José Rubens Rebelatto

Influência de um programa de atividade física de longa duração sobre a força muscular manual e a flexibilidade corporal de mulheres idosas

Influence of a Long-Term Physical Activity Program on Hand Muscle Strength and Body Flexibility Among Elderly Women Objective: The present study evaluated the influence of a two-year physical activity program on muscle strength and body flexibility among non-institutionalized elderly women (60-80 years old), from Salamanca Province in Spain. Method: Thirty-two individuals were chosen to take part in the Geriatric Revitalization Program at Salamanca University. The selection criteria were that they should be female, between 60 and 80 years old, with an attendance rate of at least 74% in the physical activity program. There were 174 physical activity sessions, over a 58-week period, three times a week, lasting 50-55 minutes each. During this period, four measurements of hand muscle strength were made, using a pressure manometer, and also of body flexibility, using the sit and reach test. The data were analyzed using ANOVA with repeated measurements. Results: There were no significant differences in relation to either muscle strength or flexibility (p=0.005). Conclusions: The program contributed towards maintaining hand grip strength over the two-year period. For body flexibility, the data indicate the need to reprogram the exercises aimed at developing this capacity.

The relationship between foot pain, anthropometric variables and footwear among older people.

OBJECTIVE To verify the prevalence of pain among older people when wearing shoes, and the relationships between foot pain, high-heeled shoes and anthropometric variables. METHOD Both feet of 227 older women and 172 older men were evaluated with respect to anthropometric variables, arch index and foot posture index. The participants were also asked about the presence of foot pain while wearing high-heeled shoes. The data were analyzed using the Chi-square test, Pearsons correlation, MANOVA, multiple regression analysis, t test, and analysis of probability. FINDINGS The prevalence of foot pain when wearing shoes was high and was associated with the female gender, however wearing high-heeled shoes was not associated with pain. The women with foot pain presented larger values for the circumferences of the metatarsal heads and the instep (after normalization with the foot length) than those without pain. The men with pain did not present different measurements from those without pain.

Quedas em idosos institucionalizados: características gerais, fatores determinantes e relações com a força de preensão manual

OBJETIVO: Identificar a ocorrencia de quedas em idosos institucionalizados no Municipio de Sao Carlos (SP), descrever os fatores determinantes e verificar sua associacao com a forca de preensao manual. METODOS: Participaram do estudo 61 idosos institucionalizados (31 homens e 30 mulheres) que foram avaliados quanto a forca de preensao manual e entrevistados quanto a eventos de queda e possiveis fatores determinantes. RESULTADOS: Verificou-se que 54,1% haviam sofrido pelo menos uma queda no ano que antecedeu a entrevista e que a incapacidade de assistir televisao possui correlacao significativa com o indice de quedas (p=0,05), ao contrario das demais atividades funcionais estudadas (deambular, tomar banho e sentar sem auxilio), dor e doencas. Foram encontradas diferencas estatisticamente significantes entre as medias de idade dos idosos que ja haviam caido (76,76 anos, ±9,17) e dos que nao haviam caido (71,05 anos, ±8,67); e entre as medias de forca de preensao manual de idosos que ja haviam caido (19,37 kgf, ±8,92) e dos que nao haviam caido (25,45 kgf, ±12,14). A analise de variância nao mostrou diferenca no numero de quedas sofridas entre homens e mulheres. CONCLUSOES: Houve alta incidencia de quedas em idosos institucionalizados no municipio estudado, sendo que os idosos com menor forca de preensao manual, os mais velhos e os incapazes de assistir televisao se mostraram mais propensos a sofrer quedas.

The relationship between the body mass index (BMI) and foot posture in elderly people

We wanted to evaluate the postural characteristics of the feet of older people and their relationship with the BMI. We evaluated 227 older women and 172 older men with respect to the BMI, the arch index (AI) and the foot posture index (FPI). The obese women presented mean values for the AI significantly greater than those of the normal and overweight women. The means for some of the criteria of the FPI were significantly higher in the obese men. There was a positive correlation between the BMI and the AI and some of the FPI criteria. The conclusion was that obese women presented flatter feet while obese men presented more pronated feet, indicating a relationship between high BMI values and postural characteristics of the feet of subjects studied.

Active Stretching Improves Flexibility, Joint Torque, and Functional Mobility in Older Women

Batista LH, Vilar AC, Ferreira JJA, Rebelatto JR, Salvini TF: Active stretching improves flexibility, joint torque, and functional mobility in older women. Objective:To investigate the effect of an active stretching program on the knee flexors with regards to flexibility, torque, and functional mobility of older women. The hypothesis of this study was that a program of active knee-flexor stretching increases flexibility and muscle torque and improves functional mobility. Design:Twelve active older women aged 68.3 ± 6.2 yrs participated in this study, which lasted 12 wks. This study was divided into three phases (A1-B-A2), each lasting 4 wks. Phases A1 and A2 were control phases (without intervention), and phase B (stretch) consisted of seven repetitions of active knee-flexor stretching (1 min each, 30-sec rest, twice a week). Flexibility, functionality, and isokinetic torque (knee flexors and extensors) were assessed by measuring the knee-extension range of motion, the “Timed Up & Go” test, and by a dynamometry test at 60°/sec. Results:Stretching increased the flexibility of the knee flexors (41.5%; P = 0.0001), knee-flexor torque (11.4%), and extensor torque (10.1%) (P ≤ 0.01) but decreased Timed Up & Go test performance (14.3%; P = 0.0001). Conclusions:The results of this study showed that an active stretching program was effective in increasing the flexibility of knee flexors, extensor and flexor torque, and functional mobility in older women.

Effects of Infrared-LED Illumination Applied During High-Intensity Treadmill Training in Postmenopausal Women

BACKGROUND DATA Technology and physical exercise can enhance physical performance during aging. OBJECTIVE The purpose of this study was to investigate the effects of infrared-light-emitting diode (LED) illumination (850 nm) applied during treadmill training. MATERIALS AND METHODS Twenty postmenopausal women participated in this study. They were randomly divided into two groups. The LED group performed treadmill training associated with infrared-LED illumination (n=10) and the control group performed only treadmill training (n=10). The training was performed during 3 months, twice a week during 30 min at intensities between 85 and 90% of maximal heart rate. The irradiation parameters were 31 mW/cm(2), treatment time 30 min, 14,400 J of total energy and 55.8 J/cm(2) of fluence. Physiological, biomechanical, and body composition parameters were measured at the baseline and after 3 months. RESULTS Both groups improved the time of tolerance limit (Tlim) (p<0.05) during submaximal constant-speed testing. The peak torque did not differ between groups. However, the results showed significantly higher values of power [from 56±10 to 73±8 W (p=0.002)] and total work [from 1,537±295 to 1,760±262 J (p=0.006)] for the LED group when compared to the control group [power: from 58±14 to 60±15 W (p≥0.05) and total work: from 1,504±404 to 1,622±418 J (p≥0.05)]. The fatigue significantly increased for the control group [from 51±6 to 58±5 % (p=0.04)], but not for the LED group [from 60±10 to 60±4 % (p≥0.05)]. No significant differences in body composition were observed for either group. CONCLUSIONS Infrared-LED illumination associated with treadmill training can improve muscle power and delay leg fatigue in postmenopausal women.

Influência da universidade aberta da terceira idade (UATI) e do programa de revitalização (REVT) sobre a qualidade de vida de adultos de meia-idade e idosos

Influence of the Open University for the Third Age (UATI) and the revitalization program (REVT) on quality of life in middle-aged and elderly adults

Efeito do programa de revitalização de adultos sobre a ocorrência de quedas dos participantes

Effect of the Adult Revitalization program on the occurrence of falls among its participants Objective: To assess the effect of the first year of an Adult Revitalization program on the number of occurrences of falls, and its relationship with the evolution of muscle strength, flexibility and dynamic balance. Method: 94 individuals (79 women and 15 men) who participated in an Adult Revitalization program in Sao Carlos, State of Sao Paulo, Brazil, for one year were evaluated regarding their hand grip strength, flexibility, dynamic balance and occurrences of falls on five occasions: an initial evaluation followed by four others at three-month intervals. Results: The women and the men experienced gains in flexibility and balance over the course of the program, but there was no significant reduction in the number of falls. Only women improved their muscle strength. The individuals who reported having fallen at least once during that year (28.72% of the participants) gained strength and flexibility, but their dynamic balance did not increase. In this group, the mean number of falls decreased between the first and the third evaluation, but increased between the third and the fourth evaluation, which coincided with the period of resting from physical activities. The individuals who did not fall presented gains in balance and flexibility but not in their hand grip strength. Conclusion: After one year, the number of falls among the participants in the Adult Revitalization program did not decrease significantly. Among the participants who fell at least once during the study period, the improvement in the number of falls occurred inversely to the improvement in handgrip strength and dynamic balance, but did not present any relationship with the improvement in flexibility.

Associação entre déficit visual e aspectos clínico-funcionais em idosos da comunidade

OBJETIVO: Identificar os fatores funcionais associados com o deficit visual em idosos da comunidade. METODOS: Foram avaliados 96 idosos quanto a acuidade visual por meio da tabela direcional de Snellen e categorizados em relacao a baixa visao (acuidade visual 0,3). Os fatores funcionais analisados foram: numero de quedas, presenca de doencas visuais, saude mental, pela Geriatric Depression Scale (GDS), funcionalidade nas atividades diarias pelo Brazilian OARS Multidimensional Functional Assessment Questionnaire (BOMFAQ) e a mobilidade funcional pelo Timed Up & Go Test (TUG). A analise inferencial foi realizada por meio dos testes Qui-Quadrado, Mann-Whitney e Coeficiente de Correlacao de Spearman, considerando α=0,05. RESULTADOS: Apresentaram baixa visao 17,7% (n=17) dos idosos. Em relacao aos idosos com visao normal, os idosos com baixa visao apresentaram idade mais avancada (p<0,001), maior numero de doencas de olho e anexos (p=0,023), maiores pontuacoes para humor deprimido (p=0,002), pior equilibrio no TUG (p=0,003) e maior numero de atividades instrumentais de vida diaria comprometidas (p=0,009). Na analise de correlacao, quanto menor a acuidade visual, maior a idade, o numero de quedas, o numero de atividades comprometidas e o tempo no TUG. CONCLUSOES: Os idosos com deficit visual desta amostra exibiram maior comprometimento funcional. Os dados deste estudo contribuem para a elaboracao de uma avaliacao fisioterapeutica voltada aos aspectos que possam identificar as limitacoes funcionais dos idosos com deficit visual e, consequentemente, estabelecer um plano terapeutico mais direcionado a sanar as dificuldades no cotidiano desses idosos.

A eficácia da terapia manual em indivíduos cefaleicos portadores e não-portadores de degeneração cervical: análise de seis casos

The effectiveness of manual therapy in individuals with headaches, with and without cervical degeneration: analysis of six cases Background: Tension-type headaches (TTH) are generally treated with prophylactic medication. With regard to Physical Therapy treatment, many types of procedures have been reported, ranging from electrotherapy and acupuncture to techniques such as cervical traction, vertebral mobilization, stretching and relaxation. Objective: To examine the evolution of six patients diagnosed with TTH who underwent a Physical Therapy treatment protocol consisting of manual therapy. Method: Six individuals were followed up (three with associated vertebral abnormalities and three with no abnormalities). Five participants were women and one was a man. They underwent treatment consisting of ten sessions of manual cervical traction, stretching, vertebral mobilization and massage. Pain intensity was assessed using a visual analog scale (VAS) and the pain threshold for pressure on the upper trapezius muscle was measured using an analog pressure algometer (PDT; pain detection threshold). The data were graphically displayed in a multiple baseline system and during a follow-up period. Results: Even though this treatment showed positive results in all cases, in relation to pain intensity, greater difficulty in completely relieving the symptoms was found among the individuals who did not have vertebral abnormalities. With regard to PDT, it was found that individuals with cervical degeneration presented greater improvement.Background: Tension-type headaches (TTH) are generally treated with prophylactic medication. With regard to Physical Therapy treatment, many types of procedures have been reported, ranging from electrotherapy and acupuncture to techniques such as cervical traction, vertebral mobilization, stretching and relaxation. Objective: To examine the evolution of six patients diagnosed with TTH who underwent a Physical Therapy treatment protocol consisting of manual therapy. Method: Six individuals were followed up (three with associated vertebral abnormalities and three with no abnormalities). Five participants were women and one was a man. They underwent treatment consisting of ten sessions of manual cervical traction, stretching, vertebral mobilization and massage. Pain intensity was assessed using a visual analog scale (VAS) and the pain threshold for pressure on the upper trapezius muscle was measured using an analog pressure algometer (PDT; pain detection threshold). The data were graphically displayed in a multiple baseline system and during a follow-up period. Results: Even though this treatment showed positive results in all cases, in relation to pain intensity, greater difficulty in completely relieving the symptoms was found among the individuals who did not have vertebral abnormalities. With regard to PDT, it was found that individuals with cervical degeneration presented greater improvement.