Luis Alberto Gobbo

Translation and validation of the walking impairment questionnaire in Brazilian subjects with intermittent claudication

BACKGROUND The Walking Impairment Questionnaire (WIQ) has been used to evaluate walking impairment in subjects with intermittent claudication (IC). However, this questionnaire has yet to be translated to Brazilian Portuguese, which limits its use in Brazilian subjects. OBJECTIVE To translate and analyze the validity and reliability of WIQ in Brazilian subjects with IC. METHODS Forty-two patients with IC, determined by the ankle-brachial index < 0.90, participated in the study. After translation and re-translation, carried out by two independent translators, the construct validity of the WIQ was analyzed by correlating the WIQ scores with the Medical Outcome Study Questionnaire Short Form 36 (SF-36) scores and the physical fitness performance (treadmill and strength tests). The reliability was analyzed with a 7-day interval between two questionnaire applications. RESULTS Significant correlations between the WIQ domains and the SF-36 (functional capacity, physical aspects, bodily pain and emotional aspects) and physical fitness performance (treadmill and strength tests) were observed. Moreover, the intraclass coefficient correlation ranged from 0.72 to 0.81, and there were no differences in WIQ scores between the two questionnaire applications. CONCLUSION The Brazilian Portuguese version of the WIQ is valid and reliable to be used in Brazilian subjects with IC.FUNDAMENTO: El Walking Impairment Questionnaire (WIQ) se utiliza para la obtencion de informaciones sobre la percepcion de locomocion de los individuos con claudicacion intermitente (CI). No obstante, este cuestionario aun no ha sido traducido al portugues, lo que limita su utilizacion en muestra brasilena. OBJETIVO: Traducir y verificar la validez y reproducibilidad del WIQ en brasilenos con CI. METODOS: Participaron en este estudio 42 individuos con CI, diagnosticados por el indice tobillo-brazo < 0,90. Luego de los procedimientos de traduccion y retraduccion del cuestionario, realizado por dos traductores independientes, la validez del constructo del WIQ se analizo al correlacionar los scores del WIQ con los scores del Medical Outcome Study Questionnaire Short Form 36 (SF-36) y con el desempeno de pruebas de aptitud fisica (marcha y de fuerza maxima). La reproducibilidad se analizo en dos aplicaciones del WIQ con 7 dias de intervalo. RESULTADOS: Se encontro correlacion significativa entre los dominios del WIQ, los dominios del SF-36 (capacidad funcional, aspectos fisicos, dolor y aspectos emocionales) y el desempeno en las pruebas de aptitud fisica (marcha y fuerza maxima). Ademas de ello, se verificaron coeficientes de correlacion intraclase que variaron de 0,72 a 0,81, y no hubo diferencia entre los scores del WIQ entre las dos aplicaciones del cuestionario. CONCLUSION: La version en portugues del WIQ es valida y reproducible en brasilenos con CI.

Body composition in taller individuals using DXA: A validation study for athletic and non-athletic populations

Abstract Dual energy X-ray absorptiometry (DXA) cannot be used to evaluate participants taller than the scan area. We aimed to analyse the accuracy of bone mineral content, fat mass, and lean mass assessed with DXA whole-body scan and from the sum of two scans (head and trunk plus limbs). Participants were 31 athletes (13 males and 18 females) and 65 non-athletes (34 males and 31 females), that fit within the DXA scan area. Three scans were performed using a Hologic Explorer-W fan-beam densitometer: a whole-body scan used as the reference; a head scan; and a trunk and limbs scan. The sum of the head scan and the trunk and limbs scan was used as the alternative procedure. Multiple regression and agreement analysis were performed. Non-significant differences between methods were observed for fat mass (0.06 kg) and lean mass (−0.07 kg) while bone mineral content from the alternative procedure differed from the reference scan (0.009 kg). The alternative procedure explained > 99% of the variance in the reference scan and low limits of agreement were observed. Precision analysis indicated low pure errors and the higher coefficients of variation were found for fat mass (whole-body: 3.70%; subtotal: 4.05%). The method proposed is a valid and simple solution to be used in individuals taller than the DXA scan area, including athletes engaged in sports recognised for including very tall competitors.

A comparison between overweight cutoff points for detection of high blood pressure in adolescents

OBJECTIVES To evaluate the accuracy of three different cutoff points for the detection of high blood pressure in adolescents, given the strong relationship between overweight and high blood pressure levels. METHODS A total of 1,021 adolescents of both sexes were enrolled in the study, selected at random from public and private schools in Londrina, Brazil. Their body weight was measured using a digital balance, and their height with a portable stadiometer with a maximum extension of 2 meters. Arterial blood pressure was measured using an automatic apparatus. The capacity of body mass index to detect high blood pressure was gauged using ROC curves and their parameters (sensitivity, specificity, and area under the curve). RESULTS The cutoff points proposed in a Brazilian standard exhibited greater accuracy (males: 0.636+/-0.038; females: 0.585+/-0.043) than the cutoff points proposed in an international (males: 0.594+/-0.040; females: 0.570+/-0.044) and a North-American standard (males: 0.612+/-0.039; females: 0.578+/-0.044). CONCLUSIONS The Brazilian proposal offered greatest accuracy for indicating high blood pressure levels.

Aptidão Física Relacionada à Saúde em Escolares de Jequié, BA, Brasil Health-Related Physical Fitness in Students from Jequié, BA, Brazil

The aim of this study was to analyze the health-related physical fitness (HRPF) in students from Jequie, BA, Brazil. Therefore, the HRPF of 182 boys and 160 girls aged 7-12 years, students from public schools, was assessed by the application of 9-minute-run/walk (indicator of cardiorespiratory capacity), modified in one minute abdominal (indicator of abdominal strength and endurance), sit-and-reach (indicator of flexibility) motor tests. The sum of the triciptal and subscapular skinfolds thickness was used as indicator of body fat. The results found indicated higher prevalence of boys and girls below (19% and 49%, respectively) than above (3% and 1%, respectively) the criteria established by the AAHPERD (1988) for indicators of body fat. Conversely, only 51% of the boys and 58% of the girls in the sit-and-reach; 11% and 7%, respectively, in the modified in one minute abdominal; and 15% and 14%, respectively, in the 9-minute-run/walk reached the established criteria. Thus, the results suggest that effective intervention programs seem necessary for the promotion of alterations in the nutritional status as well as habitual physical activity of students from Jequie.

Anthropometric Changes in the Brazilian Cohort of Older Adults: SABE Survey (Health, Well-Being, and Aging)

The aim of the present study was to analyze the anthropometric changes in a home-based cohort of Brazilian older adults who participated in the SABE Survey, conducted in 2000 and 2006. A total of 1030 men and women were examined by age group: 60–69, 70–79, and ≥80 years. This representative sample consists of the survivors of the 2000 cohort. The following anthropometric variables were assessed: body mass, arm muscle, waist and calf circumferences, triceps skinfold thickness, body mass index, waist-hip ratio, and arm muscle area according to mean values and percentile distribution. Except for body mass and body mass index, a significant difference (P < 0.05) was observed among the assessed anthropometric variables during the follow-up period. The older adults ≥80 years presented the lowest values. The reduction in the mean values of triceps skinfold thickness was greater (30%) than that of waist circumference (9%) and was more pronounced in women (21%) than in men (9%). Arm muscle circumference and area reduced by 8% and 19%, respectively, in men and 1% and 3%, correspondingly, in women. Our findings revealed reductions in the mean values for all anthropometric variables in the follow-up period from 2000 to 2006 among older adults.

Are cardiorespiratory fitness and moderate-to-vigorous physical activity independently associated to overweight, obesity, and abdominal obesity in elderly?

This study aimed to examine the independent association of cardiorespiratory fitness (CRF) and physical activity (PA) with overweight and total and abdominal obesity in an elderly population.

Effects of different resistance training frequencies on flexibility in older women

Objective The main purpose of the investigation reported here was to analyze the effect of resistance training (RT) performed at different weekly frequencies on flexibility in older women. Participants and methods Fifty-three older women (≥60 years old) were randomly assigned to perform RT either two (n=28; group “G2x”), or three (n=25; group “G3x”) times per week. The RT program comprised eight exercises in which the participants performed one set of 10–15 repetitions maximum for a period of 12 weeks. Anthropometric, body-composition, and flexibility measurements were made at baseline and post-study. The flexibility measurements were obtained by a fleximeter. Results A significant group-by-time interaction (P<0.01) was observed for frontal hip flexion, in which G3x showed a higher increase than G2x (+12.8% and +3.0%, respectively). Both groups increased flexibility in cervical extension (G2x=+19.1%, G3x=+20.0%), right hip flexion (G2x=+14.6%, G3x=+15.9%), and left hip flexion (G2x=+25.7%, G3x=+19.2%), with no statistical difference between groups. No statistically significant differences were noted for the increase in skeletal muscle mass between training three versus two times a week (+7.4% vs +4.4%, respectively). Conclusion Twelve weeks of RT improves the flexibility of different joint movements in older women, and the higher frequency induces greater increases for frontal hip flexion.

Predictors of walking capacity in peripheral arterial disease patients

OBJECTIVE: To estimate walking capacity in intermittent claudication patients through a prediction model based on clinical characteristics and the walking impairment questionnaire. METHODS: The sample included 133 intermittent claudication patients of both genders aged between 30 and 80 years. Data regarding clinical characteristics, the walking impairment questionnaire and treadmill walking test performance were obtained. Multiple regression modeling was conducted to predict claudication onset distance and total walking distance using clinical characteristics (age, height, mass, body mass index, ankle brachial index lower, gender, history of smoking and co-morbid conditions) and walking impairment questionnaire responses. Comparisons of claudication onset distance and total walking distance measured during treadmill tests and estimated by a regression equation were performed using paired t-tests. RESULTS: Co-morbid conditions (diabetes and coronary artery disease) and questions related to difficulty in walking short distances (walking indoors – such as around your house and walking 5 blocks) and at low speed (walking 1 block at average speed – usual pace) resulted in the development of new prediction models high significant for claudication onset distance and total walking distance (p<0.001). In addition, non-significant differences from the results obtained by the treadmill test and estimated by the current model (p>0.05) were observed. CONCLUSION: The current study demonstrated that walking capacity can be adequately estimated based on co-morbid conditions and responses to the walking impairment questionnaire.

Tradução e validação do Walking Impairment Questionnaire em brasileiros com claudicação intermitente

BACKGROUND The Walking Impairment Questionnaire (WIQ) has been used to evaluate walking impairment in subjects with intermittent claudication (IC). However, this questionnaire has yet to be translated to Brazilian Portuguese, which limits its use in Brazilian subjects. OBJECTIVE To translate and analyze the validity and reliability of WIQ in Brazilian subjects with IC. METHODS Forty-two patients with IC, determined by the ankle-brachial index < 0.90, participated in the study. After translation and re-translation, carried out by two independent translators, the construct validity of the WIQ was analyzed by correlating the WIQ scores with the Medical Outcome Study Questionnaire Short Form 36 (SF-36) scores and the physical fitness performance (treadmill and strength tests). The reliability was analyzed with a 7-day interval between two questionnaire applications. RESULTS Significant correlations between the WIQ domains and the SF-36 (functional capacity, physical aspects, bodily pain and emotional aspects) and physical fitness performance (treadmill and strength tests) were observed. Moreover, the intraclass coefficient correlation ranged from 0.72 to 0.81, and there were no differences in WIQ scores between the two questionnaire applications. CONCLUSION The Brazilian Portuguese version of the WIQ is valid and reliable to be used in Brazilian subjects with IC.FUNDAMENTO: El Walking Impairment Questionnaire (WIQ) se utiliza para la obtencion de informaciones sobre la percepcion de locomocion de los individuos con claudicacion intermitente (CI). No obstante, este cuestionario aun no ha sido traducido al portugues, lo que limita su utilizacion en muestra brasilena. OBJETIVO: Traducir y verificar la validez y reproducibilidad del WIQ en brasilenos con CI. METODOS: Participaron en este estudio 42 individuos con CI, diagnosticados por el indice tobillo-brazo < 0,90. Luego de los procedimientos de traduccion y retraduccion del cuestionario, realizado por dos traductores independientes, la validez del constructo del WIQ se analizo al correlacionar los scores del WIQ con los scores del Medical Outcome Study Questionnaire Short Form 36 (SF-36) y con el desempeno de pruebas de aptitud fisica (marcha y de fuerza maxima). La reproducibilidad se analizo en dos aplicaciones del WIQ con 7 dias de intervalo. RESULTADOS: Se encontro correlacion significativa entre los dominios del WIQ, los dominios del SF-36 (capacidad funcional, aspectos fisicos, dolor y aspectos emocionales) y el desempeno en las pruebas de aptitud fisica (marcha y fuerza maxima). Ademas de ello, se verificaron coeficientes de correlacion intraclase que variaron de 0,72 a 0,81, y no hubo diferencia entre los scores del WIQ entre las dos aplicaciones del cuestionario. CONCLUSION: La version en portugues del WIQ es valida y reproducible en brasilenos con CI.

Changes in skeletal muscle mass assessed by anthropometric equations after resistance training.

The aim of this study was to analyze the validity of anthropometric equations to identify changes in skeletal muscle mass (SMM) after resistance training (RT). Anthropometric and dual energy x-ray absorptiometry (DXA) measurements were obtained at baseline and after RT in 15 trained Caucasian college men. Participants performed RT over 8 weeks, consisting of 8-9 exercises of 4 sets with 12/10/8/6 maximal repetitions and 1-2 min interval between sets. The training loads were gradually increased according to gains in muscular strength. 4 anthropometric equations were used for estimation of SMM: EQ1 (SMM, g=height×[0.0553×corrected thigh girth2  + 0.0987×forearm girth2 + 0.0331×corrected calf girth2] - 2445), EQ2 (SMM, g=height×[0.031×medial thigh girth2 + 0.064×corrected calf girth2 + 0.089×corrected arm girth2] - 3006), EQ3 (SMM, kg=height×[0.00744×corrected arm girth2 + 0.00088×corrected thigh girth2 + 0.00441×corrected calf girth2] + 2.4×gender - 0.048×age + race + 7.8) and EQ4 (SMM, kg=0.244×weight + 7.8×height + 6.6×gender - 0.098×age + race - 3.3). EQ1 and EQ2 overestimated the SMM (41.3% and 19.9%, respectively; P<0.05) while EQ3 and EQ4 were similar (P>0.05) to DXA at baseline. Although all equations and DXA revealed a significant increase in SMM after RT, changes were overestimated by EQ1 and EQ2 (P<0.05), but not by EQ3 and EQ4 (P>0.05). In addition, changes in SMM over time between EQ4 and DXA were significantly correlated (r=0.62; P<0.01). Thus, changes in SMM that occur after RT can be detected by EQ4 in trained young men.