collected through a visual analog scale of 1-10 of the perception of pain by anatomical areas, and, thus, we could observe variations in the perceived pain of workers through a program of five individualized exercises for one minute each based on the analysis of the worker and the job position. Significant differences were observed in three of the four centers analyzed (1: p = 0.006; 2: p = 0.009; 3: p = 0.000; 4: p = 0.791). A five-minute exercise program in the work environment appears to be an effective tool in terms of time and an improvement in workers' perception of pain.

Valores de referencia del SPPB en personas mayores de 60 años en el País Vasco / Reference values for SPPB in people over 60 years of age in the Basque Country

Objetivo: Proporcionar valores de referencia del Short Physical Performance Battery (SPPB) en adultos y adultos mayores en el País Vasco, identificando puntos de corte para medir la fragilidad y comparar los valores con otras poblaciones de España. Emplazamiento: Bilbao capital, País Vasco (España). Participantes: 1.923 personas mayores de 60 años incluidos en el Programa de Salud para Personas Mayores del Ayuntamiento de Bilbao participaron en el estudio. El programa de actividad física (AF) se impartió dos veces por semana durante un mínimo de 12 semanas, con sesiones de 50 minutos. Mediciones principales: Se evaluó a los participantes con la prueba SPPB que evalúa: equilibrio (PE), velocidad de la marcha en 4 m (PM) y la fuerza a través de la prueba de levantarse y sentarse de la silla (PS). Según el resultado obtenido de todas las pruebas, se identificó la funcionalidad de las personas en: limitación grave (cero a cuatro puntos), moderada (cuatro a seis puntos), leve (siete a nueve puntos) y mínima (10 a 12 puntos). Resultados: Edad media 77,9 (5,6) años, siendo el 87,9% mujeres y el 12,1% hombres. La batería SPPB mostro diferencias significativas en la edad (p = 0,000) y género (p = 0,005) Además, se realizó una comparación con una población similar: 70 a 75 años = 0,6 (d de Cohen), 76 a 79 años = 0,98 (d de Cohen) y >80 años = 0,98 (d de Cohen). Conclusiones: El presente estudio señala los valores normativos para SPPB. La funcionalidad de las personas disminuye a medida que avanza la edad. A pesar de los hallazgos actuales que los profesionales de la salud disponen para una detección más eficaz de la fragilidad, muchos de ellos aún no se han traducido a la práctica clínica.(AU)

Purpose: To provide reference values of Short Physical Performance Battery (SPPB) in adults and older adults in the Basque Country by identifying cut-off points for measuring fragility and comparing the values with other populations in Spain. Location: Bilbao capital, Basque Country (Spain). Participants: 1923 people over 60 years old included in the Health Program for the Elderly of the City of Bilbao participated in the study. The PA program was delivered twice a week for a minimum of 12 weeks, with 50-minute sessions. Main measurements: Participants were evaluated with the SPPB, which assesses balance (PE), gait speed test (PM) and chair stand test (PS). Based on the results obtained from all tests, the functionality of the participants was identified as: severe (0–4 points), moderate (4–6 points), mild (7–9 points) and minimal (10–12 points) limitation. Results: Mean age was 77.9 (5.6) years, 87.9% were women and 12.1% were men. The SPPB showed significant differences in age (p = 0.000) and gender (p = 0.005). In addition, a comparison was made with a similar population: 70–75 years = 0.6 (Cohen's d), 76–79 years = 0.98 (Cohen's d), and >80 years = 0.98 (Cohen's d). Conclusions: The present study indicates normative values for SPPB. People's functionality decreases, as they get older. Despite the current findings available to health professionals for more effective detection of fragility, many of them have not yet been translated into clinical practice.(AU)

[Reference values for SPPB in people over 60 years of age in the Basque Country]. / Valores de referencia del SPPB en personas mayores de 60 años en el País Vasco.

PURPOSE: To provide reference values of Short Physical Performance Battery (SPPB) in adults and older adults in the Basque Country by identifying cut-off points for measuring fragility and comparing the values with other populations in Spain. LOCATION: Bilbao capital, Basque Country (Spain). PARTICIPANTS: 1923 people over 60 years old included in the Health Program for the Elderly of the City of Bilbao participated in the study. The PA program was delivered twice a week for a minimum of 12 weeks, with 50-minute sessions. MAIN MEASUREMENTS: Participants were evaluated with the SPPB, which assesses balance (PE), gait speed test (PM) and chair stand test (PS). Based on the results obtained from all tests, the functionality of the participants was identified as: severe (0-4 points), moderate (4-6 points), mild (7-9 points) and minimal (10-12 points) limitation. RESULTS: Mean age was 77.9 (5.6) years, 87.9% were women and 12.1% were men. The SPPB showed significant differences in age (p = 0.000) and gender (p = 0.005). In addition, a comparison was made with a similar population: 70-75 years = 0.6 (Cohen's d), 76-79 years = 0.98 (Cohen's d), and >80 years = 0.98 (Cohen's d). CONCLUSIONS: The present study indicates normative values for SPPB. People's functionality decreases, as they get older. Despite the current findings available to health professionals for more effective detection of fragility, many of them have not yet been translated into clinical practice.

Reference Values for Handgrip Strength in the Basque Country Elderly Population.

Strength training is currently the most recommended primary therapeutic strategy to prevent and reverse the decline of muscle mass, strength, and functional deterioration associated with age. The aim is to provide reference values of handgrip strength (HGS) in the Basque Country population and compare the values with other populations. A total of 1869 subjects from the health-promoting programme for adults and older adults run by the Bilbao City Council were assessed using HGS with a digital dynamometer and anthropometric data measured by Tanita to obtain the mean values according to age distribution. From the 1869 subjects, 87.5% were women and 12.5% men. The HGS was higher among men than women, 32.4 ± 6.6 versus 20.1 ± 4.7 kg, respectively, p < 0.001 at all ages. Weak HGS cut-off points by age groups ranged from 31.0 to 23.8 and from 18.9 to 12.4 in men and women, respectively. The sample data were compared (d, t, and α) with those of other populations in all age groups (group > 60 years at 95% df, p < 0.05). A health-promoting programme appears to be effective in the general population in obtaining better values in the HGS test as age increases.