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Objetivos: Comparar atividade física, sedentarismo e qualidade de vida relacionada a saúde (QVRS) em idosos institucionalizados e não institucionalizado e estabelecer um padrão de associação e predição da atividade física e do sedentarismo com os componentes físicos e mentais da QVRS. Métodos: A amostra foi composta por 383 idosos com idade ≥ 75 anos (187 institucionalizados e 196 não institucionalizados). Foram aplicados o questionário internacional de atividade física (IPAQ) e a versão reduzida do inventário de saúde (SF-36) para avaliar a atividade física e o QVRS. Também foi utilizado o Mini Exame do Estado Mental (MEEM) para exclusão de problemas cognitivos. Resultados: Foram encontradas diferenças entre idosos institucionalizados e não institucionalizados nas atividades de intensidade moderada e na caminhada, a favor dos não institucionalizados. Os idosos institucionalizados apresentaram mais minutos em atividade sedentária. Além disso, foram observadas diferenças entre os dois grupos no componente físico da QVRS, a favor dos idosos não institucionalizados. O componente mental permaneceu inalterado. A análise de regressão multivariada mostrou que a atividade física é um preditor de melhor componente físico (8-12%) e mental (5-8%) da QVRS em idosos institucionalizados e não institucionalizados. Conclusões: Idosos não institucionalizados foram mais ativos fisicamente, gastaram menos tempo em atividades sedentárias e apresentou melhor percepção do componente físico da QVRS que idosos institucionalizados. Um resultado importante e encorajador deste estudo foi que a atividade física é um preditor de melhor componente físico e mental da QVRS em idosos institucionalizados e não institucionalizados

Background: People with fibromyalgia (FM) experience a range of symptoms (chronic widespread pain, fatigue, mood disorder, sleep problems, muscle stiffness) that promote deterioration of physical condition and function. With impaired physical function, fear of falling and risk of falling increases. This study evaluated physical function, self-perceived physical fitness, falls, quality of life, and the degree of disability caused by FM according to fear and risk of falling in Spanish adult women with FM. Methods: Cross-sectional study involving 84 Spanish adult women with FM. Participants completed tests to assess their physical function and completed questionnaires to evaluate self-perceived physical fitness, falls, the disabling effect of FM, quality of life, fear of falling, and risk of falling. Nonparametric statistical tests were used to analyze possible intergroup differences (Mann–Whitney U test) and correlations between variables (Spearman’s Rho). Results: Women with a fear of falling and at risk of falling presented a worse performance in physical tests, worse self-perceived physical fitness, greater number of falls, lower quality of life, and greater degree of disability due to FM. Weak and moderate correlations were found for fear of falling and fall risk and the variables of interest. However, no intergroup differences were found, nor significant correlations in all variables. Conclusions: Women with FM who present fear of falling and risk of falling tend to have worse performance in physical function tests, in addition to worse self-perceived physical fitness, higher number of falls, poorer quality of life, and greater disabling effect of FM.

Abstract Background Malnutrition is an underestimated geriatric problem, with a high prevalence in institutionalized older adults. The identification of risk factors for malnutrition in elderly individuals must be a priority for governmental organizations worldwide. Methods A total of 98 institutionalized seniors were enrolled in a cross-sectional study. For the assessment of risk factors, sociodemographic characteristics and health-related information were collected. The Mini-Nutritional Assessment Short-Form test was used to assess malnutrition in the sample population. Results A significantly greater proportion of women than men were malnourished or at risk of malnutrition. In addition, the comparative analysis revealed that comorbidity, arthritis, balance impairment, dementia and fall episodes with serious injuries were significantly more frequent in the older adults categorized as malnourished or at risk of malnutrition than in those categorized as well-nourished. Conclusions Multivariable regression analysis revealed that being female, having a poor cognitive status and experiencing falls with injuries are the main independent factors influencing nutritional status in institutionalized older adults living in a rural area of Portugal.

Background and Objectives: Fibromyalgia, a chronic condition, manifests as widespread musculoskeletal pain, fatigue, sleep disturbances, autonomic and cognitive dysfunction, hypersensitivity to stimuli, and various somatic and psychiatric symptoms. This study, a controlled and randomized experiment, aimed to evaluate and compare the immediate effects of different treatments on fibromyalgia patients. Materials and Methods: The treatments included the EXOPULSE Mollii suit, a combination of the EXOPULSE Mollii suit with a virtual reality (VR) protocol, and a physical exercise regimen. A cohort of 89 female fibromyalgia patients was randomly assigned to one of four groups: Control (n = 20), Suit only (n = 22), Suit combined with VR (n = 21), and Exercise (n = 26). Results: This study found notable differences across the groups in several key parameters. In the Control group, significant changes were observed in Forced Expiratory Volume (FEV 1/FEV 6), the Numeric Rating Scale (NRS) for pain, Pressure Pain Threshold (PPT) at the epicondyle, cortical arousal levels, the 10 m up-and-go test, and in all measured variables related to temperature and muscle oxygenation. For the group using the suit alone, there were significant differences noted in the NRS, the chair stand test, palm temperature, and all muscle oxygenation parameters. The Suit + VR group showed significant changes in the NRS, PPT at the knee, handgrip strength test, the 10 m up-and-go test, one-leg balance test with the right leg, muscle oxygen saturation (SmO2), deoxygenated hemoglobin (HHb), and oxygenated hemoglobin (O2Hb). Finally, the Exercise group exhibited significant differences in FEV 1/FEV 6, chest perimeter difference, NRS, PPT at both the epicondyle and knee, cortical arousal, the chair stand test, the 10-m up-and-go test, and in SmO2, HHb, and O2Hb levels. Conclusions: combining neuromodulation with VR and targeted exercise regimens can effectively alleviate fibromyalgia symptoms, offering promising avenues for non-pharmacological management.

Abstract Background Fall risk assessment in older people is of major importance for providing adequate preventive measures. Current predictive models are mainly focused on intrinsic risk factors and do not adjust for contextual exposure. The validity and utility of continuous risk scores have already been demonstrated in clinical practice in several diseases. In this study, we aimed to develop and validate an intrinsic-exposure continuous fall risk score (cFRs) for community-dwelling older people through standardized residuals. Methods Self-reported falls in the last year were recorded from 504 older persons (391 women: age 73.1 ± 6.5 years; 113 men: age 74.0 ± 6.1 years). Participants were categorized as occasional fallers (falls ≤1) or recurrent fallers (≥ 2 falls). The cFRs was derived for each participant by summing the standardized residuals (Z-scores) of the intrinsic fall risk factors and exposure factors. Receiver operating characteristic (ROC) analysis was used to determine the accuracy of the cFRs for identifying recurrent fallers. Results The cFRs varied according to the number of reported falls; it was lowest in the group with no falls (− 1.66 ± 2.59), higher in the group with one fall (0.05 ± 3.13, p

Passive and active hypoxia could be used as a tool during a transitional phase to maintain the effects of warm-up and optimize athletic performance. Our purpose was to evaluate and compare the effects of four different re-warm-up strategies, i.e. rest in normoxia (RN) at FiO2 = 20.9%, rest in hypoxia (RH) at FiO2 = 15%, active (5 minutes dryland-based exercise circuit) in normoxia (AN) and active in hypoxia (AH), during the transitional phase, on subsequent 100 m maximal swimming performance. Thirteen competitive swimmers (n = 7 males; n = 6 females; age: 15.1±2.1 years; height: 164.7±8.8 cm; weight: 58.1±9.7 kg; 100 m season’s best time 72.0±11.8 s) completed a 20-minute standardized in-water warm-up followed by a 30‑minute randomized transitional phase and 100 m freestyle time trial. Compared to AH (73.4±6.2 s), 100 m swim time trials were significantly (p = 0.002; η2 = 0.766) slower in RN (75.7±6.7 s; p = 0.01), AN (75.2±6.7 s; p = 0.038) and RH (75.0±6.4 s; p = 0.009). Moreover, compared to AH (36.3±0.4ºC), tympanic temperature was significantly lower (p

Previous studies have reported that people with fibromyalgia (FM) could suffer from mitochondrial dysfunction. However, the consumption of muscle oxygen during physical exercise has been poorly studied. Therefore, this study aimed to explore the response of muscle oxygen during a fatigue protocol in people with FM and healthy controls (HC). In addition, the peak torque and the total work were assessed. A total of 31 participants (eighteen were people with fibromyalgia and thirteen were healthy controls) were enrolled in this cross-sectional study. All the participants underwent a fatigue protocol consisting of 20 repetitions at 180°·s−1 of quadriceps flexions and extensions using a Biodex System 3. The muscle oxygen saturation (SmO2), total hemoglobin (THb), deoxygenated hemoglobin (HHb) and oxygenated hemoglobin (O2Hb) values were measured using a portable near-infrared spectroscopy (NIRS) device. Significant differences between people with FM and healthy controls were found at baseline: SmO2 (FM: 56.03 ± 21.36; HC: 77.41 ± 10.82; p = 0.036), O2Hb (FM: 6.69 ± 2.59; HC: 9.37 ± 1.31; p = 0.030) and HHb (FM: 5.20 ± 2.51; HC: 2.73 ± 1.32; p = 0.039); during the fatigue protocol: SmO2 (FM: 48.54 ± 19.96; HC: 58.87 ± 19.72; p = 0.038), O2Hb (FM: 5.70 ± 2.34; HC: 7.06 ± 2.09; p = 0.027) and HHb (FM: 5.69 ± 2.65; HC: 4.81 ± 2.39; p = 0.048); and in the recovery at three min and six min for SmO2, O2Hb and HHb (p < 0.005). Furthermore, healthy control values of SmO2, O2Hb and HHb have been significantly altered by the fatigue protocol (p < 0.005). In contrast, people with FM did not show any significant alteration in these values. Moreover, significant differences were found in the peak torque at extension (FM: 62.48 ± 24.45; HC: 88.31 ± 23.51; p = 0.033) and flexion (FM: 24.16 ± 11.58; HC: 42.05 ± 9.85; p = 0.010), and the total work performed at leg extension (FM: 1039.78 ± 434.51; HC: 1535.61 ± 474.22; p = 0.007) and flexion (FM: 423.79 ± 239.89; HC: 797.16 ± 194.37; p = 0.005).

Previous studies showed that people with Fibromyalgia (FM) suffer from dysautonomia. Dysautonomia consists of persistent autonomic nervous system hyperactivity at rest and hyporeactivity during stressful situations. There is evidence that parameters reflecting the complex interplay between the autonomic nervous system and the cardiovascular system during exercise can provide significant prognostic information. Therefore, this study aimed to investigate the differences between people with FM and healthy controls on heart rate variability (HRV) and salivary parameters (such as flow, protein concentration, enzymatic activities of amylase, catalase and glutathione peroxidase) in two moments: (1) at baseline, and (2) after an exercise fatigue protocol. A total of 37 participants, twenty-one were people with fibromyalgia and sixteen were healthy controls, participated in this cross-sectional study. HRV and salivary samples were collected before and after an exercise fatigue protocol. The fatigue protocol consisted of 20 repetitions of knee extensions and flexions of the dominant leg at 180 °·s−1 (degrees per second). Significant differences were found in the HRV (stress index, LF and HF variables) and salivary biomarkers (with a higher concentration of salivary amylase in people with FM compared to healthy controls). Exercise acute effects on HRV showed that people with FM did not significantly react to exercise. However, significant differences between baseline and post-exercise on HRV significantly induce alteration on the HRV of healthy controls. Catalase significantly increased after exercise in healthy controls whereas salivary flow significantly increased in women with FM after an exercise fatigue protocol. Our study suggests that a higher α-amylase activity and an impaired HRV can be used as possible biomarkers of fibromyalgia, associated with a reduction in salivary flow without changes in HRV and catalase activity after a fatigue exercise protocol. More studies should be carried out in the future to evaluate this hypothesis, in order to find diagnostic biomarkers in fibromyalgia.

Objectives: This article aims to verify the agreement between the standard method to determine the heart rate achieved in the ventilatory threshold 1 in the cardiopulmonary exercise testing (VT1) and the mathematical models with exercise intensities suggested by the literature in order to check the most precise for fibromyalgia (FM) patients. Methods: Seventeen women with FM were included in this study. The VT1 was used as the standard method to compare four mathematical models applied in the literature to calculate the exercise intensity in FM patients: the well-known “220 − age” at 76%, Tanaka predictive equation “208 − 0.7 × age” at 76%, the FM model HRMax “209 – 0.85 × age” at 76%, and Karvonen Formula at 60%. Bland–Altman analysis and correlation analyses were used to explore agreement and correlation between the standard method and the mathematical models. Results: Significant correlations between the heart rate at the VT1 and the four mathematical estimation models were observed. However, the Bland-Altman analysis only showed agreement between VT1 and “220 − age” (bias = −114.83 + 0.868 × x; 95% LOA = −114.83 + 0.868 × x + 1.96 × 7.46 to −114.83 + 0.868 × x − 1.96 × 7.46, where x is the average between the heart rate obtained in the CPET at VT1 and “220 − age”, in this case 129.15; p = 0.519) and “209 − 0.85 × age”(bias = −129.58 + 1.024 × x; 95% LOA = −129.58 + 1.024 × x + 1.96 × 6.619 to −129.58 + 1.024 × x − 1.96 × 6.619, where x is the average between the heart rate obtained in the CPET at VT1 and “209 − 0.85 × age”, in this case 127.30; p = 0.403). Conclusions: The well-known predictive equation “220 − age” and the FM model HRMax (“209 − 0.85 × age”) showed agreement with the standard method (VT1), revealing that it is a precise model to calculate the exercise intensity in sedentary FM patients. However, proportional bias has been detected in all the mathematical models, with a higher heart rate obtained in CPET than obtained in the mathematical model. The chronotropic incompetence observed in people with FM (inability to increase heart rate with increasing exercise intensities) could explain why methods that tend to underestimate the HRmax in the general population fit better in this population.

Strength is essential for carrying out the usual activities of daily life. As there is a loss of strength in elderly, many treatments are based on delaying the loss of strength or maintaining it. Isokinetic dynamometry is the gold standard for assessing strength. It is essential that studies are conducted to allow us to identify the reliability of isokinetic strength assessments in older people. This study aimed to test the absolute and relative intra-session reliability of peak torque and work of a concentric knee extension-flexion performed at 60°/s in elderly. Fifty-two elderly subjects performed three repetitions of bilateral concentric knee extension-flexion at 60°/s using an isokinetic dynamometer. The relative and absolute reliability were calculated between the second and third repetition. The intra-class correlation coefficient values were between 0.94 and 0.98 for peak torque and work in all measures, which is considered “excellent”, except for left leg flexors in women, with values between 0.85 and 0.88, which is considered “good”. The standard error of measurement (SEM) percentage oscillated from 3.9% to 10.5%, with a smallest real difference (SRD) percentage of 10.9% to 29.2% for peak torque. The relative reliability of peak torque and work were excellent for all measures except flexors in women, evidencing the utility of isokinetic dynamometry for monitoring lower limb maximal muscle strength and work of concentric knee extension-flexion at 60°/s/s in the elderly. In addition, an SRD > 19.9% in peak torque and an SRD > 23.1% in work is considered a true change.

Prevention and treatment of osteoporosis are an issue of great concern in public health so that the increase/maintenance of whole-body bone mineral density (BMD) is clinically relevant and could reduce the financial burden. Whole-body vibration (WBV) has been recently proposed as a potential alternative to bone stimulation, which combined with therapies, could provide a new treatment for osteoporosis prevention. In this sense, moderate cyclic hypoxia protocols may help to restrain osteoclastic activity and/or stimulate osteoblastic activity, enhance the effects of whole-body vibration alone. So, the present study investigated the effects of cyclic hypoxic exposure combined with WBV training on BMD of the elderly. Healthy elderly persons (n = 30) were randomly assigned to a (1) Hypoxia-Whole Body Vibration group (HWBV; n = 10), (2) Normoxic-Whole Body Vibration group (NWBV; n = 10) or (3) Control group (CON; n = 10). During 18 weeks, HWBV performed WBV treatment under normobaric hypoxic conditions (16.1% FiO2). A vibration session included 4 bouts of 30 s (12.6 Hz–4 mm) with 1 min rest between bouts. NWBV performed the same vibration treatment as HWBV but under normoxic conditions. Whole-body and proximal femur BMD (g⋅cm−2) were measured using dual-energy X-ray absorptiometry. Two-way ANOVA indicated a borderline significant (p = 0.07) time x group interaction for total BMD; post hoc analysis revealed a slight but significant (p = 0.021) increase of BMD after treatment in the HWBV group. In conclusion, 18-week WBV training with hypoxic stimuli has shown positive effects for the participants of the current study. As changes did not differ significantly between groups, future large-scale studies will be necessary to confirm these findings.

Background and objectives: Peritoneal dialysis (PD) patients are expected to present lower levels of physical activity, unhealthy changes at the body composition level, and low levels of strength. Firstly, this study aimed to report the sex differences in physical activity, body composition and muscle strength and the relations among these variables. Secondly, we analyze the relationship between physical activity and biochemical parameters. Materials and Methods: Thirty-four patients (13 women and 21 men) participated in this study. Body composition was assessed by bioimpedance and dual-energy X-ray absorptiometry (DXA), and maximum isokinetic unilateral strength, analytical parameters and physical activity levels were evaluated. Results: The men showed higher values for weight, height, lean body mass, bone mineral content, bone mineral density (BMD) and total body water, while women showed higher values for the percentage of fat mass and hydration of lean body mass (p < 0.05). No differences between the sexes were found in different levels of physical activity; however, males registered significantly higher values for isokinetic strength variables except for knee extensor strength. BMD was positively related to sedentary activity and negatively related to moderate and vigorous activity (r = 0.383 and r = −0.404, respectively). Light physical activity was negatively correlated with albumin (r = −0.393) and total protein (r = −0.410) levels, while moderate/vigorous activity was positively correlated with urea distribution volume (r = 0.446) and creatinine clearance (r = 0.359) and negatively correlated with the triglyceride level (r = −0.455). Conclusions: PD patients with higher levels of physical activity present better results in terms of body composition and biochemical parameters. Additional studies should be conducted to clarify the relation between physical activity level and BMD.

Background: Childhood obesity is one of the most critical global health challenges. Poor knee extensor strength is associated with disability and difficulties with physical function in obese patients. The objective of this study was to evaluate the test-retest reliability of peak torque and total work in concentric flexion and concentric extension in obese children. Methods: 25 obese children aged between 6 and 11 years performed 3F maximal unilateral isokinetic repetitions with the knee extensors/flexors performing concentric actions at 60°/s. Peak torque (Nm), total work (J), and the ratio antagonist/agonist were recorded and normalized by total and lean mass. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest real difference (SRD) were computed. Results: Reliability was excellent for almost all variables. The highest ICC values were observed when work or peak torque were not divided by any other variable. However, SEM (%) and SRD (%) were lower when peak torque and work were divided by the total mass or lean mass. The antagonist/agonist ratio showed an ICC value of 0.873. Conclusion: Peak torque, total work, and the antagonist/agonist ratio are reliable in obese children.

Background: Simple field tests such as the Timed Up and Go test (TUG) and 30 s Chair Stand test are commonly used to evaluate physical function in the elderly, providing crude outcome measures. Using an automatic chronometer, it is possible to obtain additional kinematic parameters that may lead to obtaining extra information and drawing further conclusions. However, there is a lack of studies that evaluate the test-retest reliability of these parameters, which may help to judge and interpret changes caused by an intervention or differences between populations. Thus, the aim of this study was to evaluate the test-retest reliability of the Timed Up and Go test (TUG) and 30 s Chair Stand test in healthy older adults. Methods: A total of 99 healthy older adults participated in this cross-sectional study. The TUG and the 30 s Chair Stand test were performed five times and twice, respectively, using an automatic chronometer. The sit-to-stand-to-sit cycle from the 30 s Chair Stand test was divided into two phases. Results: Overall, reliability for the 30 s Chair Stand test was good for almost each variable (intraclass correlation coefficient (ICC) >0.70). Furthermore, the use of an automatic chronometer improved the reliability for the TUG (ICC >0.86 for a manual chronometer and ICC >0.88 for an automatic chronometer). Conclusions: The TUG and the 30 s Chair Stand test are reliable in older adults. The use of an automatic chronometer in the TUG is strongly recommended as it increased the reliability of the test. This device enables researchers to obtain relevant and reliable data from the 30 s Chair Stand test, such as the duration of the sit-to-stand-to-sit cycles and phases.

Considerando que alguns estudos sugerem que desequilíbrios musculares dos rotadores dos ombros estão relacionados com dores e lesões na articulação e que não existem dados normativos para jovens nadadores, o objetivo deste estudo foi: i) caracterizar o equilíbrio e fadiga musculares bem como o perfil de força isocinética dos rotadores dos ombros em nadadores jovens; ii) comparar os resultados entre nadadores com jovens não praticantes; iii) contribuir para a criação de dados normativos de rácios unilaterais dos rotadores do ombro. Foi avaliada a força isocinética com ações concên­tricas dos rotadores e respectivos rácios unilaterais (quociente entre torque dos rotadores externos e internos) em 60 nadadores (idade: 14,55 ± 0,5 anos; massa corporal: 61,16 ± 7,08 kg) e 60 não praticantes (idade: 14,62 ± 0,49 anos; massa corporal: 60,22 ± 10,01 kg). Com um dinamômetro isocinético (Biodex System 3), avaliou-se na posição de sentado (90º de abdução e de flexão do cotovelo), às velocidades angulares de 60º.s-1 e 180º.s-1. Os resultados dos índices de fadiga não revelaram diferenças entre grupos. Os nadadores apresentaram rácios unilaterais entre os 73,39±17,26% no membro dominante (MD) e 77,89±15,23% no membro não dominante (MND), para avaliações efetuadas a 60º.s-1; a 180º.s-1, obtivemos resultados entre 74,77±13,99% para MD e 70,11±14,57% para MND. Os nadadores apresentaram um maior desequilíbrio muscular, sendo a capacidade de produção de força dos rotadores internos (significativamente superior nos nadadores) o que os distingue do grupo de não praticantes.

Como é do conhecimento comum, tal como outros seres vivos, também as mulheres passam por diversas alterações anatómicas, fisiológicas e psicológicas ao longo do seu desenvolvimento (Bonganha, Santos, Rocha, Chacon-Mikahil & Madruga, 2008). Há medida que a idade cronológica avança, a mudança corporal vai-se evidenciando, sobretudo devido à diminuição da massa livre de gordura, ao aumento da massa gorda, à diminuição da densidade mineral óssea (Callejon, Franceschini, Montes & Toloi, 2005) e à redução de algumas aptidões funcionais. Alguns autores referem que o envelhecimento acarreta uma perda de autonomia e de aptidão física, ocorrendo, assim, uma perda na capacidade funcional (Valle, 2007 citado por Pendergast, Fisher & Calkins, 1993). Por seu lado, Matuso, Matsudo e Neto (2000) acrescentam ainda que a perda da massa óssea e muscular, para além do envelhecimento, pode dever-se à inatividade física, pelo que o exercício físico é considerado benéfico na promoção e na manutenção da saúde. Objetivo: Estudar a relação entre a idade pós-menopausa, a aptidão física funcional e a qualidade de vida em mulheres praticantes de hidroginástica e ginásio com máquinas hidráulicas. Pretendemos ainda perceber se existem diferenças nas variáveis referidas em função do tipo de exercício praticado.

Passive and active hypoxia could be used as a tool during a transitional phase to maintain the effects of warm-up and optimize athletic performance. Our purpose was to evaluate and compare the effects of four different re-warm-up strategies, i.e. rest in normoxia (RN) at FiO2 = 20.9%, rest in hypoxia (RH) at FiO2 = 15%, active (5 minutes dryland-based exercise circuit) in normoxia (AN) and active in hypoxia (AH), during the transitional phase, on subsequent 100 m maximal swimming performance. Thirteen competitive swimmers (n = 7 males; n = 6 females; age: 15.1±2.1 years; height: 164.7±8.8 cm; weight: 58.1±9.7 kg; 100 m season's best time 72.0±11.8 s) completed a 20-minute standardized in-water warm-up followed by a 30-minute randomized transitional phase and 100 m freestyle time trial. Compared to AH (73.4±6.2 s), 100 m swim time trials were significantly (p = 0.002; η2 = 0.766) slower in RN (75.7±6.7 s; p = 0.01), AN (75.2±6.7 s; p = 0.038) and RH (75.0±6.4 s; p = 0.009). Moreover, compared to AH (36.3±0.4ºC), tympanic temperature was significantly lower (p<0.001; η² = 0.828) at the end of the transitional phase in passive conditions (RN: 35.9±0.6; p = 0.032; RH: 36.0±0.4; p = 0.05). In addition, countermovement jump height at the end of the transitional phase was significantly higher in active than in passive conditions (p = 0.001; η² = 0.728). A dryland-based circuit under hypoxia could be useful to swimmers, once it has attenuated the decline in tympanic temperature during a 30-minute transitional phase after warm-up, improving 100 m swimming performance in young amateur swimmers. [ABSTRACT FROM AUTHOR]

Context. Hypoxic exposure has been associated with a metabolic perturbation that might affect basal energy expenditure (BEE). Objective. The aim was to examine the metabolic response during hypoxic exposure of men and women adults. Design. Crossover design with two experimental trials: normoxic and hypoxic exposure. Subjects and methods. Twenty-nine healthy subjects (14 women) participated in (1) control study (NOR), subjected first to normoxic exposure (FiO2 = 20.9%) and (2) after that, to passive normobaric hypoxic exposure study (HYP) (FiO2 = 15%). Respiratory gases and blood glucose samples were recorded every hour in hypoxia chamber (8 points in total), and blood lactate samples were collected at baseline, at 4 and 7 h to exposure. Results. In females, basal energy expenditure was significantly higher at 2h, 4h, 6h and 7h compared with NOR group. Also, BEE was lower in females compared with men from 2h of hypoxia exposure. In the HYP group the blood lactate concentration increased significantly at 4h and 7 h relative to NOR group (P < 0.05) in males. Conclusion. An exposure to moderate normobaric hypoxia did not alter metabolic response, but induced a different response on substrate oxidation in adults men and women. [ABSTRACT FROM AUTHOR]

Considering that some studies suggest that shoulder rotators muscle imbal­ances are related to joint pain and injury, and that there are no normative data for young swimmers, the aim of this study was: i) to describe the muscle balance, fatigue and isokinetic strength profile of the shoulder rotators in young swimmers; ii) to compare the results between swimmers and a group of young non-practitioners; iii) to contribute to the acquisition of normative data of unilateral ratios of shoulder rotators. We evaluated the shoulder rotators concentric strength and unilateral ratios (ratio between torque of external and internal rotators) of 60 swimmers (age: 14.55 ± 0.5 years old; body mass: 61.16 ± 7.08 kg) and 60 non-practitioners (age: 14.62 ± 0.49 years old; body mass: 60.22 ± 10.01 kg). The evaluation was performed in the sitting position (90° abduction and elbow flexion) at 60º.s-1 and 180º.s-1 angular speeds using an isokinetic dynamometer (Biodex System 3). The results of the fatigue ratios revealed no differences between the groups. Swimmers showed unilateral ratios of 73.39 ± 17.26% in the dominant limb (DL) and 77.89 ± 15,23% in the non-dominant limb (NDL) for assessments at 60º.s-1. At 180º.s-1, ratios were 74.77± 13.99% for DL and 70.11 ± 14.57% for NDL. Swimmers presented greater muscle imbalance, and differed from non-practitioners in the ability to produce power with the internal rotators, which was significantly higher in the former group.

(1) Background: Fibromyalgia (FM) is a syndrome marked by chronic widespread pain, fatigue, sleep issues, and other symptoms. Interventions like physical exercise can potentially enhance physical function in individuals with FM. This study aimed to assess physical function, perceived physical fitness, balance confidence, and fear of falling in women with FM based on their levels of pain, depression, fatigue, and sleep problems. (2) Methods: Participants underwent a series of tests and questionnaires to evaluate physical and perceptual aspects. These included the Time Up and Go, Four Step Square Test, 6-Minute Walking Test, Maximum Handgrip Strength, Back Scratch, International Fitness Scale, Activities-Specific Balance Confidence Scale, and Fall Efficacy Scale-International. Participants were categorised by the severity of their pain, depression, fatigue, and sleep problems (mild, moderate, severe). A Kruskal-Wallis test assessed intergroup differences, while Spearman's rho evaluated correlations between the study variables and symptom levels. (3) Results: Perceived physical condition varied significantly with symptom severity. Symptoms and sleep problems were notably linked to fear of falling, though no significant differences emerged in the physical tests. (4) Conclusions: In women with fibromyalgia, symptom severity was primarily related to perceptual and subjective aspects of physical condition and fall safety.

Background: People with fibromyalgia (FM) experience a range of symptoms (chronic widespread pain, fatigue, mood disorder, sleep problems, muscle stiffness) that promote deterioration of physical condition and function. With impaired physical function, fear of falling and risk of falling increases. This study evaluated physical function, self-perceived physical fitness, falls, quality of life, and the degree of disability caused by FM according to fear and risk of falling in Spanish adult women with FM. Methods: Cross-sectional study involving 84 Spanish adult women with FM. Participants completed tests to assess their physical function and completed questionnaires to evaluate self-perceived physical fitness, falls, the disabling effect of FM, quality of life, fear of falling, and risk of falling. Nonparametric statistical tests were used to analyze possible intergroup differences (Mann-Whitney U test) and correlations between variables (Spearman's Rho). Results: Women with a fear of falling and at risk of falling presented a worse performance in physical tests, worse self-perceived physical fitness, greater number of falls, lower quality of life, and greater degree of disability due to FM. Weak and moderate correlations were found for fear of falling and fall risk and the variables of interest. However, no intergroup differences were found, nor significant correlations in all variables. Conclusions: Women with FM who present fear of falling and risk of falling tend to have worse performance in physical function tests, in addition to worse self-perceived physical fitness, higher number of falls, poorer quality of life, and greater disabling effect of FM.

Depression is a mental disorder that causes great discomfort, is associated with unhealthy lifestyle habits, and affects the quality of life. People with pain show high depressive symptoms and a prevalence of physical inactivity. This study aimed to analyse the associations between depression (self-reported depression, depression status, depressive symptoms, and depression types) and physical activity frequency (PAF) in leisure time in middle-aged and older people with different pain levels (low, medium, and severe) living in Spain. A cross-sectional study based on the European Health Survey data from Spain (2014-2020) was carried out, with a final sample of 13,686 people with pain. Associations between depression-related variables and PAF were studied at the three levels of pain, comparing the prevalence of depression as a function of PAF. Regression models were performed to assess adjusted risk factors for depression (self-reported depression and depression status). It was found that PAF was related to depression at all three pain levels. Inactive people at each pain level had higher depression prevalence (self-reported depression, depression status, depression symptoms, and depressive types). Physical inactivity emerged as a risk factor for depression, both for self-reported depression and for depression status. Thus, increased PAF could help prevent or reduce depression and depressive symptoms in people with pain.

Background and Objectives: Fibromyalgia, a chronic condition, manifests as widespread musculoskeletal pain, fatigue, sleep disturbances, autonomic and cognitive dysfunction, hypersensitivity to stimuli, and various somatic and psychiatric symptoms. This study, a controlled and randomized experiment, aimed to evaluate and compare the immediate effects of different treatments on fibromyalgia patients., Materials and Methods: The treatments included the EXOPULSE Mollii suit, a combination of the EXOPULSE Mollii suit with a virtual reality (VR) protocol, and a physical exercise regimen. A cohort of 89 female fibromyalgia patients was randomly assigned to one of four groups: Control ( n = 20), Suit only ( n = 22), Suit combined with VR ( n = 21), and Exercise ( n = 26)., Results: This study found notable differences across the groups in several key parameters. In the Control group, significant changes were observed in Forced Expiratory Volume (FEV 1/FEV 6), the Numeric Rating Scale (NRS) for pain, Pressure Pain Threshold (PPT) at the epicondyle, cortical arousal levels, the 10 m up-and-go test, and in all measured variables related to temperature and muscle oxygenation. For the group using the suit alone, there were significant differences noted in the NRS, the chair stand test, palm temperature, and all muscle oxygenation parameters. The Suit + VR group showed significant changes in the NRS, PPT at the knee, handgrip strength test, the 10 m up-and-go test, one-leg balance test with the right leg, muscle oxygen saturation (SmO 2 ), deoxygenated hemoglobin (HHb), and oxygenated hemoglobin (O 2 Hb). Finally, the Exercise group exhibited significant differences in FEV 1/FEV 6, chest perimeter difference, NRS, PPT at both the epicondyle and knee, cortical arousal, the chair stand test, the 10-m up-and-go test, and in SmO 2 , HHb, and O 2 Hb levels., Conclusions: combining neuromodulation with VR and targeted exercise regimens can effectively alleviate fibromyalgia symptoms, offering promising avenues for non-pharmacological management.

Background: Rheumatoid arthritis (RA) is characterized by low physical fitness, pain, and depression. The present study aimed to examine the effects of a supervised aquatic exercise program on physical fitness, depression, and pain in women with RA and determine whether decreases in pain mediate depression., Methods: Forty-three women with RA, divided into an experimental group (EG; n = 21) and a control group (CG; n = 23), participated in a 12-week exercise program. Treatment effects were calculated via standardized difference or effect size (ES) using ANCOVA adjusted for baseline values (ES, 95% confidence interval (CI)). A simple panel of mediation was executed to determine whether changes in pain mediated improvements in depression after controlling for confounding variables, such as age, physical activity, and body mass index (BMI)., Results: The aquatic exercise program had trivial and small effects on physical fitness, large effects on pain, and moderate effects on depression. The mediation model confirmed the indirect effect of pain on the decrease of depression in the participants of the aquatic exercise program., Conclusions: Participants with RA in the aquatic exercise program experienced improvements in physical fitness, depression, and joint pain. Moreover, the improvements in joint pain mediated improvements in depression.

Background: Malnutrition is an underestimated geriatric problem, with a high prevalence in institutionalized older adults. The identification of risk factors for malnutrition in elderly individuals must be a priority for governmental organizations worldwide., Methods: A total of 98 institutionalized seniors were enrolled in a cross-sectional study. For the assessment of risk factors, sociodemographic characteristics and health-related information were collected. The Mini-Nutritional Assessment Short-Form test was used to assess malnutrition in the sample population., Results: A significantly greater proportion of women than men were malnourished or at risk of malnutrition. In addition, the comparative analysis revealed that comorbidity, arthritis, balance impairment, dementia and fall episodes with serious injuries were significantly more frequent in the older adults categorized as malnourished or at risk of malnutrition than in those categorized as well-nourished., Conclusions: Multivariable regression analysis revealed that being female, having a poor cognitive status and experiencing falls with injuries are the main independent factors influencing nutritional status in institutionalized older adults living in a rural area of Portugal., (© 2023. The Author(s).)

Previous studies have reported that people with fibromyalgia (FM) could suffer from mitochondrial dysfunction. However, the consumption of muscle oxygen during physical exercise has been poorly studied. Therefore, this study aimed to explore the response of muscle oxygen during a fatigue protocol in people with FM and healthy controls (HC). In addition, the peak torque and the total work were assessed. A total of 31 participants (eighteen were people with fibromyalgia and thirteen were healthy controls) were enrolled in this cross-sectional study. All the participants underwent a fatigue protocol consisting of 20 repetitions at 180°·s−1 of quadriceps flexions and extensions using a Biodex System 3. The muscle oxygen saturation (SmO2), total hemoglobin (THb), deoxygenated hemoglobin (HHb) and oxygenated hemoglobin (O2Hb) values were measured using a portable near-infrared spectroscopy (NIRS) device. Significant differences between people with FM and healthy controls were found at baseline: SmO2 (FM: 56.03 ± 21.36; HC: 77.41 ± 10.82; p = 0.036), O2Hb (FM: 6.69 ± 2.59; HC: 9.37 ± 1.31; p = 0.030) and HHb (FM: 5.20 ± 2.51; HC: 2.73 ± 1.32; p = 0.039); during the fatigue protocol: SmO2 (FM: 48.54 ± 19.96; HC: 58.87 ± 19.72; p = 0.038), O2Hb (FM: 5.70 ± 2.34; HC: 7.06 ± 2.09; p = 0.027) and HHb (FM: 5.69 ± 2.65; HC: 4.81 ± 2.39; p = 0.048); and in the recovery at three min and six min for SmO2, O2Hb and HHb (p < 0.005). Furthermore, healthy control values of SmO2, O2Hb and HHb have been significantly altered by the fatigue protocol (p < 0.005). In contrast, people with FM did not show any significant alteration in these values. Moreover, significant differences were found in the peak torque at extension (FM: 62.48 ± 24.45; HC: 88.31 ± 23.51; p = 0.033) and flexion (FM: 24.16 ± 11.58; HC: 42.05 ± 9.85; p = 0.010), and the total work performed at leg extension (FM: 1039.78 ± 434.51; HC: 1535.61 ± 474.22; p = 0.007) and flexion (FM: 423.79 ± 239.89; HC: 797.16 ± 194.37; p = 0.005).

Background: Whole-body vibration (WBV) is a safe and effective exercise system that affects muscle oxygen through several physiological processes, although its effects on different protocols are still unclear. Unfortunately, the COVID-19 pandemic has generated various health problems and controversy or confusion on its possible adverse consequences and impact on performance when wearing a mask during the practice of physical exercise., Aim: To analyze the acute effects of WBV exercise in muscle oxygen variables during different intervention phases with or without a surgical mask and compare protocols that differ in the order of vibration frequencies., Methods: Forty-seven healthy students participated in WBV training. They were randomly assigned to use or not use a mask between the three intervention groups: group A (8, 12.6, and 20 Hz), group B (12.6, 20, and 8 Hz), and group C (20, 8, and 12.6 Hz). Besides the 3 WBV moments, the intervention had a baseline moment, two rest time and a recovery moment. During the whole intervention, the heart rate (HR), muscle oxygen saturation (SatO 2 ), oxyhemoglobin (O 2 Hb), and deoxyhemoglobin (HHb) were registered., Results: There were no significant differences between the mask use and not use groups. Significant differences were found between the variables during the seven intervention moments and between intervention groups (A, B, or C)., Conclusion: HR, SatO 2 , and Hb were not influenced by the use of a surgical mask, but they reacted differently through the different moments and were sensitive to vibration frequencies and respective order., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Mª. Dolores Apolo-Arenas et al.)

The aim of this study was to investigate the relationship between phase angle (PhA) and physical function in institutionalized, independent older adults. Physical function was evaluated using the Senior Fitness Test Battery. PhA was measured by electrical bioimpedance at 50 khz, and body composition parameters were also registered. Results showed that PhA significantly correlated with all physical fitness tests, except for arm curls. Regarding the results of the multivariate analysis, three models were created: Model 1, formed by a dependent variable "PhA" and two predictor variables "8 ft up-and-go" and "6 min walk"; Model 2, formed by a dependent variable "PhA" and three predictor variables "8 ft up-and-go", "6 min walk" and "30-s chair stand"; and Model 3, formed by a dependent variable "PhA" and four predictor variables "8 ft up-and-go", "6 min walk", "30-s chair stand" and "arm curl". Results showed that predictor variables had a significant influence on the PhA for all three models (Model 1: p = 0.001, 12.5%; Model 2: p = 0.002, 12.9%; and Model 3: p = 0.005, 13.1%). For women, Model 1 showed a significant influence of predictor variables on the PhA ( p = 0.030, 9.3%). The results for men in Models 1, 2 and 3 showed significant influences on the PhA ( p = 0.002, 31.2%; p = 0.006, 31.6%; and p = 0.016, 31.6%; respectively). This study confirmed previous studies regarding to the relationship between PhA and physical function. It also indicates that PhA could be an excellent predictor of physical function.

Previous studies showed that people with Fibromyalgia (FM) suffer from dysautonomia. Dysautonomia consists of persistent autonomic nervous system hyperactivity at rest and hyporeactivity during stressful situations. There is evidence that parameters reflecting the complex interplay between the autonomic nervous system and the cardiovascular system during exercise can provide significant prognostic information. Therefore, this study aimed to investigate the differences between people with FM and healthy controls on heart rate variability (HRV) and salivary parameters (such as flow, protein concentration, enzymatic activities of amylase, catalase and glutathione peroxidase) in two moments: (1) at baseline, and (2) after an exercise fatigue protocol. A total of 37 participants, twenty-one were people with fibromyalgia and sixteen were healthy controls, participated in this cross-sectional study. HRV and salivary samples were collected before and after an exercise fatigue protocol. The fatigue protocol consisted of 20 repetitions of knee extensions and flexions of the dominant leg at 180 °·s -1 (degrees per second). Significant differences were found in the HRV (stress index, LF and HF variables) and salivary biomarkers (with a higher concentration of salivary amylase in people with FM compared to healthy controls). Exercise acute effects on HRV showed that people with FM did not significantly react to exercise. However, significant differences between baseline and post-exercise on HRV significantly induce alteration on the HRV of healthy controls. Catalase significantly increased after exercise in healthy controls whereas salivary flow significantly increased in women with FM after an exercise fatigue protocol. Our study suggests that a higher α-amylase activity and an impaired HRV can be used as possible biomarkers of fibromyalgia, associated with a reduction in salivary flow without changes in HRV and catalase activity after a fatigue exercise protocol. More studies should be carried out in the future to evaluate this hypothesis, in order to find diagnostic biomarkers in fibromyalgia.

Strength is essential for carrying out the usual activities of daily life. As there is a loss of strength in elderly, many treatments are based on delaying the loss of strength or maintaining it. Isokinetic dynamometry is the gold standard for assessing strength. It is essential that studies are conducted to allow us to identify the reliability of isokinetic strength assessments in older people. This study aimed to test the absolute and relative intra-session reliability of peak torque and work of a concentric knee extension-flexion performed at 60°/s in elderly. Fifty-two elderly subjects performed three repetitions of bilateral concentric knee extension-flexion at 60°/s using an isokinetic dynamometer. The relative and absolute reliability were calculated between the second and third repetition. The intra-class correlation coefficient values were between 0.94 and 0.98 for peak torque and work in all measures, which is considered “excellent”, except for left leg flexors in women, with values between 0.85 and 0.88, which is considered “good”. The standard error of measurement (SEM) percentage oscillated from 3.9% to 10.5%, with a smallest real difference (SRD) percentage of 10.9% to 29.2% for peak torque. The relative reliability of peak torque and work were excellent for all measures except flexors in women, evidencing the utility of isokinetic dynamometry for monitoring lower limb maximal muscle strength and work of concentric knee extension-flexion at 60°/s/s in the elderly. In addition, an SRD > 19.9% in peak torque and an SRD > 23.1% in work is considered a true change.

Objectives: This article aims to verify the agreement between the standard method to determine the heart rate achieved in the ventilatory threshold 1 in the cardiopulmonary exercise testing (VT1) and the mathematical models with exercise intensities suggested by the literature in order to check the most precise for fibromyalgia (FM) patients., Methods: Seventeen women with FM were included in this study. The VT1 was used as the standard method to compare four mathematical models applied in the literature to calculate the exercise intensity in FM patients: the well-known "220 - age" at 76%, Tanaka predictive equation "208 - 0.7 × age" at 76%, the FM model HRMax "209 - 0.85 × age" at 76%, and Karvonen Formula at 60%. Bland-Altman analysis and correlation analyses were used to explore agreement and correlation between the standard method and the mathematical models., Results: Significant correlations between the heart rate at the VT1 and the four mathematical estimation models were observed. However, the Bland-Altman analysis only showed agreement between VT1 and "220 - age" (bias = -114.83 + 0.868 × x ; 95% LOA = -114.83 + 0.868 × x + 1.96 × 7.46 to -114.83 + 0.868 × x - 1.96 × 7.46, where x is the average between the heart rate obtained in the CPET at VT1 and "220 - age", in this case 129.15; p = 0.519) and "209 - 0.85 × age"(bias = -129.58 + 1.024 × x ; 95% LOA = -129.58 + 1.024 × x + 1.96 × 6.619 to -129.58 + 1.024 × x - 1.96 × 6.619, where x is the average between the heart rate obtained in the CPET at VT1 and "209 - 0.85 × age", in this case 127.30; p = 0.403)., Conclusions: The well-known predictive equation "220 - age" and the FM model HRMax ("209 - 0.85 × age") showed agreement with the standard method (VT1), revealing that it is a precise model to calculate the exercise intensity in sedentary FM patients. However, proportional bias has been detected in all the mathematical models, with a higher heart rate obtained in CPET than obtained in the mathematical model. The chronotropic incompetence observed in people with FM (inability to increase heart rate with increasing exercise intensities) could explain why methods that tend to underestimate the HRmax in the general population fit better in this population.