José Ailton Oliveira Carneiro

Obese elderly women exhibit low postural stability: a novel three-dimensional evaluation system

OBJECTIVE: The aim of this study was to evaluate the multisegmental static postural balance of active eutrophic and obese elderly women using a three-dimensional system under different sensory conditions. METHODS: A cross-sectional study was conducted on 31 elderly women (16 eutrophic and 15 obese) aged 65 to 75 years. The following anthropometric measurements were obtained: weight, height, waist and hip circumference, and handgrip strength. The physical activity level was evaluated using the International Physical Activity Questionnaire. Body composition was measured using the deuterium oxide dilution technique. The Polhemus® Patriot (three-dimensional) equipment was used to measure the parameters of postural balance along the anteroposterior and laterolateral axes. The data acquisition involved one trial of 60 s to test the limit of stability and four trials of 90 s each under the following conditions: (1) eyes open, stable surface; (2) eyes closed, stable surface; (3) eyes open, unstable surface; and (4) eyes closed, unstable surface. RESULTS: For the limit of stability, significant differences were observed in the maximum anteroposterior and laterolateral displacement (p<0.01) and in the parameter maximum anteroposterior displacement in the eyes closed stable surface condition (p<0.01) and maximum anteroposterior and laterolateral displacement in the eyes open unstable surface (p<0.01 and p = 0.03) and eyes closed unstable surface (p<0.01 and p<0.01) conditions. CONCLUSIONS: Obese elderly women exhibited a lower stability limit (lower sway area) compared with eutrophic women, leaving them more vulnerable to falls.

Structure and evolution of tetraodontoid teeth: An autoradiographic study (Pisces, Tetraodontiformes)

For years teeth of tetraodontoid fishes generally have been considered coalescent even though “coalescence,” which also is found in fishes of other families, has never been well defined. This paper deals with some aspects of coalescence of the teeth in tetraodontoids and attempts to define this condition. The sites of osteodentinogenesis and the mechanisms by which hard tissues are formed, reabsorbed, and abraded during feeding were analyzed from semiserial decalcified sections and from ground sections, as well as from autoradiographs of the premaxilla and dentary bones of Sphoeroides greeleyi. The observations reported here, taken together with other data we have obtained on members of the Tetraodontoidei, permit clear definitions of “tooth” and “supporting bone,” and consequently the structural meaning of coalescence. From these data we hypothesize how coalesced masticatory structures may have evolved in this group.

Body composition, physical performance and muscle quality of active elderly women

Fat gain is one of the major factors aggravating physical disability in the elderly population, which presents an increase in fat mass and a decrease in lean mass compared to the young population. For this reason it is important to assess body composition and the effects of these alterations in obese elderly women. The purpose of this study was to assess body composition, physical performance and muscle quality in active elderly women. Cross-sectional study included 75 elderly women (29 eutrophic and 46 obese) 65-80 years old. Body composition was evaluated by dual energy X-ray absorptiometry (DXA) and the physical performance was determined by 6-minute walk test (6MWT), handgrip strength (HS) and knee extension strength (KES). Muscle quality was calculated as the ratio between muscle strength and lean mass. Fat free mass, lean mass, fat mass and percent body fat were significantly higher in the obese group (p<0.05). Furthermore, the obese group showed a poorer performance than the eutrophic group in the 6MWT (432.31±66.13 m and 472.07±74.03 m, respectively, p=0.01). HS and KES did not differ between groups, however, regarding muscle quality, the obese group exhibited a impaired in comparison to the eutrophic group in the upper (11.45±2.57 kg and 13.31±2.03 kg, respectively, p<0.01) and lower limb (2.91±1.16 kg and 3.44±0.97 kg, respectively, p=0.05). The increase in muscle mass detected in the obese elderly was not sufficient to maintain adequate muscle quality and physical function, showing a negative influence of the excess of body fat.

Comparação da oscilação postural estática na posição sentada entre jovens e idosos saudáveis

OBJECTIVES: To describe a new method to analyze the static sitting postural sway and to compare the results of healthy young and older adult subjects. METHODS: Thirty-eight healthy subjects took part in the study, including 17 young adults (mean age 23±2.38 years old) and 21 older adults (mean age 67±2.42 years old). The device used to quantify trunk sway was the magnetic field sensor Polhemus® 3Space Isotrack II. The measurements were taken in the eyes-opened (EO) and eyes-closed (EC) condition with the subjects seated first on a wooden stable surface (SS) then on a foam unstable surface (US) without back or foot support. Each sensory condition was assessed for 90 seconds. The analyzed parameters were: maximum amplitude (Amp), total trajectory (Traj) and mean velocity (Vel) in the sagittal (X) and frontal (Y) planes. RESULTS: In the EO and EC conditions on SS, young adults presented greater postural sway in the X and Y planes on the Traj and Vel parameters. In the US, young adults showed greater Y Traj and Y Vel in the EO and EC conditions, and there was no significant difference between the groups with regard to X Traj and X Vel in the EC condition. The young adults presented greater Amp only in the EOSS condition in the X plane. CONCLUSIONS: The young adult subjects presented greater sway in the sitting position than the older adult subjects. In addition, the Polhemus® device was a useful tool to analyze static sitting postural sway and can be used in future studies that associate static sitting postural sway with the effect of various motor tasks.

Coalescence of teeth in fishes

In this paper the concept of coalescence of teeth previously defined for the Tetraodontoid fishes is extended to some other teleostomes. Comments are made on the «dentigerous plates» of non-teleostomian fishes and on the dermal plates bearing odontodes found in some fossil groups.

Software for subjective visual vertical assessment: an observational cross-sectional study

UNLABELLED Spatial orientation in relation to the gravitational axis is significantly important for the maintenance of the posture, gait and for most of the humans motor activities. The subjective visual vertical exam evaluates the individuals perception of vertical orientation. OBJECTIVES The aims of this study were (1) to develop a virtual system to evaluate the subjective visual vertical exam, (2) to provide a simple tool to clinical practice and (3) to assess the subjective visual vertical values of healthy subjects using the new software. STUDY DESIGN observational cross-sectional study. METHODS Thirty healthy volunteers performed the subjective visual vertical exam in both static and dynamic conditions. The exam consisted in adjusting a virtual line in the vertical position using the computer mouse. For the static condition, the virtual line was projected in a white background. For the dynamic condition, black circles rotated in clockwise or counterclockwise directions. Six measurements were taken and the mean deviations in relation to the real vertical calculated. RESULTS The mean values of subjective visual vertical measurements were: static -0.372º; ± 1.21; dynamic clockwise 1.53º ± 1.80 and dynamic counterclockwise -1.11º ± 2.46. CONCLUSION This software showed to be practical and accurate to be used in clinical routines.

Perfıl de fragilidade e fatores associados em idosos cadastrados em uma Unidade de Saúde da Família

The scope of this study was to identify the profile of fragility and associated factors among the elderly registered in a Family Health Unit. It involved an observational, exploratory, household -based and cross-sectional study conducted with 139 elderly individuals. The data were collected using a structured questionnaire requesting the following information: personal history, family and self-reported diseases, socio-demographic information, level of physical activity, behavior variables, number of falls in the last year, depressive symptoms, unintentional weight loss and fatigue. Anthropometric measurements (weight and height) were also taken and the body mass index (BMI) was calculated. Descriptive analyses and Pearsons chi-square test or Fishers exact test were performed, with a significance level of p < 0.05. SPSS software version 21.0 was used for statistical analysis. The prevalence of fragility among the elderly was: frail (16.9%), pre-frail (61.8%) and non-frail (21.3%), respectively. The fragility profile was associated with: age (p < 0.001), BMI (p = 0.018), family situation (p = 0.014), level of physical activity (p < 0.001) and falls (p = 0.043). In this study, a high prevalence was observed of pre-frail and frail elderly individuals and identified factors associated with this syndrome.O objetivo deste estudo foi identificar o perfil de fragilidade e os fatores associados a idosos cadastrados em uma Unidade de Saude da Familia. Trata-se de um estudo observacional de corte transversal, exploratorio de base domiciliar, realizado com 139 idosos. Os dados foram coletados por meio de um questionario estruturado, contendo as seguintes informacoes: antecedentes pessoais, familiares e doencas autorreferidas, sociodemograficas, nivel de atividade fisica, variaveis comportamentais, eventos de quedas no ultimo ano, sintomatologia depressiva, perda de peso nao intencional e fadiga. Foram ainda realizadas medidas antropometricas (peso e altura) e calculado o Indice de Massa Corporea (IMC). Foram realizadas analises descritivas e o teste de qui-quadrado de Pearson, ou exato de Fisher, com nivel de significância (p < 0,05). Para as analises, foi utilizado o programa estatistico SPSS®, versao 21.0. Encontrou-se uma prevalencia de idosos frageis de 16,9%, pre-frageis de 61,8% e nao fragil de 21,3%. Foram observadas associacoes de fragilidade com grupo etario (p < 0,001), IMC (p = 0,018), arranjo familiar (p = 0,014), atividade fisica (p < 0,001) e quedas (p = 0,043). Neste estudo, observou-se uma alta prevalencia de idosos pre-frageis e frageis e identificou fatores associados com esta sindrome.

Analysis of static postural balance using a 3d electromagnetic system.

UNLABELLED Early detection of postural disorders is essential for timely interventions in patients with imbalance. AIM A pilot study describing a new tool for evaluating static postural balance. STUDY DESIGN A cross-sectional study of a contemporary series. MATERIAL AND METHOD Twenty-five volunteers (15 women and 10 men) were evaluated. The mean age was 25.8 ± 4.2 years, the mean weight was 63.9 ± 13.1Kg, the mean height was 1.68 ± 0.08 m and the body mass index was 22.3±3.3kg/m2. Posturography was done by analysing postural sway with an electromagnetic system; a sensor was attached to the skin over the spinous process of the first thoracic vertebra. Tests were carried out with the subjects in the orthostatic position for 90 seconds, with eyes opened(EO) and closed(EC) on stable and unstable surfaces. RESULTS When the influence of the surface was analyzed (stable x unstable) in the EO condition, there were significant differences in the middle-lateral parameters (m-l) (p=0.004) and total path (p=0.01), and in the m-l (p=0.004) and total (p=0.014) speed. In the EC condition, there were significant differences in all parameters (p<0.001). The influence of the vision was observed in all parameters only on unstable surfaces (p<0.05). CONCLUSION The new tool was efficient for analysing postural sway.

Body composition, muscle strength and quality of active elderly women according to the distance covered in the 6-minute walk test

BACKGROUND Changes arising from the aging process, particularly changes in body composition, contribute to the functional decline of the elderly. OBJECTIVE To compare the body composition and muscle strength, mobility and quality in active elderly women according to the distance walked during the 6-minute walk test (6MWT). METHOD The study included 77 active elderly women aged 65 to 80 years, who were divided into tertiles (A, B and C) according to the distance covered in the 6MWT. We performed anthropometric and clinical evaluations. Body composition was determined by dual energy X-ray absorptiometry (DXA). Handgrip strength (HGS) was measured with a portable dynamometer (Saehan), and knee extension strength (KES) was measured with the one repetition maximum test (1-RM). Functional mobility was assessed by the Timed Up and Go (TUG) test, and body balance was assessed by the Berg Balance Scale (BBS). Muscle quality was defined by the ratio between muscle strength (kgf) and muscle mass (kg). RESULTS The group that walked the shortest distance in the 6MWT had a higher BMI (A=30.8±7.0, B=27.2±4.2 and C=25.9±3.5 kg/m2), greater amount of fat mass (A=31.3±10.7, B=25.9±6.7 and C=23.81±6.46 kg) lower HGS (A=21.8±5.1, B=22.1±3.5 and C=25.5±5.1 kgf), lower knee extension strength (A=30.6±10.9, B=40.4±12.5 and C=47.2±10.1 kgf), lower arm muscle quality (A=10.1±3.7, B=11.6±2 and C=12.7±2.2 kg) and lower leg muscle quality (A=1.78±1, B=2.84±0.98 and C=3.31±0.77 kg). There was no significant difference between muscle mass (p=0.25) and lean mass (p=0.26). CONCLUSION Body fat has a negative influence on functional performance, even among active elderly women.

Estudo do equilíbrio postural estático em pacientes com vestibulopatia mediante sistema de sensores eletromagnéticos tridimensionais

The vestibular-ocular reflex assessment is important, but not enough. Tridimensional electromagnetic sensor systems represent a new method to assess posturography. AIM: To assess body sway in healthy subjects who had positive Dix Hallpike and Epley maneuvers and with other vestibular dysfunctions by means of a three-dimensional system. Study design: Prospective. MATERIALS AND METHODS: We had 23 healthy women, 15 with peripheral vestibular dysfunction found upon caloric test and 10 with positive Epley and Dix Hallpike maneuvers. All tests performed in the following positions: open and closed eyes on stable and unstable surfaces. RESULTS: With the Eyes Open and on a stable surface, p < 0.01 between the control group and the one with peripheral vestibular dysfunction in all variables, except the a-p maximum, full speed and mediolateral trajectory velocity, which had a p < 0.01 between the group with vestibular dysfunction and controls in all positions. The group with positive Epley and Dix Hallpike maneuvers had p < 0.01 at full speed and in its components in the x and y in positions with open and eyes closed on an unstable surface. CONCLUSION: The tridimensional electromagnetic sensors system was able to generate reliable information about body sway in the study volunteers.UNLABELLED The vestibular-ocular reflex assessment is important, but not enough. Tridimensional electromagnetic sensor systems represent a new method to assess posturography. AIM To assess body sway in healthy subjects who had positive Dix Hallpike and Epley maneuvers and with other vestibular dysfunctions by means of a three-dimensional system. STUDY DESIGN Prospective. MATERIALS AND METHODS We had 23 healthy women, 15 with peripheral vestibular dysfunction found upon caloric test and 10 with positive Epley and Dix Hallpike maneuvers. All tests performed in the following positions: open and closed eyes on stable and unstable surfaces. RESULTS With the Eyes Open and on a stable surface, p < 0.01 between the control group and the one with peripheral vestibular dysfunction in all variables, except the a-p maximum, full speed and mediolateral trajectory velocity, which had a p < 0.01 between the group with vestibular dysfunction and controls in all positions. The group with positive Epley and Dix Hallpike maneuvers had p < 0.01 at full speed and in its components in the x and y in positions with open and eyes closed on an unstable surface. CONCLUSION The tridimensional electromagnetic sensors system was able to generate reliable information about body sway in the study volunteers.