Low dynamic muscle strength and its associations with fatigue, functional performance, and quality of life in premenopausal patients with systemic lupus erythematosus and low disease activity: a case–control study

Abstract Background The purpose of the present study was to compare dynamic muscle strength, functional performance, fatigue, and quality of life in premenopausal systemic lupus erythematosus (SLE) patients with low disease activity versus matched-healthy controls and to determine the association of dynamic muscle strength with fatigue, functional performance, and quality of life in SLE patients. Methods We evaluated premenopausal (18–45 years) SLE patients with low disease activity (Systemic lupus erythematosus disease activity index [SLEDAI]: mean 1.5 ± 1.2). The control (n = 25) and patient (n = 25) groups were matched by age, physical characteristics, and the level of physical activities in daily life (International Physical Activity Questionnaire IPAQ). Both groups had not participated in regular exercise programs for at least six months prior to the study. Dynamic muscle strength was assessed by one-repetition maximum (1-RM) tests. Functional performance was assessed by the Timed Up and Go (TUG), in 30-s test a chair stand and arm curl using a 2-kg dumbbell and balance test, handgrip strength and a sit-and-reach flexibility test. Quality of life (SF-36) and fatigue were also measured. Results The SLE patients showed significantly lower dynamic muscle strength in all exercises (leg press 25.63%, leg extension 11.19%, leg curl 15.71%, chest press 18.33%, lat pulldown 13.56%, 1-RM total load 18.12%, P < 0.001-0.02) compared to the controls. The SLE patients also had lower functional performance, greater fatigue and poorer quality of life. In addition, fatigue, SF-36 and functional performance accounted for 52% of the variance in dynamic muscle strength in the SLE patients. Conclusions Premenopausal SLE patients with low disease activity showed lower dynamic muscle strength, along with increased fatigue, reduced functional performance, and poorer quality of life when compared to matched controls.

Influência da obesidade e da força de preensão palmar no equilíbrio postural estático de idosas ativas

O objetivo deste estudo foi investigar a influência da obesidade e da força de preensão palmar (FPP) no equilíbrio postural estático de idosas ativas nas condições de olhos abertos e fechados. Participaram 31 idosas (16 eutróficas e 15 obesas). A idade média e o Índice de Massa Corpórea (IMC) das eutróficas foram, respectivamente, 68,3±2,7 anos e 23,4±1,6kg/m², e das obesas 69,1±2,7 anos e 33,5±3kg/m². A FPP foi avaliada usando um dinamômetro (JAMAR). O equilíbrio postural estático foi avaliado usando um sistema tridimensional nas condições de olhos abertos (OA) e fechados (OF), durante 90 segundos cada condição. A FPP das idosas eutróficas foi 25,1±4,6kgf e das obesas foi 24,8±5,2kgf, não havendo diferenças significativas. No equilíbrio postural, foram observadas diferenças significativas entre os grupos apenas no deslocamento máximo a-p com AO (p=0,04) e OF (p<0,01), com as idosas obesas apresentando menor deslocamento a-p em relação às eutróficas. Não houve correlação entre o deslocamento máximo a-p com IMC e a FPP. No presente estudo FPP não influenciou o equilíbrio postural estático, enquanto a obesidade foi fator determinante de menor deslocamento ântero-posterior de idosas ativas.

The Integrated European Project "GEHA - GEnetics of Healthy Aging": recruitment, health status assessment and survival of the Italian 90+ sibpairs

The present study is part of the EU Integrated Project “GEHA – Genetics of Healthy Aging” (Franceschi C et al., Ann N Y Acad Sci. 1100: 21-45, 2007), whose aim is to identify genes involved in healthy aging and longevity, which allow individuals to survive to advanced age in good cognitive and physical function and in the absence of major age-related diseases. Aims The major aims of this thesis were the following: 1. to outline the recruitment procedure of 90+ Italian siblings performed by the recruiting units of the University of Bologna (UNIBO) and Rome (ISS). The procedures related to the following items necessary to perform the study were described and commented: identification of the eligible area for recruitment, demographic aspects related to the need of getting census lists of 90+siblings, mail and phone contact with 90+ subjects and their families, bioethics aspects of the whole procedure, standardization of the recruitment methodology and set-up of a detailed flow chart to be followed by the European recruitment centres (obtainment of the informed consent form, anonimization of data by using a special code, how to perform the interview, how to collect the blood, how to enter data in the GEHA Phenotypic Data Base hosted at Odense). 2. to provide an overview of the phenotypic characteristics of 90+ Italian siblings recruited by the recruiting units of the University of Bologna (UNIBO) and Rome (ISS). The following items were addressed: socio-demographic characteristics, health status, cognitive assessment, physical conditions (handgrip strength test, chair-stand test, physical ability including ADL, vision and hearing ability, movement ability and doing light housework), life-style information (smoking and drinking habits) and subjective well-being (attitude towards life). Moreover, haematological parameters collected in the 90+ sibpairs as optional parameters by the Bologna and Rome recruiting units were used for a more comprehensive evaluation of the results obtained using the above mentioned phenotypic characteristics reported in the GEHA questionnaire. 3. to assess 90+ Italian siblings as far as their health/functional status is concerned on the basis of three classification methods proposed in previous studies on centenarians, which are based on: • actual functional capabilities (ADL, SMMSE, visual and hearing abilities) (Gondo et al., J Gerontol. 61A (3): 305-310, 2006); • actual functional capabilities and morbidity (ADL, ability to walk, SMMSE, presence of cancer, ictus, renal failure, anaemia, and liver diseases) (Franceschi et al., Aging Clin Exp Res, 12:77-84, 2000); • retrospectively collected data about past history of morbidity and age of disease onset (hypertension, heart disease, diabetes, stroke, cancer, osteopororis, neurological diseases, chronic obstructive pulmonary disease and ocular diseases) (Evert et al., J Gerontol A Biol Sci Med Sci. 58A (3): 232-237, 2003). Firstly these available models to define the health status of long-living subjects were applied to the sample and, since the classifications by Gondo and Franceschi are both based on the present functional status, they were compared in order to better recognize the healthy aging phenotype and to identify the best group of 90+ subjects out of the entire studied population. 4. to investigate the concordance of health and functional status among 90+ siblings in order to divide sibpairs in three categories: the best (both sibs are in good shape), the worst (both sibs are in bad shape) and an intermediate group (one sib is in good shape and the other is in bad shape). Moreover, the evaluation wanted to discover which variables are concordant among siblings; thus, concordant variables could be considered as familiar variables (determined by the environment or by genetics). 5. to perform a survival analysis by using mortality data at 1st January 2009 from the follow-up as the main outcome and selected functional and clinical parameters as explanatory variables. Methods A total of 765 90+ Italian subjects recruited by UNIBO (549 90+ siblings, belonging to 258 families) and ISS (216 90+ siblings, belonging to 106 families) recruiting units are included in the analysis. Each subject was interviewed according to a standardized questionnaire, comprising extensively utilized questions that have been validated in previous European studies on elderly subjects and covering demographic information, life style, living conditions, cognitive status (SMMSE), mood, health status and anthropometric measurements. Moreover, subjects were asked to perform some physical tests (Hand Grip Strength test and Chair Standing test) and a sample of about 24 mL of blood was collected and then processed according to a common protocol for the preparation and storage of DNA aliquots. Results From the analysis the main findings are the following: - a standardized protocol to assess cognitive status, physical performances and health status of European nonagenarian subjects was set up, in respect to ethical requirements, and it is available as a reference for other studies in this field; - GEHA families are enriched in long-living members and extreme survival, and represent an appropriate model for the identification of genes involved in healthy aging and longevity; - two simplified sets of criteria to classify 90+ sibling according to their health status were proposed, as operational tools for distinguishing healthy from non healthy subjects; - cognitive and functional parameters have a major role in categorizing 90+ siblings for the health status; - parameters such as education and good physical abilities (500 metres walking ability, going up and down the stairs ability, high scores at hand grip and chair stand tests) are associated with a good health status (defined as “cognitive unimpairment and absence of disability”); - male nonagenarians show a more homogeneous phenotype than females, and, though far fewer in number, tend to be healthier than females; - in males the good health status is not protective for survival, confirming the male-female health survival paradox; - survival after age 90 was dependent mainly on intact cognitive status and absence of functional disabilities; - haemoglobin and creatinine levels are both associated with longevity; - the most concordant items among 90+ siblings are related to the functional status, indicating that they contain a familiar component. It is still to be investigated at what level this familiar component is determined by genetics or by environment or by the interaction between genetics, environment and chance (and at what level). Conclusions In conclusion, we could state that this study, in accordance with the main objectives of the whole GEHA project, represents one of the first attempt to identify the biological and non biological determinants of successful/unsuccessful aging and longevity. Here, the analysis was performed on 90+ siblings recruited in Northern and Central Italy and it could be used as a reference for others studies in this field on Italian population. Moreover, it contributed to the definition of “successful” and “unsuccessful” aging and categorising a very large cohort of our most elderly subjects into “successful” and “unsuccessful” groups provided an unrivalled opportunity to detect some of the basic genetic/molecular mechanisms which underpin good health as opposed to chronic disability. Discoveries in the topic of the biological determinants of healthy aging represent a real possibility to identify new markers to be utilized for the identification of subgroups of old European citizens having a higher risk to develop age-related diseases and disabilities and to direct major preventive medicine strategies for the new epidemic of chronic disease in the 21st century.

Hypovolemia contributes to the pathogenesis of orthostatic hypotension in patients with diabetes mellitus

PURPOSE: To investigate whether body sodium content and blood volume contribute to the pathogenesis of orthostatic hypotension in patients with diabetes mellitus. SUBJECTS AND METHODS: Exchangeable sodium, plasma and blood volumes, and catecholamine, renin, and aldosterone levels were assessed in 10 patients with Type II diabetes mellitus who had orthostatic hypotension and control groups of 40 diabetic patients without orthostatic hypotension and 40 normal subjects of similar age and sex. In subgroups, clinical tests of autonomic function and cardiovascular reactivity to norepinephrine and angiotensin II infusions were performed. RESULTS: In diabetic patients with orthostatic hypotension, mean (+/- SD) supine blood pressure was 165/98 +/- 27/12 mm Hg (P <0.05 compared with other groups) and mean upright blood pressure was 90/60 +/- 38/18 mm Hg. Compared with controls, diabetic patients with orthostatic hypotension had a 10% lower blood volume. They also had less exchangeable sodium than patients with diabetes who did not have orthostatic hypotension (P <0.01). Compared with both groups of controls, diabetic patients with orthostatic hypotension had decreased 24-hour urinary norepinephrine excretion and a reduced diastolic blood pressure response to handgrip (P <0.05). Moreover, they displayed reduced products of exchangeable sodium or blood volume and sympathetic function indexes. Cardiovascular pressor reactivity to norepinephrine was enhanced (P <0.01) and beat-to-beat variation decreased (P <0.01) in both groups of diabetic patients. Microvascular complications were more prevalent in the diabetic patients with orthostatic hypotension (90% vs 35%). CONCLUSIONS: Patients who have Type II diabetes mellitus and orthostatic hypotension are hypovolemic and have sympathoadrenal insufficiency; both factors contribute to the pathogenesis of orthostatic hypotension.

Effects of pediatric adiposity on heart rate variability

The relationship between obesity and heart rate variability (HRV) has been studied in adults and adolescents, but is not determined in young pediatrics. The purpose of this study was to assess autonomic activity using HRV in a pediatric population. We hypothesized that obese children would have reduced parasympathetic and increased sympathetic activity compared to age-matched subjects. 42 pediatric subjects (ages 3-5) were classified into 3 groups based on body mass index-for-age; normal, overweight and obese. HRV and respiratory rate were recorded during 3 minute baseline, 2 minute isometric handgrip and 3 minute recovery. HRV was analyzed in the time domain [heart rate (HR), RR interval (RRI) and RRI standard deviation (RRISD)] and frequency domain [low frequency (LF), high frequency (HF) and LF/HF ratio] using repeated measures ANOVA. Spearman’s correlations were used to examine the relations between BMI and HRV at rest. Significant condition effects were found between baseline, exercise and recovery, but these responses were not significantly different between the normal, overweight and obese children. BMI was negatively correlated with LF/HF, while BMI was positively correlated with RRISD, LF, HF and nHF. Our data demonstrate that higher BMI in the pediatric population is correlated with higher parasympathetic and lower sympathetic activity. These findings are contrary to HRV responses observed in adults and adolescents, suggesting complex relationships between age, obesity and autonomic control of the heart. The data supports the concept of an age reliance of HRV and a novel relationship between adiposity and body mass index in 3-5 year olds.

Non-invasive and non-occlusive blood pressure estimation via a chest sensor

The clinical demand for a device to monitor Blood Pressure (BP) in ambulatory scenarios with minimal use of inflation cuffs is increasing. Based on the so-called Pulse Wave Velocity (PWV) principle, this paper introduces and evaluates a novel concept of BP monitor that can be fully integrated within a chest sensor. After a preliminary calibration, the sensor provides non-occlusive beat-by-beat estimations of Mean Arterial Pressure (MAP) by measuring the Pulse Transit Time (PTT) of arterial pressure pulses travelling from the ascending aorta towards the subcutaneous vasculature of the chest. In a cohort of 15 healthy male subjects, a total of 462 simultaneous readings consisting of reference MAP and chest PTT were acquired. Each subject was recorded at three different days: D, D+3 and D+14. Overall, the implemented protocol induced MAP values to range from 80 ± 6 mmHg in baseline, to 107 ± 9 mmHg during isometric handgrip maneuvers. Agreement between reference and chest-sensor MAP values was tested by using intraclass correlation coefficient (ICC = 0.78) and Bland-Altman analysis (mean error = 0.7 mmHg, standard deviation = 5.1 mmHg). The cumulative percentage of MAP values provided by the chest sensor falling within a range of ±5 mmHg compared to reference MAP readings was of 70%, within ±10 mmHg was of 91%, and within ±15mmHg was of 98%. These results point at the fact that the chest sensor complies with the British Hypertension Society (BHS) requirements of Grade A BP monitors, when applied to MAP readings. Grade A performance was maintained even two weeks after having performed the initial subject-dependent calibration. In conclusion, this paper introduces a sensor and a calibration strategy to perform MAP measurements at the chest. The encouraging performance of the presented technique paves the way towards an ambulatory-compliant, continuous and non-occlusive BP monitoring system.

Detection of muscle wasting in patients with chronic heart failure using C-terminal agrin fragment: results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF).

AIMS Skeletal muscle wasting affects 20% of patients with chronic heart failure and has serious implications for their activities of daily living. Assessment of muscle wasting is technically challenging. C-terminal agrin-fragment (CAF), a breakdown product of the synaptically located protein agrin, has shown early promise as biomarker of muscle wasting. We sought to investigate the diagnostic properties of CAF in muscle wasting among patients with heart failure. METHODS AND RESULTS We assessed serum CAF levels in 196 patients who participated in the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF). Muscle wasting was identified using dual-energy X-ray absorptiometry (DEXA) in 38 patients (19.4%). Patients with muscle wasting demonstrated higher CAF values than those without (125.1 ± 59.5 pmol/L vs. 103.8 ± 42.9 pmol/L, P = 0.01). Using receiver operating characteristics (ROC), we calculated the optimal CAF value to identify patients with muscle wasting as >87.5 pmol/L, which had a sensitivity of 78.9% and a specificity of 43.7%. The area under the ROC curve was 0.63 (95% confidence interval 0.56-0.70). Using simple regression, we found that serum CAF was associated with handgrip (R = - 0.17, P = 0.03) and quadriceps strength (R = - 0.31, P < 0.0001), peak oxygen consumption (R = - 0.5, P < 0.0001), 6-min walk distance (R = - 0.32, P < 0.0001), and gait speed (R = - 0.2, P = 0.001), as well as with parameters of kidney and liver function, iron metabolism and storage. CONCLUSION CAF shows good sensitivity for the detection of skeletal muscle wasting in patients with heart failure. Its assessment may be useful to identify patients who should undergo additional testing, such as detailed body composition analysis. As no other biomarker is currently available, further investigation is warranted.

Detection of Malnutrition in Patients Undergoing Maintenance Haemodialysis: A Quantitative Data Analysis on 12 Parameters

Background Protein-energy-malnutrition (PEM) is common in people with end stage kidney disease (ESKD) undergoing maintenance haemodialysis (MHD) and correlates strongly with mortality. To this day, there is no gold standard for detecting PEM in patients on MHD. Aim of Study The aim of this study was to evaluate if Nutritional Risk Screening 2002 (NRS-2002), handgrip strength measurement, mid-upper arm muscle area (MUAMA), triceps skin fold measurement (TSF), serum albumin, normalised protein catabolic rate (nPCR), Kt/V and eKt/V, dry body weight, body mass index (BMI), age and time since start on MHD are relevant for assessing PEM in patients on MHD. Methods The predictive value of the selected parameters on mortality and mortality or weight loss of more than 5% was assessed. Quantitative data analysis of the 12 parameters in the same patients on MHD in autumn 2009 (n = 64) and spring 2011 (n = 40) with paired statistical analysis and multivariate logistic regression analysis was performed. Results Paired data analysis showed significant reduction of dry body weight, BMI and nPCR. Kt/Vtot did not change, eKt/v and hand grip strength measurements were significantly higher in spring 2011. No changes were detected in TSF, serum albumin, NRS-2002 and MUAMA. Serum albumin was shown to be the only predictor of death and of the combined endpoint “death or weight loss of more than 5%”. Conclusion We now screen patients biannually for serum albumin, nPCR, Kt/V, handgrip measurement of the shunt-free arm, dry body weight, age and time since initiation of MHD.

Análisis de la estructura del juego y parámetros morfológicos y fisiológicos en bádminton

En este trabajo se ha realizado un análisis de la estructura del juego y de los parámetros morfológicos y fisiológicos en jugadores de bádminton. Para ello se han realizado 4 estudios aplicados. Objetivo: Los objetivos del trabajo han sido: (1) comprobar si existen diferencias entre el lado dominante y no dominante de las medidas antropométricas en jugadores de bádminton de máximo nivel nacional, así como verificar si el lado del cuerpo donde se realiza la medición puede influir en el cálculo de la composición corporal y del somatotipo. (2) Comparar la estuctura temporal y notacional en partidos de individual masculino entre los Juegos Olímpicos de Pekín y de Londres para observar como ha evolucionado el bádminton de 2008 a 2012. (3) Medir la ocurrencia de daño muscular después de un partido simulado de bádminton y su influencia en parámetros físicos y hematológicos. (4) Investigar la efectividad de una bebida energética que contiene cafeína para mejorar el rendimiento físico y el rendimiento en un partido en jugadores de élite de bádminton. Metodología: Para caracterizar el bádminton participaron en esta tesis un total de 78 jugadores de bádminton de élite (63 hombres y 15 mujeres), distribuidos en tres estudios y se analizaron 40 sets de bádminton de individual masculino usando los videos oficiales de los Juegos Olímpicos de Pekín 2008 y Londres 2012. En el primer estudio se tomaron medidas de pliegues cutáneos, diámetros, longitudes y perímetros del lado dominante y no dominante de los jugadores. Se calculó la composición corporal y el somatotipo. En el segundo estudio se analizaron los factores temporales y los factores notacionales de los partidos. En el tercer estudio se midieron la fuerza máxima isométrica, la velocidad en test específicos de bádminton y se tomaron muestras de sangre antes y después de jugar un partido de bádminton de 45 minutos. En el cuarto estudio se realizó un experimento a doble ciego, aleatorizado y controlado con placebo, los jugadores ingirieron 3 mg de cafeína por kilógramo de masa corporal en forma de bebida energética, o la misma bebida sin cafeína (placebo). En este estudio se registraron diferente tests específicos de bádminton (tests de salto, fuerza máxima y test de agilidad) y se jugó un partido simulado de 45 minutos. Resultados y discusión: (1) El porcentaje óseo fue mayor calculado a partir de las mediciones del lado dominante (dominante = 16.37 ± 1.14 %, no dominante = 15.66 ± 1.12 %; P < 0.001), mientras que el porcentaje muscular fue mayor calculado a partir de las mediciones del lado no dominante (dominante = 49.39 ± 2.60 %, no dominante = 50.18 ± 2.69%; P < 0.001). (2) La duración del set (Pekín: 1124.6 ± 229.9 s vs Londres: 1260.3 ± 267.1 s.; P < 0.05), el tiempo real de juego (Pekín: 306.9 ± 45.7 s vs Londres: 354.7 ± 86.5 s; P < 0.05), tiempo de rally, golpeos por rally, tiempo de descanso en el punto 11, tiempo de descanso entre sets y golpeos por rally fueron significativamente mayores en Londres que en Pekín. (3) El partido simulado de bádminton no afectó a la fuerza isométrica máxima (Pre: 1263.6 ± 245.5, Post: 1290.8 ± 240.4 N) o a la velocidad específica de bádminton (Pre: 21.0 ± 1.7, Post: 20.9 ± 1.8 s), sin embargo las concentraciones de mioglobina y de creatina quinasa en sangre aumentaron de 26.5 ± 11.6 a 197.3 ± 70.2 μg • L-1 y de 258.6 ± 192.2 a 466.0 ± 296.5 U • L-1, respectivamente después del partido de bádminton. (4) En comparación con la bebida placebo, la ingesta de la bebida energética con cafeína incrementó la altura del SJ (34.5±4.7 vs. 36.4±4.3 cm; P < 0.05) y del CMJ (37.7 ± 4.5 vs. 39.5 ± 5.1 cm; P < 0.05) y aumentó el número de aceleraciones totales durante el partido (7395 ± 1594 vs. 7707 ± 2033 aceleraciones; P < 0.05). Conclusiones: (1) Existen asimetrías corporales en los jugadores de bádminton de alto nivel, al encontrarse diferencias en los diámetros óseos y en los perímetros entre el lado dominante y no dominante. Al calcular la composición corporal con el lado dominante de los jugadores de bádminton se está sobreestimando el porcentaje óseo e infraestimando el porcentaje muscular. (2) El bádminton está evolucionando hacía rallies más largos con intervalos de descanso mayores, lo que resulta en partidos más largos. (3) El partido de bádminton generó daño muscular, sin embargo, el nivel de daño muscular alcanzado después de un partido de bádminton no produjo una disminución del rendimiento muscular. (4) El uso de una bebida energética con cafeína puede ser una ayuda nutricional eficaz para aumentar el rendimiento en el salto y patrones de actividad durante el juego en jugadores de élite de bádminton. ABSTRACT: This study analyzes the structure of the game and the morphological and physiological parameters in badminton players, investigated in four applied studies. Purpose: The purposes of the study were: (1) To check if there are differences between the dominant and non-dominant side in the anthropometric measures of badminton players at the highest national level and verify if the side of the body where the measurements are performed can influence the calculation of the body composition and the somatotype. (2) To compare the temporal and notational structure in men’s singles matches between the Olympic Games in Beijing and London to observe the evolution of badminton between 2008 and 2012. (3) To asses the occurrence of muscle damage after a simulated badminton match and its influence on physical and haematological parameters. (4) To determine the effectiveness of a commercially available energy drink that contains caffeine to improve match performance in elite badminton players. Methods: A total of 78 elite badminton players (63 men and 15 women) participated in this thesis to characterize the sport of badminton distributed in three studies and 40 sets of men’s singles badminton analyzed using the official videos of the Olympic Games of Beijing 2008 and London 2012. In the first study skinfolds, diameters, lengths and perimeters of the dominant and non-dominant side of the players were measured and body composition and somatotype were calculated. In the second study the temporal and notational factors were analyzed. In the third study maximal isometric force and speed in badminton specific tests were measured and blood samples were taken before and after a badminton match of 45 minutes. In the fourth study, a double-blind, randomized placebo-controlled experiment, players ingested 3 mg of caffeine per kilogram of body mass in the form of an energy drink or an identical drink with no caffeine content (placebo). In this study different badminton specific tests (jump tests, handgrip force test and an agility test) were recorded and a simulated badminton match of 45 minutes was played. Results and discussion: (1) The percentage of bone was higher when calculated from measurements of the dominant body side (dominant = 16.37 ± 1.14 %, nondominant = 15.66 ± 1.12 %; P < 0.001), while the muscle percentage was higher when calculated from measurements of the non-dominant side (dominant = 49.39 ± 2.60 %, non-dominant = 50.18 ± 2.69%; P < 0.001). (2) Set duration (Beijing: 1124.6 ± 229.9 s vs. London: 1260.3 ± 267.1 s.; P < 0.05), real time played (Beijing: 306.9 ± 45.7 s vs. London: 354.7 ± 86.5 s; P < 0.05), rally time, shots per rally, rest time at point 11, rest time between sets and shots per rally were significantly higher in London than in Beijing. (3) A simulated badminton match did not affect maximal isometric force (Pre: 1263.6 ± 245.5, Post: 1290.8 ± 240.4 N) or specific badminton speed (Pre: 21.0 ± 1.7, Post: 20.9 ± 1.8 s), however, concentrations of myoglobin and creatine kinase in blood increased from 26.5 ± 11.6 to 197.3 ± 70.2 μg • L-1 and from 258.6 ± 192.2 to 466.0 ± 296.5 U • L-1, respectively after the badminton match. (4) In comparison to the placebo drink, the caffeinated beverage increased height in the SJ (34.5±4.7 vs. 36.4±4.3 cm; P < 0.05) and in the CMJ (37.7 ± 4.5 vs. 39.5 ± 5.1 cm; P < 0.05) and increased the number of total accelerations during the match (7395 ± 1594 vs. 7707 ± 2033 accelerations; P < 0.05). Conclusions: (1) Body asymmetries were found in high level badminton players, due to the differences found in bone diameters and perimeters between the dominant and non-dominant body side. When calculating body composition with the dominant side of the badminton players we are overestimating bone percentage and underestimating muscle percentage. (2) Badminton is evolving towards longer rallies with greater rest intervals, resulting in longer matches. (3) The badminton match generated muscle damage, however, the level of muscle damage reached after a badminton match did not produce a decrease in muscle performance. (4) The ingestion of an energy drink containing caffeine might be an effective ergogenic nutritional supplement to increase jump performance and activity patterns during the game in elite badminton players.

Prevalência e incidência de obesidade sarcopênica em coorte de idosos domiciliados no município de São Paulo

Introdução: Evidências epidemiológicas mostram que a obesidade sarcopênica (OS) em idosos está associada a um acelerado declínio funcional e alto risco de morbimortalidade, sendo que seu impacto tem se tornado grande preocupação dos profissionais de saúde. Objetivo: Estimar a prevalência e a incidência de obesidade sarcopênica, em coorte de idosos domiciliados no município de São Paulo/Brasil 2000 e 2010. Casuística e Métodos: Foram utilizados dados do Estudo SABE (Saúde, Bem-estar e Envelhecimento), realizado no município de São Paulo em 2000 (2.143 idosos), e em 2010 (795 idosos). A população deste estudo foi constituída por idosos ( 70 anos), de ambos os sexos, que apresentaram todos os dados necessários para este estudo e que concordaram em participar, totalizando 871 idosos analisados em 2000 e 656 idosos em 2010. As variáveis de estudo foram: 1. Dependente - obesidade sarcopênica, identificada segundo: obesidade, diagnosticada pelo valor da circunferência da cintura (CC 94 cm e CC 80 cm para homens e mulheres, respectivamente); sarcopenia, identificada por: 1- força muscular, pelo teste de preensão manual (FPM - kg) (baixa P25; normal > P25, da mesma população), 2- massa muscular (MM), obtida pelo índice de massa muscular (IMM=MM/altura²) (baixa P20; normal > P20, da mesma população) e 3- desempenho físico, identificado pelo teste (tempo dependente segundos) de sentar e levantar 5 vezes de uma cadeira (SeL) , com os braços cruzados sobre o peito (baixo P75; normal < P75); 2. Explanatórias - sexo e grupos etários (70 79 e 80). Foram classificados com OS idosos que apresentaram, simultaneamente, valores de CC adotados e baixo desempenho e baixa MM, ou então, desempenho normal, mas baixas FPM e MM. A prevalência de obesidade sarcopênica em 2000 e em 2010 foi estimada pelo número de casos de OS identificados nos dois momentos, onde foram realizadas comparações entre os intervalos de confiança, para verificar diferença estatística em idosos ( por cento ) com OS, segundo variáveis explanatórias, com nível de significância de 5 por cento . Para o cálculo do coeficiente de incidência de OS, em 2010, foi considerado o tempo de observação de cada indivíduo, determinado de maneira específica para cada caso. Para os cálculos foi utilizado o programa: Stata/SE ® 10.0 for Windows. Resultados: Dos 871 idosos analisados em 2000, 85 (7,4 por cento ) foram identificados com OS [6,5 por cento mulheres (IC 5,08,4) e 4,8 por cento 80 anos (IC 3,6-6,4)] (p 5 por cento ), e, em 2010, (n=656), 73 (9,2 por cento ) foram identificados com OS [7,2 por cento mulheres (IC 5,5-9,4) e 5,3 por cento 80 anos (IC 4,0-7,0)] (p 5 por cento ). Em 10 anos, foram identificados 43 novos casos de OS. O coeficiente de incidência foi 15,29/1000 pessoas/ano entre 2000 e 2010. Conclusões: A prevalência de OS em 2000 e 2010 foi maior nas mulheres e nos idosos mais longevos, sendo que, em ambos os casos, foi maior em 2010, quando comparada a 2000. Não houve diferença significativa entre os coeficientes de incidência, segundo as variáveis explanatórias.

The muscle strength and bone density relationship in young women: dependence on exercise status

Aim. Numerous studies report an association between muscle strength and bone mineral density (BMD) in young and older women. However, the participants are generally non-athletes, thus it is unclear if the relationship varies by exercise status. Therefore, the purpose was to examine the relationships between BMD and muscle strength in young women with markedly different exercise levels. Methods. Experimental design: cross-sectional. Setting: a University research laboratory. Participants: 18 collegiate gymnasts and 22 age- and weight-matched recreationally active control women. Measures: lumbar spine, femoral neck, arm, leg and whole body BMD (g/cm(2)) were assessed by dual X-ray absorptiometry. In addition, lumbar spine and femoral neck bone mineral apparent density (BMAD, g/cm(3)) was calculated. Handgrip strength and knee extensor and flexor torque (60degrees/s) were determined by dynamometry, and bench press and leg press strength (1-RM) using isotonic equipment. Results. BMD at all sites and bench press, leg press and knee flexor strength were greater in gymnasts than controls (p

Does estrogen fluctuation throughout the menstrual cycle impact flow-mediated dilation during exercise in healthy premenopausal women?

The endothelium is the inner most layer of cells that lines all arteries. A primary function of endothelial cells is to regulate responses to increased blood flow and the resulting frictional forces or shear stress by producing factors such as nitric oxide that mediate arterial dilation (flow mediated dilation (FMD)). Menstrual cycle variations in estrogen (E2) have been shown to influence brachial artery (BA) FMD in response to transient increases in shear stress brought about by the release of a brief forearm occlusion (reactive hyperemia (RH)). FMD can also be assessed in response to a sustained shear stress stimulus such as that created with handgrip exercise (HGEX), and studies have shown that RH- and HGEX stimulated FMD provide unique information regarding endothelial function. However, the impact of menstrual phase on HGEX-FMD is unknown. Therefore, the purpose of this study was to determine the impact of cyclical changes in E2 levels on HGEX-FMD over two discrete phases of the menstrual cycle. FMD was assessed via ultrasound. 12 subjects (21 ± 2yrs) completed two experimental visits: (1) low estrogen phase (early follicular) and (2) High estrogen phase (late follicular). In each visit both RH- and HGEX-FMD (6 min handgrip exercise) were assessed. Results are mean ± SD. E2 increased from the low to the high estrogen phase of the menstrual cycle (low: 34 ± 8, high: 161 ± 113pg/mL, p = 0.004). There was no change in mean FMD between phases (RH-FMD: 7.7 ± 4.3% vs. 6.4 ± 3.1%, p = 0.139; HGEX-FMD: 4.8 ± 2.8% vs. 4.8 ± 2.3%, p = 0.979). The observation that both RH- and HGEX-FMD did not differ between phases indicates that menstrual cycle fluctuations in estrogen may not universally impact endothelial function in young, healthy premenopausal women. Further research is needed to improve our understanding of the mechanisms that underlie variability in the impact of menstrual phase on both transient and sustained FMD responses.

Efeitos do treinamento resistido com máquinas pneumáticas e resistência elástica progressiva na força, capacidade funcional e equilíbrio em mulheres idosas : um ensaio clínico randomizado

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Educação Física, Programa de Pós-Graduação Strictu-Sensu em Educação Física, 2015.

Circuit resistance training improved endothelial dysfunction in obese aged women

Introduction: It is widely accepted that obesity is associated with endothelial dysfunction. In a recent paper, we have also found circuit resistance training may reduce visceral fat in obese aged women. Accordingly, the current study was conducted to ascertain the effects of circuit resistance training on markers of endothelial dysfunction in this population group. Methods: In the present interventional study, a total of 48 obese aged women were recruited from the community. Twenty-four of them were randomly assigned to perform a 12-week resistance circuit training programme, 3-days per week. This training was circularly performed in 6 stations: arm curl, leg extension, seated row, leg curl, triceps extension and leg press. The Jamar handgrip electronic dynamometer was used to assess maximal handgrip strength of the dominant hand. Lastly, serum samples were analysed using an immunoassay (ELISA) for endothelin-1, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1). Results: When compared to baseline, resistance training significantly reduced serum levels of endothelin-1 (2.28 ± 0.7 vs. 1.98 ± 1.1 pg/ml; p = 0.019; d = 0.67) and ICAM-1 (290 ± 69 vs. 255 ± 76 ng/ml; p = 0.004; d = 0.92) in the experimental group. No significant changes in any of the tested outcomes were found in the control group. Conclusion: A short-term circuit resistance program improved endothelial dysfunction in aged obese women. Further studies on this topic are still required to consolidate this approach in clinical application.

An allometric modelling approach to identify the optimal body shape sssociated with, and differences between brazilian and peruvian youth motor performance

Children fromdevelopedanddevelopingcountriesdifferintheirbodysizeandshapedueto markeddifferencesacrosstheirlifehistorycausedbysocial,economicandculturaldifferenceswhicharealsolinkedtotheirmotorperformance(MP).Weusedallometricmodelsto identifysize/shapecharacteristicsassociatedwithMPtestsbetweenBrazilianandPeruvianschoolchildren.Atotalof4,560subjects,2,385girlsand2,175boysaged9–15years werestudied.Heightandweightweremeasured;biological maturation wasestimated with thematurityoffsettechnique;MPmeasuresincludedthe12minuterun(12MR),handgrip strength(HG),standinglongjump(SLJ)andtheshuttlerunspeed(SR)tests;physicalactivity(PA)wasassessedusingtheBaeckequestionnaire.Amultiplicativeallometricmodel wasadoptedtoadjustforbodysizedifferencesacrosscountries.Reciprocalponderalindex (RPI)wasfoundtobethemostsuitablebodyshapeindicatorassociatedwiththe12MR, SLJ,HGandSRperformance.Apositivematurationoffset parameterwasalsoassociated withabetterperformanceinSLJ,HGandSRtests.Sexdifferenceswerefoundinallmotor tests.BrazilianyouthshowedbetterscoresinMPthantheirPeruvianpeers,evenwhen controlling fortheirbodysizedifferencesThecurrentstudyidentifiedthekeybodysize associatedwithfourbodymass-dependentMPtests.Biological maturationandPAwere associatedwithstrengthandmotorperformance.Sexdifferenceswerefoundinallmotor tests,aswellasacrosscountriesfavoringBrazilianchildrenevenwhenaccountingfortheir bodysize/shapedifferences.