Physical Activity Level and Motor Aptitude: Motor Domains and Identification Capacity of Brazilian Insufficiently Active Older Adults.

BACKGROUND: A decrease in the physical activity level in old age is common, which results in an increase in the number of falls and chronic conditions. Associated with that occurs the decline in motor skills as a result of the deficit in the interaction of cognitive and motor processes. Physical activity levels can be associated differently with each motor domain. ; Objective: We analyzed the relationship between physical activity level and motor aptitude and to identify which motor domains were most sensitive to detect insufficiently active level in older adults. ; Methods: 385 elderly people of both sexes participated in the study. For the evaluation of the subjects, the International Questionnaire on Physical Activity and the Motor Scale for Older Adults were adopted. ; Results: The majority of the elderly were active. In comparing motor aptitude between active and insufficiently active (IAC) elders a significant difference was found in the Global Coordination, Balance, Body Scheme and General Motor Aptitude. From the analysis of the Area Under the Curve (AUC), we verified that these domains also were the ones that presented adequate diagnostic accuracy to identify IAC elderly. Besides that, active elderly have presented the General Motor Aptitude classified within normality while the IAC below the normal. ; Conclusion: Our data suggest that IAC older adults present lower motor aptitude than the active elderly, especially in the domains of Global Coordination, Balance, Body Scheme and General Motor Aptitude, and that these domains were sensitive to indicate IAC older adults.

Early rehabilitation using a passive cycle ergometer on muscle morphology in mechanically ventilated critically ill patients in the Intensive Care Unit (MoVe-ICU study): study protocol for a randomized controlled trial.

BACKGROUND: Patients in Intensive Care Units (ICU) are often exposed to prolonged immobilization which, in turn, plays an important role in neuromuscular complications. Exercise with a cycle ergometer is a treatment option that can be used to improve the rehabilitation of patients on mechanical ventilation (MV) in order to minimize the harmful effects of immobility. METHODS/DESIGN: A single-blind randomized controlled trial (the MoVe ICU study) will be conducted to evaluate and compare the effects of early rehabilitation using a bedside cycle ergometer with conventional physical therapy on the muscle morphology of the knee extensors and diaphragm in critical ill patients receiving MV. A total of 28 adult patients will be recruited for this study from among those admitted to the intensive care department at the Hospital de Clínicas de Porto Alegre. Eligible patients will be treated with MV from a period of 24 to 48 h, will have spent maximum of 1 week in hospital and will not exhibit any characteristics restricting lower extremity mobility. These subjects will be randomized to receive either conventional physiotherapy or conventional physiotherapy with an additional cycle ergometer intervention. The intervention will be administered passively for 20 min, at 20 revolutions per minute (rpm), once per day, 7 days a week, throughout the time the patients remain on MV. Outcomes will be cross-sectional quadriceps thickness, length of fascicle, pennation angle of fascicles, thickness of vastus lateralis muscle, diaphragm thickness and excursion of critical ICU patients on MV measured with ultrasound. DISCUSSION: The MoVe-ICU study will be the first randomized controlled trial to test the hypothesis that early rehabilitation with a passive cycle ergometer can preserve the morphology of knee extensors and diaphragm in critical patients on MV in ICUs. TRIAL REGISTRATION: NCT02300662 (25 November 2014).