The aims of this study were to compare the effects of a multicomponent exercise program provided at a center (CB) versus done part at home and part at a center (H+CB) on frailty status, strength, physical function, and gait of prefrail older women. Twenty-five women were randomly allocated into the CB (n = 14; 69 ± 6 years) and the H+CB (n = 11; 69 ± 7 years) groups. Both groups completed an exercise program including strengthening, balance, and gait exercises. The program was 12 weeks long, done three times per week, for 60 min per session. Frailty, knee and hip muscle strength, spatiotemporal parameters of the usual and maximum speed dual-task gait, and physical function were assessed at baseline and after program completion. The exercise program reversed the prefrail status of most participants independently of the mode of delivery. Strength increased in both groups, but the CB group had more pronounced improvements in gait and physical function. H+CB exercise programs are good options for prefrail older women.
Sabrine N. Costa, Edgar R. Vieira and Paulo C. B. Bento
Edgar R. Vieira and Helenice J.C.G. Coury
Research and clinical recordings of lumbar flexion demand practicable and precise methodology for quantifying variations.
To describe and evaluate the parallel reliability of 2 methods of measuring lumbar fexion—perpendicular stick markers (SM) and the distanciometer (DM)—using an electrogoniometer (EGM) as reference.
Parallel measurement for reliability.
25 healthy men.
Simultaneous measure of lumbar flexion at preestablished positions (0°, 15°, 30°, and 45°).
Data from SM and DM, recorded simultaneously.
High parallel reliability was found when comparing the EGM data with the SM (r = .997; measurement error: 0.6° ± 0.7°; no differences: t-test P = .260) and with the DM (r = .962; measurement error: 2.8° ± 1.9°; no differences: t-test P = .973).
Considering the reliability, practicability, and low cost of the described methods, they can be regarded as applicable and useful.
Edgar R. Vieira, Ruth Tappen, Sareen S. Gropper, Maria T. Severi, Gabriella Engstrom, Marcio R. de Oliveira, Alexandre C. Barbosa and Rubens A. da Silva
The objective of this pilot study was to evaluate a 6-month exercise program completed by 10 older Caribbean Americans. Assessments were done at baseline and 3 and 6 months, and included walks on an instrumented mat at preferred speed, and during street crossing simulations with regular (10 s) and reduced time (5 s). There were no significant differences on preferred walking speed over time. Differences between the street crossing conditions were found only at 6 months. Significant changes over time among the assessments were found only during street crossing with reduced time. Street crossing with reduced time was the only walking condition sensitive to capture changes associated with participating in the exercise program. There was a significant increase in dorsiflexion strength overtime. At 6 months it was significantly higher than at baseline and 3 months. The program was feasible, acceptable, and had some positive effects on walking, knee flexion, and dorsiflexion strength.
Robson Dias Scoz, Cesar F. Amorim, Bruno O.A. Mazziotti, Rubens A. Da Silva, Edgar R. Vieira, Alexandre D. Lopes and Ronaldo E.C.D. Gabriel
Objective: To assess the diagnostic validity of an isokinetic testing to detect partial injuries on the anterior cruciate ligament (ACL). Design: Prospective diagnostic study. Settings: Orthopedic clinic, physiotherapy clinic, orthopedic hospital, and diagnostic/image clinic. Participants: Consecutive patients (n = 29) with unilateral knee complaint submitted to physical examination, magnetic resonance images (MRIs), and isokinetic testing prior to surgery of ACL reconstruction. Interventions: Not applicable. Main Outcome Measures: The isokinetic torque curves data from extensor and flexor muscles were converted to frequency domain by fast Fourier transformation and compared with healthy contralateral limb. Differences were categorized as unstable knees and these conclusions were compared with patient’s physical examinations (doctor’s conclusion on ACL integrity) and MRIs (as the radiologist conclusions on ACL integrity). After surgery, all intraoperatively confirmed partial injured patient’s data were collected. The diagnostic accuracy measures to compare the conclusions of all 3 professionals included sensitivity, specificity, positive predictive value, negative predictive value, disease prevalence, positive likelihood ratio, and accuracy—all using a confidence interval of 95%. Results: Compared with MRI, the sensitivity of isokinetic test for an ACL partial injury was 90.00%, specificity 83.33%, positive predictive value 52.94%, negative predictive value 97.56%, and accuracy 84.48%. Compared with physical examination, the sensitivity of isokinetic test for an ACL partial injury was 85.71%, specificity 78.43%, positive predictive value 35.29%, negative predictive value 97.56%, and accuracy 79.31%. Conclusions: This method of isokinetic data analysis through fast Fourier transformation can be used to improve diagnostic accuracy of a difficult detection injury. Even present, a partial ACL injury can produce a stable knee during isokinetic testing and could be used to detect candidates for conservative treatment based on strengthening exercises, reducing surgery risks, and financial and social impact on patient’s life.