Sarcopenic obesity is associated with disability in older people, especially in women. Resistance exercises are recommended for this population, but their efficacy is not clear. To evaluate the effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity. Twenty-eight women 65 to 80 years old, with a body mass index ≥30kg/m2 and handgrip strength ≤21kg were randomly allocated to two groups. The experimental group underwent a 10-week resistance exercise program designed to improve strength, power, and endurance of lower-limb muscles, with open chain and closed chain exercises. The control group had their health status monitored through telephone calls. The primary outcomes were lower limb muscle performance measured by knee extensor strength, power and fatigue by isokinetic dynamometry, and mobility measured by the Short Physical Performance Battery and by gait velocity. The secondary outcome was health-related quality of life assessed by the SF-36 Questionnaire. The average rate of adherence was 85%, with few mild adverse effects. There were no significant between-group differences for any of the outcomes. In this study, a progressive resistance exercise program with high-speed component was not effective for improving the physical function of older women with sarcopenic obesity.
1 March 2016 in The Journal of nutrition, health and aging
Background Sarcopenia is defined as a progressive and generalized loss of skeletal muscle mass and strength. The specific threshold of muscle weakness that leads to mobility limitations has not been identified. Objectives To determine the best cutoff point of handgrip strength for identifying mobility limitation and to investigate the factors associated with muscle weakness and mobility limitation in community-dwelling older people. Design Transversal study. Setting Cities of Belo Horizonte, Barueri and Santa Cruz in Brazil. Participants 1374 community-dwelling older people from the Frailty study in Brazilian older people (FIBRA Study). Measurements Outcomes included muscle weakness determined according to gender-specific handgrip strength cutoff points generated by Receiver Operating Characteristic curves, mobility limitation defined as a gait speed = 0.8 m/s; and a combination of both muscle weakness and mobility limitation. Associated factors included socio-demographic variables, lifestyle, anthropometrics, health conditions, use of health services and disability. Results The cutoff points of handgrip strength with the best balancing between sensitivity and specificity for mobility limitation were 25.8 kgf for men (sensitivity 69%, specificity 73%) and 17.4 kgf (sensitivity 60%, specificity 66%) for women. Age and disability in instrumental activities of daily living were associated with all outcomes. Women had greater odds of mobility limitation than men. Physical inactivity, body fat, diabetes, depression, sleeping disturbances, number of medications and occurrence of falls remained as significant associated factors in the final model. Conclusions Handgrip strength can be a useful tool to identify mobility limitation in clinical practice. Interventions to prevent or minimize impacts of sarcopenia should stimulate physical activity and improvement of body composition in addition to the management of chronic diseases and disabilities.
This time-series study examined a 10-year historical series of the physical activity prevalence for leisure and transportation in the Brazilian adult population. Information from 512,969 adults interviewed from the Vigitel between 2010 and 2019 was analyzed. Individuals who reported practicing at least 150 minutes/week of moderate-intensity physical activity or at least 75 minutes/week of vigorous-intensity physical activity were considered active during leisure time. Individuals who reported walking or cycling to/from work, course, or school at least 30 minutes/day, equivalent to at least 150 minutes/week of moderate-intensity physical activity, were considered active during transportation. The prevalence of physical activity for leisure and transportation was calculated annually and stratified by sex, age group, schooling, and race/skin color. The segmented regression model was applied to analyze the time series. Annual percent change and average annual percent change were calculated. Over time, the prevalence of physical activity for leisure increased, and the prevalence of physical activity for transportation decreased. The highest prevalence of physical activity for leisure was observed among males, young individuals, and those with high education. Older adults, those with high education, and white people presented the lowest prevalence of active transport. Policymakers should propose strategies that encourage and facilitate physical activity for leisure in women, individuals aged ≥ 35 years, and those with less education (< 12 years), and physical activity for transportation among older adults (≥ 60 years), those with high education (≥ 12 years), and white people.
Background: Sarcopenic obesity is a health condition that combines excess adipose tissue and loss of muscle mass and strength. Sarcopenic obesity predisposes to more functional disabilities than obesity or sarcopenia alone. Progressive resistance exercises are recommended for older people as a potential treatment for sarcopenia and also for obesity. However, there is a lack of evidence indicating which programmes are best applied to older people, and no studies have investigated their effects on sarcopenic obese people. The aims of this protocol study are to investigate and compare the efficacy of land-based and aquatic resistance exercise programmes on improving muscle performance, functional capacity and quality of life of older women with sarcopenic obesity. Methods/Design: This is a protocol study for a parallel randomised controlled clinical trial. Eligible participants are older women (≥65 years) with a body mass index ≥30 kg/m 2 and hand grip strength ≤21 kg force. A total sample of 36 participants will be randomly allocated to one of the intervention groups in blocks of three: land-based, aquatic or control. Each intervention group will undergo 2-week sessions of a 10-week therapeutic exercise programme for strength, power and endurance training of the lower-limb muscles. Participants in the control group will not participate in any strengthening activity for lower limbs and will receive telephone calls once a week. Baseline and final evaluation of outcomes will encompass muscle performance of the lower limbs assessed by an isokinetic dynamometer; functional tests of usual walking speed, maximal walking speed (shuttle walking test), stair speed and the Short Physical Performance Battery; and health-related quality of life (Medical Outcomes Study Short Form Questionnaire – SF-36). Data collectors will be blinded to randomisation and will not be in touch with participants during the interventions. Discussion: This study is the first randomised controlled trial designed to evaluate resistance exercises in older patients with sarcopenic obesity. If our hypothesis proves correct, both intervention programmes will be effective, with the land-based exercises conferring better results in muscle performance. Trial registration: Registro Brasileiro de Ensaios Clínicos: RBR-9p5q67
As mulheres apresentam risco aumentado para a osteoartrite (OA) de joelhos e obesidade. Associadas, essas doenças podem gerar dor e prejuízos funcionais, principalmente em atividades de locomoção. Este estudo visou comparar o impacto do grau de obesidade nos sintomas e capacidade funcional de mulheres com OA de joelhos. Foram selecionadas 13 mulheres obesas (com índice de massa corporal - IMC>30 kg/m²) e 15 com obesidade mórbida (IMC>40 kg/m²), todas com OA bilateral de joelhos. Os sintomas de dor, rigidez e dificuldades funcionais foram avaliados pelo questionário The Western Ontario and McMaster Osteoarthritis Index (Womac). A capacidade funcional foi verificada por quatro testes de velocidade: marcha usual, marcha rápida, subir e descer escadas. Os dois grupos apresentaram um impacto moderado da obesidade na OA de joelhos, sem diferença quanto aos sintomas. As obesas se saíram melhor do que as obesas mórbidas nos testes de marcha usual e subir escadas, mas não nas atividades de marcha rápida e descer escadas, mais complexas e estressantes para a articulação do joelho. Conclui-se que o grau de obesidade não teve impacto nos sintomas de dor, rigidez e dificuldades funcionais associadas à OA de joelhos entre mulheres obesas e obesas mórbidas. E, em dois testes de capacidade funcional, as obesas dos dois grupos tiveram desempenho semelhante, sugerindo que outros fatores podem influenciar o desempenho funcional de obesas com OA de joelhos.
25 September 2021 in International Journal of Environmental Health Research
This study aimed to investigate the association of individual and environmental characteristics with walking for transportation among older Brazilian people living in a large urban area. Data from 825 participants (≥ 60 years) from a multistage household survey in Belo Horizonte, Brazil, were used. Walking for transportation was evaluated using the International Physical Activity Questionnaire. The environmental variables included six perceived neighborhood scales (walkability, quality of services, physical disorder, safety, social disorder, and social cohesion). A Poisson regression analysis with robust variance was performed. The walking for transportation was significantly associated with walkability scale, lower family income (up to four minimum wages), very good/good self-rated health, and high social participation. Our results suggest that promoting adequate conditions for walkability in urban areas, expanding the opportunities for social participation, and improving general health is essential to increase walking levels for transportation among this older Brazilian population.