Exercise programs improve mobility and balance in people with Parkinson's disease

Compromised balance and loss of mobility are among the major consequences of Parkinson's disease (PD). The literature documents numerous effective interventions for improving balance and mobility. The purpose of this study was to verify the effectiveness of two exercise programs on balance and mobility in people with idiopathic PD. Thirty-four participants, with idiopathic PD that ranged from Stage I to Stage III on the Hoehn & Yahr (H&Y) scale, were assigned to two groups. Group 1 (n = 21; 67±9 years old) was engaged in an intensive exercise program (aerobic capacity, flexibility, strength, motor coordination and balance) for 6 months: 72 sessions, 3 times a week, 60 minutes per session; while Group 2 (n = 13; 69±8 years old) participated in an adaptive program (flexibility, strength, motor coordination and balance) for 6 months: 24 sessions, once a week, 60 minutes per session. Balance and basic functional mobility were assessed in pre- and post-tests by means of the Berg Balance Scale and the Timed Up and Go Test. Before and after the interventions, groups were similar in clinical conditions (H&Y, UPDRS, and Mini-Mental). A MANOVA 2 (programs) by 2 (moments) revealed that both groups were affected by the exercise intervention. Univariate analyses showed that participants improved their mobility and balance from pre- to post-test. There were no differences between groups in either mobility or balance results. Both the intensive and adaptive exercise programs improved balance and mobility in patients with PD. © 2009 Elsevier Ltd. All rights reserved.

Avaliação dos fatores de risco para osteoporose em mulheres na pós-menopausa

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Capacidade funcional de hemiparéticos crônicos submetidos a um programa de fisioterapia em grupo

Este estudo tem como objetivos analisar a eficácia da fisioterapia em grupo sobre a marcha, o equilíbrio corporal e o risco de queda, e verificar se há correlação entre a capacidade funcional da marcha e o equilíbrio em indivíduos com hemiparesia crônica. Participaram do estudo 21 adultos hemiparéticos, com idade média de 58,9±10,6 anos, com seqüela de no mínimo 1 ano após acidente vascular encefálico isquêmico ou hemorrágico. Os sujeitos foram submetidos a um programa de 1 hora de fisioterapia em grupo duas vezes por semana durante seis meses. Foram avaliados por meio da escala de equilíbrio de Berg (EEB) e do teste de levantar e caminhar cronometrado TLCC (TUG, na sigla em inglês de timed up & go) antes do programa, após 13 e ao fim de 26 semanas. Os resultados mostram uma redução progressiva, embora não-significativa, no tempo de execução do TLCC e aumento progressivo, também não-significativo, do escore na EEB. Foi observada forte correlação entre as duas escalas (r=0,7, p<0,05). Assim, a terapia não foi efetiva para produzir melhora nos escores dos testes, mas contribuiu para manter a mobilidade.

Fatores de risco para osteoporose em mulheres na pós-menopausa do sudeste brasileiro

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Intermittent Therapy with 1,25 Vitamin D and Calcitonin Prevents Cyclosporin-Induced Alveolar Bone Loss in Rats

Bone loss associated with cyclosporin A (CsA) therapy can result in serious morbidity to patients. Intermittent administration of 1,25 Vitamin D and calcitonin reduces osteopenia in a murine model of postmenopausal osteoporosis. The purpose of this study was to evaluate the effects of this therapeutic approach on CsA-induced alveolar bone loss in rats. Forty male Wistar rats were allocated to four experimental groups according to the treatment received during 8 weeks: (1) CsA (10 mg/kg/day, s.c.); (2) 1,25 Vitamin D (2 mu g/kg, p.o.; in weeks 1, 3, 5, and 7) plus calcitonin (2 mu g/kg, i.p.; in weeks 2, 4, 6, and 8); (3) CsA concurrently with intermittent 1,25 Vitamin D and calcitonin administration; and (4) the control treatment group (vehicle). At the end of the 8-week treatment period, serum concentrations of bone-specific alkaline phosphatase, tartrate-resistant acid phosphatase (TRAP-5b), osteocalcin, interleukin (IL)-1 beta, IL-6, and tumor necrosis factor alpha (TNF-alpha) were measured and an analysis of bone volume, bone surface, number of osteoblasts, and osteoclasts was performed. CsA administration resulted in significant alveolar bone resorption, as assessed by a lower bone volume and an increased number of osteoclasts, and increased serum bone-specific alkaline phosphatase, TRAP-5b, IL-1 beta, IL-6, and TNF-alpha concentrations. The intermittent administration of calcitriol and calcitonin prevented the CsA-induced osteopenic changes and the increased serum concentrations of TRAP-5b and inflammatory cytokines. Intermittent calcitriol/calcitonin therapy prevents CsA-induced alveolar bone loss in rats and normalizes the production of associated inflammatory mediators.

Effect of hormone therapy on postural balance in postmenopausal women

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Evaluation of postural balance in postmenopausal women and its relationship with bone mineral density- a cross sectional study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Pixel intensity and fractal analyses: detecting osteoporosis in perimenopausal and postmenopausal women by using digital panoramic images

Objective. Pixel intensity values (PI) and fractal dimensions (FD) were compared in selected mandibular regions on digital panoramic images of normal, osteopenic, and osteoporotic perimenopausal and postmenopausal women to evaluate their relative efficacies in detecting osteoporotic-associated bone density changes.Study design. Standardized mandibular angle, body, and canine/premolar (C/PM) regions on 54 charge-coupied device (CCD) digital panoramic images of normal and potentially osteoporotic postmenopausal women were analyzed for PI and FD. Lumbar spine and femoral neck dual-energy x-ray absorptiometry QXA) on each patient served as the reference standard examination. Pearson correlation coefficients and analysis of variance (ANOVA) were performed.Results. There was significant correlation among PI measurements (P < 0.01), and no significant correlation between FD. C/PM had significantly lower PI than control C/PM (P = 0.049).Conclusions. Osteoporotic changes in mandibular C/PM cancellous bone were detected in our study population on CCD digital panoramic images by using a robust image analysis paradigm. Future automated application of such image analysis could enable widespread, cost effective screening for osteoporosis in dental settings.

Effects of soy protein and resistance exercise on body composition and blood lipids in postmenopausal women

Objective: To assess the effect of soy protein and progressive resistance training on body composition and lipids in postmenopausal women.Design: In a controlled trial, 46 postmenopausal women were randomized to one of four groups: 25 g of soy protein (SP, n = 10), 25 g of soy protein plus resistance exercise (SPE, n = 14), 25 g of maltodextrine (placebo) (PL, n = 11), or placebo plus resistance exercise (PLE, n = 11). Progressive resistance training was held three times a week for 16 weeks and included 8 exercises (3 series of 8-12 repetitions). At baseline and after 16 weeks, body mass index, waist circumference (WC), body fat, muscle mass and serum lipid levels were measured. To confirm isoflavone absorption, urinary concentrations were determined. The t-test of Student and ANOVA were used in the statistical analysis.Results: Subjects were classified as overweight and showed android fat distribution: Urinary isoflavone excretion indicated compliance to soy protein treatment. After 16 weeks of intervention, both SPE and PLE groups showed a significant increase of 1.3 kg in muscle mass and reduction in WC of -1.4 and -2.1 cm, respectively (p < 0.05). Significant decreases in the mean values of total cholesterol and LDL (-29.0 and -24.0 mg/dL, p < 0.001 and p < 0.006, respectively) were observed in the users of soy protein alone (SP).Conclusions: Soy protein supplementation did not influence the indicators of body composition. However, it exerted possible favorable effects on lipid profile in postmenopausal women. The increase in muscle mass and reduction in abdominal fat were correlated with resistance training. (c) 2006 Elsevier B.V.. All rights reserved.

Effect of 6-months of physical exercise on the nitrate/nitrite levels in hypertensive postmenopausal women

Background: Evidences have showed that the incidence of arterial hypertension is greater in postmenopausal women as compared to premenopausal. Physical inactivity has been implicated as a major contributor to weight gain and abdominal obesity in postmenopausal women and the incidence of cardiovascular disease increases dramatically after menopause. Additionally, more women than men die each year of coronary heart disease and are twice as likely as men to die within the first year after a heart attack. A healthy lifestyle has been strongly associated with the regular physical activity and evidences have shown that physically active subjects have more longevity with reduction of morbidity and mortality. Nitric oxide (NO) produced by endothelial cells has been implicated in this beneficial effect with improvement of vascular relaxing and reduction in blood pressure in both laboratory animals and human. Although the effect of exercise training in the human cardiovascular system has been largely studied, the majority of these studies were predominantly conducted in men or young volunteers. Therefore, the aim of this work was to investigate the effects of 6 months of dynamic exercise training (ET) on blood pressure and plasma nitrate/nitrite concentration (NOx-) in hypertensive postmenopausal women. Methods: Eleven volunteers were submitted to the ET consisting in 3 days a week, each session of 60 minutes during 6 months at moderate intensity (50% of heart rate reserve). Anthropometric parameters, blood pressure, NOx- concentration were measured at initial time and after ET. Results: A significant reduction in both systolic and diastolic blood pressure values was seen after ET which was accompanied by markedly increase of NOx- levels (basal: 10 ± 0.9; ET: 16 ± 2 μM). Total cholesterol was significantly reduced (basal: 220 ± 38 and ET: 178 ± 22 mg/dl), whereas triglycerides levels were not modified after ET (basal: 141 ± 89 and ET: 147 ± 8 mg/dl). Conclusion: Our study shows that changing in lifestyle promotes reducftion of arterial pressure which was accompanied by increase in nitrite/nitrate concentration. Therefore, 6-months of exercise training are an important approach in management arterial hypertension and play a protective effect in postmenopausal women. © 2009 Zaros et al; licensee BioMed Central Ltd.

Factors that contribute to low bone density in postmenopausal women in different Amazonian communities

Background: The aim of this study was to verify socioeconomic differences, nutrition, body balance and quality of life (QoL) in postmenopausal women with low bone mineral density (BMD) in two Amazonian communities. Methods: A total of 42 female volunteers participated in the study. The volunteers were separated into two groups: Villa (n= 20; 53±5.5 years) and City (n= 22; 56±7.9 years). The following evaluation instruments were used: dual energy X-ray absorptiometry (DXA); a socioeconomic questionnaire; a QoL questionnaire; a dietary habits questionnaire; and a balance test. Parametric and nonparametric tests were used. Results: The data showed significant differences in socioeconomic level (Δ%=+15.9%, p=0.000),lumbar spine L2-L4 (Δ%=+0.10%,p=0.007), balance(Δ%=+4.3%,p=0.03)and some important aspects of nutrition, such as the consumption of milk (Δ%=+34%, p=0.01) and alcohol (+14.8%, p=0.0001). These significant differences also contributed to the total QoL score (Δ%=+76.2%, p=0.000) and the majority of the QoL-related functions. Conclusion: This study verified that socioeconomic level, nutritional status, physical activity levels and QoL can influence the BMD of postmenopausal women. The study suggests new strategies for official health organizations to use in order to prevent and treat osteoporosis. In addition, this study can provide an orientation to physical activity, nutrition and medical professionals. © The Author(s), 2011.

Adapted Judo training on bone-variables in postmenopausal women in pharmacological treatment

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)