Publications by authors named "André Bonadias Gadelha"

20 Publications

  • Page 1 of 1

Effects of dynamic and isometric resistance training protocols on metabolic profile in hemodialysis patients: a randomized controlled trial.

Appl Physiol Nutr Metab 2021 Mar 2. Epub 2021 Mar 2.

Universidade Catolica de Brasilia, 28106, Physical Education, Taguatinga, DF, Brazil.

To compare the effect of dynamic (DRT) and isometric (IRT) resistance training on glycemic homeostasis, lipid profile, and nitric oxide (NO) in hemodialysis (HD) patients. Patients were randomly distributed into three groups: control (CTL; n=65), DRT (n=65), and IRT (n=67). Patients were tested for fasting blood glucose, glycated hemoglobin, oral glucose tolerance test, insulin resistance, lipid profile, leptin, insulin, adiponectin, C-reactive protein, and NO were assessed pre- and post-intervention period. Patients underwent to strength and body composition assessments. Subjects allocated in both DRT and IRT groups took part in a 24-week resistance training program, three times per week. Each training session was approximately one hour before dialysis and consisted of 3 sets of 8-12 repetitions at low intensity. Total workload was higher in the DRT as compared with the IRT. This heightened workload related to better glycemic homeostasis in HD patients as measured by regulation of insulin, adiponectin, and leptin, while improvement of triglycerides, free-fat mass, and muscle strength. Additionally, NO levels were increased on DRT group. NO was significantly correlated with glucose intolerance (r=-0.42, p=0.0155) and workload (r=0.46, p=0.0022). The IRT group only improved strength (p<0.05). 24-week of DRT improved glycemic homeostasis, lipid profile, and NO in HD patients. Although IRT seems to play an important role in increasing strength, DRT might be a better choice to promote metabolic adjustments in HD patients. Clinical Trial http://www.ensaiosclinicos.gov.br/rg/RBR-3gpg5w/; nº RBR-3gpg5w Novelty Bullets: -DRT might be a better choice for metabolic improvements in CKD patients. -Exercise-training might treat metabolic imbalance in CKD patients.
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http://dx.doi.org/10.1139/apnm-2020-0900DOI Listing
March 2021

Effects of pre-dialysis resistance training on sarcopenia, inflammatory profile, and anemia biomarkers in older community-dwelling patients with chronic kidney disease: a randomized controlled trial.

Int Urol Nephrol 2021 Feb 20. Epub 2021 Feb 20.

Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, DF, Brazil.

Background: Sarcopenia and chronic kidney disease (CKD) have been associated with negative outcomes in older people, including inflammatory profile and anemia biomarkers.

Aims: To investigate the effects of pre-dialysis resistance training (RT) on sarcopenia, inflammatory profile, and anemia biomarkers in older patients with CKD.

Methods: A total of 107 patients with CKD (65.4 ± 3.7 years) were randomly allocated into four groups: sarcopenic RT (n = 37), non-sarcopenic RT (n = 20), sarcopenic control (n = 28), and non-sarcopenic control (n = 22). DXA and handgrip strength were used to classify sarcopenia according to EWGSOP-2. Treatment groups underwent a 24-week intervention with RT before each dialysis session, three times per week. Blood sample analysis for ferritin, hepcidin, iron availability, and inflammatory profile (TNFα, IL-6, and IL-10) was conducted. All-cause mortality was recorded over 5 years.

Results: Sarcopenic RT group increased iron availability after the intervention, while their counterparts decreased. Ferritin and hepcidin significantly decreased in sarcopenic RT group. RT elicited a reduction in both TNFα and IL-6, while increasing IL-10 in both intervention groups. The rate of sarcopenic subjects substantially decreased after the intervention period (from 37 to 17 in the RT group; p = 0.01). The proportion of deaths was higher (P = 0.033) for sarcopenic subjects (Controls 35.7% vs RT 29.7%) when compared to non-sarcopenic subjects (Controls 18% vs RT 10%). The proportion of deaths decreased according to the randomization group (X2 = 8.704; P < 0.1).

Conclusions: The 24-week RT intervention elicited a better sarcopenia status, better inflammatory profile, and improved anemia biomarkers. Sarcopenia was associated with higher mortality rate in older patients with CKD.
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http://dx.doi.org/10.1007/s11255-021-02799-6DOI Listing
February 2021

Association between dynapenic abdominal obesity and inflammatory profile in diabetic older community-dwelling patients with end-stage renal disease.

Exp Gerontol 2021 Apr 15;146:111243. Epub 2021 Jan 15.

Graduate Program of Physical Education, Catholic University of Brasilia, Brasília, Distrito Federal, Brazil; Seção de Educação Física, Colégio Militar de Brasília, Asa Norte, Brasília, DF, Brazil.

Background: Obesity and poor strength impose higher risk factor for end-stage renal disease (ESRD) patients. It is expected that the combination of both conditions might be critically associated with the inflammatory profile in this population, especially in community-dwelling elderly. So, diagnosis of dynapenic obesity and inflammation is an important tool in the management of chronic kidney disease patients at imminent risk of hospitalization.

Purpose: To investigate the association between dynapenic abdominal obesity and inflammatory markers in community-swelling elderly with ESRD.

Methods: Two hundred and forty-seven community-dwelling older patients (66.74 ± 3.20 years; n = 150, 60.73%, males) undergoing maintenance phase hemodialysis volunteered for this study. The study sample was categorized into four groups according to handgrip strength and waist circumference as follows: control, dynapenia (low strength alone), abdominal obesity (high waist circumference alone), and dynapenic obesity (D/AO) (the combination of low strength and high waist circumference). Blood samples were collected for tumor necrosis factor alpha (TNF-α), interleukin (IL)- 6 and IL- 10. Results were considered significant at P < 0.05.

Results: Proportions for control, abdominal obesity, dynapenic, and D/AO were 38.5%, 15.8%, 25.9%, and 19.8%, respectively. Higher concentrations of TNF-α were found in the D/AO group (P < 0.0001). This group also displayed lower levels of IL-10 (P < 0.0001). Further, the D/AO traits were strongly associated with TNF-α and IL-10 (P < 0.0001).

Conclusion: The closely relation between D/AO and inflammatory profile provides evidence that the pooled information of low muscle strength and abdominal obesity may be clinically relevant for the management of ESRD patients.
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http://dx.doi.org/10.1016/j.exger.2021.111243DOI Listing
April 2021

Cut-Off Values in the Prediction of Success in Olympic Distance Triathlon.

Int J Environ Res Public Health 2020 12 18;17(24). Epub 2020 Dec 18.

Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland.

Cut-off points and performance-related tools are needed for the development of the Olympic distance triathlon. The purposes of the present study were (i) to determine cut-off values to reach the top three positions in an Olympic distance triathlon; (ii) to identify which discipline present the highest influence on overall race performance and if it has changed over the decades. Data from 1989 to 2019 ( = 52,027) from all who have competed in an official Olympic distance triathlon events (World Triathlon Series and Olympics) were included. The cut-off value to achieve a top three position was calculated. Linear regressions were applied for performance trends overall and for the top three positions of each race. Men had cut-off values of: swimming = 19.5 min; cycling = 60.7 min; running = 34.1 min. Women's cut-off values were: swimming = 20.7 min; cycling = 71.6 min; running = 38.1 min. The running split seemed to be the most influential in overall race time regardless of rank position or sex. In conclusion, cut-offs were established, which can increase the chances of achieving a successful rank position in an Olympic triathlon. Cycling is the discipline with the least influence on overall performance for both men and women in the Olympic distance triathlon. This influence pattern has not changed in the last three decades.
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http://dx.doi.org/10.3390/ijerph17249491DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766989PMC
December 2020

Effects of resistance training on hepcidin levels and iron bioavailability in older individuals with end-stage renal disease: A randomized controlled trial.

Exp Gerontol 2020 10 4;139:111017. Epub 2020 Jul 4.

Catholic University of Brasilia, Federal District, Brazil.

Anemia is an inherent complication of older individuals with end-stage renal disease (ESRD) that is associated with inflammation which in turn is an important factor in the activation of hepcidin that contributes to the decrease in serum iron. Athough resistance training (RT) seems to reduce inflammation in ESRD, its influence on hepcidin and iron availability in hemodialysis patients is unclear. Therefore, the aim of this study was to exemine the effects of RT in on inflammatory profile, hepcidin, and iron status in older individuals with ESRD. End-stage renal disease patients (N: 157, age: 66.8 ± 3.6; body mass: 73 ± 15 body mass index:27 ± 3), were assigned to control (CTL n: 76) and exercise groups (RT n: 81). RT consisted of 24 weeks/3 days per week of a moderate intensity. There was an increase in the bioavailability of iron (ΔRT: 22.2; ΔCTL: -1 μg/dL, p < 0.0001), a decrease in hepcidin levels (ΔRT: -7.9; ΔCTL: 0.2 ng/mL, p < 0.0001),and an improvement of the inflammatory profile. These novel findings show that RT is a potential coadjuvant to reduce iron deficiency by decreasing the levels of hepcidin and pro-inflammatory markers in older patients undergoing hemodialysis.
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http://dx.doi.org/10.1016/j.exger.2020.111017DOI Listing
October 2020

Dynapenic abdominal obesity and the incidence of falls in older women: a prospective study.

Aging Clin Exp Res 2020 Jul 5;32(7):1263-1270. Epub 2019 Sep 5.

Faculdade de Educação Física, University of Brasília, Campus Darcy Ribeiro, Asa Norte, Brasília, 70910-900, Distrito Federal, Brazil.

Background: Dynapenic abdominal obesity (D/AO) has been associated with negative outcomes in older people, including trait of falls.

Aims: To assess the association between D/AO and the incidence of falls over 18 months in older community-dwelling women.

Methods: A total of 201 older women (67.97 ± 6.02 years; 27.70 kg/m) underwent waist circumference measurement, and had handgrip strength assessed using a hydraulic dynamometer. Dynapenia was classified using the lower tertile of handgrip strength, while abdominal obesity was considered as a waist circumference > 88 cm. D/AO was the combination of both aforementioned criteria. Volunteers were classified into four groups: normal, abdominal obesity, dynapenic, and D/AO. Participants were then tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Chi-square and multivariable Cox proportional regressions were conducted.

Results: The overall incidence of falls over the follow-up was 27.5%; and for normal, dynapenic, abdominal obesity, and D/AO were 14.7%, 17.2%, 27.5%, and 40.4% (X = 8.341; P = 0.039), respectively. D/AO was associated with a higher risk of falls (hazard ratio: 3.595 [95% CI: 1.317-9.815], even after adjustments for age, body mass index, physical activity level, regular use of medications, peripheral sensation, chronic diseases, and history of lower-limbs pain.

Conclusions: D/AO is more closely related to falls than either dynapenia or abdominal obesity alone, and is independently associated with an increased incidence of falls in older women. These results provide support for the concept that the combined evaluation of muscle strength and central obesity may be clinically relevant in this population.
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http://dx.doi.org/10.1007/s40520-019-01318-zDOI Listing
July 2020

Stages of sarcopenia, bone mineral density, and the prevalence of osteoporosis in older women.

Arch Osteoporos 2019 03 13;14(1):38. Epub 2019 Mar 13.

Faculty of Physical Education, University of Brasília, Asa Norte, Brasilia, Distrito Federal, 70910-900, Brazil.

A better understanding of the relationship between osteoporosis and sarcopenia may help to develop effective preventive and therapeutic strategies. In the present study, the association between different stages of sarcopenia, BMD, and osteoporosis was examined. The salient findings indicate that a dose-response relationship exists between sarcopenia stages and bone-related phenotypes.

Purpose: To assess the association between sarcopenia stages, bone mineral density (BMD), and the prevalence of osteoporosis in older women.

Methods: Two hundred thirty-four women (68.3 ± 6.3 years) underwent body composition and BMD measurements using dual-energy X-ray absorptiometry. Quadriceps isokinetic torque was evaluated, and the timed up-and-go test was conducted as a measure of function. Sarcopenia stages were classified according to European Working Group on Sarcopenia in Older People (EWGSOP): nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia. Osteoporosis was defined as BMD value (hip or spine) 2.5 standard deviations below a young-adult reference population. Between-group differences were examined using ANOVA for continuous variables and chi-squared for categorical variables. Logistic regression was performed to evaluate the association between sarcopenia stages and osteoporosis.

Results: Rates of osteoporosis were 15.8%, 19.2%, 35.3%, and 46.2% for nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia, respectively (P = 0.002). Whole-body and femoral neck BMD values were significantly lower among all sarcopenia stages when compared to nonsarcopenia (all P values < 0.05, η 0.113 to 0.109). The severe sarcopenia group also showed significantly lower lumbar spine BMD values and T-scores (both P values < 0.05; η 0.035 and 0.037, respectively). When clustered, sarcopenia and severe sarcopenia exhibited lower BMD values for all sites (all P values < 0.01), and presented a significantly higher risk for osteoporosis (odds ratio 3.445; 95% CI 1.521-7.844).

Conclusion: The observed results provide support for the concept that a dose-response relationship exists between sarcopenia stages, BMD, and the presence of osteoporosis. These findings strengthen the clinical significance of the EWGSOP sarcopenia definition and indicate that severe sarcopenia should be viewed with attention by healthcare professionals.
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http://dx.doi.org/10.1007/s11657-019-0591-4DOI Listing
March 2019

A reference equation for normal standards for knee extensor isokinetic strength in Brazilian older women.

Aging Clin Exp Res 2019 Oct 4;31(10):1531-1537. Epub 2018 Dec 4.

Faculdade de Educação Física, Universidade de Brasília (UnB), Campus Universitário Darcy Ribeiro, Asa Norte, Brasília, Distrito Federal, CEP 70910-970, Brazil.

Background: Knee extensor strength assessment has been especially emphasized in older people, but lack of reference values limits its usefulness in geriatric evaluation.

Aims: The aim of this study was to develop a reference equation for knee extensor isokinetic strength standards in older women.

Methods: Knee extensor isokinetic tests at 60°/s were performed in 390 Brazilian older women aged 60-84 years (67.38 ± 5.56 years) and in a separate validation sample of 110 women (67.94 ± 6.13 years). A regression equation for peak torque (PT) was derived and compared to commonly used formulas: the equations of Neder and Gross. Age, weight and height were the only significant predictors (multiple R = 0.55; R = 0.30; p < 0.001). The proposed equation was examined in the independent sample. Percent from predicted values was calculated and Bland-Altman plots were constructed.

Results: Both the Neder and Gross equations significantly underestimated predicted PT values (both p < 0.001); mean bias were 6.79 and 6.75, respectively. The proposed equation [PT = 39.72 - (1.24 × age) + (0.44 × weight) + (69.70 × height)] was matched with the independent sample, with a percent predicted isokinetic strength of approximately 95%, a mean bias approximately 40% lower 4.23 than the other equations, and stable across all age groups.

Conclusions: Available equations for knee extensor isokinetic strength are not adequate for older women. The equation developed in the present study provided considerably lower average error and thus with more suitable reference values.
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http://dx.doi.org/10.1007/s40520-018-1084-9DOI Listing
October 2019

Stages of sarcopenia and the incidence of falls in older women: A prospective study.

Arch Gerontol Geriatr 2018 Nov - Dec;79:151-157. Epub 2018 Jul 19.

Faculty of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil.

The purpose of the present study was to assess the association between different stages of sarcopenia and the incidence of falls over 18 months in older community-dwelling women. 246 women (68.1 ± 6.2 years) underwent body composition using dual-energy x-ray absorptiometry, knee extensors isokinetic peak torque, and Timed Up-and-Go assessments. The stages of sarcopenia were classified according to the European Working Group on Sarcopenia in Older People. Volunteers were classified into four groups as follows: nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia. Participants were tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Cox proportional regressions were conducted. A total of 195 women were followed over the 18-month period. Proportions of each sarcopenia stage were 6.7%, 13.8%, and 12.8% for presarcopenia, sarcopenia, and severe sarcopenia, respectively. The proportion of fallers progressively increased according to the severity of sarcopenia, with 15.4%, 40.7%, and 72% for presarcopenia, sarcopenia, and severe sarcopenia, respectively (X = 30.637; p < 0.001). Severe sarcopenia was consistently associated with a higher risk of falls (hazard ratio: 3.843; 95% CI: 1.816-8.131), even after adjustments for age, body mass index, physical activity level, regular use of four or more medications, reduced peripheral sensation, presence of two or more chronic diseases, and history of lower-limbs pain. It is concluded that severe sarcopenia is independently associated with higher incidence of falls in older women. These results provide support for the concept that sarcopenia staging has clinical implications and might be an useful supplement to other routine falls risk assessment tools.
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http://dx.doi.org/10.1016/j.archger.2018.07.014DOI Listing
May 2019

The relationship between muscle quality and incidence of falls in older community-dwelling women: An 18-month follow-up study.

Exp Gerontol 2018 09 21;110:241-246. Epub 2018 Jun 21.

College of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil.

Introduction: Important components that might mediate the relationship between aging and falls are reduced muscle strength and mass. Although muscle-related phenotypes have been linked to falls in older people, the role of muscle quality has yet to be examined.

Aim: To investigate the relationship between muscle quality and incidence of falls over an 18-month follow-up in older community-dwelling women.

Methods: A total of 167 women (68.1 ± 6.2 years) underwent quadriceps isometric peak torque and thigh-muscle thickness assessments using isokinetic dynamometer and ultrasound, respectively. Muscle quality was considered as the ratio between maximal strength and muscle thickness. Participants were tracked by phone calls for ascertainment of falls during the follow-up period. Cox proportional regressions and X tests were performed, with statistical significance set at P < 0.05.

Results: A total of 139 volunteers were successful tracked over the follow-up period. The overall incidence of fall was 23.4% (95% CI: 16.5-31.0). Rate of fallers among individuals with low-muscle quality (57.7%) was higher than in those with normal muscle quality (15.3%) (X = 21.132; P < 0.001). The proportion of multiple fallers was also significantly higher (X = 11.029; P < 0.001) among volunteers with low-muscle quality when compared to those with normal muscle quality (14.8% and 3.6%, respectively). The presence of low-muscle quality was associated with a significantly greater risk of falls over the follow-up (hazard ratio: 4.619; 95% CI: 2.302-9.269).

Conclusion: Low-muscle quality is associated with a higher incidence of falls in older women. These findings provide support for the concept that muscle quality is a clinically meaningful assessment among older people.
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http://dx.doi.org/10.1016/j.exger.2018.06.018DOI Listing
September 2018

Normative Values of Knee Extensor Isokinetic Strength for Older Women and Implications for Physical Function.

J Geriatr Phys Ther 2019 Oct/Dec;42(4):E25-E31

Faculty of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil.

Background And Purpose: Lower-limb strength is required for everyday activities and thus its evaluation has been especially emphasized in older adults. Isokinetic testing is a criterion standard method to assess muscle strength; however, lack of reference values limits its usefulness in geriatric evaluation and rehabilitation. The aim of this study was to develop reference values of knee extensor isokinetic strength for older women. As a secondary aim, functional tests were performed for clinical significance validation.

Methods: A total of 453 older women aged 60 to 84 years participated in this study. Knee extensor isokinetic strength was measured using the Biodex System dynamometer at 60° per second. The Timed Up and Go test and the 5 times Sit-to-Stand test were used for functional performance evaluation. Participants were categorized into age groups of 5 years range. The 20th, 40th, 60th, and 80th percentiles were used for stratification purposes.

Results And Discussion: As expected, mean strength values significantly decreased with advancing age groups. Isokinetic percentile groups are presented according to age. Individuals in the lower percentile strata showed significantly reduced performance in both the Timed Up and Go and 5 times Sit-to-Stand tests (P < .05).

Conclusion: This study provides normative values of isokinetic knee extensor strength in older women. The association between lower isokinetic knee extensor strength strata and reduced functional capacity supports the potential application of these reference values in clinical and research settings. Future studies should ascertain these findings in different female populations.
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http://dx.doi.org/10.1519/JPT.0000000000000198DOI Listing
July 2020

Severity of sarcopenia is associated with postural balance and risk of falls in community-dwelling older women.

Exp Aging Res 2018 May-Jun;44(3):258-269. Epub 2018 Mar 20.

a Faculty of Physical Education , University of Brasília , Brasília , Distrito Federal , Brazil.

Background/Study context: Falls represent the leading cause of accidental deaths in the elderly. Sarcopenia is a geriatric syndrome defined as the loss of muscle mass and strength. However, the association between falls and sarcopenia is still unclear. Thus, the aim of the present study was to investigate the association between different stages of sarcopenia and postural balance, risk of falls, and fear of falling in community-dwelling older women.

Methods: A total of 196 women (68.6 ± 6.5 years) underwent body composition (Dual-energy X-ray Absorptiometry), muscle strength (isokinetic), and functional (Timed Up-and-Go) assessments. Sarcopenia was classified according to European Working Group on Sarcopenia in Older People. Center of pressure (CoP) sway, risk, and fear of falling were assessed through force platform, QuickScreen, and Falls Efficacy Scale, respectively. ANOVA models and chi-squared were used to compare groups.

Results: Severe sarcopenic subjects presented higher risk of falling when compared to the other stages (p < 0.01). Regarding CoP sway, both mean speed and mediolateral range were significantly higher in severe sarcopenia when compared to both nonsarcopenia and presarcopenia (p < 0.05). Fear of falling was higher in all sarcopenia stages when compared to nonsarcopenic individuals (p < 0.05).

Conclusion: Sarcopenia negatively affects balance, and both risk and fear of falling in community-dwelling older women. Moreover, this study provides evidence that sarcopenia severity is further associated to reduced balance and imposes an even greater risk of falls in the elderly.
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http://dx.doi.org/10.1080/0361073X.2018.1449591DOI Listing
January 2019

Muscle quality is associated with dynamic balance, fear of falling, and falls in older women.

Exp Gerontol 2018 04 9;104:1-6. Epub 2018 Jan 9.

College of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil. Electronic address:

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http://dx.doi.org/10.1016/j.exger.2018.01.003DOI Listing
April 2018

The Association Between Body Adiposity Measures, Postural Balance, Fear of Falling, and Fall Risk in Older Community-Dwelling Women.

J Geriatr Phys Ther 2019 Jul/Sep;42(3):E94-E100

College of Physical Education, University of Brasília, Brasília/DF, Brazil.

Background And Purpose: Recent investigations demonstrate an association between obesity and the propensity of older adults to fall. The aim of this study was to investigate the association between body adiposity measures, postural balance, fear of falling, and risk of falls in older women.

Methods: One hundred forty-seven volunteers took part in this cross-sectional study. Participants underwent body composition assessment using dual-energy x-ray absorptiometry and had body mass index, waist circumference (WC), and body adiposity index measured. Postural balance was assessed using a force platform, while fear of falling and risk of falls were, respectively, evaluated by the Falls Efficacy Scale-International and the QuickScreen Clinical Falls Risk Assessment.

Results And Discussion: All adiposity measures were correlated to at least 1 postural stability parameter and to fear of falling (ρ= 0.163, P < .05 to r = 0.337, P < .001); however, WC was the index most strongly correlated to risk of falls (ρ= 0.325; P < .001). When obesity was classified using WC, it was observed that compared with nonobese individuals (n = 51), obese individuals (n = 96) exhibited greater center of pressure displacement in the anteroposterior and mediolateral axes, especially during conditions with feet apart (P < .05). The obese group also exhibited an increased fear of falling (28.04 vs 24.59; P = .002) and had a higher proportion of individuals with increased fall risk (72% vs 35%; P < .001).

Conclusion: In summary, adiposity measures are associated with risk of falls in older women, which might be mediated by reduced postural balance and increased fear of falling. Among these indices, WC, an easy and low-cost assessment, demonstrated the strongest association with falls-related outcomes.
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http://dx.doi.org/10.1519/JPT.0000000000000165DOI Listing
April 2020

Obesity is Associated With Altered Plantar Pressure Distribution in Older Women.

J Appl Biomech 2017 Oct 19;33(5):323-329. Epub 2017 Sep 19.

1 University of Brasília.

Increased plantar pressure has been found to be related with greater risk of falling. Although there is evidence suggesting that obesity is linked to foot disorders, the association between obesity and plantar pressure of older adults has been poorly investigated. The purpose of this study was to examine the association between obesity and plantar pressure distribution and to explore its relationship with body fat distribution. Two hundred and eleven older women took part in this cross-sectional study. Body mass index was taken for obesity classification. Whole body, android, and gynoid fat percentage was assessed using dual-energy x-ray absorptiometry. Peak plantar pressure was evaluated during gait using an Emed AT-4 pressure platform. Obese volunteers generated greater peak pressure at midfoot (187.26 kPa) compared to both normal weight (128.52 kPa, p < .001) and overweight (165.74 kPa, p < .001). Peak plantar pressure at midfoot was also greater in overweight compared to normal weight (p < .001). At forefoot, peak pressure was higher in the obese (498.15 kPa) compared to normal weight volunteers (420.41 kPa, p = .007). Additionally, whole body, android, and gynoid fat percentage were significantly associated with peak pressure at midfoot and forefoot. Therefore, clinicians dealing with falls should consider the effect of increased body weight on plantar pressure.
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http://dx.doi.org/10.1123/jab.2016-0357DOI Listing
October 2017

Body Adiposity Index, but not Visceral Adiposity Index, Correlates with Inflammatory Markers in Sarcopenic Obese Elderly Women.

Exp Aging Res 2017 May-Jun;43(3):291-304

a College of Physical Education , University of Brasília , Brasília , Brazil.

Background/Study Context: The association of body adiposity index (BAI) and visceral adiposity index (VAI) with inflammatory markers has yet to be understood. The aim of this work was to investigate the association of BAI and VAI with inflammatory markers in elderly women with sarcopenic obesity (SO).

Methods: A total of 130 women (age: 66.7 ± 5.2 years) underwent body composition analysis by dual-energy x-ray absorptiometry (DEXA). Volunteers were classified according to SO definition. BAI, VAI, and waist-to-hip ratio (WHR) were calculated. Blood samples were collected for C-reactive protein (CRP), tumor necrosis factor, and interleukin-6 (IL-6) measurements.

Results: SO prevalence was 20.8%. BAI correlated with the DEXA-derived body fat content (r = .90), CRP (r = .55), and IL-6 (r = .53), whereas WHR correlated with CRP (r = .60) only (all p < .01). VAI did not correlate with any of the inflammatory variables.

Conclusion: Simple and cheap anthropometric indices such as BAI and WHR may be better predictors of low-grade inflammation than VAI in elderly women with SO.
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http://dx.doi.org/10.1080/0361073X.2017.1298959DOI Listing
November 2017

Effects of resistance training on sarcopenic obesity index in older women: A randomized controlled trial.

Arch Gerontol Geriatr 2016 Jul-Aug;65:168-73. Epub 2016 Mar 31.

Physiology of Exercise and Health Research Group, College of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil; University of Brasília, Brasília, Brazil.

The purpose of this study was to examine the effects of resistance training (RT) on sarcopenic obesity (SO) in older women. 243 older women underwent body composition measurement using dual-energy X-ray absorptiometry, and the SO index was calculated. This randomized controlled trial adopted from the baseline sample, 113 volunteers (67.0±5.2years) were randomly assigned to a control group (CG, n=64) or an experimental group (EG, n=69). The EG took part in a 24-week RT program, conducted three times per week. Body composition measurements were repeated at the end of the training program. RT induced a significant increase in fat-free mass (P<0.01), but not decrease in fat mass in the EG. Moreover, the SO index was also significantly improved in the EG (P<0.01), while it decreased significantly in the CG (P<0.01). It is concluded that RT is an effective approach to promote body composition alterations in older women, and it might improve SO-related phenotypes.
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http://dx.doi.org/10.1016/j.archger.2016.03.017DOI Listing
July 2017

Author's reply.

Clin Interv Aging 2015 ;10:1659-60

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April 2016

Resistance training improves isokinetic strength and metabolic syndrome-related phenotypes in postmenopausal women.

Clin Interv Aging 2015 7;10:1299-304. Epub 2015 Aug 7.

College of Physical Education, University of Brasília, Brasília, DF, Brazil.

Purpose: To examine the effects of resistance training (RT) on metabolic syndrome-related phenotypes in postmenopausal women.

Patients And Methods: Twenty-two postmenopausal women (65.0±4.2 years) underwent 12 weeks of whole body progressive training with intensity prescribed based on rating of perceived exertion. Dominant knee extension strength was assessed using an isokinetic dynamometer before and after the intervention. Moreover, all volunteers had blood samples collected for lipid profile, glycemic control, and C-reactive protein analyses. Waist circumference and arterial blood pressure were also measured at baseline and after the training period. Student's t-tests for paired samples and repeated measures ANOVA were used to compare dependent variables, and statistical significance was set at P<0.05.

Results: Isokinetic muscle strength significantly increased (P<0.01) with training. It was observed that waist circumference as well as total and low-density lipoprotein cholesterol levels significantly decreased with training (P<0.01). Total cholesterol/high-density lipoprotein cholesterol ratio, an important marker of cardiovascular disease incidence, was also significantly reduced (from 3.91±0.91 to 3.60±0.74; P<0.01) after the program. Blood glucose, basal insulin, and homeostatic model assessment of insulin resistance were also significantly reduced (P<0.01). No significant alterations were observed for resting blood pressure, triglycerides, or C-reactive protein.

Conclusion: Based on the observed results, it can be concluded that a 12-week progressive RT program, besides increasing isokinetic muscle strength, induces beneficial alterations on metabolic syndrome-related phenotypes in postmenopausal women. These findings highlight this mode of exercise as an important component of public health promotion programs for aged women. RT improves isokinetic strength and metabolic syndrome-related phenotypes in postmenopausal women.
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http://dx.doi.org/10.2147/CIA.S87036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535561PMC
April 2016

Sarcopenia and sarcopenic obesity classifications and cardiometabolic risks in older women.

Arch Gerontol Geriatr 2014 Jul-Aug;59(1):56-61. Epub 2014 Apr 5.

Physiology of Exercise and Health Research Group, Faculty of Physical Education of University of Brasília, Campus Darcy Ribeiro, Brasília, Brazil; University of Brasília, Brasília, Brazil.

The purpose of this study was to examine the association between sarcopenia and sarcopenic obesity (SO) with cardiometabolic risk factors in postmenopausal women. 149 volunteers (67.17±6.12 years) underwent body composition assessment using dual energy X-ray absorptiometry (DXA) and had analyzed blood samples collected for lipid profile, glucose metabolism and C-reactive protein (CRP). Sarcopenia was defined as an appendicular fat-free mass (AFFM) divided by height squared ≤5.45 kg/m(2) while SO was classified based on the residuals of a regression. Waist circumference (WC) and arterial blood pressure were also measured. Student's t-tests and correlations were used for analyses. Prevalence of sarcopenia and SO were respectively 16.8 and 21.5%. WC was significantly correlated with all the examined risk factors. AFFM relative to height squared was positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP), CRP, insulinaemia, HOMA score, and those classified as sarcopenic presented lower HOMA score when compared to nonsarcopenic. Regarding SO, although volunteers classified presented significantly higher fat mass (FM) and lower AFFM, it was not observed association with the examined risk factors. These findings support the association between WC and cardiometabolic risk factors in older women. In contrast, the approaches used to define sarcopenia and SO are not associated with cardiometabolic impairments.
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http://dx.doi.org/10.1016/j.archger.2014.03.012DOI Listing
October 2014