Marisete Peralta Safons

Effect of equine-assisted therapy on the postural balance of the elderly

OBJECTIVE To determine whether equine-assisted therapy (hippotherapy) produces alterations in the balance of the elderly. METHODS The sample included 17 older adults who were divided into experimental (7 subjects) and control (10 subjects) groups. Stabilometry data were acquired with a force platform. The Timed Up and Go test (TUG) was used for clinical analysis of seated balance, transfer from a seated to a standing position, walking stability and changes in gait. Sixteen equine-assisted therapy sessions were carried out. RESULTS Mann-Witney was used to compare the means between groups and no significant differences were found in the analyzed stabilometric parameters. In intragroup comparison with the Wilcoxon test, a significant increase in the variables COPy and Area (p=0.02) was observed. Equine-assisted therapy significantly affected (p=0.04) TUG test means between the experimental and control groups (Mann-Witney). Intragroup TUG test means were also significantly affected (p=0.04) according to the Wilcoxon test. CONCLUSIONS Because senescence tends to normalize stabilometric measures, the number of equine-assisted therapy sessions was insufficient to determine any differences. Nevertheless, the significant improvement in TUG test scores demonstrates that this treatment frequency was a predictor of reduced fall risk in the elderly. Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under number ACTRN12610000534088.

Effects of hippotherapy on mobility, strength and balance in elderly §

OBJECTIVES To assess the chronic effects of hippotherapy on functional mobility, muscle strength and balance in elderly. METHODS 28 volunteers, between the age of 60 and 84, were randomly recruited and divided in experimental group (EG), with 12 individuals (8 women and 4 men) and control group (CG), with 16 individuals (14 women and 2 men). The EG group participated in an 8-week hippotherapy program. Before and after the study period functional mobility was assessed and measured by Time Up and Go Test (TUG), muscle strength of the lower limbs was measured by 30s Chair Stand Test (30CST) and performance in balance was measured by the Berg Balance Scale (BBS). A mixed ANOVA model (group×testing time) was applied to establish the effect of the different groups on the functional variables. RESULTS The functional capacity of the EG group was increased if compared to CG group after the intervention of the BBS (p=0.003) and 30CST (p=0.032), but not of the TUG (p=0.063). CONCLUSION The results indicated that hippotherapy improves the lower limb strength and balance in elderly.

Sarcopenia and sarcopenic obesity classifications and cardiometabolic risks in older women

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. Students 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.

Comparison of adiposity indices and cut-off values in the prediction of metabolic syndrome in postmenopausal women.

AIMS To compare adiposity indices and to assess their various cut-off values for the prediction of metabolic syndrome (MetS) in postmenopausal women. METHODS One hundred forty nine volunteers (67.17±6.12 years) underwent body composition assessment using DXA and had 5 anthropometric indices measured (Waist Circumference, WC; Waist-to-Height Ratio, WHtR; Body Mass Index, BMI; Body Adiposity Index, BAI; and Conicity Index). Blood pressure was assessed using an oscillometric device and fasting blood samples were collected. MetS was classified according NCEP-ATP III. Cut-off values to predict MetS were obtained using Receiver Operating Characteristic (ROC) curve analyses and odds ratios were also calculated. RESULTS MetS prevalence was 29.5% and subjects who were classified with MetS showed worse cardiometabolic outcomes and higher anthropometric indices values (p<0.05). With the exception of total- and LDL-cholesterol, all remaining variables were significantly correlated with at least one of the adiposity indices, with the strongest relationships observed for the indices reflecting central body fat. The cut-off values were 88cm, 0.57cm/cm, 26.85kg/m(2), 43.7%, 36.34%, and 1.24 units for WC, WHtR, BMI, DXA-derived body fat percentage, BAI, and conicity index, respectively. Significant greater risks for MetS were found for volunteers who had WHtR (odds=9.08; CI: 1.81-45.47) or WC (odds=5.20; CI: 1.30-20.73) measurements above cut-off values. CONCLUSION Adiposity indices are associated with MetS in postmenopausal women in different degrees. Indices which consider central adiposity such as WC and WHtR have a stronger relationship with MetS compared to DXA-derived body fat percentage, which is considered a gold standard.

The association between body adiposity measures, postural balance, fear of falling, and fall risk in older community-dwelling women

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.