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- Prevenir para não cair: guia de exercíciosPublication . Fernandes, Beatriz; Cebola, Marisa; Ferreira, Miguel Marques; Tomás, Maria TeresaA atividade física e o exercício regular são importantes para a saúde física e mental de qualquer cidadão desde os mais jovens aos mais idosos e desde os mais saudáveis aos menos saudáveis. A atividade física regular e o exercício regular podem reduzir o risco de desenvolver algumas doenças ou podem mesmo ser um tratamento eficaz para muitas doenças crónicas. Muitos estudos demonstraram já que pessoas com diabetes, doenças cardíacas ou respiratórias, artrites, hipertensão arterial ou problemas de equilíbrio, entre outros, beneficiam dos efeitos positivos da atividade física e do exercício regular na gestão das suas doenças. Por isso mantenha-se ativo. Faça uma atividade que lhe dê prazer, preferivelmente todos os dias pelo menos durante 30 minutos. Caminhe idealmente 10.000 passos por dia. Passeie o seu cão, suba as escadas em vez de ir de elevador, ou faça outra atividade. Reduza o tempo que passa sentado. Adicionalmente a isto, ou em alternativa, oferecemos-lhe neste guia um conjunto de exercícios que o vão ajudar a manter-se mais ativo e a manter a sua força muscular, a sua flexibilidade e no geral a sua capacidade funcional.
- Functional capacity and levels of physical activity in aging: a 3-year follow-upPublication . Tomás, Maria Teresa; Galán-Mercant, Alejandro; Alvarez Carnero, Elvis; Fernandes, BeatrizOver the last decades, the world elderly population has increased exponentially and this tendency will continue during the coming years; from 2000 to 2050, people over 60 will double and those over 80 will quadruple. Loss of independence occurs as people age due to mobility restrictions, frailty, and decreased functional fitness and cognitive abilities. Evidence has shown that appropriate programs and policies contribute to keep older adults healthy and independent over time. The purpose of this chapter is to report the results of our 3-year follow-up study designed to characterize functional physical fitness in a sample of Portuguese community-dwelling older adults to propose a set of functional parameters that decline the most. We studied a group of 43 elderly people, aged 60 and over. Variables assessed on the participants were anthropometric measurements, functional capacity with the Senior Fitness Test battery (muscle strength, aerobic endurance, flexibility, agility, and dynamic balance), handgrip strength, levels of physical activity, and balance. Three years after the first assessment, a second assessment of the same variables was conducted. We analyzed what were the variables that, for this group, were related to a healthier aging and the relation with different physical activity levels. Our study showed that the distance covered in 6-min walk test and handgrip strength seem to explain a great amount of variability on functional variables that have changed on this period (68% of balance, lower and upper functional strength, respectively) and the active participants showed fewer decrements with aging in anthropometric and functional variables than those inactive or insufficiently active (p < 0.05). Greater importance should be given to prescription of exercise targeting older adults and, specifically, walking and manual activities should be given more attention as components of a community exercise program.
- Body composition changes over three years in older adults: a descriptive longitudinal analysisPublication . Tomás, Maria Teresa; Galán-Mercant, Alejandro; Fernandes, BeatrizIntroduction: Many studies analyze body composition changes in older adults. However, few studies analyze body composition in elderly people with functional measures. Studies using Double X-Ray analysis (DXA) or Bioimpedance analysis proved to be reliable but expensive or only possible in a laboratory environment. The purpose of our study was to analyze changes in body composition over three years using anthropometric measures in a sample of elderly people in order to perceive functional changes. Methods: Forty-three participants (12 men; 31 women) aged 60 years and over and independent in activities of daily life were assessed using anthropometric measures in the first moment and past three years. Weight, height, waist and hip circumference were measured, and body mass index (BMI) and waist-to-hip ratio (WHR) were also calculated. Skeletal muscle mass (SMM) was also calculated using Al-Gindan et al. (2014) equations and normalized for height to found skeletal muscle index (SMI) in order to analyze cut-off points associated with physical disability according to Janssen et al (2004). Results: A significant difference was found over three years in SMM (p = 0.007), SMI (p = 0.027), BMI (p = 0.041) and WHR (p = 0.003). The majority of the participants has decreased SMM, SMI, and BMI and increased WHR, which favors a worst prognostic for comorbidities associated with these variables, and a tendency for sarcopenic obesity seems to be present although more studies are needed. Also, we found that using cut-off points for disability risk 83.3% of the men and 38.7% of the women of our sample were at moderate or high risk of disability. Three years later this percentage has increased but only for women to 54.8%. Conclusions: Although men are at risk of disability, women quickly lose their functional capacity, making necessary a rapid intervention to reduce the risk of disability in this population.
- Sarcopenia in liver transplant due to familial amyloidotic polyneuropathy (FAP): the relevance of muscle massPublication . Tomás, Maria Teresa; Melo, Xavier; Mateus, Élia; Barroso, Eduardo; Santa-Clara, HelenaIntroduction: Loss of muscle mass and function is a common occurrence in liver transplant Familial Amyloidotic Polyneuropathy (FAP) patients. Sarcopenia is associated with morbidity and mortality before and after liver transplantation. However, the ability of skeletal muscle mass to recover after transplant remains questionable and thus the importance of clinical exercise prescription. Methods: Participants were 39 FAP patients aged 23-59 years, who had been submitted to a liver transplant (Tx) (22 men) between 2 and 4 months post-tx. Sarcopenia was defined according to the International Working Group on Sarcopenia and Society of Sarcopenia, Cachexia, and Wasting Disorders. Whole-body dual x-ray absorptiometry was used to measure body fat and lean-soft tissue. Skeletal Muscle Index (SMI) was calculated adjusting the value of appendicular skeletal mass to the squared height. Functional aerobic capacity was assessed using the 6 min walk test (6MWT), and handgrip strength were measured on the dominant hand using a hand dynamometer. Results: The prevalence of sarcopenia using SMI was 45.5% in men and 41.2% in women. A fat mass higher than 16% for men and 26% for women was found in 54.5% of men and 52.9% of women. Also, 27.3% of men and 17.6% of the women could be classified as having sarcopenia with low mobility (distance < 400 m). Discussion and Conclusions: Sarcopenia is common in FAP patients and a liver transplant seems to increase the prevalence, also because an aggressive medication with impact on muscle metabolism should be made longtime. More data are needed on the long-term effects of sarcopenia after transplant, especially in light of the high rate of metabolic syndrome. A clinical exercise prescription seems to be necessary for these patients but more studies are needed (e.g. longitudinal studies).
- Handgrip strength and falls among community-dwelling older adultsPublication . Fernandes, Beatriz; Galán-Mercant, Alejandro; Tomás, Maria TeresaIntroduction: Falls prevention in older adults includes early screening for fall risk; risk factor assessment and specialized intervention. Several variables such as balance, gait speed and mobility have been used to assess the risk of falling. More recently, handgrip strength has also been identified for this purpose. The aim of this study was to investigate the relationship between handgrip strength and balance, gait speed and mobility in community-dwelling older adults. Methods: A sample of 45 community-dwelling older adults (16 M; 30F), aged 76.9 ± 8.6 was enrolled in the study. Inclusion criteria were age 65 and over; ability to walk autonomously (with or without assistive devices) and to understand and perform the tests. Participants were excluded if they had limitations interfering with the performance of tests and medical contraindications for exercise. A balance was assessed with the Berg Balance Scale (BBS), mobility with the 8-foot-up-and-go-test, gait speed with the 4-meter walk test and handgrip strength with the hydraulic dynamometer Jamar®. A Spearman’s correlation was run to investigate whether there were associations between variables. Results: A strong positive correlation was found between handgrip strength and balance (rs = 0.645, p = 0.000) and handgrip strength and gait speed (rs = 0.593, p = 0.000). Results from the 8-foot-up-and-go-test (7.8 ± 3.4 s) did not reveal increased risk of falling; however, there was a strong negative correlation between mobility and balance (rs = 0.758, p = 0.000), gait speed (rs = -0.681, p = 0.000) and handgrip strength (rs = -0.632, p = 0.000). Conclusions: For our participants as handgrip strength increases gait speed and balance also increase. Decreases in balance, gait speed, and handgrip strength are related to mobility decline which is related to an increased risk of falling. Our results point-out handgrip strength as a valuable measure to identify the risk of falling. Further studies with larger samples are needed to confirm these results.