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Knowledge of how the different types of sedentary behaviors (SB) are associated with functional limitations can guide professionals who work with older adults on better recommendations about the amount of daily time that should be encouraged in each type of SB. The objective was to estimate the associations between two SB typologies (SB television [TV] and SB computer/internet) and the presence of handgrip strength, lower limb strength, gait speed, and balance limitations in Brazilian community-dwelling older adults. This is a cross-sectional study with 1,298 community-dwelling older adults (≥60 years). SB was assessed by self-reporting daily time spent watching TV or using computer/internet (categorized into <2, 3–4, and ≥5 hr/day). Outcomes were handgrip strength, lower limb strength, gait speed, and balance limitations considering referenced cutoff points. Older adults in SB TV ≥5 hr/day had 1.75 (95% confidence interval [CI] [1.07, 2.86]) and 1.88 (95% CI [1.02, 3.46]) times more chances of handgrip strength and gait speed limitations, respectively. On the other hand, those who spent 3–4 and ≥5 hr/day in SB computer/internet had 0.45 (95% CI [0.20, 0.99]) and 0.37 (95% CI [0.15, 0.93]) had less chances of lower limb strength and balance limitations, respectively. In conclusion, functional limitations would be associated differently depending on the type of SB in the older adults sampled. [ABSTRACT FROM AUTHOR]

Background: Sarcopenic obesity (SO) is a clinical disorder characterized by increased adiposity and decreased muscle mass and function, commonly observed in older adults. However, most of the studies that investigated SO prevalence rates were not based on current standardized diagnostic methods. Thus, this study aims to estimate the prevalence rates of SO and their level of agreement using different instruments proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) Consensus, in a sample of hospitalized older adults with severe obesity. Methods: A cross-sectional study with 90 older adults (≥ 60 years) with severe obesity (body mass index ≥ 35 kg/m/²) seeking an in-hospital multidisciplinary body weight reduction program. Skeletal muscle function was assessed using the five-repetition Sit-Stand test (5-SSt) and Handgrip Strength (HGS). Body composition was evaluated by high percentages of fat mass (FM), low appendicular lean mass (ALM/W), and skeletal muscle mass (SMM/W), adjusted to body weight. The stage of SO was assessed on the presence of at least one comorbidity and specific cut-offs were adopted for each step. All analyses were performed according to gender and age range. Results: The prevalence rates of SO in the total sample were 23.3%, 25.5%, 31.1%, and 40.0% considering altered values of 5-SSt+FM+ALM/W, HGS+FM+ALM/W, 5-SSt+FMSSM/W, and HGS+FM+SSM/W, respectively. Higher prevalence rates were observed among female and old elderly subgroups, regardless of the diagnostic combination. There were weak agreements between the muscle function tests (5-SSt versus HGS) using both muscle mass indexes in the total sample and all subgroups. Moderate agreements were observed between muscle mass indexes (SMM/W versus ALM/W) in the total sample, male and younger older adults (using 5-SSt), and strong agreements for men and younger older adults (using HGS). Conclusion: The discrepancies observed between the prevalence rates and their levels of agreement reinforce the need for new studies in similar populations aiming for better standardization of SO assessment. [ABSTRACT FROM AUTHOR]

Background: Achondroplasia is a rare genetic disease, yet the most common form of dwarfism, characterized by limb shortening and disproportionate short stature along with musculoskeletal changes, such as postural deviations. Although postural changes in the spine in children with achondroplasia have been well investigated, little is known about the association of achondroplasia with spinal movements/mobility. Methods: This preliminary study aims to explore the association of achondroplasia with spinal mobility in children with achondroplasia compared to age- and sex-matched healthy individuals. Spinal posture and mobility were assessed using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Between-group differences were determined using a two-way analysis of variance. Results: Children with achondroplasia had smaller thoracic lateral flexion [difference between groups (Δ) = 20.4°, 95% CI 0.1°–40.6°, p = 0.04], lumbar flexion (Δ = 17.4°, 95% CI 5.5°–29.4°, p = 0.006), lumbar extension (Δ = 14.2°, 95% CI 5.7°–22.8°, p = 0.002) and lumbar lateral flexion (Δ = 19.6°, 95% CI 10.7°–28.4°, p < 0.001) than age- and sex-matched healthy individuals, except for thoracic extension (Δ = 16.5°, 95% CI 4.4°–28.7°, p = 0.009) which was greater in children with achondroplasia. No differences were observed in global spinal postures between the two groups. Conclusions: Spinal mobility appears to be more influenced by achondroplasia than global spinal postures in childhood. These results also highlight the importance of considering the musculoskeletal assessment of segmental spinal postures and rehabilitative interventions aimed at promoting spinal flexibility in children with achondroplasia. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of combined training (COMB, a combination of moderate-intensity continuous training-MICT and high-intensity interval training-HIIT) vs. continuous MICT administered during a 3-week in-hospital body weight reduction program (BWRP) on body composition, physical capacities, and substrate oxidation in adolescents with obesity. The 3-week in-hospital BWRP entailed moderate energy restriction, nutritional education, psychological counseling, and two different protocols of physical exercise. Twenty-one male adolescents with obesity (mean age: 16.1 ± 1.5 years; mean body mass index [BMI] 37.8 ± 4.5 kg m−2) participated in this randomized control trial study (n:10 for COMB, n:11 MICT), attending ~ 30 training sessions. The COMB group performed 3 repetitions of 2 min at 95% of peak oxygen uptake (V′O2 peak) (e.g., HIIT ≤ 20%), followed by 30 min at 60% of V′O2 peak (e.g., MICT ≥ 80%). Body composition, V′O2 peak, basal metabolic rate (BMR), energy expenditure, and substrate oxidation rate were measured during the first week (W0) and at the end of three weeks of training (W3). The two training programs were equivalent in caloric expenditure. At W3, body mass (BM) and fat mass (FM) decreased significantly in both groups, although the decrease in BM was significantly greater in the MICT group than in the COMB group (BM: − 5.0 ± 1.2 vs. − 8.4 ± 1.5, P < 0.05; FM: − 4.3 ± 3.0 vs. − 4.2 ± 1.9 kg, P < 0.05). V′O2 peak increased only in the COMB by a mean of 0.28 ± 0.22 L min−1 (P < 0.05). The maximal fat oxidation rate (MFO) increased only in the COMB group by 0.04 ± 0.03 g min−1 (P < 0.05). COMB training represents a viable alternative to MICT for improving anthropometric characteristics, physical capacities, and MFO in adolescents with obesity during a 3-week in-hospital BWRP. [ABSTRACT FROM AUTHOR]

Background: Fat-free mass (FFM) is lower in obese subjects with Prader-Willi syndrome (PWS) than in obese subjects without PWS. FFM prediction equations developed in non-PWS subjects may, thus, not work in PWS subjects. Aim: To test whether the estimation of FFM from bioelectrical impedance analysis (BIA) in PWS subjects requires population-specific equations. Methods: Using dual-energy X-ray absorptiometry, this study measured FFM in 27 PWS and 56 non-PWS obese women and evaluated its association with the impedance index at 50 kHz (ZI50), i.e. the ratio between squared height and whole-body impedance at 50 kHz. Results: At the same level of ZI50, PWS women had a lower FFM than non-PWS women. However, when PWS-specific equations were used, FFM was accurately estimated at the population level. An equation employing a dummy variable coding for PWS status was able to explain 85% of the variance of FFM with a root mean squared error of 3.3 kg in the pooled sample (n = 83). Conclusion: Population-specific equations are needed to estimate FFM from BIA in obese PWS women. [ABSTRACT FROM AUTHOR]

Prader-Willi syndrome (PWS) is a rare neurodevelopmental imprinting disorder caused by the lack of expression of a paternally derived region of chromosome 15. In addition to hypotonia, cognitive impairment, hypothalamic dysfunction with pituitary hormone deficiencies and hyperphagia, patients may show a distinctive facial appearance. Despite it has been known for a long time, it almost always refers to a qualitative evaluation of the face and minor anomalies could have escaped from a mere visual inspection. The study aimed to better characterize the facial phenotype of patients with PWS through a noninvasive quantitative approach [1]. Facial images of 15 Italian adult subjects with genetically confirmed diagnosis of PWS (6 males, mean±SD age 41±5 years; 9 females, 37±8 years), without previous history of craniofacial traumas or surgery, were acquired through stereophotogrammetry. From the 3D coordinates of 50 facial landmarks, 42 linear distances, 30 angles and 9 ratios were calculated and expressed as z-score values by referring to 403 healthy subjects matched for age and sex. Concerning the face as a whole, patients with PWS showed decreased middle and lower facial depths (mean z-score±SD -1.0±0.9 and -1.2±1.0, respectively). With reference to parts of the face, patients showed decreased mandibular ramus length (-1.0±1.0) with smaller gonial angles (-1.9±1.2), short palpebral fissures (-1.2±0.8), lesser inclination of the ears (-1.2±1.1), and decreased height of both upper and lower vermilion (-1.2±1.0 and -1.1±1.3, respectively). The current study provided a quantitative description of facial phenotype of PWS, detailing information about known distinctive features and pointing out facial abnormalities that had never been reported, such as a thin lower vermilion. Albeit slight, it could represent a phenotypic trait of PWS; nevertheless it needs to be confirmed on more patients. Facial morphometric analysis proved once again to be useful in detecting even subtle anomalies not always appreciable on clinical inspection. [ABSTRACT FROM AUTHOR]

Obese adolescents (OB) have an increased O2 cost of exercise, attributable in part to an increased O2 cost of breathing. In a previous work a short (3‐week) program of respiratory muscle endurance training (RMET) slightly reduced in OB the O2 cost of high‐intensity cycling and improved exercise tolerance. We hypothesized that during treadmill walking the effects of RMET would be more pronounced than those observed during cycling. Sixteen OB (age 16.0 ± 0.8 years; body mass [BM] 127.7 ± 14.2 kg; body mass index 40.7 ± 4.0 kg/m2) underwent to 3‐week RMET (n = 8) superimposed to a multidisciplinary BM reduction program, or (CTRL, n = 8) only to the latter. Heart rate (HR) and pulmonary O2 uptake (V˙O2) were measured during incremental exercise and 12‐min constant work rate (CWR) walking at 60% (moderate‐intensity, MOD) and 120% (heavy‐intensity, HEAVY) of the gas exchange threshold (GET). The O2 cost of walking (aerobic energy expenditure per unit of covered distance) was calculated as V˙O2/velocity. BM decreased (~4–5 kg) both in CTRL and in RMET. V˙O2peak and GET were not affected by both interventions; the time to exhaustion increased following RMET. During MOD and HEAVY RMET decreased V˙O2, the O2 cost of walking (MOD: 0.130 ± 0.033 mL/kg/m [before] vs. 0.109 ± 0.027 [after], P = 0.03; HEAVY: 0.196 ± 0.031 [before] vs. 0.180 ± 0.025 [after], P = 0.02), HR and rates of perceived exertion; no significant changes were observed in CTRL. In OB a short RMET program lowered the O2 cost of MOD and HEAVY walking and improved exercise tolerance. RMET could represent a useful adjunct in the control of obesity. In obese adolescents a short RMET program significantly lowered the oxygen cost of moderate‐ and heavy‐intensity walking and improved exercise tolerance. RMET could represent a useful adjunct in the control of obesity. [ABSTRACT FROM AUTHOR]