Growth and physical development of children at apparent risk of sarcopenia.

BACKGROUND: The consequences of sarcopenia on growth have received little attention. We analysed the potential risk resulting from the low lean mass for age expressed through the appendicular lean body mass index (aLBMI) and the ratio aLBM/trunk fat mass (trFM). METHODS: The sample consisted of 580 participants 10-13 yrs evaluated twice in a 12-month interval: height, trFM, total and aLBM, whole-body bone mineral density less head (WBLH BMD), tibia and radius SOS, maturity and handgrip strength were measured. All variables except maturity and BMI were standardised according to sex and age group (Z-score) using the sample as a reference. A high risk of sarcopenia was identified for Z-scores ≤ -1 on aLBMI (Group B) or aLBM/trFM (Group C), while Z-scores > -1 on both markers were considered at low risk for sarcopenia (Group A). The ANCOVA adjusted for maturity was used to compare the three groups. RESULTS: Girls showed a more significant decrease in the total BMC/LBM ratio in Group B and a minor increase in WBLH BMD in Group C (p < 0.050); boys in Group B showed a tendency to gain less height (p = 0.053). CONCLUSION: The high risk of sarcopenia expressed through aLBMI or aLBM/trFM Z-score ≤ -1 compromises bone mineralisation in girls. IMPACT: The findings emphasise the necessity of implementing routine screening protocols for sarcopenia risk within clinical environments and educational institutions. Such screenings should extend beyond merely assessing body mass index to encompass broader body composition variables like lean body mass. By integrating these assessments into routine health evaluations, healthcare professionals and educators can proactively identify at-risk individuals and initiate timely interventions for suboptimal physical growth and development.

Idades de referência dos atletas medalhados nos campeonatos de Portugal de atletismo: estudo de 30 anos (1990-2019) / Reference ages of medallists at the Portuguese athletics championships: a 30-year study (1990-2019)

RESUMO Segundo a literatura, um inventário preciso da distribuição das idades de melhor desempenho nas diferentes disciplinas do atletismo pode proporcionar uma informação ímpar na altura de se produzirem planos e programas de treino de longo prazo para eventos ao mais alto nível. O presente estudo tem como objetivo identificar a idade de melhor desempenho dos atletas participantes nos campeonatos de Portugal de atletismo, com referência às disciplinas e setores que caracterizam a competição. Foram consideradas todas as participações medalhadas (pista coberta - PC, n = 2310; ar livre - AL, n = 3161). Os intervalos de confiança para a idade média dos atletas medalhados foram obtidos com recurso ao método de Equações de Estimação Generalizadas. Os resultados indicaram a média de idades, (i) PC, mais baixa no salto com vara feminino (21.60 anos) e no salto em comprimento masculino (24.42 anos), e mais elevada nos 3000 m marcha feminino (25.18 anos) e nos 5000 m marcha masculino (29.70 anos); (ii) AL, mais baixa no salto em comprimento feminino (22.90 anos) e nos 200 m masculino (23.46 anos), e mais elevada nos 5000 m feminino (27.55 anos) e 10000 m marcha masculino (32.23 anos). Os resultados sugerem que as idades de melhor desempenho ocorrem (i) PC, entre os 23 e os 24 anos nas atletas femininas, e os 24 e os 25 nos atletas masculinos; (ii) AL, entre os 23 e os 25 anos nas atletas femininas, e os 24 e 26 anos nos atletas masculinos. O conhecimento objetivo das idades de melhor desempenho nos campeonatos de Portugal de atletismo, por sexo e disciplina, poderá ser uma informação útil para uma gestão eficiente de talentos e das carreiras desportivas.

ABSTRACT According to the literature, a precise inventory of the distribution of the best-performing ages in the different athletics disciplines can provide unique information when producing long-term training plans and programs for events at the highest level. This study aims to identify the age at which athletes participating in the Portuguese athletics championships performed best, with reference to the disciplines and sectors that characterize the competition. All medal-winning participations were considered (indoor track and field, n = 2310; outdoor track and field, n = 3161). Confidence intervals for the average age of medal-winning athletes were obtained using the Generalized Estimating Equations method. The results indicated that the average ages were (i) Indoor track and field - lower in the women's pole vault (21.60 years) and men's long jump (24.42 years), and higher in the women's 3000 m run (25.18 years) and men's 5000 m race walk (29.70 years); (ii) Outdoor track and field - lower in the women's long jump (22.90 years) and men's 200m (23.46 years), and higher in the women's 5000 m (27.55 years) and men's 10000 m race walk (32.23 years). The results suggest that the best-performing ages are (i) Indoor track and field - between 23 and 24 years old in female athletes and 24 and 25 years old in male athletes; (ii) Outdoor track and field - between 23 and 25 years old in female athletes, and 24 and 26 years old in male athletes. Objective knowledge of the best-performing ages in the Portuguese athletics championships by gender and discipline could be useful information for efficient talent and career management.

Gait Analysis in Children with Cerebral Palsy: Are Plantar Pressure Insoles a Reliable Tool?

Cerebral palsy (CP) is a common cause of motor disability, and pedobarography is a useful, non-invasive, portable, and accessible tool; is easy to use in a clinical setting; and can provide plenty of information about foot-soil interaction and gait deviations. The reliability of this method in children with CP is lacking. The aim of this study is to investigate test-retest reliability and minimal detectable change (MDC) of plantar pressure insole variables in children with CP. Eight children performed two trials 8 ± 2.5 days apart, using foot insoles to collect plantar pressure data. Whole and segmented foot measurements were analyzed using intraclass correlation coefficients (ICC). The variability of the data was measured by calculating the standard error of measurement (SEM) and the MDC/ICC values demonstrated high test-retest reliability for most variables, ranging from good to excellent (ICC ≥ 0.60). The SEM and the MDC values were considered low for the different variables. The variability observed between sessions may be attributed to the heterogeneous sub-diagnosis of CP.

Sports injuries patterns in children and adolescents according to their sports participation level, age and maturation.

BACKGROUND: Growth can make young athletes more vulnerable to sports injuries. Increased knowledge about injury profile and its predictors is an important part of an overall risk management strategy but few studies have produced information. METHODS: Information about injury profile and sports participation (SP) level was obtained by LESADO and RAPIL II questionnaires. They were distributed to 651 participants aged between 10 and 18 years attending four schools. Maturity measures were evaluated through maturity offset (MO) and Tanner-Whitehouse III method. Bivariate analysis was used to identify the set of candidate predictors for multinomial logistic regression analysis that was used to determine significant predictors of injury type and body area injury location. RESULTS: Regarding injury type predictors recreative boys had more chances of having a sprain or a fracture than a strain. Also, recreative and scholar girls had more chances of having a sprain than a strain. As MO decreased, the chances of girls having a strain or a fracture when compared to sprains were higher. For body area location boys with 10-11 years were more likely to have upper limbs injuries than boys of other ages. This was also confirmed by MO. Spine and trunk injuries were more likely to occur in federate and no sports participation girls. CONCLUSIONS: Injury type and body area injury location differed significantly by SP level, age group and MO.

The effectiveness of a randomised clinical trial of PLE2 NO self-management and exercise programme for knee osteoarthritis to improve self-efficacy.

OBJECTIVE: This study aims to assess the effectiveness of a 12-weeks self-management and exercise intervention to improve self-efficacy in older individuals with knee osteoarthritis (KOA) DESIGN: Randomised Controlled Trial. SETTING: Four different community settings. SUBJECTS: Eighty individuals aged 60 years or over with clinical and radiographic knee osteoarthritis. INTERVENTION: The subjects were randomly assigned to (1) a combined self-management and exercise programme (treatment group) and (2) an educational programme (control group). MAIN MEASURES: The primary outcome was self-efficacy and secondary outcomes were physical activity, health-related quality of life and skill-related physical fitness measures. RESULTS: Sixty-seven participants, mean age 69.1 (5.8) years, completed the study: 32 in the control group and 35 in the treatment group. A significant group effect favourable to the treatment group was observed in the following variables: self-efficacy (F[2,64] = 9.2, p = 0.003), physical activity (F[2,64] = 43.6, p < 0.001) and balance for most painful knee (F(2,64) = 4.87, p = 0.031) and less painful knee (F[2,64] = 6.94, p = 0.010). No improvements regarding health-related quality of life, gait speed and agility were found. This study supports the importance of a combined self-management and exercise intervention to improve self-efficacy and physical activity in KOA individuals.

Bedside clinical tests to assess sensitization in office workers with chronic neck pain.

OBJECTIVE: This study aimed to assess pain sensitization in individual office workers with chronic neck pain through simple bedside quantitative sensory tests (QST) and to associate the findings with pain intensity and pain catastrophizing. METHODS: One hundred-and-four office workers with chronic neck pain were assessed using pressure pain threshold (PPT) considering pain sensitive if PPTs were lower than 155 kPa in the upper trapezius and 245 kPa in the tibialis anterior. Pain sensitive to temporal summation of pain (TSP) was considered if there was a difference of two points in the visual analogue scale (VAS) comparing the first and last stimulus. Pain sensitive was considered to conditioned pain modulation (CPM) if the CPM-effect was less than -7.5%. Pain intensity and catastrophizing were measured using VAS and with the Pain Catastrophizing Scale. RESULTS: There was at least one pain sensitive QST finding in 66 office workers (63.5%). TSP findings were the most common (48.1%), followed by PPT's (31.7%) and CPM (20.2%). Based on the QST findings, office workers were divided based on the number of individual QST findings, and higher pain intensity and pain catastrophizing scores were found in office workers with one (N = 38, P < 0.05) or two (N = 28, P < 0.05) compared with office workers with no QST findings (N = 38). CONCLUSION: This study demonstrated that most office workers with chronic neck pain exhibit either widespread pressure hyperalgesia, facilitated TSP or impaired CPM, indicating pain sensitization within the central nervous system. This was associated with increased clinical pain and pain catastrophizing rumination scores.

Energy intake and expenditure in children and adolescents, contributions of biological maturity.

OBJECTIVE: The aim of this study was to examine the relationship between the ratio of energy intake (EI) and energy expenditure (EE) and body composition, physical activity and macronutrients intake, considering maturity as a moderator. METHODS: The study involved 459 adolescents aged 10 to 17. Energy and macronutrients intake were estimated using a valid Food Frequency Questionnaire; basal metabolic rate (BMR) was predicted from Schofield equations and EE was estimated using BMR and physical activity level obtained through a Portuguese validated biosocial questionnaire. Body mass index, body composition, and bone age were objectively measured. Statistical analyses included independent samples t-tests, ANCOVA and Pearson correlations. All analyses were adjusted for chronological age, sex, and EI. RESULTS: Body mass index, fat and fat-free mass, physical activity and protein intake were negatively correlated with EI/EE (P < .001). The study showed significant interactions between maturity and body mass index, fat-free mass and physical activity level. Maturity attenuated the negative relationships between EI/EE and body mass index, fat-free mass and physical activity, especially among early maturers. All categories of maturity showed implications in body mass index for values lower than 23.8 kg/m2 . A significant EI/EE reduction was observed among late maturers with a fat-free mass above 39.8 kg. CONCLUSIONS: Our findings suggest that maturity moderates the relationship between EI/EE and body mass index, fat-free mass and physical activity, especially evident among late maturers.

Health-related quality of life of Portuguese children and adolescents according to diet quality and food intake.

PURPOSE: The implication of adolescence diet quality and of certain specific foods' intake on HRQoL remain underexplored, and little importance has been given to biological changes (e.g. growth, maturation, dimorphism, body composition), that remarkably increase the variability of diet and physical activity behaviours. The aim of this study was to analyse the relationship between diet quality and food intake with HRQoL in adolescents, considering maturity, body composition, and physical activity level. METHODS: In total 669 Portuguese adolescents aged 10-17 years, attending three secondary schools, were enrolled in this cross-sectional study. Diet quality was assessed by Diet Quality International-Index (DQI-I), physical activity level was self-reported, and the HRQoL was assessed by the KIDSCREEN-52 questionnaire. The KIDSCREEN-52 includes ten dimensions (physical well-being, psychological well-being, moods and emotions, self-perception, autonomy, parent relations and home life, social support and peers, school environment, social acceptance and bullying and financial resources) and it allowed to compute a general index of the HRQoL (KIDSCREEN-10 index) through a selection of 10 items out of the KIDSCREEN-52 list. Fat mass was obtained by skinfold thickness. Maturity was objectively measured. The level of significance was set at α = 0.05. RESULTS: Boys scored higher in HRQoL and in physical well-being, self-perception, autonomy, parent relations and home life than girls. Intakes of unhealthy foods were negatively correlated with physical well-being, self-perception, and social acceptance and bullying, while healthy foods were positively correlated with psychological well-being, moods and emotions, self-perception, and school environment. The DQI-I showed to be positively correlated with physical well-being. Participants who reported to have a higher DQI-I (≥ 60) perceived better their school environment and social acceptance and bullying. However, those results were not determined by diet quality but rather by bone age and physical activity level. CONCLUSION: Our results showed that boys reported higher HRQoL and higher scores in the majority of HRQoL dimensions, compared to girls. The intake of unhealthy foods was negatively correlated with some HRQoL dimensions, whilst healthy foods showed positive correlations with some HRQoL dimensions. Biological maturity and physical activity level revealed to be important confounders in the study of diet quality and perception of school environment and social acceptance and bullying in adolescents.

Adaptation of Proximal Femur to Mechanical Loading in Young Adults: Standard Vs Localized Regions Evaluated by DXA.

Regions of the proximal femur with less adaptive protection by mechanical loading may be at increased risk of structural failure. Since the size and location of these regions diverge from those defined by the dual-energy X-ray absorptiometry manufacturers the purpose of this study was to compare areal bone mineral density (aBMD) of different regions of the proximal femur considering impact loads from physical activity (PA). The participants were 134 young adults divided into 2 groups according to the impact of PA performed in the last 12 mo: high-impact PA and low-impact PA. The aBMD of the proximal femur was assessed by dual-energy X-ray absorptiometry at the standard femoral neck, intertrochanter, and trochanter, and at specific locations of the superolateral femoral neck and intertrochanteric region. The bone-specific physical activity questionnaire was used to estimate the impact load of PA. Comparisons between groups were adjusted for body height and body lean mass. Interaction analysis between sex and PA groups were conducted with analysis of variance. Comparisons of aBMD between bone regions were analyzed separately for men and women with repeated measures analysis of variance. In the high-impact PA group, men benefit more than women at all bone regions, except the aBMD at intertrochanteric region. Analyses of repeated measures did not reveal any significant interaction effect between bone regions (standard vs specific) and PA groups (low vs high-impact). In conclusion, aBMD differences due to mechanical loading were more pronounced in men than in women; the magnitude of the aBMD differences as a result of different levels of PA was similar between standard and localized regions.

Measuring psychosocial factors and predicting work ability among cemetery workers.

BACKGROUND: The work of cemetery workers presents high physical demands and significant psychosocial stressors, but there are no studies about the influence of these risk factors on their work ability. OBJECTIVES: The present study aims to analyse how socio-demographic and psychosocial factors are related to work ability among cemetery workers. METHODS: A cross-sectional survey was applied at seven cemeteries of Lisbon, between November and December of 2015. The response rate was 88.9% (n = 168). The survey involved socio-demographic data, the Work Ability Index, and COPSOQII. Multiple linear regression analysis, using the backward elimination stepwise method, was done to identify the significant predictors of work ability. RESULTS: Results indicated a high prevalence of unsatisfactory WAI scores (39.5%), which, together with a mean age of 51 years showed these participants may have a high probability of being declared unfit for their current jobs. The main predictors of work ability were: general health, burnout, temporary work impairment, job satisfaction, age, and quality of leadership. CONCLUSIONS: The study highlights the relationship between age, health perception, work impairment, psychosocial variables, and work ability. This knowledge is crucial for the organization of occupational health programmes fitting the needs of cemetery workers and aiming at retaining these workers until the legal retirement age.

Monitoring Work Ability Index During a Two-Year Period Among Portuguese Municipality Workers.

In Portugal, little is known about the work ability profiles of municipal workers and their changes during working life. In order to characterize and understand the changes in work ability among municipal workers, a prospective study was designed to begin in 2015 in the municipality of Sintra, in the surroundings of Lisbon, and to collect data every two years. The present paper aims at characterizing the changes in the work ability of those workers between 2015 and 2017 and to identify the main predictors. Data collection was based on a questionnaire that encompassed socio-demographic data, the Copenhagen Psychosocial Questionnaire II (COPSOQ II), the Nordic questionnaire adapted, and the Work Ability Index (WAI). In this two-year period, the work ability of municipal workers decreased and the main predictive factors were age, lower-back pain, negative health perception, the presence of burnout, and making manual efforts. Still, there were factors that act as positive predictors of an excellent work ability, such as having training in the previous two years, a good sense of community at work, and a favorable meaning of work. In summary, the intervention strategies in the work field should take into consideration the main predictors of work ability that are relevant for each organization.

Effects of Chronic Cold-Water Immersion in Elite Rugby Players.

PURPOSE: Although the acute effects of cold-water immersion (CWI) have been widely investigated, research analyzing the effects of CWI over a chronic period in highly trained athletes is scarce. The aim of this study was to investigate the effects of CWI during an intense 3-wk preseason phase in elite rugby athletes. METHODS: A total of 23 elite male rugby union athletes were randomized to either CWI (10 min at 10°C, n = 10) or a passive recovery control (CON, n = 13) during 3 wk of high-volume training. Athletes were exposed to either CWI or CON after each training day (12 d in total). Running loads, conditioning, and gym sessions were kept the same between groups. Measures of countermovement jump, perceived muscle soreness, and wellness were obtained twice a week, and saliva samples for determining cortisol and interleukin-6 were collected once per week. RESULTS: Although no significant differences were observed between CWI and CON for any measure, CWI resulted in lower fatigue markers throughout the study as demonstrated by the moderate effects on muscle soreness (d = 0.58-0.91) and interleukin-6 (d = -0.83) and the small effects (d = 0.23-0.38) on countermovement jump in comparison with CON. CONCLUSIONS: CWI may provide some beneficial effect by reducing fatigue and soreness during an intense 3-wk training phase in elite rugby athletes.

Health-related quality of life of Portuguese children and adolescents according to their biological maturation and volume of physical activity.

PURPOSE: The purpose of this study was to analyze the relationship between biological maturation and health-related quality of life (HRQoL) in Portuguese children and adolescents of both sexes when the effect of chronological age (CA) and volume of physical activity (VPA) were removed. METHODS: HRQoL, biological maturation, CA, and VPA were assessed in 750 children and adolescents, 11-17 years old, from 3 schools in Lisbon, Portugal. The KIDSCREEN-52 was used to assess HRQoL. Maturity indicator was bone age (BA), using Tanner-Whitehouse III method (TW3). The participants were classified into three different maturity categories: late, on time, and early maturers. VPA was assessed by questionnaire (RAPIL II). An analysis of covariance (ANCOVA), using the CA and the VPA as covariates was completed. The level of significance was set at p ≤ 0.05. RESULTS: Analysis of covariance suggested an influence of biological maturation in physical well-being dimension in both sexes, with early-maturing girls and boys having worst perception. Maturity groups were also influent in moods and emotions for girls. CA seems to be particularly important in self-perception and parent relation and home life for girls and in school environment for boys. CONCLUSION: Biological maturation and CA have relevant impact on some HRQoL dimensions. These variables, due to their nature and effect should be considered particularly when working with specific domains of HRQoL as physical well-being in both sexes, moods and emotions and self-perception and parent relation and home life for girls and in school environment for boys.

Long-term swimming training modifies acute immune cell response to a high-intensity session.

PURPOSE: Long-term training influence on athletes' immune cell response to acute exercise has been poorly studied, despite the complexity of both chronic and acute adaptations induced by training. The purpose of the study is to study the influence of a 4-month swimming training cycle on the immune cell response to a high-intensity training session, during 24 h of recovery, considering sex, maturity, and age group. METHODS: Forty-three swimmers (16 females, 14.4 ± 1.1 years; 27 males, 16.2 ± 2.0) performed a standardized high-intensity session, after the main competition of the first (M1), and second (M2) macrocycles. Blood samples were collected before (Pre), immediately after (Post), 2 h after (Post2h) and 24 h after (Post24h) exercise. Haemogram and lymphocytes subsets were assessed by an automatic cell counter and by flow cytometry, respectively. Subjects were grouped according to sex, competitive age groups, or pubertal Tanner stages. Results express the percentage of relative differences from Pre to Post, Post2h and Post24h. Upper respiratory symptoms (URS) and training load were quantified. RESULTS: At M2, we observed smaller increases of leukocytes (M1: 14.0 ± 36.3/M2: 2.33 ± 23.0%) and neutrophils (M1: 57.1 ± 71.6/M2: 38.9 ± 49.9%) at Post; and less efficient recoveries of total lymphocytes (M1: - 22.0 ± 20.1/M2: - 30.0 ± 18.6%) and CD19+ (M1: 4.09 ± 31.1/M2: - 19.1 ± 24.4%) at Post2h. At Post2h, the increment of CD4+/CD8+ was smaller in youth (M1: 21.5 ± 16.0/M2: 9.23 ± 21.4%), and bigger in seniors (M1: 3.68 ± 9.21/M2: 23.2 ± 15.0%); and at Post24h late pubertal swimmers' CD16+56+ recovered less efficiently (M1: - 0.66 ± 34.6/M2: - 20.5 ± 34.2%). CONCLUSIONS: The training cycle induced an attenuated immune change immediately after exercise and a less efficient recovery of total lymphocytes, involving an accentuated CD19+ decrease. The concomitant higher URS frequency suggests a potential immune depression and a longer interval of susceptibility to infection.

Prevalence and injury profile in Portuguese children and adolescents according to their level of sports participation.

BACKGROUND: It is becoming increasingly apparent that sports can present danger in the form of injuries. The extent of this problem calls for preventive actions based on epidemiological research. METHODS: Two questionnaires (LESADO and RAPIL II) were distributed in four schools to 651 subjects aged between 10 and 18 years, involved in different levels of physical activity (PA) - recreative sports, school sports, federated sports and no sports participation (except physical education classes). Bone age was evaluated through Tanner-Whitehouse III method and anthropometric measures according to ISAK. RESULTS: From 247 subjects (37.9%) it was reported a sports injury during the previous six months. The most injured body areas were lower limbs (53.8%), followed by upper limbs (29.0%) and the type of injuries found was strains (33.7%), sprains (27.1%) and fractures (23.1%). The most frequent causes were direct trauma (51.9%), indirect trauma (29.5%) and overuse (12.7%). A high percentage was relapses and chronic injuries (40.9%). The OR for age group ≥16 years was 2.26 suggesting that those ≥16 years were 2.26 times more likely to have an injury than the younger subjects and concerning the PA level, school and federated sports subjects were 4.21 and 4.44 times more likely to have an injury than no sports participation subjects. CONCLUSIONS: Sports injuries in school age subjects were predominantly minor conditions where sprains and strains were the major injuries. They resulted mostly of trauma situations and lower and upper limbs were the most affected areas. Injury occurrence increased with age and was higher in school and federated athletes.

A randomized controlled trial of a combined self-management and exercise intervention for elderly people with osteoarthritis of the knee: the PLE2NO program.

OBJECTIVE: To assess the effectiveness of a 12-week self-management and exercise intervention (the PLE2NO program) in elderly individuals with knee osteoarthritis. DESIGN: Randomized controlled trial. SETTING: Four different community settings. SUBJECTS: Eighty individuals aged 60 years or older with clinical and radiographic knee osteoarthritis enrolled in the study. INTERVENTION: A combined self-management and exercise intervention (treatment group) and an educational intervention (control group). MAIN MEASURES: The primary outcomes were pain and other knee osteoarthritis symptoms (swelling, crackling, limitation on movement, and stiffness), self-management behaviors (communication with physician and cognitive symptom management), and functional lower limb strength. Secondary outcomes were knee osteoarthritis-specific health-related quality of life, self-perceived health, aerobic capacity, lower and upper limb flexibility, and handgrip strength. RESULTS: In all, 67 participants, mean age 69.1 ± 5.8 years, completed the study: 32 in the Educational Group and 35 in the Self-Management and Exercise Group. A significant group effect favorable to the Self-Management and Exercise Group was observed in the following variables: communication with the physicians ( P = .048), aerobic capacity ( P = .035), and functional lower limb strength ( P = .015). Although no significant group effect was detected, clinical improvements in pain (31%) and knee osteoarthritis symptoms (29%) were observed in the experimental group. No improvements regarding cognitive symptom management, self-perceived health, lower limb flexibility, and handgrip strength were found. CONCLUSION: This study supports the importance of a combined self-management and exercise intervention to improve functional lower limb strength and aerobic capacity in a Portuguese sample. Additionally, pain and other symptoms have improved clinically.

Predictors of walking capacity in obese adults with knee osteoarthritis.

INTRODUCTION: Knee osteoarthritis(KOA) has a considerable prevalence in obese individuals and recommendations of weight loss for KOA management are gaining greater importance. Exercise is recommended to interrupt the cycle obesity-KOA-pain-inactivity, where walking is the most common exercise pattern recommended for obese individuals who initiate a weight loss exercise program. Thus this study aimed to analyse the factors which can affect the walking capacity in obese adults with symptomatic KOA. METHODS: 48 obese adults (age=55±7years; BMI=35±5 Kg/m2) with clinical and radiological KOA completed self-reported questionnaires (Knee Injury and Osteoarthritis Outcome Score, Brief Pain Inventory and Beck Depression Inventory), physical function tests (Six Minutes Walking Test-6MWT, chair sit and reach-CSRT, five repetition sit-to-stand test-FRSTST, handgrip strength-HST, isokinetic knee strength) and body composition was determined. RESULTS: The best model (F= 41.485; p<.001) explained 73% of the 6MWT's variance, where fat mass of the most painful limb, knee pain severity and lower limb strength were the strongest predictors of the 6MWT. CONCLUSION: Despite the importance of lower limb fat mass and strength, pain was the only variable that appeared as a predictor of 6MWT in the three tested models. The existence of knee pain affects the capacity to walk or to perform weight bearing exercises and consequently the exercise's adherence, compromising the objective of body composition improvement. Thus, authors suggest that, additionally to the lower limb strengthening, knee pain should be screened, controlled and acknowledged for exercise prescription. This study is inserted in the PICO Project (Clinical trial: NCT01832545).

Physical Activity-Related Injury Profile in Children and Adolescents According to Their Age, Maturation, and Level of Sports Participation.

BACKGROUND: Physical activity (PA) is beneficial, enhancing healthy development. However, one-third of school-age children practicing sports regularly suffer from an injury. These injuries are associated with sex, chronological age, and PA level. PURPOSE: To identify the importance of age, PA level, and maturity as predictors of injury in Portuguese youth. STUDY DESIGN: Descriptive epidemiological study. LEVEL OF EVIDENCE: Level 3. METHODS: Information about injury and PA level was assessed via 2 questionnaires (LESADO RAPIL II) from 647 subjects aged 10 to 17 years. Maturity offset according to Mirwald (time before or after peak height velocity) and Tanner-Whitehouse III bone age estimates were used to evaluate maturation. Binary logistic regression and gamma regression were used to determine significant predictors of injury and injury rate. RESULTS: Injury occurrence was higher for both sexes in recreational, school, and federated athletes (athletes engaged in sports that are regulated by their respective federations, with formal competition). These injuries also increased with age in boys and in the higher maturity offset group in girls. Injury rate was higher for both sexes in the no sports participation group. Early-maturing girls, with higher bone age and lower maturity offset, showed higher injury rate. CONCLUSION: Injuries in Portuguese youth were related to PA level, age, and biological maturation. Recreational, school, and federated athletes had more injury ocurrences while subjects with no sports participation had higher injury risk. Older subjects had more injuries. Early-maturing girls that had just passed peak height velocity may be particularly vulnerable to risk of sports injury because of the growing process. CLINICAL RELEVANCE: Increased knowledge about injury with specific PA exposure data is important to an overall risk management strategy. This study has deepened the association between injury and biological maturation variables.

Somatotype and Body Composition of Normal and Dysphonic Adult Speakers.

OBJECTIVE: Voice quality provides information about the anatomical characteristics of the speaker. The patterns of somatotype and body composition can provide essential knowledge to characterize the individuality of voice quality. The aim of this study was to verify if there were significant differences in somatotype and body composition between normal and dysphonic speakers. STUDY DESIGN: Cross-sectional study. METHODS: Anthropometric measurements were taken of a sample of 72 adult participants (40 normal speakers and 32 dysphonic speakers) according to International Society for the Advancement of Kinanthropometry standards, which allowed the calculation of endomorphism, mesomorphism, ectomorphism components, body density, body mass index, fat mass, percentage fat, and fat-free mass. Perception and acoustic evaluations as well as nasoendoscopy were used to assign speakers into normal or dysphonic groups. RESULTS: There were no significant differences between normal and dysphonic speakers in the mean somatotype attitudinal distance and somatotype dispersion distance (in spite of marginally significant differences [P < 0.10] in somatotype attitudinal distance and somatotype dispersion distance between groups) and in the mean vector of the somatotype components. Furthermore, no significant differences were found between groups concerning the mean of percentage fat, fat mass, fat-free mass, body density, and body mass index after controlling by sex. CONCLUSION: The findings suggested no significant differences in the somatotype and body composition variables, between normal and dysphonic speakers.

Determinants of sleepiness at work among railway control workers.

In the last two decades the control of the Portuguese railway network has become much more centralized in three centres, there integrating the functions of route flow management, electrical control and signalling. This study aimed to investigate the influence of work and individual determinants in sleepiness among railway control workers, namely socio-demographic factors, work ability, psychosocial factors, shiftwork characteristics, fatigue perception, and sleep. Sleepiness by shift was associated with quality of sleep, job satisfaction, fatigue perception, quantitative demands, and age. The results indicate a high prevalence of sleepiness during the night shift and show the relevance of the quality of sleep as a predictor in the three models of sleepiness for morning, afternoon and night shifts. This study, done at the major Portuguese railway control centre, alerted managers to the importance of schedule planning as well as sleepiness prevention plans and makes these results a reference for future research.