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Pereira FSM, Thomasini RL, Pereira DS, Silva TJ, Leite CA, Reis LGO, Câmara VADA, da Costa MBR, Bakir JVS, Xavier LS, Pereira LSM, Parentoni AN, Lacerda ACR. Association Between the Length of Leukocyte Telomeres and Functional Performance of Older Adults: Observational Study. Rejuvenation Res 2024; 27:44-50. [PMID: 38279807 DOI: 10.1089/rej.2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2024] Open
Abstract
Despite current literature pointing to a link between shortened telomeres and aging, chronic diseases, and geriatric syndromes, the precise implications of this connection remain unclear. The aim of this exploratory, cross-sectional, observational study was to investigate the association between the relative telomere length (RTL) of peripheral blood leukocyte subtypes (mononuclear cells and granulocytes) and physical performance using the Short Physical Performance Battery (SPPB) in older adults. A cohort of 95 participants was recruited, which included men and women aged over 60 years (70.48 ± 5.5 years). It was found that mononuclear cell RTL was significantly lower than that of granulocytes (p < 0.0001). Moreover, individuals with good SPPB performance exhibited lower mononuclear cell RTL compared with those with moderate or poor performance. However, no significant differences were observed in granulocyte RTL between different SPPB performance groups. The global SPPB score showed an inverse correlation with mononuclear cell RTL, but this correlation was not present with granulocyte RTL. Similarly, the SPPB sit-to-stand domain correlated with mononuclear cell RTL, but no such correlation was found with granulocyte RTL. Our findings challenge conventional expectations, suggesting that shorter mononuclear cell RTL may be associated with favorable functional capacity. The variations in RTL between mononuclear cells and granulocytes highlight their distinct biological roles and turnover rates. A history of immune responses may influence mononuclear cell RTL dynamics, while telomerase activity may protect granulocyte RTL from significant shortening. The unexpected associations observed in mononuclear cell RTL emphasize the complex interplay between immune responses, cellular aging, and functional capacity in older adults.
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Affiliation(s)
- Fabiana Souza Máximo Pereira
- Faculty of Medicine of Diamantina, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
- Post-Graduation Program in Health Sciences (PPGCS), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Ronaldo Luis Thomasini
- Faculty of Medicine of Diamantina, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
- Post-Graduation Program in Health Sciences (PPGCS), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
- Post-Graduation Program in Pharmaceutical Sciences, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
- Multi-Centric Post-Graduation Program in Physiological Sciences (PMPGCF), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Daniele Sirineu Pereira
- Department of Physiotherapy, Sciences Rehabilitation Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thyago José Silva
- Faculty of Medicine of Diamantina, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
- Post-Graduation Program in Health Sciences (PPGCS), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
- Post-Graduation Program in Pharmaceutical Sciences, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Cleyde Amaral Leite
- Multi-Centric Post-Graduation Program in Physiological Sciences (PMPGCF), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | | | | | | | - João Víctor Santos Bakir
- Faculty of Medicine of Diamantina, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Laise Santos Xavier
- University Center of Lavras, Section of Aesthetics and Cosmetics, Lavras, Brazil
| | - Leani Souza Máximo Pereira
- Department of Physiotherapy, Sciences Rehabilitation Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Master Program Science of Health Faculty of Medical Science Minas Gerais, Belo Horizonte, Brazil
| | - Adriana Netto Parentoni
- Department of Physiotherapy, Post-Graduation Program in Rehabilitation and Functional Capacity, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Post-Graduation Program in Health Sciences (PPGCS), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
- Department of Physiotherapy, Post-Graduation Program in Rehabilitation and Functional Capacity, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
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Batista PP, Perracini MR, do Carmo Correia de Lima M, de Amorim JSC, Pereira DS, Pereira LSM. Risk of sarcopenia and mobility of older adults during the COVID-19 pandemic: the longitudinal data from the REMOBILIZE study. Aging Clin Exp Res 2024; 36:80. [PMID: 38546804 PMCID: PMC10978643 DOI: 10.1007/s40520-024-02720-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/01/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND We assessed whether clinical, functional and behavioral factors were associated with the decrease in mobility trajectories reported in older people at risk of sarcopenia (RS) and without risk of sarcopenia (NRS) during COVID-19 pandemic. METHODS We prospectively analyzed mobility trajectories reported in older adults with RS and NRS over 16-month follow-up (Remobilize study). The self-perceived risk of sarcopenia and mobility were assessed using the SARC-F and the Life-Space Assessment (LSA) tools, respectively. Gender, age, comorbidities, pain, functional limitation, physical activity (time spent in walking; min/week), and sitting time (ST; hours/day) were assessed. We used a multilevel model to determine changes in mobility between groups and over time. RESULTS Mobility was lower in RS than in NRS. Older people at RS, who were women, aged 70-79 years and 80 years or older, inactive, and with moderate to severe functional limitation experienced reduced mobility trajectories reported over the pandemic. For older people at NRS, trajectories with reduce mobility reported were experienced by women with comorbidities, for those with insufficient walking time and aged 70-79 years; aged 70-79 years and with ST between 5 and 7 hours/day; for those with insufficient walking time and increased ST; and for those with pain and increased ST. CONCLUSION Mobility trajectories reported in older people at risk of sarcopenia were negatively influenced by insufficient level of physical inactivity and pre-existing moderate to severe functional limitation. Health and social interventions should be target to avoid mobility limitation during and after the COVID-19 pandemic.
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Affiliation(s)
- Patricia Parreira Batista
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6.627. Pampulha, Belo Horizonte, MG, Brazil.
| | - Monica Rodrigues Perracini
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Maria do Carmo Correia de Lima
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Daniele Sirineu Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6.627. Pampulha, Belo Horizonte, MG, Brazil
| | - Leani Souza Máximo Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6.627. Pampulha, Belo Horizonte, MG, Brazil
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, MG, Brazil
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de Oliveira MPB, Pereira DS, da Silva SLA, Alencar MA, Iunes DH, da Silva Alexandre T. Are assessment measures for components of the International Classification of Functioning, Disability and Health reproducible for use on pre-frail and frail older adults? A systematic review. Exp Gerontol 2023; 182:112300. [PMID: 37769825 DOI: 10.1016/j.exger.2023.112300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/06/2022] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To analyze the internal consistency, reliability and measurement error of assessment measures for body structure and function (postural balance, muscle strength, cardiorespiratory function and physical fitness), activity (walking and mobility) and participation (quality of life and social reintegration) outcomes for use on pre-frail and frail older adults. METHODS Searches were performed in six databases (Medline, Embase, ScienceDirect, Web of Science, The Cochrane Library and Lilacs) and reproducibility studies were included. Cronbach's alpha and the classification proposed by Terwee et al. (2007) were used for the interpretation of internal consistency. The intraclass correlation coefficient (ICC) and the Munro classification were used for the determination of reliability. The standard error of measurement (SEM), minimal detectable change (MDC) as well as percentages of error (SEM%) and change (MDC%) were calculated. Methodological quality of the studies was appraised using Boxes 4, 6 and 7 of the COSMIN Risk of Bias checklist. RESULTS Six studies were included in the present systematic review, with a total of 835 (82.4 years; 582 women and 253 men) pre-frail and frail older adults analyzed. Seven measures were identified for the assessment of body structure and function, activity and participation outcomes (Hierarchical Assessment of Balance and Mobility, Self-Assessment of Physical Fitness, Sarcopenia Quality of Life, Reintegration to Normal Living Index, Two-Minute Walking test, Six-Minute Walking test and Ten-Meter Walking test). The following measurement properties were identified: internal consistency = 0.84 (mean Cronbach's alpha); reliability = 0.87 (mean ICC); SEM range = 0.06 to 10.10; MDC range = 0.13 to 28.10; SEM% range = 5.2 % to 9.5 %; and MDC% range = 10.7 % to 28.5 %. CONCLUSION The present systematic review found adequate internal consistency, high reliability and an acceptable measurement error for assessment measures of body structure and function, activity and participation outcomes for use on pre-frail and frail older adults.
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Affiliation(s)
| | - Daniele Sirineu Pereira
- Department of Physical Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Mariana Asmar Alencar
- Department of Physical Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Denise Hollanda Iunes
- Department of Physical Therapy, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil.
| | - Tiago da Silva Alexandre
- Department of Gerontology and Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
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Ferreira ACL, Pereira DS, da Silva SLA, Carvalho GA, Pereira LSM. Validity and reliability of the short form brief pain inventory in older adults with nociceptive, neuropathic and nociplastic pain. Geriatr Nurs 2023; 52:16-23. [PMID: 37192570 DOI: 10.1016/j.gerinurse.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the validity and reliability of the Short Form Brief Pain Inventory (SF-BPI) for community-dwelling Brazilian older adults with chronic neuropathic, nociceptive and nociplastic pain. METHODS Cross-sectional psychometric testing was conducted in a convenience sample, n=114 (66.5 ± 4.9 years). RESULTS The 2-factor structure of the SF-BPI was ratified by confirmatory factor analysis. Convergent validity was found between the SF-BPI and the Present Pain Intensity (PPI). There was good overall internal consistency (Cronbach's α: 0.87). Test-retest reliability was excellent for pain intensity and interference scores of the SF-BPI (ICC: 0.90 and 0.96, respectively), as well as inter-rater reliability for both dimensions (ICC: 0.77). CONCLUSION The findings support the validity and reliability of the SF-BPI for community-dwelling older adults with chronic pain and may contribute to health professionals having a brief multidimensional assessment for more effective therapeutic approaches in this population.
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Affiliation(s)
- Ana Carolina Lopes Ferreira
- Department of Physiotherapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil; Sarah Network of Rehabilitation Hospitals, Avenida Amazonas, 5953, Gameleira, Belo Horizonte, Minas Gerais, CEP 30180-001, Brazil.
| | - Daniele Sirineu Pereira
- Department of Physiotherapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil
| | - Silvia Lanziotti Azevedo da Silva
- Department of Collective Health/School of Medicine, Federal University of Juiz de Fora, Av. Eugênio do nascimento s/n°, Dom Bosco, Juiz de Fora, Minas Gerais, CEP 36038-330, Brazil
| | - Guilherme Almeida Carvalho
- Sarah Network of Rehabilitation Hospitals, Avenida Amazonas, 5953, Gameleira, Belo Horizonte, Minas Gerais, CEP 30180-001, Brazil
| | - Leani Souza Máximo Pereira
- Department of Physiotherapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil
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do Nascimento Cândido G, Batalha APDB, da Silva Chaves GS, Pereira DS, Britto RR. Effects of exercise training parameters on cardiorespiratory fitness of individuals with type 2 diabetes mellitus: a systematic review and meta-analysis. J Diabetes Metab Disord 2023; 22:97-118. [PMID: 37255785 PMCID: PMC10225374 DOI: 10.1007/s40200-023-01205-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/20/2023] [Indexed: 04/07/2023]
Abstract
Purpose To assess the effects of exercise training parameters on cardiorespiratory fitness of individuals with type 2 diabetes mellitus (T2DM). Methods This systematic review was registered on PROSPERO (CRD42020210470). Searches were performed on PubMed, PEDro EMBASE, MEDLINE (Ovid), LILACS, PsycINFO, SCIELO, CINAHL, and Cochrane Library. The primary outcome was cardiorespiratory fitness, defined as maximal oxygen uptake (VO2max) during a maximal or submaximal exercise test. Two independent reviewers extracted data and assessed the risk of bias. Data were pooled using a random effects model and expressed as mean difference (MD) and 95% confidence interval (95%CI). Heterogeneity (I2) was assessed using Cochran's Q test. The risk of bias and quality of evidence was assessed using the Cochrane risk of bias tool and GRADE. Results Twenty-two studies comparing exercise and control groups were included. The risk of bias indicated some concerns in most studies, and the quality of evidence was rated very low. Interventions with moderate (MD = 1.91, 95%CI = .58 to 3.34) and progressive exercise intensity (MD = 2.70, 95%CI = 2.43 to 2.96) and volume (MD = 1.72, 95%CI = .59 to 2.85) showed greater improvements in VO2max. Conclusions Protocols that progressively increased exercise training parameters improved the cardiorespiratory fitness response. Progressive exercise might be more suitable for individuals with T2DM. Our conclusion may be limited due to the very low quality of evidence. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01205-5.
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Affiliation(s)
- Gabriela do Nascimento Cândido
- Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG CEP: 31270-901 Brazil
| | - Ana Paula Delgado Bomtempo Batalha
- Graduate Program in Rehabilitation Sciences and Physical-Functional Performance, Faculty of Physical Therapy, Federal University of Juiz de Fora, Av. Eugênio Do Nascimento S/N, Juiz de Fora, MG CEP: 36038-330 Brazil
| | | | - Daniele Sirineu Pereira
- Department of Physical Therapy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG CEP: 31270-901 Brazil
| | - Raquel Rodrigues Britto
- Department of Physical Therapy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG CEP: 31270-901 Brazil
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Germano ML, Dos Santos Gomes C, de Souza Barbosa JF, Neto NJ, Pereira DS, Ahmed T, Borrero CLC, Guerra RO. Allostatic load and physical performance in older adults: Findings from the International Mobility in Aging Study (IMIAS). Arch Gerontol Geriatr 2023; 109:104961. [PMID: 36806404 DOI: 10.1016/j.archger.2023.104961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/27/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE This study aimed to evaluate the association between Allostatic Load (AL) and physical performance scores in older adults from four cities in North and South America. METHODS In this cross-sectional study, data from 1101 volunteers from three countries (Canada, Brazil, and Colombia) from the International Mobility in Aging Study (IMIAS) were used to evaluate the association between AL index and Short Physical Performance Battery (SPPB) scores. Three multiple linear regression models adjusted by age, Socioeconomic Status (SES), chronic conditions, depression symptoms, and Leganés Cognitive Test (LCT) were developed to estimate the independent association between SPPB and AL. Mediation analysis with 2012 LA data and covariates was performed to access the total, direct, and indirect effects of mediation on SPPB scores from 2016. RESULTS AL and SPPB were inversely associated, with older adults with high allostatic load scoring lower on SPPB (β: -0.234, Std: 0.033, p-value: <0.001). Indirect effects were evidenced between age, SES and chronic conditions with AL and SPPB scores. Chronic conditions also had a total effect on SPPB scores and were also mediated by AL. However, indirect effects of depressive symptoms and LCT on SPPB scores mediated by AL were not observed. CONCLUSIONS Findings from this study support that increased AL index determines worse physical performance states after full adjustments. AL has a mediator role between the number of chronic diseases, depressive symptoms, cognitive status and physical performance. Socioeconomic status also influenced physical scores mediated by the AL index.
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Affiliation(s)
- Matheus Lucena Germano
- Graduate Program in Physiotherapy, Department of Physiotherapy, Federal University of Rio Grande do Norte, Senador Salgado Filho Avenue, Natal, Brazil
| | - Cristiano Dos Santos Gomes
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Senador Salgado Filho Avenue, Natal, Brazil
| | - Juliana Fernandes de Souza Barbosa
- Laboratory of Physical Therapy and Collective Health, Physical Therapy Department, Federal University of Pernambuco, Jornalista Aníbal Fernandes Avenue Recife, Brazil
| | - Nailton José Neto
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, General Cordeiro de Faria Street, Natal, Brazil
| | - Daniele Sirineu Pereira
- School of Physical Education, Physiotherapy and Occupational Therapy, Department of Physiotherapy, Federal University of Minas Gerais. Presidente Carlos Luz, 6627 - Pampulha, Belo Horizonte, MG, Brazil
| | - Tamer Ahmed
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | | | - Ricardo Oliveira Guerra
- Graduate Program in Physiotherapy, Department of Physiotherapy, Federal University of Rio Grande do Norte, Senador Salgado Filho Avenue, Natal, Brazil.
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Seixas MB, Ghisi GLDM, Oh P, Pereira DS, Moreira APB, Jansen AK, Batalha APDB, Cândido GDN, de Almeida JA, Pereira DAG, da Silva LP. Feasibility of Remote Delivering an Exercise and Lifestyle Education Program for Individuals Living with Prediabetes and Diabetes in Brazil. Int J Environ Res Public Health 2022; 19:16697. [PMID: 36554577 PMCID: PMC9779705 DOI: 10.3390/ijerph192416697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to test the feasibility of remote delivering a 12-week exercise and lifestyle education program (ExLE) or a 12-week exercise program (Ex) for individuals with prediabetes and diabetes in terms of acceptability, implementation, practicality, and limited efficacy. The programs were internet- or telephone-based delivered, depending on the participants' internet access and technology literacy. Of the 196 individuals screened, 15 were included in the study (internet-based delivery (n = 13); telephone-based delivery (n = 2)). Twelve participants completed the program they were randomized to, and most reported being satisfied with the study interventions (acceptability). Data collection procedures, weekly follow-up, study website visits, and educational materials were proper (implementation), and the adherence rate to study interventions ranged from 24% to 58% (practicality). Additionally, both programs (ExLE and Ex) seemed to promote beneficial changes in functional capacity (limited efficacy). The internet-based remote delivery of the interventions showed feasibility. Therefore, in future trials, exercise and educational interventions can be internet-based remote delivered to individuals with prediabetes and diabetes with internet access and technology literacy. In addition, some adjustments to eligibility criteria, study websites, more accessible ways of recording exercise sessions and using educational materials, and an initial supervised exercise session are recommended.
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Affiliation(s)
- Mariana Balbi Seixas
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Physical Education, Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Rua José Lourenço Kelmer S/N, Juiz de Fora 36036-900, MG, Brazil
| | - Gabriela Lima de Melo Ghisi
- Cardiovascular Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON M4G 1R7, Canada
| | - Paul Oh
- Cardiovascular Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON M4G 1R7, Canada
| | - Daniele Sirineu Pereira
- Department of Physical Therapy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
- Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | | | - Ann Kristine Jansen
- Department of Nutrition, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Ana Paula Delgado Bomtempo Batalha
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Physical Education, Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Rua José Lourenço Kelmer S/N, Juiz de Fora 36036-900, MG, Brazil
| | - Gabriela do Nascimento Cândido
- Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Josiane Aparecida de Almeida
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Rehabilitation Sciences and Physical-Functional Performance, Faculty of Physical Therapy, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
| | - Danielle Aparecida Gomes Pereira
- Department of Physical Therapy, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
- Graduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Lilian Pinto da Silva
- Cardiovascular Research Unit and Exercise Physiology, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
- Graduate Program in Physical Education, Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Rua José Lourenço Kelmer S/N, Juiz de Fora 36036-900, MG, Brazil
- Graduate Program in Rehabilitation Sciences and Physical-Functional Performance, Faculty of Physical Therapy, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento S/N, Juiz de Fora 36038-330, MG, Brazil
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Barbosa ARC, Nunes DP, Lima DB, Colombo FA, Nunes JB, Santos Orlandi AAD, Rocha GDS, Pereira DS, Corona LP, Brito TRPD. Association of Social Support Network with Telomere Length: A Cross-Sectional Study with Community-Dwelling Older Adults. Rejuvenation Res 2022; 25:253-259. [PMID: 36103374 DOI: 10.1089/rej.2022.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Considering that telomere length can be determined not only by issues related to cell biology but also by aspects related to social factors and environmental exposures, studies on the relationship between social aspects and telomere length can help to better understand the still scarcely known aspects of the human aging process. Thus, this research seeks to verify whether social support networks are associated with telomere length in older adults. This is a cross-sectional study conducted with 448 individuals aged at least 60 years living in the urban area of an inland Brazilian municipality. Relative quantification of telomere length was obtained through real-time qPCR. Social support was assessed through the Medical Outcomes Study Social Support Scale. Descriptive statistics and multiple logistic regression were used in data analysis. The evaluated social support networks for older adults consist in a mean of 16.4 people, and the percentage of older adults who reported up to five members in their network was 27.75%. Shorter telomere length was identified in 25% of the participants, and the older adults who reported having up to five members in their support network were more likely to have a shorter telomere length than those who reported more numerous networks (odds ratio: 1.89, p = 0.011) regardless of gender, age, household arrangement, cognitive decline, and dependence for basic and instrumental activities of daily living, which suggests that measures that stimulate the creation and maintenance of social support networks should be implemented to improve older adults' health.
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Hanna FSA, Pereira DS, Souza GL, Lima AB, Magalhães-Gama F, Tarragô AM, Malheiro A, Costa AG. ASSOCIAÇÃO DO POLIMORFISMO NLRP3 C/T RS10754558 COM O AUMENTO DE BLASTOS NA MÉDULA ÓSSEA EM PACIENTES COM LEUCEMIA LINFOBLÁSTICA AGUDA. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Coelho de Amorim JS, Ornellas G, Lloyd-Sherlock P, Pereira DS, da Silva A, Duim E, Lima CA, Perracini MR. Discontinuation of Health Interventions Among Brazilian Older Adults During the Covid-19 Pandemic: REMOBILIZE Study. Int J Health Serv 2022; 52:330-340. [PMID: 35404167 PMCID: PMC9006088 DOI: 10.1177/00207314221092354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/22/2021] [Accepted: 02/21/2022] [Indexed: 11/25/2022]
Abstract
The objective of this study was to analyze changes in access to health interventions during the pandemic among Brazilian older adults and to investigate the factors associated with social and health inequalities. We conducted an online survey with Brazilian adults aged 60 + years between May and June 2020. A multidimensional questionnaire was used to investigate access to health interventions during the pandemic and associated factors. Of 1482 participants, 56.5% reported health care before the pandemic, and 36.4% discontinued it during the pandemic. The discontinuation rate was 64.4% (95% CI 61.1-67.6). Participants with higher educational level (nine or more years of education: OR 0.34; 95% CI 0.17-0.70) and higher income (eight or more times the minimum wage: OR 0.54; 95% CI 0.36-0.81) were associated with less probability of discontinuation. Presenting multimorbidity (OR: 1.42; 95% CI 1.06-1.90) and polypharmacy (OR: 0.61; 95% CI 0.46-0.81) were associated with discontinuity in health interventions. Our study showed that structural health inequities in access to health care shaped the rates of discontinuation in health care interventions during the COVID-19 pandemic. Strategic actions should be set up to actively monitor socially vulnerable older adults and strengthen community-based services to mitigate the discontinuation of health care interventions.
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Affiliation(s)
| | - Giulianna Ornellas
- Instituto Federal de Educação, Ciência e Tecnologia, Rio de Janeiro (RJ), Brazil
| | | | | | - Alexandre da Silva
- Department of Collective Health, Faculdade de Medicina de Jundiaí, Jundiaí, Brazil
| | - Etienne Duim
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Camila Astolphi Lima
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Monica Rodrigues Perracini
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo, Brazil
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil
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Silva AM, Pereira DS, Torres JL, de Souza MG, de Carvalho DG, Kosour C, Viana JU, da Silva SLA. Association Between Physical Functioning and Time Until a New Hospitalization in Community-Dwelling Older Adults: A Prospective Cohort Study. J Geriatr Phys Ther 2022:00139143-990000000-00001. [PMID: 35420562 DOI: 10.1519/jpt.0000000000000344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE Physical functioning refers to the ability to independently perform activities that require physical ability, and may be an important tool for predicting a higher risk of hospitalization. The objective of this study was to verify whether aspects of physical functioning are independently associated with the risk for new hospitalization in older adults seen in primary health care. METHODS This prospective cohort study consisted of 473 older adults 60 years and older who had not been hospitalized in the prior year. Hospitalization records were obtained with authorization from the hospital admission. Depending on physical functioning, the probability of a new hospital admission within the next 5 years was determined based on survival analysis and the Kaplan-Meier curve. Physical functioning was evaluated using 5 easy-to-administer tests: handgrip strength using a Jamar dynamometer, functional performance using the Short Physical Performance Battery, balance using the step test, mobility using the Timed Up and Go (TUG) test, and gait speed using the 4-m walk test. The association between poor physical functioning and new hospitalization was verified using a Cox regression model, adjusted for sex, age, number of comorbidities, number of medications, and BMI. Models were implemented separately for each physical functioning test. RESULTS In the sample, 32% had been hospitalized at least once in 5 years. The Kaplan-Meier curve showed a decrease in the probability of nonhospitalization within the next 5 years. Cox regression analysis showed an association between hospitalization within the next 5 years and mobility on the TUG test of more than 12.4 seconds in the crude (hazard ratio [HR] = 1.33, 95% CI = 1.10-1.60) and adjusted models (HR = 1.26, 95% CI = 1.02-1.56), and balance using the step test of more than 7.5 seconds in the crude (HR = 1.27, 95% CI = 1.03-1.56) model. CONCLUSIONS Physical functioning tests demonstrated that poor physical performance predicts new hospitalization, and reinforced the importance of their application in physical therapy practice in primary health care settings.
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Affiliation(s)
- Anderson Martins Silva
- Instituto de Ciências da Motricidade, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, Brazil
| | - Daniele Sirineu Pereira
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Juliana Lustosa Torres
- Departamento de Medicina Preventiva e Social/Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Maria Geracina de Souza
- Instituto de Ciências da Motricidade, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, Brazil
| | | | - Carolina Kosour
- Instituto de Ciências da Motricidade, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, Brazil
| | - Joana Ude Viana
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Batista PP, Perracini MR, de Amorim JSC, de Lima MDCC, Lima CA, Pereira DS, Dantas RG, Fittipaldi EODS, Santos AD, Campos HLM, Pereira LSM. Prevalence risk of sarcopenia in older Brazilian adults during the pandemic: A cross-sectional analysis of the Remobilize Study. SAO PAULO MED J 2022; 141:e2022159. [PMID: 36541952 PMCID: PMC10065115 DOI: 10.1590/1516-3180.2022.0159.r1.19082022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Social distancing has led to lifestyle changes among older adults during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES This study aimed to estimate the prevalence risk of sarcopenia (RS) and investigate its associated factors during the COVID-19 pandemic in older Brazilian adults. DESIGN AND SETTING Cross-sectional observational analysis of baseline data as part of the Remobilize Study. METHODS Participants in the study were older adults (≥ 60 years), excluding those who were bedridden or institutionalized. The data collected consisted of answers about the RS (SARC-F), functional status, walking, sedentary behavior (SB), pain, comorbidity, and life space mobility. RESULTS A total of 1,482 older adults (70 ± 8.14 years, 74% women) participated in the study, and an RS prevalence of 17.1% was found. (95% confidence interval [CI] 15.25-19.15%). The adjusted multivariate model showed a significant association between RS and functional limitation (odds ratio [OR]: 19.05; CI 13.00-28.32), comorbidity (OR: 5.11; CI 3.44-7.81), pain (OR: 4.56; CI 3.33-6.28), total walking (OR: 0.99; CI 0.99-1.00), SB of 8-10 hours (OR: 1.85; CI 1.15-2.93), and SB of > 10 hours (OR: 3.93; CI 2.48-6.22). RS was associated with mobility during the pandemic (OR: 0.97; CI 0.96-0.98). P < 0.05. CONCLUSIONS During the pandemic, the prevalence of RS in older Brazilians was estimated at 17.1%. Moderate to severe functional limitation, comorbidities, presence of pain, walking, longer SB period, and reduced life space mobility significantly contributed to RS in older adults during the pandemic.
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Affiliation(s)
- Patricia Parreira Batista
- PT, MSc. Doctoral Student Postgraduate Program in Rehabilitation
Sciences, Department of Physiotherapy, Universidade Federal de Minas Gerais
(UFMG), Belo Horizonte (MG), Brazil
| | - Monica Rodrigues Perracini
- PT, PhD. Professor, Master’s and Doctoral Programs in Physical
Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo (SP), Brazil;
Master’s and Doctoral Programs in Gerontology, Faculty of Medical Sciences,
Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | | | - Maria do Carmo Correia de Lima
- PT, PhD. Faculty of Medical Sciences, Master’s and Doctoral
Programs in Gerontology, Universidade Estadual de Campinas (UNICAMP), Campinas
(SP), Brazil
| | - Camila Astolphi Lima
- PT, PhD. Postdoctoral Student of Master’s and Doctoral Program
in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo (SP),
Brazil
| | - Daniele Sirineu Pereira
- PT, PhD. Professor, Postgraduate Program in Rehabilitation
Sciences, Department of Physiotherapy, Universidade Federal de Minas Gerais
(UFMG), Belo Horizonte (MG), Brazil
| | - Renata Gonçalves Dantas
- PT, MSc. Doctoral Student of Master’s and Doctoral Program in
Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo (SP),
Brazil; and Professor of Physical Therapy, Universidade Estadual do Sudoeste da
Bahia (UESB), Vitória da Conquista (BA), Brazil
| | | | - Aurélio Dias Santos
- PT, MSc. Professor, Department of Physiotherapy, Centro
Universitário Dr. Leão Sampaio (UNILEÃO), Juazeiro do Norte (CE), Brazil
| | - Hércules Lázaro Morais Campos
- PT, MSc. Professor, Department of Physiotherapy, Universidade
Federal do Amazonas/Instituto de Saúde e Biotecnologia (UFAM/ISB), Coari (AM),
Brazil. Doctoral Student, Postgraduate Program in Public Health, Universidade
Federal do Espírito Santo (UFES), Vitória (ES), Brazil
| | - Leani Souza Máximo Pereira
- PT, PhD. Professor, Postgraduate Program in Rehabilitation
Sciences, Department of Physiotherapy, Universidade Federal de Minas Gerais
(UFMG), Belo Horizonte (MG), Brazil
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Felício DC, Elias Filho J, Pereira DS, Queiroz BZD, Leopoldino AAO, Rocha VTM, Pereira LSM. The effect of kinesiophobia in older people with acute low back pain: longitudinal data from Back Complaints in the Elders (BACE). CAD SAUDE PUBLICA 2021; 37:e00232920. [PMID: 34932682 DOI: 10.1590/0102-311x00232920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 03/04/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate the course of low back pain (LBP) intensity over a period of 12 months in older people with and without kinesiophobia.This was an international multicenter study. LBP intensity was examined by using the Numerical Pain Scale at baseline and over five follow-up periods. The Fear-Avoidance Beliefs Questionnaire was used to measure patients' beliefs and fears. The study included 532 older adults (non kinesiophobic = 227; kinesiophobic = 305). The individuals had moderate pain at baseline, with a significant difference observed between the groups. Participants showed a rapid improvement in the first 6 weeks, followed by minor improvements in the succeeding months. However, a significant difference between groups remained during the follow-up period. Independently, kinesiophobia is a significant prognostic factor. These findings suggest the importance of screening for psychosocial factors in the management of older patients with LBP. Practice implications: patients need to be warned that pain can be perpetuated by inappropriate avoidance behaviors that may later lead to disability.
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Vieira GIA, Pereira DS, Silva SLAD. Fatores associados a quedas entre idosos adscritos à Estratégia Saúde da Família: estudo transversal. SaudPesq 2021. [DOI: 10.17765/2176-9206.2021v14n4e8714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Este estudo objetivou identificar fatores associados a quedas entre idosos adscritos à Estratégia de Saúde da Família (ESF). Estudo transversal observacional exploratório de base populacional, realizado com amostra de 571 idosos. A coleta de dados foi realizada por instrumento semiestruturado e testes validados GDS-Scale, FESI-Brasil, TUG test, e SPPB. As associações foram determinadas por Modelos de Regressão Logística. Em relação à ocorrência de quedas no ano anterior, 139 (26%) relataram ter sofrido queda. Foram associados a quedas maior número de comorbidades (OR1,56 IC95%1,007-2,430), uso de dispositivo auxiliar de marcha (OR2,18 IC95%1,054-4,556), relato de alteração auditiva (OR1,61 IC95%1,036-2,495), negativa de prática regular de exercício físico (OR0,571 IC95%0,359-0,895), presença de dor (OR1,650 IC95%1,073-2,558), e baixa autoeficácia em relação a quedas (OR1,568 IC95%1,010-2,442). Foram identificados ao final do estudo seis fatores associados a quedas entre idosos adscritos à ESF, que devem ser inseridos na avaliação desta população.
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Ghisi GLDM, Seixas MB, Pereira DS, Cisneros LL, Ezequiel DGA, Aultman C, Sandison N, Oh P, da Silva LP. Patient education program for Brazilians living with diabetes and prediabetes: findings from a development study. BMC Public Health 2021; 21:1236. [PMID: 34174860 PMCID: PMC8236150 DOI: 10.1186/s12889-021-11300-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 06/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background Globally, the incidence of diabetes is increasing and strategies to reach a comprehensive approach of care are needed, including education in self-management. This is particularly true in low and middle-income countries where the number of people living with diabetes is higher than in the high-income ones. This article describes the development of a structured patient education program for Brazilians living with diabetes or prediabetes. Methods These steps were undertaken: 1) a 4-phase needs assessment (literature search of local diabetes guidelines, environmental scan, evaluation of information needs of patients identified by diabetes experts, and patient focus groups); and, 2) the translation and cultural adaptation of the patient guide (preparation, translation, back-translation, back-translation review, harmonization, and proofreading). Results Four of the seven guidelines identified include educational aspects of diabetes management. No structured education program was reported from the environmental scan. Regarding the information needs, 15 diabetes experts identified their patients’ needs, who referred that they have high information needs for topics related to their health condition. Finally, results from six patient focus groups were clustered into six themes (self-management, physical activity, eating habits, diabetes medication, psychosocial being, and sleep), all embedded into the new education program. Constructive theory, adult learning principles, and the Health Action Process Approach model were used in program development and will be used in delivery. The developed program consists of 18 educational sessions strategically mapped and sequenced to support the program learning outcomes and a patient guide with 17 chapters organized into five sections, matched with weekly lectures. Conclusions This program is a sequential and theoretical strategic intervention that can reach programs in Brazil to support diabetes and prediabetes patient education. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11300-y.
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Affiliation(s)
- Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, M4G 1R7, ON, Canada
| | - Mariana Balbi Seixas
- Faculty of Physical Therapy, Federal University of Juiz de Fora, Juiz de Fora, MG, 36038-330, Brazil
| | - Daniele Sirineu Pereira
- Department of Physiotherapy, Federal University of Minas Gerais, Belo Horizonte, 31270-901, MG, Brazil
| | - Ligia Loiola Cisneros
- Department of Physiotherapy, Federal University of Minas Gerais, Belo Horizonte, 31270-901, MG, Brazil
| | | | - Crystal Aultman
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, M4G 1R7, ON, Canada
| | - Nicole Sandison
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, M4G 1R7, ON, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, M4G 1R7, ON, Canada
| | - Lilian Pinto da Silva
- Faculty of Physical Therapy, Federal University of Juiz de Fora, Juiz de Fora, MG, 36038-330, Brazil.
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Perracini MR, de Amorim JSC, Lima CA, da Silva A, Trombini-Souza F, Pereira DS, Pelicioni PHS, Duim E, Batista PP, dos Santos RB, de Lima MDCC. Impact of COVID-19 Pandemic on Life-Space Mobility of Older Adults Living in Brazil: REMOBILIZE Study. Front Public Health 2021; 9:643640. [PMID: 33898378 PMCID: PMC8062747 DOI: 10.3389/fpubh.2021.643640] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background: The COVID-19 pandemic hit Brazil in a scenario of substantial socioeconomic and health inequalities. It is unknown the immediate impact of social restriction recommendations (i.e., lockdown, stay-at-home) on the life-space mobility of older people. Objective: To investigate the immediate impact of COVID-19 pandemic on life-space mobility of community-dwelling Brazilian older adults and examine the social determinants of health associated with change in life-space mobility. Design: Baseline data from a prospective cohort study (REMOBILIZE Study). Setting: Community. Subject: A convenience snowball sample of participants aged 60 and older (n = 1,482) living in 22 states in Brazil. Methods: We conducted an online and phone survey using an adapted version of the Life-Space Assessment (LSA). Linear regression models were used to investigate social determinants of health on the change in LSA score. Results: Regardless of their gender and social determinants of health, participants showed a significant reduction in life-space mobility since COVID-19 pandemic outbreak. Life-space mobility reduction was higher among black individuals, those living alone and aged between 70 and 79. Other variables associated with change in life-space mobility, to a lesser extent, were sex, education and income. Conclusion: Social restriction measures due to pandemic caused substantial reduction in older adults' life-space mobility in Brazil. Social inequalities strongly affected vulnerable groups. Concerted actions should be put in place to overcome the deterioration in life-pace mobility amongst these groups. Failure in minimizing health inequalities amplified by the pandemic may jeopardize the desired achievements of the Decade of Healthy Aging.
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Affiliation(s)
- Monica R. Perracini
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil
| | | | - Camila Astolphi Lima
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Alexandre da Silva
- Department of Collective Health, Faculdade de Medicina de Jundiaí, Jundiaí, Brazil
| | - Francis Trombini-Souza
- Master's and Doctoral Program in Rehabilitation and Functional Performance, Universidade de Pernambuco, Petrolina, Brazil
| | - Daniele Sirineu Pereira
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Etiene Duim
- Department of Diagnostic and Ambulatory Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Renato Barbosa dos Santos
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Maria do Carmo Correia de Lima
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil
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Rodrigues IFA, Alves VP, Gomes LDO, Pereira DS, Nóbrega ODT, Silva KHCVE. Associação entre eventos estressores e citocinas inflamatórias e anti-inflamatórias em pessoas idosas longevas. Rev bras geriatr gerontol 2021. [DOI: 10.1590/1981-22562021024.200350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo investigar a associação entre a frequência de eventos estressores e citocinas em pessoas idosas longevas. Métodos os participantes responderam a um questionário constituído de variáveis sociodemográficas, indicaram quais eventos estressores constantes no Inventário de Eventos Estressores de vida ocorreram nos últimos cinco anos e responderam a escala de depressão geriátrica (GDS). Foram dosados por citometria de fluxo: interleucina (IL) 10, IL-6, IL-4, IL-2, fator de necrose tumoral (TNF-α) e interferon gama (IFN-γ). A análise descritiva foi realizada para a caracterização da amostra. Para investigar a associação entre as variáveis foi desenvolvido um modelo de regressão linear múltipla, utilizando o método Backward. Resultados Participaram da pesquisa 91 pessoas idosas com média de idade de 82 anos. Mais da metade da amostra relatou morte de ente querido como o evento estressor mais prevalente (61%). Nessa amostra foi possível perceber que quanto mais eventos estressores foram relatados, menor o nível de IL-4 (p=0,046), da mesma forma que o estado civil viuvez, onde os dados mostraram que quem é viúvo tem menos eventos estressores em comparação a quem é casado (p=0,037). Conclusão Evidenciou-se a importância de um olhar mais cuidadoso dos profissionais de saúde na avaliação multidimensional da pessoa idosa, de forma que se obtenham subsídios para a implementação de programas e intervenções específicos que possam amenizar a percepção dos eventos estressores vivenciados, colaborando com menores danos decorrentes da imunossenescência.
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Felício DC, Elias J, de Queiroz BZ, Diz JBM, Pereira DS, Pereira LSM. Knee extension strength and handgrip strength are important predictors of Timed Up and Go test performance among community-dwelling elderly women: a cross-sectional study. SAO PAULO MED J 2021; 139:77-80. [PMID: 33656127 PMCID: PMC9632498 DOI: 10.1590/1516-3180.2020.0182.r1.30102020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/30/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Handgrip and knee extension strengths have each been used to characterize disability. However, it has been reported that the association between handgrip and knee extension strengths is weak. OBJECTIVE To evaluate the influence of knee extensor and handgrip muscle strength on Timed Up and Go (TUG) test results among elderly women with worse (≥ 10 seconds) and better (< 10 seconds) performance, after controlling for confounders. DATA AND SETTING Cross-sectional study on a sample selected according to convenience, carried out in a federal public institution of higher education. METHODS Assessment of handgrip was carried out using the Jamar dynamometer (Lafayette Instrument Company, Inc., Lafayette, United States). Knee extensor muscle performance was measured using an isokinetic dynamometer (Biodex System 3 Pro; Biodex Medical Systems, Inc., United States), The confounding factors were education, age, comorbidities, body mass index and Geriatric Depression Scale and Human Activity Profile scores. Functional performance was assessed through the TUG test. A backward linear regression model was used. RESULTS 127 elderly women performed the TUG test in more than 10 seconds and 93 in less than 10 seconds. However, regardless of test performance, handgrip strength and knee extension strength comprised the reduced final model. CONCLUSIONS Knee extension strength and handgrip strength might be particularly useful indicators for measuring disability.
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Affiliation(s)
- Diogo Carvalho Felício
- PT, PhD. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil; Postgraduate Program on Rehabilitation Sciences and Functional-Physical Performance, School of Physiotherapy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.
| | - José Elias
- PT, MSc. Physiotherapist, Postgraduate Program on Rehabilitation Sciences and Functional-Physical Performance, School of Physiotherapy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.
| | - Bárbara Zille de Queiroz
- PT, PhD. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
| | - Juliano Bergamaschine Mata Diz
- PT, MSc. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
| | - Daniele Sirineu Pereira
- PT, PhD. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
| | - Leani Souza Máximo Pereira
- PT, PhD. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
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19
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Silva AM, Pereira DS, Souza MGD, Carvalho DG, Lopes ITF, Silva SLAD. Fatores associados à adesão a grupos de atividades físicas na atenção básica. Fisioter Pesqui 2020. [DOI: 10.1590/1809-2950/18015427032020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O objetivo do estudo foi verificar a adesão de usuários a grupos de atividade física realizados por fisioterapeutas na atenção básica (AB) e seus fatores associados. Quanto à metodologia, trata-se de estudo transversal, quantitativo. Foi aplicado um questionário semiestruturado e outro de adesão adaptado, que investiga fatores gerais, motivadores e barreiras que podem influenciar na adesão. A amostra foi subdivida em 3 grupos em relação à adesão: 1-30% de frequência em 6 meses baixa adesão, de 31 - 70% média e acima de 71% alta adesão. Os grupos foram comparados pelos testes de Kruskall-Wallis e análise de variância (Anova) e a associação avaliada por regressão logística multinomial. Nos resultados, em relação à adesão, 46,8% da amostra apresentou baixa, 42,2% média e 11% alta adesão entre os 154 participantes, com média etária de 58,98±11,54 anos para fatores gerais, barreiras e motivadores foram diferentes (p<0,05) entre os grupos, e menor relato de fatores gerais de não adesão reduziram a chance de média adesão aos grupos. O maior tempo de participação nos grupos aumentou a chance de média e alta adesão em toda a amostra. Concluímos que o conhecimento dos fatores que influenciam positivamente na adesão, como tempo de participação, disposição e interesse, facilitam o desenvolvimento de estratégias pelos profissionais da AB para sua manutenção. Os resultados mostraram que existem fatores que interferem na adesão aos grupos realizados na AB.
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Rocha VCLG, Pereira DS, Pereira MJ, Silva SLAD. [Validity and consistency of the entries in the Health Care Network's patient records for the use of services by the elderly]. Cien Saude Colet 2020; 25:2103-2112. [PMID: 32520258 DOI: 10.1590/1413-81232020256.19682018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 09/26/2018] [Indexed: 11/22/2022] Open
Abstract
The scope of this article is to verify the validity and consistency of entries in medical records and self-reporting about the use of the health services by elderly users of the Health Care Network. It involved a cross-sectional, population-based observational study. Entries in medical, dental, home visit, referral to the secondary sector and hospitalization appointment records for the years 2015 and 2016 were evaluated. The concordance percentage, Kappa coefficient, sensitivity, specificity and predictive values for each item were also analyzed. The highest concordance percentage (81.93%) with a significant Kappa coefficient (p = 0.03) was for hospitalization. The dentistry appointments revealed a higher Kappa coefficient (k = 0.271) with significance of p=0.01. The analyses showed high specificity in the hospitalization records (83%), and a greater sensitivity for home visits (74%). Positive predictive values were low for hospitalization (8%), and negative predictive values were low for medical appointments (17%). The low concordance between the use of the self-reported health service and entries in medical records highlight one of the possible causes of the fragmentation in continuity of care.
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Affiliation(s)
- Vanessa Carvalho Leite Gama Rocha
- Instituto de Ciências da Motricidade, Curso de Fisioterapia, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales, Santa Clara. 31270-901, Alfenas, MG, Brasil.
| | - Daniele Sirineu Pereira
- Instituto de Ciências da Motricidade, Curso de Fisioterapia, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales, Santa Clara. 31270-901, Alfenas, MG, Brasil.
| | - Maria Jaqueline Pereira
- Instituto de Ciências da Motricidade, Curso de Fisioterapia, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales, Santa Clara. 31270-901, Alfenas, MG, Brasil.
| | - Silvia Lanziotti Azevedo da Silva
- Instituto de Ciências da Motricidade, Curso de Fisioterapia, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales, Santa Clara. 31270-901, Alfenas, MG, Brasil.
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Moreira LB, Silva SLAD, Castro AEFD, Lima SS, Estevam DO, Freitas FASD, Vieira ÉLM, Pereira DS. Factors associated with functional capacity in the elderly enrolled in the Family Health Strategy. Cien Saude Colet 2020; 25:2041-2050. [PMID: 32520252 DOI: 10.1590/1413-81232020256.26092018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 09/28/2018] [Indexed: 01/06/2023] Open
Abstract
The study investigated the prevalence of functional capacity decline and its associated factors in the older people enrolled in the Family Health Strategy (ESF) in a city in the south of Minas Gerais. This is an observational, cross-sectional, population-based study with 406 elderly (70.49 years ± 6.77). The functional capacity was evaluated by the Short Physical Performance Battery (SPPB), and its associated factors were evaluated by a structured questionnaire including sociodemographic, economic, clinical and physical aspects. The analysis of plasma levels of inflammatory mediators was performed by the ELISA method. Multiple linear regression was used for the analyses (p < 0.05). The prevalence of functional decline in the sample was 57.6% and factors associated with functional capacity were advanced age, female gender, number of medications, depressive symptoms, high plasma concentrations of the soluble receptor of tumor necrosis factor alpha 1 (sTNFR1) and low handgrip strength. The results demonstrated that functional capacity was associated with a network of multidimensional factors. This study contributes to the practice of ESF professionals by indicating the main factors that can guide actions to promote and prevent the decline of functional capacity in the elderly population.
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Affiliation(s)
- Lorrane Brunelle Moreira
- Instituto de Ciências da Motricidade, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales 2600, Santa Clara. 37133-840, Alfenas, MG, Brasil.
| | - Silvia Lanziotti Azevedo da Silva
- Instituto de Ciências da Motricidade, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales 2600, Santa Clara. 37133-840, Alfenas, MG, Brasil.
| | - Ana Emília Fonseca de Castro
- Instituto de Ciências da Motricidade, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales 2600, Santa Clara. 37133-840, Alfenas, MG, Brasil.
| | - Sara Souza Lima
- Instituto de Ciências da Motricidade, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales 2600, Santa Clara. 37133-840, Alfenas, MG, Brasil.
| | - Dayane Oliveira Estevam
- Instituto de Ciências da Motricidade, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales 2600, Santa Clara. 37133-840, Alfenas, MG, Brasil.
| | - Flávia Alexandra Silveira de Freitas
- Instituto de Ciências da Motricidade, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales 2600, Santa Clara. 37133-840, Alfenas, MG, Brasil.
| | | | - Daniele Sirineu Pereira
- Instituto de Ciências da Motricidade, Universidade Federal de Alfenas. Av. Jovino Fernandes Sales 2600, Santa Clara. 37133-840, Alfenas, MG, Brasil.
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Pereira FSM, Thomasini RL, Lustosa LP, Pereira DS, Pereira LSM, Kassab GBI, Silva TJ, Guerra RO, Parentoni AN. Is the Leukocyte Telomere Length Associated with Decreased Physical Functional Capacity in the Elderly? Rejuvenation Res 2020; 23:387-393. [PMID: 31992162 DOI: 10.1089/rej.2019.2264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Leukocyte telomere length in the elderly has been positively associated with healthy living and physical activity. Factors that interfere with telomere shortening are similar to those that may be associated with decreasing functional capacity. To investigate the relationship between mean leukocyte telomere length and functional capacity in community-dwelling elderly individuals, this is an observational, cross sectional, multicentric study conducted with elderly Brazilian patients. Sample characterization was performed using a sociodemographic clinical questionnaire. Telomere length was evaluated by quantitative polymerase chain reaction, and functional capacity was evaluated by the Short Physical Performance Battery (SPPB). A total of 113 elderly individuals (age 70 ± 5.4 years; 75 women and 38 men) were enrolled in this study. Unexpectedly, it was found that lower relative telomere length was associated with better physical capacity in the global SPPB score. Although telomere shortening is observed with increasing age, it is not associated with decreased functional capacity. Functionality is broad and multidimensional, involving the connection of biopsychosocial and cultural factors. While functionality may not be considered a marker of functional aging in an elderly cohort, it can still play an important role in longitudinal studies, which attempt to elucidate process theories. Future studies should use different techniques to measure telomere lengths in subpopulations of cells.
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Affiliation(s)
- Fabiana Souza Máximo Pereira
- Faculty of Medicine of Diamantina, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil.,Department Physiotherapy, Post-Graduation Program in Rehabilitation and Functional Capacity (PPGReab), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Ronaldo Luis Thomasini
- Faculty of Medicine of Diamantina, NEPii-Center for Studies of Infectious and Inflammatory Diseases, Multi-Centric Post-Graduation Program in Physiological Sciences (PMPGCF) and Post-Graduation Program in Pharmaceutical Sciences (PPGCiFarm), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Lygia Paccini Lustosa
- Department of Physiotherapy, Sciences Rehabilitation Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Daniele Sirineu Pereira
- Department of Physiotherapy, Sciences Rehabilitation Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Leani Souza Máximo Pereira
- Department of Physiotherapy, Sciences Rehabilitation Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Gabriel Brum Issa Kassab
- Faculty of Medicine of Diamantina, NEPii-Center for Studies of Infectious and Inflammatory Diseases, Multi-Centric Post-Graduation Program in Physiological Sciences (PMPGCF) and Post-Graduation Program in Pharmaceutical Sciences (PPGCiFarm), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Thyago José Silva
- Faculty of Medicine of Diamantina, NEPii-Center for Studies of Infectious and Inflammatory Diseases, Multi-Centric Post-Graduation Program in Physiological Sciences (PMPGCF) and Post-Graduation Program in Pharmaceutical Sciences (PPGCiFarm), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | | | - Adriana Netto Parentoni
- Department Physiotherapy, Post-Graduation Program in Rehabilitation and Functional Capacity (PPGReab), Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
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de Carvalho GR, de Oliveira EA, Rocha VTM, Pereira DS, Pereira LSM. Cross-cultural adaptation and reliability of the pain response to activity and position questionnaire. Adv Rheumatol 2019; 59:53. [PMID: 31791421 DOI: 10.1186/s42358-019-0098-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization reports that one of the main incapacitating conditions in older adults is osteomusculoskeletal disorders, and among these is low back pain. There are few instruments translated and transculturally adapted with psychometric properties evaluated for older adults with this health condition in Brazil. The Pain Response to Activity and Positioning (PRAP) questionnaire enables classification of older adults through functional performance. The objective of this study was to perform a cross-cultural adaptation and verify the reliability of the PRAP for older Brazilian people with chronic low back pain. METHODS A cross-sectional methodological study from the international study "Back Complaints in the Elders". We included individuals aged ≥60 years, with chronic lumbar pain complaints lasting ≥3 months. The transcultural translation and adaptation process followed the criteria proposed by Beaton and Guilhemeim, 1993. Reliability was tested using an unweighted Cohen's Kappa. RESULTS Thirty-six (36) older adults participated in the study (71.15 ± 7.23 years, 94.4% female). The intra-rater reliability for Low Back Pain (LBP) was between 0.50-1.00 and 0.23-0.84 for lower limbs, while the inter-rater reliability for LBP was between 0.25-0.63 and between 0.18-0.53 for lower limbs. The criteria for low back pain diagnosis showed intra and inter-rater agreement of 0.52 and 0.47, respectively. CONCLUSION The Brazilian version of the instrument showed adequate reliability and ability to classify older adults in the diagnosis of LBP by reporting the performance of daily activities, and is indicated for use in the context of research and clinical practice. TRIAL REGISTRATION There is no trial registration. This is a methodological study.
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Affiliation(s)
| | | | - Vitor Tigre Martins Rocha
- Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia da Universidade Federal de Minas Gerais, Rua Groenlândia, 276/ 201-Sion CEP, Belo Horizonte, MG, 30.320-060, Brazil
| | - Daniele Sirineu Pereira
- Departamento de Fisioterapia da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leani Souza Máximo Pereira
- Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia da Universidade Federal de Minas Gerais, Rua Groenlândia, 276/ 201-Sion CEP, Belo Horizonte, MG, 30.320-060, Brazil.
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Chini LT, Pereira DS, Nunes AA. Validation of the Fall Risk Tracking Tool (FRRISque) in elderly community dwellers. Cien Saude Colet 2019; 24:2845-2858. [PMID: 31389533 DOI: 10.1590/1413-81232018248.28962017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/09/2018] [Indexed: 11/22/2022] Open
Abstract
This study aimed to validate of Fall Risk Tracking Tool (FRRISque) in elderly community dwellers. A cross-sectional evaluative screening study was carried out on a sample of 854 elderly. In addition to the pilot version of FRRISque, the QuickScreen® tool was applied as a standard reference in order to validate a concurrent criterion, determining sensitivity and specificity values. Most of the elderly people were female (57.6%) with an average age of 71.87 years. The multivariate logistic regression analyses showed that only 10 FRRISque items contribute to increased elderly fall risk and they refer to the risk factors of previous falls, use of a walking aid device, polypharmacy, use of psychotropic substances, difficulty to ascend and descend a slope, difficulty to walk for a distance of 100 meters, visual and hearing impairment, low physical activity and poorly lit environment. This risk stratification model assumes sensitivity values of 91.3% and specificity values of 73.4%. The FRRISque is defined as a valid, simple, low-cost and of easy and rapid application tool that can be used by all primary health care professionals, including community health workers.
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Affiliation(s)
- Lucélia Terra Chini
- Escola de Enfermagem, Universidade Federal de Alfenas (Unifal). R. Gabriel Monteiro da Silva 700, Centro. 37130-001 Alfenas MG Brasil.
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Lustosa LP, Batista PP, Pereira DS, Pereira LSM, Scianni A, Ribeiro-Samora GA. Comparison between parameters of muscle performance and inflammatory biomarkers of non-sarcopenic and sarcopenic elderly women. Clin Interv Aging 2017; 12:1183-1191. [PMID: 28814844 PMCID: PMC5546767 DOI: 10.2147/cia.s139579] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Sarcopenia is a multifactorial geriatric syndrome with complex interrelationships. Increased plasma levels of inflammatory mediators increase the catabolic stimuli of the musculature, thereby causing a decrease in mass and muscular function. Objective The objective of this study was to compare the performance of the knee extensors test (by isokinetic dynamometer) and plasma levels of interleukin-6 (IL-6) and soluble receptors of tumor necrosis factor alpha (sTNFR1) between sarcopenics and non-sarcopenics community-dwelling elderly women residents of Brazil. Material and methods The diagnosis of sarcopenia included measurements of body composition (by densitometry with dual energy source of X-ray), handgrip strength (by Jamar® dynamometer), and the usual gait velocity according to the recommendations of the European Working Group on Sarcopenia in Older People. In both sarcopenics and non-sarcopenics elderly women, we evaluated the muscle function by knee extensors test (using an isokinetic dynamometer Byodex System 4 Pro®) at angular speeds of 60°/s and 180°/s) and also we evaluated the plasma concentrations of IL-6 and sTNFR1. Comparisons of muscle performance between groups were carried out using mixed factorial ANOVA with post hoc Bonferroni test; sTNFR1 and IL-6 variables were analyzed by applying Mann–Whitney U test. Results Statistical differences were observed between groups regarding muscle power (P=0.01), total work adjusted to body weight (P=0.01) at a rate of 180°/s, and plasma levels of sTNFR1 (P=0.01). Conclusion Sarcopenic elder women showed lower performance of the lower limbs, especially at a higher speed, predisposing these older women to greater vulnerability in functional activities that require agility and postural stability. Plasma levels of sTNFR1 were higher for non-sarcopenics elderlies. However, due to the observational nature of the study, it was impossible to infer causality among the variables surveyed.
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Affiliation(s)
| | | | | | | | - Aline Scianni
- Physical Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte
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Boo YL, How KN, Pereira DS, Chin PW, Foong KK, Lim SY. Pulmonary actinomycosis masquerading as lung cancer: A case report. Med J Malaysia 2017; 72:246-247. [PMID: 28889138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pulmonary actinomycosis is a rare yet important and challenging diagnosis to make. It is commonly confused with other lung diseases, such as tuberculosis and bronchogenic carcinoma, leading to delay diagnosis or misdiagnosis. A 49-year-old man presented with a chronic cough, hemoptysis, and pleuritic chest pain. His initial imaging studies including computed tomography (CT) was suggestive of bronchogenic carcinoma. A subsequent CTguided biopsy was consistent with pulmonary actinomycosis and excluded the possibility of bronchogenic carcinoma. He was treated with antibiotic therapy and achieved remission with complete radiological resolution upon follow-up.
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Affiliation(s)
- Y L Boo
- Hospital Sultanah Nora Ismail, Department of Medicine, Batu Pahat, Johor, Malaysia.
| | - K N How
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Medicine, Serdang, Selangor, Malaysia
| | - D S Pereira
- Hospital Enche' Besar Hajjah Khalsom, Department of Medicine, Kluang, Johor, Malaysia
| | - P W Chin
- Hospital Enche' Besar Hajjah Khalsom, Department of Medicine, Kluang, Johor, Malaysia
| | - K K Foong
- Hospital Sultanah Aminah, Department of Medicine, Johor Bahru, Johor, Malaysia
| | - S Y Lim
- Hospital Sultanah Nora Ismail, Department of Medicine, Batu Pahat, Johor, Malaysia
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Felício DC, Diz JBM, Pereira DS, Queiroz BZD, Silva JPD, Moreira BDS, Oliveira VC, Pereira LSM. Handgrip strength is associated with, but poorly predicts, disability in older women with acute low back pain: A 12-month follow-up study. Maturitas 2017; 104:19-23. [PMID: 28923172 DOI: 10.1016/j.maturitas.2017.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/22/2017] [Accepted: 07/14/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Older women with low back pain (LBP) constitute a special subpopulation at risk of severe and permanent disability. It is important to identify factors limiting functionality in this population in order to reduce costs and improve both prevention and intervention. Handgrip strength (HGS) is a biomarker of aging associated with several adverse health outcomes, but long-term associations with disability in older patients with LBP are not known. OBJECTIVE To examine whether HGS predicts disability in older women with acute low back pain (LBP). METHODS Longitudinal analyses were conducted with a sample of 135 older women from the international multicenter study Back Complaints in the Elders (BACE-Brazil). Women aged 60 years and over with a new episode of acute LBP were included. HGS was assessed with Jamar® dynamometer, and disability was assessed using the Roland Morris questionnaire and gait speed test. Variables were assessed at baseline and at 12-month follow-up. Linear regression models explored associations between HGS and disability measures. RESULTS Significant association was found between HGS at baseline and gait speed at 12-month follow-up (r=-0.24; p=0.004). A multivariable-adjusted model showed that this association was independent of age, body mass index, and pain intensity (adjusted R2=0.13; p<0.001). A final prediction model showed an incremental difference of only 2.1% in gait speed after inclusion of HGS as an independent variable. No association was found between HGS and score on the Roland Morris questionnaire. CONCLUSION Caution is needed regarding the use of HGS as a predictive measure of disability in older women with acute LBP. Changes in gait speed were very small and unlikely to be of clinical relevance.
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Affiliation(s)
- Diogo Carvalho Felício
- Department of Physical Therapy, Federal University of Juiz de Fora, s/n Eugênio do Nascimento Avenue, 36038-330, Juiz de Fora, Minas Gerais, Brazil; Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Juliano Bergamaschine Mata Diz
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Daniele Sirineu Pereira
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil; Faculty of Physical Therapy, Federal University of Alfenas, 2600 Jovino Fernandes Sales Avenue, 31270-901, Alfenas, Minas Gerais, Brazil.
| | - Bárbara Zille de Queiroz
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Juscélio Pereira de Silva
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Bruno de Souza Moreira
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Vinícius Cunha Oliveira
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil; Department of Physical Therapy, Postgraduate Program in Rehabilitation and Functional Performance, Federal University of Vales do Jequitinhonha e Mucuri, Campus JK, 5000 MGT 367 Highway, 39100-000, Diamantina, Minas Gerais, Brazil.
| | - Leani Souza Máximo Pereira
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Federal University of Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
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Diz JBM, de Souza Moreira B, Felício DC, Teixeira LF, de Jesus-Moraleida FR, de Queiroz BZ, Pereira DS, Pereira LSM. Brain-derived neurotrophic factor plasma levels are increased in older women after an acute episode of low back pain. Arch Gerontol Geriatr 2017; 71:75-82. [PMID: 28376368 DOI: 10.1016/j.archger.2017.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/08/2017] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Low back pain (LBP) is a growing public health problem in old age, and it is associated with disabling pain and depressive disorders. We compared brain-derived neurotrophic factor (BDNF) plasma levels, a key neurotrophin in pain modulation, between older women after an acute episode of LBP and age-matched pain-free controls, and investigated potential differences in BDNF levels between controls and LBP subgroups based on pain severity, presence of depressive symptoms and use of analgesic and antidepressant drugs. METHODS A total of 221 participants (154 with LBP and 67 pain-free) were studied. A comprehensive assessment of sociodemographic and clinical variables was conducted including pain severity (11-point NRS), depressive symptoms (GDS-15), age, body mass index, physical activity and total number of comorbidities and medications in use. RESULTS BDNF levels in LBP group were significantly higher than controls (7515.9±3021.2; Md=7116.0 vs 6331.8±3364.0; Md=5897.5pg/mL, P=0.005). LBP subgroups exhibited higher BDNF levels than controls, regardless of pain severity, presence of depressive symptoms and use of analgesic drugs. BDNF levels were significantly higher in LBP subgroup without use of antidepressant drugs compared to both controls and LBP subgroup with use of antidepressant drugs. DISCUSSION This study provides evidence that older women with acute low back pain exhibit higher BDNF plasma levels compared to pain-free controls. Subgroup comparisons suggest that use of pain-relief drugs may influence BDNF levels. The study results offer a novel target for research on mechanisms of back pain in older adults.
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Affiliation(s)
- Juliano Bergamaschine Mata Diz
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Bruno de Souza Moreira
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Diogo Carvalho Felício
- Department of Physical Therapy, Universidade Federal de Juiz de Fora, s/n Eugênio do Nascimento Avenue, 36038-330, Juiz de Fora, Minas Gerais, Brazil.
| | - Luiza Faria Teixeira
- Department of Physical Therapy, Universidade do Vale do Sapucaí, 320 Coronel Alfredo Custódio de Paula Avenue, 37550-000, Pouso Alegre, Minas Gerais, Brazil.
| | - Fabianna Resende de Jesus-Moraleida
- Department of Physical Therapy, Faculty of Medicine, Universidade Federal do Ceará, 949 Alexandre Barúna Street, 60430-160, Fortaleza, Ceará, Brazil.
| | - Bárbara Zille de Queiroz
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Daniele Sirineu Pereira
- Department of Physical Therapy, Universidade Federal de Alfenas, 2600 Jovino Fernandes Sales Avenue, 31270-901, Alfenas, Minas Gerais, Brazil.
| | - Leani Souza Máximo Pereira
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
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Queiroz BZ, Pereira DS, Rosa NMDB, Lopes RA, Felício DC, Pereira DG, Dias JMD, Dias RC, Pereira LSM. Functional performance and plasma cytokine levels in elderly women with and without low back pain. J Back Musculoskelet Rehabil 2016; 28:343-9. [PMID: 25271196 DOI: 10.3233/bmr-140526] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Low back pain (LBP) is a complaint of great importance among the elderly due to its significant impact on function. LBP could contribute to changes in the regulatory process of inflammatory mediators observed in elders. The aim of this study was to compare plasma levels of interleukin(IL)-6, soluble tumor necrosis factor receptor 1(sTNF-R1), and functionality among 3 groups of elderly women: GI, with LBP; GII, without LBP but reports of other pain; and GIII, without any reported pain. MATERIAL AND METHOD This was an observational study of a subsample of the international Back Complaints in the Elders cohort study. IL-6 and sTNF-R1 were measured using the enzyme-linked immunosorbent assay. Functionality was assessed using the Timed Up and Go, gait speed and Roland Morris Disability Questionnaire; and pain, using the numerical pain scale. RESULTS Two hundred and thirteen women aged 71.35 ± 4.76 years were included. GI presented the highest sTNF-R1 levels (p=0.016), worst TUG performance (p< 0.001) and slowest gait speed (p< 0.01) compared to GII and GIII, which were similar (p > 0.05). No difference was found between the IL-6 plasma levels in any of the groups. CONCLUSION Elderly women with LBP had the highest sTNF-R1 plasma levels and the worst functional performance compared to elderly women with reports of other pain (not LBP) or no pain.
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Affiliation(s)
- Bárbara Zille Queiroz
- Rehabilitation Sciences Program, Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Daniele Sirineu Pereira
- Rehabilitation Sciences Program, Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Nayza Maciel de Britto Rosa
- Rehabilitation Sciences Program, Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renata Antunes Lopes
- Rehabilitation Sciences Program, Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Diogo Carvalho Felício
- Rehabilitation Sciences Program, Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Danielle Gomes Pereira
- Rehabilitation Sciences Program, Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - João Marcos Domingues Dias
- Rehabilitation Sciences Program, Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rosângela Correa Dias
- Rehabilitation Sciences Program, Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Leani Souza Máximo Pereira
- Rehabilitation Sciences Program, Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Moreira BDS, Dos Anjos DMDC, Pereira DS, Sampaio RF, Pereira LSM, Dias RC, Kirkwood RN. The geriatric depression scale and the timed up and go test predict fear of falling in community-dwelling elderly women with type 2 diabetes mellitus: a cross-sectional study. BMC Geriatr 2016; 16:56. [PMID: 26940811 PMCID: PMC4776357 DOI: 10.1186/s12877-016-0234-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 02/25/2016] [Indexed: 12/13/2022] Open
Abstract
Background Fear of falling is a common and potentially disabling problem among older adults. However, little is known about this condition in older adults with diabetes mellitus. The aims of this study were to investigate the impact of the fear of falling on clinical, functional and gait variables in older women with type 2 diabetes and to identify which variables could predict the fear of falling in this population. Methods Ninety-nine community-dwelling older women with type 2 diabetes (aged 65 to 89 years) were stratified in two groups based on their Falls Efficacy Scale-International score. Participants with a score < 23 were assigned to the group without the fear of falling (n = 50) and those with a score ≥ 23 were assigned to the group with the fear of falling (n = 49). Clinical data included demographics, anthropometrics, number of diseases and medications, physical activity level, fall history, frailty level, cognition, depressive symptoms, fasting glucose level and disease duration. Functional measures included the Timed Up and Go test (TUG), the five times sit-to-stand test (5-STS) and handgrip strength. Gait parameters were obtained using the GAITRite® system. Results Participants with a fear of falling were frailer and presented more depressive symptoms and worse performance on the TUG and 5-STS tests compared with those without a fear of falling. The group with the fear of falling also walked with a lower velocity, cadence and step length and increased step time and swing time variability. The multivariate regression analysis showed that the likelihood of having a fear of falling increased 1.34 times (OR 1.34, 95 % CI 1.11–1.61) for a one-point increase in the Geriatric Depression Scale (GDS-15) score and 1.36 times (OR 1.36, 95 % CI 1.07–1.73) for each second of increase in the TUG performance. Conclusions The fear of falling in community-dwelling older women with type 2 diabetes mellitus is associated with frailty, depressive symptoms and dynamic balance, functional mobility and gait deficits. Furthermore, both the GDS-15 and the TUG test predict a fear of falling in this population. Therefore, these instruments should be considered during the assessment of diabetic older women with fear of falling.
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Affiliation(s)
- Bruno de Souza Moreira
- Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil.
| | | | - Daniele Sirineu Pereira
- Nursing School, Physical Therapy Course, Universidade Federal de Alfenas, Minas Gerais, Alfenas, Brazil.
| | - Rosana Ferreira Sampaio
- Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil. .,Department of Physical Therapy, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil.
| | - Leani Souza Máximo Pereira
- Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil.
| | - Rosângela Corrêa Dias
- Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil.
| | - Renata Noce Kirkwood
- Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil.
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de Souza A, Pelegrini TDS, Ribeiro JHDM, Pereira DS, Mendes MA. Concept of family insufficiency in the aged: critical literature analysis. Rev Bras Enferm 2015; 68:1176-85. [PMID: 26676443 DOI: 10.1590/0034-7167.2015680625i] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 08/05/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to identify the attributes of the "family insufficiency" concept of the aged in the literature. METHOD critical literature analysis. RESULTS family insufficiency is characterized as a complex process of psychosocial interaction, founded mainly on low social support of the aged and impaired family ties. Its antecedents are found in contemporary transformations within the family system, intergenerational conflicts, impaired family relationships and social vulnerability of the family. The consequences of family insufficiency include social vulnerability of the aged, decline of psychological and functional health, lower quality of life and unsuccessful aging. An original theoretical proposal was elaborated for the concept of family insufficiency in the elderly, with the identification of its attributes, antecedents and consequences. CONCLUSION the findings of this study constitute a theoretical advancement in the Family Insufficiency Syndrome in elderly people and provide data for future field research in developing the concept.
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Affiliation(s)
- Alessandra de Souza
- Grupo de Pesquisa Tecnologias e Inovações em Saúde, Escola de Enfermagem, Universidade Federal de Alfenas, Alfenas, MG, Brasil
| | - Tamara Dos Santos Pelegrini
- Grupo de Pesquisa Tecnologias e Inovações em Saúde, Escola de Enfermagem, Universidade Federal de Alfenas, Alfenas, MG, Brasil
| | - João Henrique de Morais Ribeiro
- Grupo de Pesquisa Tecnologias e Inovações em Saúde, Escola de Enfermagem, Universidade Federal de Alfenas, Alfenas, MG, Brasil
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da Cruz Anjos DM, de Souza Moreira B, Pereira DS, Picorelli AMA, Pereira DAG, Kirkwood RN, Dias RC, Pereira LSM. Impact of Type-2 Diabetes Time Since Diagnosis on Elderly Women Gait and Functional Status. Physiother Res Int 2015; 22. [DOI: 10.1002/pri.1651] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 05/15/2015] [Accepted: 07/17/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Daniela Maria da Cruz Anjos
- Graduate Programme in Rehabilitation Sciences; Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
- Physical Therapy Course; Faculdade Estácio de Sá; Belo Horizonte Minas Gerais Brazil
| | - Bruno de Souza Moreira
- Graduate Programme in Rehabilitation Sciences; Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
| | - Daniele Sirineu Pereira
- Physical Therapy Course, Nursing School; Universidade Federal de Alfenas; Alfenas Minas Gerais Brazil
| | | | - Danielle Aparecida Gomes Pereira
- Graduate Programme in Rehabilitation Sciences; Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
- Department of Physical Therapy; Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
| | - Renata Noce Kirkwood
- Graduate Programme in Rehabilitation Sciences; Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
- Department of Kinesiology and Physical Education; Wilfrid Laurier University; Waterloo Ontario Canada
| | - Rosângela Corrêa Dias
- Graduate Programme in Rehabilitation Sciences; Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
| | - Leani Souza Máximo Pereira
- Graduate Programme in Rehabilitation Sciences; Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
- Department of Physical Therapy; Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
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Picorelli AMA, Pereira DS, Felício DC, Dos Anjos DM, Pereira DAG, Dias RC, Assis MG, Pereira LSM. Adherence of older women with strength training and aerobic exercise. Clin Interv Aging 2014; 9:323-31. [PMID: 24600212 PMCID: PMC3933242 DOI: 10.2147/cia.s54644] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Participation of older people in a program of regular exercise is an effective strategy to minimize the physical decline associated with age. The purpose of this study was to assess adherence rates in older women enrolled in two different exercise programs (one aerobic exercise and one strength training) and identify any associated clinical or functional factors. Methods This was an exploratory observational study in a sample of 231 elderly women of mean age 70.5 years. We used a structured questionnaire with standardized tests to evaluate the relevant clinical and functional measures. A specific adherence questionnaire was developed by the researchers to determine motivators and barriers to exercise adherence. Results The adherence rate was 49.70% in the aerobic exercise group and 56.20% in the strength training group. Multiple logistic regression models for motivation were significant (P=0.003) for the muscle strengthening group (R2=0.310) and also significant (P=0.008) for the aerobic exercise group (R2=0.154). A third regression model for barriers to exercise was significant (P=0.003) only for the muscle strengthening group (R2=0.236). The present study shows no direct relationship between worsening health status and poor adherence. Conclusion Factors related to adherence with exercise in the elderly are multifactorial.
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Affiliation(s)
- Alexandra Miranda Assumpção Picorelli
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniele Sirineu Pereira
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Diogo Carvalho Felício
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniela Maria Dos Anjos
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Danielle Aparecida Gomes Pereira
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rosângela Corrêa Dias
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcella Guimarães Assis
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leani Souza Máximo Pereira
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Pereira DS, Mateo ECC, de Queiroz BZ, Assumpção AM, Miranda AS, Felício DC, Rocha NP, da Cruz dos Anjos DM, Pereira DAG, Teixeira AL, Pereira LSM. TNF-α, IL6, and IL10 polymorphisms and the effect of physical exercise on inflammatory parameters and physical performance in elderly women. Age (Dordr) 2013; 35:2455-2463. [PMID: 23430759 PMCID: PMC3824985 DOI: 10.1007/s11357-013-9515-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 01/28/2013] [Indexed: 06/01/2023]
Abstract
High levels of inflammatory mediators are associated with reduced physical capabilities and muscle function in the elderly. Single nucleotide polymorphisms (SNPs) may affect the expression and synthesis of these molecules, thus influencing the intensity of the inflammatory response and susceptibility to certain diseases. Physical exercise may attenuate age-related chronic inflammation and improve physical performance. This study evaluated the interaction between the SNP rs1800629 in TNF-α, rs1800795 in IL6, and rs1800896 in IL10 and the effect of physical exercise on physical performance and inflammation in elderly women. There was a significant interaction between rs1800629 and the effect of exercise on physical performance and between the combined 3-SNP genotype and changes in physical performance in response to exercise. These SNPs did not influence the effect of exercise on inflammatory parameters. Elderly women with a combination of genotypes associated with an anti-inflammatory profile (low TNF-α and IL-6 production, high IL-10 production) showed better physical performance independent of exercise modality, evidence of an interactive influence of genetic and environmental factors on improving physical performance in elderly women.
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Affiliation(s)
- Daniele Sirineu Pereira
- />Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais/UFMG, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, Minas Gerais Brazil
| | - Elvis Cristian Cueva Mateo
- />Laboratório de Imunofarmacologia, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais Brazil
| | - Bárbara Zille de Queiroz
- />Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais/UFMG, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, Minas Gerais Brazil
| | - Alexandra Miranda Assumpção
- />Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais/UFMG, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, Minas Gerais Brazil
| | - Aline Silva Miranda
- />Laboratório de Imunofarmacologia, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais Brazil
| | - Diogo Carvalho Felício
- />Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais/UFMG, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, Minas Gerais Brazil
| | - Natália Pessoa Rocha
- />Laboratório de Imunofarmacologia, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais Brazil
| | - Daniela Maria da Cruz dos Anjos
- />Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais/UFMG, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, Minas Gerais Brazil
| | - Danielle Aparecida Gomes Pereira
- />Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais/UFMG, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, Minas Gerais Brazil
| | - Antonio Lucio Teixeira
- />Laboratório de Imunofarmacologia, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais Brazil
| | - Leani Souza Máximo Pereira
- />Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais/UFMG, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, Minas Gerais Brazil
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Felicio DC, Pereira DS, Assumpção AM, de Jesus-Moraleida FR, de Queiroz BZ, da Silva JP, de Brito Rosa NM, Dias JMD, Pereira LSM. Poor correlation between handgrip strength and isokinetic performance of knee flexor and extensor muscles in community-dwelling elderly women. Geriatr Gerontol Int 2013; 14:185-9. [PMID: 23617580 DOI: 10.1111/ggi.12077] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2013] [Indexed: 12/25/2022]
Abstract
AIM To investigate the correlation between handgrip strength and performance of knee flexor and extensor muscles determined using an isokinetic dynamometer in community-dwelling elderly women. METHODS This was a cross-sectional study. Sample selection for the study was made by convenience, and 221 (71.07 ± 4.93 years) community-dwelling elderly women were included. Knee flexor and extensor muscle performance was measured using an isokinetic dynamometer Biodex System 3 Pro. The isokinetic variables chosen for analysis were peak torque, peak torque/bodyweight, total work/bodyweight, total work, average power, and agonist/antagonist ratio at the angular velocities of 60°/s and 180°/s. Assessment of handgrip strength was carried out using the Jamar dynamometer. Spearman's correlation coefficient was calculated to identify intervariable correlations. RESULTS Only knee flexor peak torque (60°/s) and average power (60°/s), and knee extensor peak torque (180°/s) and total work (180°/s) were significantly (P < 0.05), yet poorly, correlated with handgrip strength (r < 0.30). CONCLUSION The majority of analyses did not show any correlation between variables assessed by isokinetic dynamometer and handgrip dynamometer. Caution is required when generalizing handgrip strength as a predictor of global muscle strength in community-dwelling elderly women.
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Affiliation(s)
- Diogo Carvalho Felicio
- Department of Physical Therapy, Post Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte/MG, Brazil
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Lustosa LP, Máximo Pereira LS, Coelho FM, Pereira DS, Silva JP, Parentoni AN, Dias RC, Domingues Dias JM. Impact of an exercise program on muscular and functional performance and plasma levels of interleukin 6 and soluble receptor tumor necrosis factor in prefrail community-dwelling older women: a randomized controlled trial. Arch Phys Med Rehabil 2012; 94:660-6. [PMID: 23168399 DOI: 10.1016/j.apmr.2012.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 11/08/2012] [Accepted: 11/09/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the impact of a muscle resistance program (MRP) on muscular and functional performance and on interleukin 6 (IL-6) and soluble tumor necrosis factor receptor-1 (sTNFr1) plasma levels in prefrail community-dwelling women. DESIGN Randomized controlled trial crossover design with a postintervention and short-term follow-up. SETTING University hospital. PARTICIPANTS Prefrail community-dwelling women (N=32; ≥65y). INTERVENTION The MRP was designed based on the exercise at 75% of each participant's maximum load (10wk, 3 times/wk). MAIN OUTCOME MEASURES Plasma concentrations of IL-6 and sTNFr1 (high-sensitivity enzyme-linked immunosorbent assay kits), muscle strength of the knee extensors (isokinetic), and functional performance (Timed Up & Go [TUG] test and 10-meter walk test [10MWT]). RESULTS There were significant differences in functional and muscular performance between the pre-MRP, post-MRP, and 10-week follow-up period. After the MRP, both functional (TUG, pre-MRP=11.1s vs post-MRP=10.4s, P=.00; 10MWT, pre-MRP=4.9s vs post-MRP, 4.4s, P=.00) and muscular performances (pre-MRP=77.8% and post-MRP=83.1%, P=.02) improved. After cessation of the MRP (follow-up period), sTNFr1 plasma levels increased by 21.4% at 10-week follow-up (post-MRP, 406.4pg/mL; 10-week follow-up, 517.0pg/mL; P=.03). There were significant differences in sTNFr1 (P=.01). CONCLUSIONS The MRP was effective in improving functional and muscular performances, although alterations in plasma levels of IL-6 and sTNFr1 could not be identified after the MRP. Cessation of the MRP after 10 weeks resulted in increased plasma levels of sTNFr1.
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Affiliation(s)
- Lygia Paccini Lustosa
- Rehabilitation Science, Universidade Federal de Minas Gerais and Centro Universitário de Belo Horizonte, Belo Horizonte, MG, Brazil
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Abstract
O diabetes mellitus (DM) tem associação com várias comorbidades que comprometem ainda mais a funcionalidade do idoso. Essa doença crônica está vinculada ao risco de incapacidade para realizar atividades rotineiras. O objetivo deste estudo foi comparar a capacidade funcional de idosos diabéticos e não diabéticos. Trata-se de uma pesquisa observacional transversal que avaliou 40 idosos, divididos em dois grupos, sendo 20 diabéticos (71,1±4,6 anos) e 20 não diabéticos (71,7±4,4 anos). Os grupos foram semelhantes quanto ao gênero, idade e índice de massa corpórea (IMC). Para avaliação da capacidade funcional foram realizados o teste de desempenho físico modificado (TDMF) e o teste de caminhada de seis minutos (TC6). A percepção subjetiva do esforço foi avaliada por meio da escala de Borg modificada e o teste de sensibilidade pela percepção de um conjunto de seis monofilamentos de náilon de Semmes-Weinstein. Os dados foram analisados por meio do Mann-Whitney test. O grupo de idosos diabéticos percorreu menor distância no TC6 (396±55,6x481,5±73,1 m; p=0,0003) e apresentou pior teste de sensibilidade quando comparado com os não diabéticos, mas nenhuma diferença foi encontrada no TDMF. Os idosos diabéticos relataram pior aptidão física quando comparados com os não diabéticos.
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Santos MLAS, Gomes WF, Pereira DS, Oliveira DMG, Dias JMD, Ferrioli E, Pereira LSM. Muscle strength, muscle balance, physical function and plasma interleukin-6 (IL-6) levels in elderly women with knee osteoarthritis (OA). Arch Gerontol Geriatr 2011; 52:322-6. [PMID: 20627334 DOI: 10.1016/j.archger.2010.05.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 05/08/2010] [Accepted: 05/10/2010] [Indexed: 12/30/2022]
Abstract
An increased circulating level of inflammatory cytokines has been associated with sarcopenia, functional disability, chronic diseases, and mortality in the elderly. Osteoarthritis (OA) is a disease common to this population, the seriousness of articular degeneration has been associated to the increase in some cytokines, IL-6 among them. The aim of the present study was to correlate IL-6 plasma levels with muscle strength, endurance, muscle balance hamstring/quadriceps (H/Q) and physical function in 80 elderly women (71.2 ± 5.3) with knee OA. IL-6 was measured using enzyme-linked immunosorbent assay (ELISA). Quadriceps and hamstring muscle strength, endurance and hamstring-quadriceps muscle balance were assessed using a Biodex system 3 pro(®) isokinetic dynamometer. Physical function was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Spearman's correlation coefficient was used to explore the relationship between the outcomes at the significance level of α=0.05. IL-6 was inversely correlated to the endurance of the hamstring muscles (r=-0.232; p=0.03) and muscle balance (H/Q) on the lower right side at 180°/s (r=-0.254; p=0.023). No significant correlation between IL-6, muscle strength and physical function was found. Our results show that elevated levels of IL-6 may possibly contribute to the reduction of the endurance of hamstring muscles and H/Q muscle balance in the elderly studied.
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Affiliation(s)
- M L A S Santos
- Departamento de Fisioterapia da Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, CEP: 31270-901, Belo Horizonte, Minas Gerais, Brazil.
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Coelho FM, Pereira DS, Lustosa LP, Silva JP, Dias JMD, Dias RCD, Queiroz BZ, Teixeira AL, Teixeira MM, Pereira LSM. Physical therapy intervention (PTI) increases plasma brain-derived neurotrophic factor (BDNF) levels in non-frail and pre-frail elderly women. Arch Gerontol Geriatr 2011; 54:415-20. [PMID: 21684022 DOI: 10.1016/j.archger.2011.05.014] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 05/08/2011] [Accepted: 05/09/2011] [Indexed: 11/19/2022]
Abstract
Biomarkers are important factors in the identification of the frail elderly (higher risk of developing disease) and in assessing the impact of PTI. On the other hand, BDNF has been related to neuroprotection in a series of central nervous system diseases in older age. The levels of BDNF in groups of elderly women classified according to Fried phenotype (non-frail and pre-frail) were compared. We assessed the impact of a PTI on BDNF levels. A convenience sample of 48 elderly women was randomly selected. The PTI group was composed by 20 elderly women selected from this group. Plasma neurotrophic factors, such as BDNF, glial-derived neutrophic factor (GDNF), and nerve growth factor (NGF) were measured by enzyme-linked immunosorbent assay (ELISA). Timed-up-and-go (TUG) test, hand-grip and work/body weight were evaluated before and after the intervention. Plasma concentrations of BDNF were significantly higher in non-frail in comparison to pre-frail elderly women. After the PTI, higher levels of BDNF were found in elderly women (before 351±68 pg/ml and after 593±79 pg/ml; p<0.001). Both groups had an increase in BDNF levels after the PTI. The low levels of BDNF in pre-frail elderly women suggest that this neurotrophic factor may be a key pathophysiological mediator in the syndrome of frailty. The fact that PTI increased BDNF levels in both groups suggests that it may be possible to modify this phenotype.
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Affiliation(s)
- F M Coelho
- Departamento de Fisioterapia da Escola de Educacao Fisica, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Avenida Antonio Carlos, 6627 Pampulha, 31270-901 Belo Horizonte, Minas Gerais, Brazil.
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Santos MLADS, Gomes WF, Queiroz BZD, Rosa NMDB, Pereira DS, Dias JMD, Pereira LSM. Desempenho muscular, dor, rigidez e funcionalidade de idosas com osteoartrite de joelho. Acta ortop bras 2011. [DOI: 10.1590/s1413-78522011000400004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Verificar a correlação do desempenho dos músculos do joelho e os domínios dor, rigidez e funcionalidade do Questionário Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) de idosas com osteoartrite de joelho (OA). MÉTODOS: Estudo transversal observacional com uma amostra de 80 idosas (71,2 ± 5,3 anos) com diagnóstico clínico de OA de joelho. Força, resistência e equilíbrio musculares foram avaliados por meio do dinamômetro isocinético Biodex System 3 Pro, nas velocidades angulares de 60º/s e 180º/s; a funcionalidade, presença de dor e rigidez foram avaliadas pelo questionário WOMAC. A correlação entre as variáveis foi analisada pelo teste de Spearman. RESULTADOS: Houve correlação inversa significativa da força e resistência musculares do quadríceps (QUA) e isquiossurais (IQS) nas velocidades de 60º/s e 180°/s, respectivamente, e da relação de equilíbrio muscular IQS/QUA a 180°/s com todos os domínios do WOMAC (p<0.05). CONCLUSÕES: A redução da força e da resistência e a presença de desequilíbrio dos músculos do joelho correlacionaram-se inversamente com todos os domínios do WOMAC, apontando para a necessidade de intervenções que envolvam um trabalho de fortalecimento, resistência e equilíbrio muscular de extensores e flexores de joelho, visando a redução do impacto da OA na dor, rigidez e funcionalidade do idoso. Nivel de Evidência I, Estudos diagnósticos, Investigação de um exame para diagnóstico.
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de Britto Rosa NM, de Queiroz BZ, Pereira DS, di Sabatino Santos MLA, Oliveira DMG, Narciso FMES, Pereira LSM. Interleukin-6 plasma levels and socioeconomic status in Brazilian elderly community-dwelling women. Arch Gerontol Geriatr 2010; 53:196-9. [PMID: 21109313 DOI: 10.1016/j.archger.2010.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Revised: 10/19/2010] [Accepted: 10/20/2010] [Indexed: 11/24/2022]
Abstract
Aging is related to a chronic increase in inflammatory cytokines. Adverse socioeconomic conditions are associated with increased plasma levels of these molecules, especially interleukin (IL)-6. Considering the differential profile of elderly Brazilians regarding their socioeconomic and cultural aspects, the objectives of this study were: to assess the correlation and differences between levels of IL-6 and socioeconomic status (education and income) in elderly women. IL-6 levels were measured using ELISA. The Spearman test was used to determine the correlation between IL-6 and socioeconomic status, and the Kruskal-Wallis and Mann-Whitney tests for cytokine level differences across education and income. IL-6 showed a significant inverse correlation with education (r = -0.205, p = 0.014) and income (r = -0.185, p = 0.028). Differences in IL-6 levels were registered across the education variables. The results corroborate evidence that low socioeconomic status is related to higher IL-6 plasma levels in elderly women.
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Affiliation(s)
- Nayza Maciel de Britto Rosa
- Departamento de Fisioterapia da Escola de Educação Física, Fisioterapia e Terapia Ocupacional da Universidade Federal de Minas Gerais, UFMG, Av Antônio Carlos, 6627 Campus Pampulha, 31270-901 Belo Horizonte, MG, Brazil
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Marra TA, Pereira DS, Faria CDCM, Tirado MGA, Pereira LSM. Influence of socio-demographic, clinical and functional factors on the severity of dementia. Arch Gerontol Geriatr 2010; 53:210-5. [PMID: 21109312 DOI: 10.1016/j.archger.2010.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 10/28/2010] [Accepted: 10/29/2010] [Indexed: 10/18/2022]
Abstract
Dementia is one of the most relevant illnesses due to its functional impact on the elderly. The aim of the present study was to determine the influence of socio-demographic, clinical, cognitive and functional factors on the severity of dementia in elderly individuals. One hundred six elderly individuals with a diagnosis of dementia as determined by the DSM-IV/APA participated in the study. Cognition was assessed by the mini-mental state examination (MMSE); functional performance of basic and instrumental activities of daily living (BADLs and IADLs) was assessed by the Katz index (KI), Lawton-Brody index (LBI) and Pfeffer index (PI). The severity of dementia was established through the clinical dementia rating (CDR). In order to determine the influence of factors on the degree of dementia, ordinal regression analysis was performed. Age, MMSE, KI, LBI and PI scores had statistically significant associations to the severity of dementia. However, only the age (odds ratio (OR) = 0.197; confidence interval (CI) = 0.060-0.643) and performance in IADLs (LBI: OR = 1.237, CI = 1.077-1.422; PI: OR = 0.641, CI = 0.548-0.750) were maintained in the final ordinal regression model, R(2) = 0.818. The results show that elderly individuals over 80 years of age and those with a more compromised performance in IADLs have a greater chance of exhibiting more severe degrees of dementia. These findings suggest that the ability to perform IADLs may be an important variable in differentiating degrees of the severity of dementia.
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Affiliation(s)
- T A Marra
- Physiotherapy Department of the Universidade Federal de Minas Gerais, Av Antônio Carlos, 6627 CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil
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Pereira LSM, Marra TA, Faria CDCDM, Pereira DS, Martins MAA, Dias JMD, Dias RC. Adaptação transcultural e análise da confiabilidade do Southampton Assessment of Mobility para avaliar a mobilidade de idosos brasileiros com demência. CAD SAUDE PUBLICA 2006; 22:2085-95. [PMID: 16951880 DOI: 10.1590/s0102-311x2006001000014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2005] [Accepted: 02/16/2006] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste trabalho foi adaptar transculturalmente o instrumento Southampton Assessment of Mobility e testar sua confiabilidade intra e interexaminadores para idosos brasileiros da comunidade, com demência, classificados quanto à gravidade pelo Clinical Dementia Rating. O instrumento adaptado foi aplicado em uma amostra de 107 idosos (76,26 anos ± 7,59; 27,1% homens, 72,9% mulheres) com diagnóstico clínico de demência dado pelo serviço de geriatria do Centro de Referência em Atenção ao Idoso Professor Caio Benjamin Dias, do Estado de Minas Gerais, Hospital das Clínicas, Universidade Federal de Minas Gerais, Minas Gerais, Brasil. Dentre os avaliados, 39 (76,85 anos ± 7,75; 23,1% homens, 76,9% mulheres) foram aleatorizados para avaliação da confiabilidade. A ferramenta estatística foi o teste kappa. Os resultados mostraram que a confiabilidade intra e interexaminadores foram, respectivamente: demência leve 0,89-0,86; moderada 0,79-0,85 e grave 0,53-0,49. O instrumento adaptado demonstrou ser aplicável à população alvo e demonstrou ter confiabilidade "quase perfeita" para demência leve e moderada. Para a demência grave os índices de confiabilidade foram "moderados".
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Guenechea G, Gan OI, Inamitsu T, Dorrell C, Pereira DS, Kelly M, Naldini L, Dick JE. Transduction of human CD34+ CD38- bone marrow and cord blood-derived SCID-repopulating cells with third-generation lentiviral vectors. Mol Ther 2000; 1:566-73. [PMID: 10933981 DOI: 10.1006/mthe.2000.0077] [Citation(s) in RCA: 149] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The major limitations of Moloney murine leukemia virus (MoMLV)-based vectors for human stem cell applications, particularly those requiring bone marrow (BM) stem cells, include their requirement for mitosis and retroviral receptor expression. New vectors based upon lentiviruses such as HIV-1 exhibit properties that may circumvent these problems. We report that novel third-generation, self-inactivating lentiviral vectors, expressing enhanced green fluorescent protein (EGFP) and pseudotyped with vesicular stomatitis virus G glycoprotein (VSV-G), can efficiently transduce primitive human repopulating cells derived from human BM and cord blood (CB) tested by the SCID-repopulating cell (SRC) assay. Highly purified CD34+ CD38- CB or BM cells were efficiently transduced (4-69%) and stably expressed in EGFP for 40 days in culture following infection for only 24 h without fibronectin, polybrene, or cytokines. Nonobese diabetic/severe combined immune-deficient (NOD/SCID) mice transplanted with transduced cells from either CB or BM donors were well engrafted, demonstrating maintenance of SRC during the infection procedure. Serially obtained femoral BM samples indicated that the proportion of EGFP+ cells within both myeloid and lymphoid lineages was maintained or even increased over time, averaging 42.3 +/- 6.6% for BM donors and 23.3 +/- 7.2% for CB at 12 weeks. Thus, the third-generation lentivectors readily transduce human CB and BM stem cells, under minimal conditions of ex vivo culture, where MoMLV-based vectors are ineffective. Since CB is inappropriate for most therapeutic applications, the efficient maintenance and transduction of BM-derived SRC during the short infection procedure are notable advantages of lentivectors.
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Affiliation(s)
- G Guenechea
- Hospital for Sick Children and Department of Molecular and Medical Genetics, University of Toronto, Ontario, Canada
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Dorrell C, Gan OI, Pereira DS, Hawley RG, Dick JE. Expansion of human cord blood CD34(+)CD38(-) cells in ex vivo culture during retroviral transduction without a corresponding increase in SCID repopulating cell (SRC) frequency: dissociation of SRC phenotype and function. Blood 2000; 95:102-10. [PMID: 10607692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Current procedures for the genetic manipulation of hematopoietic stem cells are relatively inefficient due, in part, to a poor understanding of the conditions for ex vivo maintenance or expansion of stem cells. We report improvements in the retroviral transduction of human stem cells based on the SCID-repopulating cell (SRC) assay and analysis of Lin(-) CD34(+)CD38(-) cells as a surrogate measure of stem cell function. Based on our earlier study of the conditions required for ex vivo expansion of Lin(-)CD34(+) CD38(-) cells and SRC, CD34(+)-enriched lineage-depleted umbilical cord blood cells were cultured for 2 to 6 days on fibronectin fragment in MGIN (MSCV-EGFP-Neo) retroviral supernatant (containing 1.5% fetal bovine serum) and IL-6, SCF, Flt-3 ligand, and G-CSF. Both CD34(+)CD38(-) cells (20.8%) and CFC (26.3%) were efficiently marked. When the bone marrow of engrafted NOD/SCID mice was examined, 75% (12/16) contained multilineage (myeloid and B lymphoid) EGFP(+) human cells composing as much as 59% of the graft. Half of these mice received a limiting dose of SRC, suggesting that the marked cells were derived from a single transduced SRC. Surprisingly, these culture conditions produced a large expansion (166-fold) of cells with the CD34(+)CD38(-) phenotype (n = 20). However, there was no increase in SRC numbers, indicating dissociation between the CD34(+)CD38(-) phenotype and SRC function. The underlying mechanism involved apparent downregulation of CD38 expression within a population of cultured CD34(+)CD38(+) cells that no longer contained any SRC function. These results suggest that the relationship between stem cell function and cell surface phenotype may not be reliable for cultured cells. (Blood. 2000;95:102-110)
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Affiliation(s)
- C Dorrell
- Programs in Cancer/Blood and Developmental Biology, Hospital for Sick Children, Toronto, Ontario, Canada
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Gan OI, Dorrell C, Pereira DS, Ito CY, Wang JC, Dick JE. Characterization and retroviral transduction of an early human lymphomyeloid precursor assayed in nonswitched long-term culture on murine stroma. Exp Hematol 1999; 27:1097-106. [PMID: 10378899 DOI: 10.1016/s0301-472x(99)00037-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In the hierarchy of human hematopoietic progenitors, long-term culture-initiating cells (LTC-IC) and extended LTC-IC belong to the earliest cell populations that can be assayed in vitro. We report the identification of a multipotential lymphomyeloid progenitor detected in a nonswitch culture system. We observed the emergence of CD33+ myeloid and CD19+ B-lymphoid cells following plating of lineage-depleted (Lin-) CD34 -enriched or purified CD34+ CD38- cord blood cells on MS-5 stroma in the absence of exogenous cytokines. Both CD19+ CD20- pro-B and CD19+ CD20+ pre-B lymphocytes coexist with myeloid cells in long-term culture. A limiting dilution approach was used to show that a single CD34+ CD38- cell can generate lymphomyeloid progeny in conventional (5-week) and extended (10-week) cultures. Most of the clones in long-term culture or extended long-term culture contained not only lymphoid and myeloid cells, but also myeloid clonogenic progenitors. A high proportion of CD34+ CD38- cells gave rise to lymphomyeloid clones after 5 and 10 weeks of culturing (up to 48% and 16%, respectively), which distinguishes the assay reported here from those using switch culture conditions. We performed retroviral gene transfer experiments involving 1-3 days of exposure of Lin CD34+ -enriched cells to virus encoding enhanced green fluorescent protein. Monitoring of gene transfer efficiency into LTC-IC by enhanced green fluorescent protein fluorescence showed that it is possible to achieve marking of lymphomyeloid LTC-IC, albeit to a lesser extent than myeloid-restricted LTC-IC.
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Affiliation(s)
- O I Gan
- Department of Cancer and Blood Research, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
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Abstract
This study reports the development of a novel osteochondral graft for cartilage repair. A technique of proteoglycan extraction via timed enzymatic digestion with hyaluronidase and trypsin and subsequent processing with a chloroform-methanol solution to remove cellular debris from a fresh-frozen bovine osteochondral sample is a method described to prepare a stable biological carrier of low immunogenicity. Lyophilization of the carrier followed by rehydration in a suspension of lapine chondrocytes produced a chimeric xenograft that succeeded in vivo in enhancing cartilage repair. In a pilot study, full-thickness articular cartilage defects treated with these xenografts demonstrated improved healing compared to untreated defects or defects treated with unseeded grafts at 2, 6, and 12 weeks postimplantation. The xenograft provoked a mild inflammatory response; however this did not impede the repair process. Further investigation of this novel chimeric xenograft eventually may yield a method of cartilage repair superior to current methods of treatment.
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Affiliation(s)
- B C Toolan
- Department of Orthopaedic Surgery, Hospital for Joint Diseases Orthopaedic Institute, New York, New York 10003, USA
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Pereira DS, Dorrell C, Ito CY, Gan OI, Murdoch B, Rao VN, Zou JP, Reddy ES, Dick JE. Retroviral transduction of TLS-ERG initiates a leukemogenic program in normal human hematopoietic cells. Proc Natl Acad Sci U S A 1998; 95:8239-44. [PMID: 9653171 PMCID: PMC20960 DOI: 10.1073/pnas.95.14.8239] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Many chimeric oncogenes have been identified by virtue of the association between chromosomal translocation and specific human leukemias. However, the biological mechanism by which these oncogenes disrupt the developmental program of normal human hematopoietic cells during the initiation of the leukemogenic process is poorly understood due to the absence of an appropriate experimental system to study their function. Here, we report that retroviral transduction of TLS-ERG, a myeloid leukemia-associated fusion gene, to human cord blood cells results in altered myeloid and arrested erythroid differentiation and a dramatic increase in the proliferative and self-renewal capacity of transduced myeloid progenitors. Thus, TLS-ERG expression alone induced a leukemogenic program that exhibited similarities to the human disease associated with this translocation. These results provide an experimental examination of the early stages of the human leukemogenic process induced by a single oncogene and establish a paradigm to functionally assay putative leukemogenic genes in normal human hematopoietic cells.
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Affiliation(s)
- D S Pereira
- Department of Genetics, Research Institute, Hospital for Sick Children, and Department of Medical and Molecular Genetics, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada
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Elwood NJ, Zogos H, Pereira DS, Dick JE, Begley CG. Enhanced megakaryocyte and erythroid development from normal human CD34(+) cells: consequence of enforced expression of SCL. Blood 1998; 91:3756-65. [PMID: 9573012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The product of the SCL gene is a basic helix-loop-helix (bHLH) transcription factor that is essential for the development of hematopoietic stem cells in both the embryo and the adult. However, once the stem cell compartment is established, the function of SCL in subsequent differentiation and commitment events within normal hematopoietic cells remains undefined. The aim of the current study was to investigate this role using purified normal human hematopoietic CD34(+) cells. An SCL retrovirus was used to transduce CD34(+) cells isolated from human bone marrow, peripheral blood, and umbilical cord blood. Enforced expression of SCL increased by a median of twofold the number of erythroid colonies, with an increase in both colony size and the rate of hemoglobinization. Unexpectedly, enforced expression in CD34(+) cells also significantly increased the number of megakaryocyte colonies, but with no impact on the size of colonies. There was no consistent effect on the number nor size of granulocyte-macrophage (GM) colonies. The proliferative effect of enforced SCL expression on erythroid cells was attributed to a shortened cell cycle time; the self-renewal capacity of erythroid or GM progenitors was unchanged, as was survival of cells within colonies. These results demonstrate a role for SCL in determining erythroid and megakaryocyte differentiation from normal human hematopoietic CD34(+) cells.
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Affiliation(s)
- N J Elwood
- Rotary Bone Marrow Research Laboratories, Victoria, Australia.
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