Functional fitness trends among older adults in Portugal between 2008 and 2018: Keeping up with a healthy aging process.

OBJECTIVES: Maintaining a healthy aging process is vital to combating and delaying the adverse health outcomes faced by the growing older adult population, where a key aspect to achieving healthy aging is the preservation of functional fitness. This study aims to present trends on the functional fitness of Portuguese older adults between 2008 and 2018 and build new normative reference standards for the Senior Fitness Battery Tests. DESIGN: Cross-sectional study. METHODS: Functional fitness was measured with the Senior Fitness Battery Tests in two national representative cohorts of the Portuguese older adult population (≥65 years) using the 2008 (n = 4712) and 2018 (n = 2717) surveys. Changes were assessed according to sex and age group. Sex and age-group normative fitness scores were developed. RESULTS: Overall findings suggested that older adults' point prevalence for arm-curl, 8-ft up-and-go, and 30-s chair sit-to-stand remained stable between 2008 and 2018, with declining trends being observed for the 6-min walk and back-scratch tests. However, results for trends varied when stratified by sex and age categories. CONCLUSIONS: Our results suggest a trend toward a stabilization of most of the functional fitness tests over the past decade, but with a critical decline in the 6-min walk test. Thus, this test should be targeted by future health-care policies. Moreover, this investigation provides new and updated normative reference standards for the Senior Fitness Battery Tests that should be used as a tool to promote a healthy aging process among Portuguese older adults.

Physical fitness trends in a nationally representative sample of Portuguese youth: What has changed from 2008 to 2018?

This investigation aimed to describe the current physical fitness (PF) status of Portuguese youth, compare secular trends from 2008 and 2018, and establish updated age- and sex-specific percentile values for distinct PF tests. In 2008 and 2018, 22 048 and 8960 children and adolescents (10-18 years) were included in two national cross-sectional investigations. PF was evaluated using the FITESCOLA® battery tests and the handgrip strength test. Independent sample t-tests and chi-squared tests were used to model the results. Weight smoothed percentile values were calculated using Cole's Lambda-Mu-Sigma (LMS) method. All analyses were weighted according to age, sex, and geographic region. In 2018, boys surpassed girls in the 20-m shuttle run, curl-ups, push-ups, standing long, and vertical jump tests, while girls performed better in the sit-and-reach (p < 0.05). The percentage of boys and girls meeting the healthy zone in the 20-min shuttle run test did not differ between 2008 and 2018 (p ≥ 0.05). In boys, a higher percentage fell in the healthy zone for the curl-up and push-up tests in 2018 compared to 2008 (85.8% vs. 83.4%, and 57.8% vs. 53.8%; p < 0.05). Girls improved their flexibility component (sit-and-reach test), with a higher percentage meeting the healthy zone in 2018 (32.6% vs. 36.9%; p < 0.05); an opposite trend was seen for boys (65.5% vs. 50.1%; p < 0.05). The present investigation provides new and updated PF percentile curves for Portuguese youth, which can be used as a general overview of the current PF state among the Portuguese young population.

Results from Portugal's 2022 report card on physical activity for children and youth.

Background: The purpose of this study is to update results of Portuguese's Report Card on Physical activity (PA) for Children and Adolescents. Methods: The grades were assigned by results derived from the PA and Fitness in Portugal 2021 Portuguese Report Card and corresponds to the third report for the Portuguese children and adolescents. It includes indicators of PA and sedentary behavior (SB) that are common to the GLOBAL matrix 4.0: Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behaviors, Family and Peers, School, Community and the Environment, Government and Physical Fitness. The search focused on published national evidence/data sources (academia, NGO, governmental) from end 2018 onwards excluding data obtained during the covid-19 pandemic. Results: The grades were assigned as follows: Overall PA (D-), Organized Sport Participation (C-), Active Play (D+), Active Transportation (D-), Sedentary behaviors (C+), Physical Fitness (C), Family and Peers (B), School (A), Community and Environment (B), and Government (B). Conclusion: In line with previous Portuguese Report Cards, a large proportion of Portuguese children and adolescents are not sufficiently active nor fit enough setting urgency for effective strategies. Particular attention should be given to Active play, Active transport and Organized Sports Participation has their grades have decreased. Some actions in selected indicators as Governmental and policy seems promising however results weren't seen yet. Despite the strong support of schools with mandatory curricula in PE no correspondent change is observed in fitness or PA, so more research is needed to find why.

Physical Activity and Sedentary Behavior in the Portuguese Population: What Has Changed from 2008 to 2018?

PURPOSE: Assessment of trends in physical activity (PA) and sedentary time (ST) is important for evaluating the effectiveness of national policies and setting goals to improve population PA. This study describes changes in measured PA and ST through motion sensors of the Portuguese population from 2008 to 2018. METHODS: PA and ST were measured with accelerometry from individuals (≥10 yr) participating in the 2008 ( n = 4 532) and 2018 ( n = 6 369) Portuguese PA Surveillance Systems. Changes were analyzed using generalized linear and logistic models adjusted for accelerometer wear time. A weight factor was applied to all analyses in order to achieve national representativeness of the present results. RESULTS: In 2018, 15.4%, 71.2%, and 30.6% of Portuguese youth, adults, and older adults met the PA recommendations. Compared with 2008, the percentage meeting the PA guidelines increased in youth females (4.7% vs 7.7%, P < 0.05) and adult males (72.2% vs 79.4%, P < 0.05). A decrease in ST was observed for adult males, whereas ST increased in all youth. Male youth decreased the number of breaks in ST (BST per hour), whereas a favorable increase was found for both adult and older adult males and females. CONCLUSIONS: PA has remained fairly stable between 2008 and 2018 for all groups, except for youth females and adult males. For ST, a favorable decrease was observed for adult males; however, an inverse trend was found in youth. These results are relevant for policy makers to develop health care policies aimed at promoting PA and reducing ST across all age-groups.

Can Physical Activity Make Up for the Self-Care Disability Effects of Too Much Sitting? A Moderation Analysis in Octogenarians Residing in Living Care Facilities.

BACKGROUND AND PURPOSE: Physical activity can delay the progression of self-care disability in older adults residing in living care facilities. Nonetheless, older adults residing in living care facilities spend most of their time sedentary and do not meet the physical activity recommendation, which may result in increasing self-care disability in this population group. In this study, we aimed to determine whether the association between sedentary time and self-care disability was moderated by moderate-to-vigorous physical activity (MVPA) in older adults residing in living care facilities. METHODS: Sedentary time and MVPA were both measured with accelerometers. Self-care disability was assessed with the Barthel Index. A multivariate regression model was used to ascertain the effects of the interaction between sedentary time and MVPA on the self-care disability of participants. The Johnson-Neyman technique was then used to estimate the exact MVPA threshold at which the effect of sedentary time on self-care disability became nonsignificant. RESULTS: We found a significant effect of sedentary time on self-care disability (standardized ß=-1.66; 95% CI -1.77 to -1.54, P = .013). Results indicated that MVPA moderates the relationship between self-care disability status and sedentary time (standardized ß= 1.14; 95% CI 1.13 to 1.14, P = .032). The Johnson-Neyman technique determined that 51 min/day of MVPA would offset the negative effects of sedentary time on self-care disability. CONCLUSIONS: Our results suggest physical therapists should focus on reducing sedentary time alongside physical activity to prevent the progression to dependency in octogenarians residing in living care facilities.

Abdominal obesity in adolescents: Development of age-specific waist circumference cut-offs linked to adult IDF criteria.

OBJECTIVES: The purpose of this study was to develop age- and sex-specific waist circumference (WC) cut-off points, linked to older adolescent and adult criteria for abdominal obesity, to be applied to children in the clinical setting. METHODS: A total of 16,788 adolescents aged 10 to 16 years were assessed for WC. Smoothed age and sex-specific WC curves were obtained using Cole's LMS method. RESULTS: Percentiles that corresponded to the International Diabetes Federation (IDF) recommendations used for older adolescents and adults (16+ years old) were the 97th percentile for boys and the 87th percentile for girls. Using these cutoffs, a total of 368 boys and 1138 girls were categorized as abdominally obese, in contrast to 1654 boys and 987 girls that were identified using the current IDF pediatric criteria (90th percentile). CONCLUSIONS: We provide age- and sex-specific cut-off points that can be used to identify abdominal obesity in adolescents. The present findings provide a tool that can be used in the clinical setting for the early detection and prevention of adult obesity. Population-specific cutoffs may be required for pediatric ages to diagnose children at risk.

Results From Portugal's 2016 Report Card on Physical Activity for Children and Youth.

BACKGROUND: This article describes the procedures and development of the first Portuguese Report Card on Physical Activity in Children and Adolescents. METHODS: Comprehensive searches for data related to indicators of physical activity (PA) were completed by a committee of physical activity and sports specialists. Grades were assigned to each indicator consistent with the process and methodology outlined by the Active Healthy Kids Canada Report Card model. RESULTS: Nine indicators of PA were graded. The following grades were assigned: Overall Physical Activity Levels, D; Organized Sport Participation, B; Active Play, D; Active Transportation, C; Sedentary Behaviors, D; Family and Peers, C; Schools, B; Community and the Built Environment, D; and Government, C. CONCLUSIONS: Portuguese children and adolescents do not reach sufficient physical activity levels and spend larger amounts of time spent in sedentary behaviors compared with recommendations. Effective policies of PA promotion and implementation are needed in different domains of young people's daily lives.

Does an in-season detraining period affect the shoulder rotator cuff strength and balance of young swimmers?

Imbalance in shoulder rotator muscles is a well-documented problem in swimmers, and it is important to implement land-based strength training programs. Meanwhile, the effects of a detraining period on swimmers' shoulder rotator muscles are unknown. The purpose of this study was to analyze the effects of a strength training program and detraining on the strength and balance of shoulder rotator cuff muscles in young swimmers, despite the continuity of usual water training. An experimental group (n = 20) and a control group (n = 20) of young male swimmers with the same characteristics (age, body mass, height, training volume, and maturational state) were evaluated. In both groups, the peak torques of shoulder internal (IR) and external (ER) rotators were assessed during preseason, midseason (16 weeks), and postseason (32 weeks). The experimental group underwent a strength training regimen from baseline to 16 weeks and a detraining period from 16 to 32 weeks. Concentric action at 60°·s-1 and 180°·s-1 was measured using an isokinetic dynamometer. The ER/IR strength ratios were obtained. At 60°·s-1, there were significant increments in IR strength and the ER/IR ratio in both shoulders. This trend was the same throughout the competitive season. The tendency was the same at 180°·s-1 because training effects were noted primarily in IR and ER/IR ratios. Moreover, the absence of land-based strength training, from 16 to 32 weeks, revealed a reduction in the ER/IR ratio values in both shoulders. Our findings suggest that young swimmers' coaches should use dry-land strength training protocols, and that it is recommended that these should be conducted on a regular basis (during the whole season).

Shoulder rotator cuff balance, strength, and endurance in young swimmers during a competitive season.

The purpose of this study was to analyze the effects of a competitive swim season on the strength, balance, and endurance of shoulder rotator cuff muscles in young swimmers. A repeated measures design was used with 3 measurements performed during the swim season. A swimmers group (n = 20) of young men with no dry land training and a sedentary group (n = 16) of male students with the same characteristics (age, body mass, height, and maturational state) were evaluated. In both groups, the peak torque of shoulder internal rotator (IRt) and external rotator (ERt) was assessed during preseason, midseason (16 weeks), and postseason (32 weeks). Concentric action at 60 and 180°·s(-1) was measured using an isokinetic dynamometer. The ER/IR strength ratios and endurance ratios were also obtained. At 60°·s(-1), there were significant training effects in the IRt strength and ER/IR ratio on both shoulders. This trend was the same throughout the competitive season. The same trend was present at 180°·s(-1) because the training effects are seen primarily in IRt and ER/IR ratios. With respect to endurance ratios, within-group data were similar in ERt and IRt for both shoulders, with no significant differences between moments. However, between-group differences occurred mostly in the IRt. Results suggest that a competitive swim season favors the increase of muscular imbalances in the shoulder rotators of young competitive swimmers, mainly because of increased levels of IRt strength and endurance that are proportionally larger than those of their antagonists. A compensatory strength training program should be considered.

Prevalence of overweight, obesity, and abdominal obesity in a representative sample of Portuguese adults.

This study determined the prevalence of overweight, obesity, and abdominal obesity in the Portuguese adults and examined the relationship between above mentioned prevalences and educational level. Body mass, stature, and waist circumference were measured in a representative sample of the Portuguese population aged 18-103 years (n = 9,447; 18-64 years: n = 6,908; ≥ 65 years: n = 2,539). Overweight and obesity corresponded to a body mass index ranging between 25-29.9 kg/m(2) and ≥ 30 kg/m(2), respectively. Abdominal obesity was assessed as >102 cm for males and >88 cm for females. After adjusting for educational level, the combined prevalences of overweight and obesity were 66.6% in males and 57.9% in females (18-64 years). Respective values in older adults (≥ 65 years) were 70.4% for males and 74.7% for females. About 19.3% of adult males and 37.9% of adult females presented abdominal obesity. Correspondent values in older adults were 32.1%, for males, and 69.7%, for females. In adults, low educational level was related to an increased risk for overweight (OR = 2.54; 95% CI: 2.08-3.09), obesity (OR = 2.76; 95% CI: 2.20-3.45), and abdominal obesity (OR = 5.48; 95% CI: 4.60-6.52). This reinforces the importance of adjusting public health strategies for educational level.

Prevalence of the Portuguese population attaining sufficient physical activity.

PURPOSE: Physical activity has many health benefits, and to implement strategies, mainly in those groups with insufficient levels of practice, it is important to evaluate physical activity. The main purpose of this study was to describe the prevalence of physical activity in the Portuguese population aged 10 yr and older using accelerometry. METHODS: The accelerometers were worn for four consecutive days, and a valid record was defined as at least 3 d with 10 h of wear time, including one weekend day. Considering these conditions, 4696 participants were included. RESULTS: According to the recommendations of 60 min·d(-1) of physical activity, 36% of participants age 10-11 yr (boys = 51.6%, girls = 22.5%) and 4% age 16-17 yr (boys = 7.9%, girls = 1.2%) were considered sufficiently active. In adulthood, ∼70% of participants age 18-64 yr (men = 76.6%, women = 65.2%) and 35% age older than 64 yr (men = 46%, women = 29%) reached the recommendation of 30 min·d(-1) of physical activity, when counting every minute of moderate or greater intensity. Considering bouts of 10 min or more of moderate or greater intensity in participants older than 17 yr, the prevalence was 4%-6% at 18-39 yr, 7%-9% at 40-64 yr, and ∼3% in persons age 65 yr or older. CONCLUSIONS: The design and implementation of strategies to promote physical activity for health among children and adolescents and older adults, particularly girls/women, should be encouraged.

Waist circumference percentiles for Portuguese children and adolescents aged 10 to 18 years.

UNLABELLED: The purposes of this study were to develop age- and sex-specific waist circumference reference data for Portuguese children and adolescents aged 10-18 years and to compare them with those from other countries. This was a school-based study performed in Portugal. A total of 22,003 children and adolescents aged 10-18 years were included in the study. Smoothed sex- and age-specific 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentile curves of waist circumference were estimated using Cole's lambda-mu-sigma method. Waist circumference values increased with age in both boys and girls, and boys had higher values than girls at every age and percentile. In both sexes, the Portuguese values in the 90th percentile were closer to the Bolivian values and considerably lower than those of the American children for all age groups. CONCLUSION: The data presented provide information for abdominal risk assessment and clinical and lifestyle intervention; our results also provide useful baseline data information for the implementation of a surveillance system required to monitor trends and factors associated with abdominal obesity in children and adolescents.

Prevalence of overweight and obesity among Portuguese youth: a study in a representative sample of 10-18-year-old children and adolescents.

PURPOSE: The aim of this research was to report the prevalence of overweight and obesity in a representative sample of Portuguese youth. METHODS: This was a school-based study performed in Portugal. A total of 22 048 children and adolescents aged 10-18 years were included in the study. The World Health Organization (WHO) and the International Obesity Task Force (IOTF) cut-offs were used to categorise overweight and obese participants. RESULTS: Using IOTF cut-offs the prevalence of overweight and obesity was 17.0 and 4.6% in girls, and 17.7 and 5.8% in boys, respectively (p < 0.001 for overweight and p > 0.05 for obesity), whereas WHO cut-offs resulted in overweight and obesity prevalence scores of 23.1 and 9.6% in girls, and 20.4 and 10.3% in boys, respectively (p < 0.001 for overweight and p >0.05 for obesity). With IOTF cut-offs, a lower prevalence of obesity and overweight was observed at higher ages, in both genders. With the WHO cut-offs, a lower prevalence of obesity and overweight was observed at higher ages, in boys. In girls, the prevalence of overweight and obesity increases from 10 to 12 years of age and decreases from the age of 13 to 18 years. CONCLUSION: The prevalence for overweight/obesity among Portuguese children and adolescents vary according to the cut-off points used and are also of concern requiring strategies to promote healthy weight gain among children and adolescents.

Fitness efficacy of vibratory exercise compared to walking in postmenopausal women.

In this study, we compared the efficacy of 8 months of low-frequency vibration and a walk-based program in health-related fitness. Twenty-seven postmenopausal women were randomly assigned into two groups: whole-body vibration (WBV) group (n = 18) performed three times/week a static exercise on a vibration platform (6 sets of 1-min with 1 min of rest, with a 12.6 Hz of frequency and an amplitude of 3 mm); walk-based program (WP) group (n = 18) performed three times/week a 60-min of walk activity at 70-75% of maximal heart rate. A health-related battery of tests was applied. Maximal unilateral concentric and eccentric isokinetic torque of the knee extensors was recorded by an isokinetic dynamometer. Physical fitness was measured using the following tests: vertical jump test, chair rise test and maximal walking speed test over 4 m. Maximal unilateral isokinetic strength was measured in the knee extensors in concentric actions at 60 and 300 degrees /s, and eccentric action at 60 degrees /s. After 8 months, the WP improved the time spent to walk 4 m (20%) and to perform the chair rise test (12%) compared to the WBV group (P = 0.006, 0.002, respectively). In contrast, the comparison of the changes in vertical jump showed the higher effectiveness of the vibratory exercise in 7% (P = 0.025). None of exercise programs showed change on isokinetic measurements. These results indicate that both programs differed in the main achievements and could be complementary to prevent lower limbs muscle strength decrease as we age [ISRCTN76235671].