Rosa María Alfonso-Rosa

Effects of supervised whole body vibration exercise on fall risk factors, functional dependence and health-related quality of life in nursing home residents aged 80+

OBJECTIVE To test the feasibility and effectiveness of whole-body vibration (WBV) therapy on fall risk, functional dependence and health-related quality of life in nursing home residents aged 80+ years. DESIGN Twenty-nine 80-95 years old volunteers, nursing home residents were randomized to an eight-week WBV intervention group) (n=15) or control group (n=14). Functional mobility was assessed using the timed up and go (TUG) test. Lower limb performance was evaluated using the 30-s Chair Sit to Stand (30-s CSTS) test. Postural stability was measured using a force platform. The Barthel Index was used to assess functional dependence and the EuroQol (EQ-5D) was used to evaluate Health-Related Quality of Life. All outcome measures were assessed at baseline and at a follow-up after 8 weeks. RESULTS At the 8-week follow up, TUG test (p<0.001), 30-s CSTS number of times (p=0.006), EQ-5Dmobility (p<0.001), EQ-5DVAS (p<0.014), EQ-5Dutility (p<0.001) and Barthel index (p=0.003) improved in the WBV intervention group when compared to the control group. CONCLUSIONS An 8-week WBV-based intervention in a nursing home setting is effective in reducing fall risk factors and quality of life in nursing home residents aged 80+.

The relationship between nutritional status, functional capacity, and health-related quality of life in older adults with type 2 diabetes: a pilot explanatory study.

ObjectiveTo explore the relationship between nutritional status, functional capacity and health-related quality of life (HRQoL) in older adults with type 2 diabetes (T2DM).DesignCross-sectional study.Setting and participantsForty two non-insulin dependent older adults from a primary care center in Seville, Spain.MeasurementsFunction was assessed with a battery of standardized physical fitness tests. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) and the European Quality of Life Questionnaire (EQ-5D-3L) was used to assess HRQoL.ResultsThere was an association between MNA-nutritional status and lower body strength as assessed by the chair sit-stand test (rho=.451; p=.037) and between MNA-nutritional status and EQ-5D-3L-HRQoL (EQ-5D-3Lutility, rho=.553; p<.001 and EQ-5D-3LVAS rho=.402; p<.001). An MNA item by item correlation analysis with HRQoL and lower limb strength demonstrated that HRQoL appears to be related to functional capacity (principally lower body strength, motor agility and cardiorespiratory fitness) among participants. These results were maintained when correlations were adjusted for co-morbidity.ConclusionOur results demonstrated that nutritional status is moderately associated with HRQoL and lower limb strength in patients with T2DM. Our data suggest that more emphasis should be placed on interventions to encourage a correct diet and stress the needed to improve lower body strength to reinforce better mobility in T2DM population

Effects of a 12-wk whole-body vibration based intervention to improve type 2 diabetes

OBJECTIVE To test the feasibility, safety and effectiveness of a 12-wk whole body vibration (WBV) intervention on glycemic control, lipid-related cardiovascular risk factors and functional capacity among type 2 diabetes mellitus (T2DM) patients in a primary care context. METHODS Fifty non-insulin dependent T2DM patients were randomized 1:1 to an intervention group that, in addition to standard care, received a 12-wk WBV intervention, and a control group receiving only standard care (from February 2012 through May 2012). Outcomes, including glycated hemoglobin (HbA1c), fasting blood glucose, lipid-related cardiovascular risk factors (i.e., cholesterol, triglycerides, lipoproteins, LDL/HDL and atherogenic index) and functional capacity were measured at baseline and after the 12-wk intervention. RESULTS After intervention, there was a reduction in HbA1c and fasting blood glucose when compared to the control group, with a mean difference in change scores between groups of -0.55% (95% CI -0.15 to -0.76) and -33.95 mm/dl (95% CI -51.38 to -3.47), respectively. Similarly, most lipid-related cardiovascular risk factors (i.e., cholesterol, triglycerides and atherogenic index) were also reduced (p<0.05). CONCLUSION A 12-wk WBV intervention in a primary care context is feasible, safe and effective in improving glycemic profile, lipid-related cardiovascular risk factors and functional capacity among T2DM patients. TRIAL NUMBER ACTRN12613000021774.

Factors Associated with the Risk of Falls of Nursing Home Residents Aged 80 or Older

Background: Falls are the leading cause of mortality and morbidity in older and represents one of the major and most costly public health problems worldwide. Purpose: Evaluate the influences of lower limb muscle performance, static balance, functional independence and quality of life on fall risk as assessed with the timed up and go (TUG) test. Design: Cross‐sectional study. Methods: Fifty‐two residents aged 80 or older were assessed and distributed in one of the two study groups (no risk of falls; risk of falls) according to the time to complete the TUG test. A Kistler force platform and linear transducer was used to determinate lower limb muscle performance. Postural Stability (static balance) was measured by recording the center of pressure. The EuroQol‐5 dimension was used to assess Health‐related quality of life and the Barthel index was used to examine functional status. Students t‐test was performed to evaluate the differences between groups. Correlations between variables were analyzed using Spearman or Pearson coefficient. ROC (receiver operating charasteristic) analysis was used to determine the cut‐off points related to a decrease in the risk of a fall. Findings: Participants of no‐fall risk group showed better lower limb performance, quality of life, and functional status. Cut‐off points were determined for each outcome. Conclusions: Risk of falls in nursing home residents over the age of 80 is associated with lower limb muscle performance, functional status, and quality of Life. Clinical Relevance: Cut‐off points can be used by clinicians when working toward fall prevention and could help in determining the optimal lower limb muscle performance level for preventing falls.

Test-retest reliability and minimal detectable change scores for fitness assessment in older adults with type 2 diabetes

Purpose: To assess the intraclass correlation coefficients (ICCs) and to determine the minimal detectable change (MDC95) scores of the data for the Hand Grip Strength Test, the Chair Sit and Reach Test (CSRT), the Timed “Up and Go” (TUG) test, the 6‐Minute Walk Test (6MWT) and 30 seconds Sit to Stand Test (30s‐STS) test in older adults with type 2 NIDDM. Design: Test–retest reliability. Methods: Eighteen subject participated in two sessions (1 week apart), which included the different tests. Findings: High ICCs (≥0.92) were found for all tests. The MDC95 scores were as follows: 4.0 kg for Hand Grip Strength Tests, 7.5 cm for the right leg‐CSRT, 9.0 cm for the left leg‐CSRT, 1.0 second for the TUG test, 27 m for the 6MWT, and 3.3 repetitions for the 30s‐STS test. Conclusions: All tests evaluated are reliable outcome measures for type 2 NIDDM patients. Clinical relevance: This study has generated novel MCD95 data, which will assist nursing practitioners in both prescribing the most beneficial exercise and interpreting posttreatment changes after rehabilitation in patients with T2DM.

Depression symptoms are associated with key health outcomes in women with fibromyalgia: a cross‐sectional study

To analyze the association between depression severity and other fibromyalgia‐ (FM) related symptoms such as pain, fatigue, sleep problems, severity of the disease, activity pattern, functional capacity and quality of life.

Cost-utility analysis of a 12-week whole-body vibration based treatment for people with type 2 diabetes: reanalysis of a RCT in a primary care context

• Whole Body Vibration (WBV) has been exhibited to be effective as a co-adjuvant treatment for type 2 diabetes (T2DM) patients in primary care.

Replacing Sedentary Time: Meta-analysis of Objective-Assessment Studies

CONTEXT The aim was to summarize estimates of the potential benefits for cardiometabolic risk markers and all-cause mortality of replacing time spent in sedentary behaviors with light-intensity physical activity or with moderate to vigorous physical activity, from studies using device-based measurement. EVIDENCE ACQUISITION Four databases covering the period up to December 2016 were searched and analyzed (February 2017). Data were extracted by two independent reviewers. For the meta-analyses, the estimated regression coefficients (β) and 95% CIs were analyzed for BMI, waist circumference, and high-density lipoprotein cholesterol. Pooled relative rate and 95% CIs were calculated for fasting glucose, fasting insulin, and homeostatic model assessment-insulin resistance values. Hazard ratios were extracted from studies of all-cause mortality risk. EVIDENCE SYNTHESIS Ten studies (with 17,390 participants) met the inclusion criteria. Reallocation of 30 minutes of sedentary time to light-intensity physical activity was associated with reductions in waist circumference, fasting insulin, and all-cause mortality risk; and with an increase in high-density lipoprotein cholesterol. Reallocating 30 minutes of sedentary time to moderate to vigorous physical activity was associated with reductions in BMI, waist circumference, fasting glucose, fasting insulin, and all-cause mortality (not pooled) and with an increase in high-density lipoprotein cholesterol. CONCLUSIONS Replacing sedentary time with either light-intensity physical activity or moderate to vigorous physical activity may be beneficial, but when sedentary time is replaced with moderate to vigorous physical activity, the predicted impacts are stronger and apparent for a broader range of risk markers. These findings point to potential benefits of replacing sedentary time with light-intensity physical activity, which may benefit those less able to tolerate or accommodate higher-intensity activities, including many older adults.

Autonomous physical activity based program versus aerobic exercise based interventions to improve health and cardiovascular status in sedentary overweight adults: A review

This review aims to identify improvements on health-related variables, produced by autonomous physical activity interventions and reducing sedentary behaviour, compared with improvements produced by interventions of aerobic exercise in sedentary and overweight / obesity. 17 design studies Randomized Controlled Trial (RCT) were finally included, with subjects ≥ 18 years and a Body Mass Index (BMI) ≥ 25. The results show similar results in both types of interventions, and the conclusion reached was that there is insufficient evidence of benefits of one type of intervention over another.

Influência do nível de atividade física sobre a aptidão física e qualidade de vida relacionada à saúde em idosos portadores ou não de diabetes mellitus tipo 2

INTRODUCCION: Los ejercicios fisicos son considerados como siendo uno de los componentes para la mejoria de las condiciones de salud en diabeticos tipo 2. Ademas de eso, algunos estudios han sugerido que niveles mas altos de aptitud fisica tambien pueden mejorar la calidad de vida relacionada con la salud (CVRS). No obstante, no hay estudios publicados que hayan sido planeados, especificamente, para examinar esta relacion. OBJETIVO: El objetivo de este estudio fue evaluar el efecto del nivel de actividades fisicas sobre la aptitud fisica y la CVRS, y determinar si hay diferencias cuando se comparan individuos con y sin diabetes mellitus tipo 2. METODO: Cincuenta y cuatro participantes, con diabetes tipo 2, y 54 participantes, de edades comparables, sin diabetes, fueron voluntarios a fin de participar en este estudio. La aptitud fisica (prueba de 30 segundos para levantarse de la silla, prueba de caminata de seis minutos y prueba de sentarse y alcanzar algo) y la CVRS (VC-36) fueron evaluadas. RESULTADOS: Los participantes con diabetes tipo 2 presentaron menores puntuaciones en promedio para la prueba de sentarse y alcanzar algo, y una puntuacion mas alta en componente mental en comparacion con los participantes de control. Cuando los dos grupos fueron clasificados con respecto al nivel de actividades fisicas, se encontraron diferencias significativas con referencia a funcion social, salud mental, salud general y vitalidad, entre los pacientes insuficiente y minimamente activos. CONCLUSION: Los participantes con niveles mas altos de practicas de actividades fisicas tambien mostraron mejor aptitud fisica, la cual, conjuntamente con las mejorias en la CVRS, puede tener implicaciones clinicas para la prevencion y el tratamiento de la diabetes mellitus tipo 2.INTRODUCTION: Physical exercise is considered to improve different health outcomes in type 2 diabetic patients. In addition, a few studies have suggested that higher levels of fitness might also enhance health-related quality of life (HRQoL). However, there are no published studies that were specifically designed to examine this relationship. OBJECTIVE: The aim of the current study was to assess the effect of physical activity level on physical fitness and HRQoL and determine whether differences existed when comparing people with and without type 2 diabetes mellitus. METHODS: Fifty-four participants with type 2 diabetes and 54 age-matched participants without diabetes volunteered to participate in this study. Physical fitness (30-second chair stand test, six-min walk test and sit-and-reach test) and HRQoL (36-item Short Form Health Survey) were assessed. RESULTS: Participants with type 2 diabetes had lower mean scores for sit and reach and higher mental component score than control participants. When both groups were categorized regarding their level of physical activity significant differences were found in relation to social function, mental health, general health and vitality between poorly and minimally active patients. CONCLUSIONS: Participants with the greater levels of physical activity also reported better physical fitness which together with the improvement in HRQoL may have clinical implications in the prevention and treatment of type 2 diabetes mellitus.