Context: There seems to be no consensus on which aspects better distinguish the different levels of spinal cord injury regarding body composition, strength, and functional independence. Objective: The study aimed to determine which variables better differentiate tetraplegia (TP) from paraplegia and high paraplegia (HP) from low paraplegia (LP). Design: Cross-sectional study. Setting: Rehabilitation hospital network. Patients: Forty-five men with spinal cord injury, n = 15 for each level (TP, HP, and LP) causing complete motor impairment (American Spinal Injury Association Impairment Scale: A or B) were enrolled in the study. Main Outcome Measures: The 1-maximum repetition test, functional independence measure, spinal cord independence measure, and body composition (skinfold sum, body fat percentage, and body mass index) were assessed. Discriminant analysis was carried out using the Wilks lambda method to identify which strength and functional variables can significantly discriminate subjects for injury classification (TP, HP, and LP). Results: The discriminant variable for TP versus HP was body mass index and for TP versus LP was 1-maximum repetition (P ≤ .05). There were no variables that discriminated HP versus LP. Conclusions: The discriminant variables for TP versus HP and TP versus LP were body mass index and 1-maximum repetition, respectively. The results showed that HP and LP are similar for strength and functional variables.
Rodrigo Rodrigues Gomes Costa, Rodrigo Luiz Carregaro and Frederico Ribeiro Neto
Frederico Ribeiro Neto, Rodrigo Rodrigues Gomes Costa, Ricardo Tanhoffer, Martim Bottaro and Rodrigo Luiz Carregaro
Context: Strength training is one of the most common interventions employed to increase functional independence during rehabilitation of individuals with spinal cord injury (SCI). However, in the literature, different results have been reported in terms of strength modifications after a SCI compared with a control group (CG). Objective: This study aimed to verify whether discriminant analysis using relative and absolute strength is able to discriminate individuals with different levels of SCI from a CG and to compare strength values of men with different levels of SCI with a CG. Design: Cross-sectional study. Setting: Rehabilitation hospital setting. Participants: A total of 36 individuals with SCI stratified in tetraplegia (TP; C6–C8), high paraplegia (HP; T1–T6), and low paraplegia (LP; T7–L2), and 12 matched control subjects were enrolled in the study. Main Outcome Measures: The subjects performed a maximum strength test of elbow extension/flexion and also shoulder abduction/adduction and flexion/extension in an isokinetic dynamometer. Discriminant analysis was carried out to identify which strength variables would be able to discriminate the TP, HP, or LP groups from the CG. A 1-way analysis of variance was performed to compare peak torque and agonist/antagonist ratio means. Results: Shoulder adduction, followed by elbow extension peak torque, was the best variable for discriminating the TP group from the CG (function coefficients: −0.056 and 0.051, respectively, Wilks Λ = 0.41, P ≤ .05). There were no significant differences between the HP group, LP group, and CG. Conclusions: The strength similarity of the paraplegic groups and the CG should not be extrapolated for activities of daily living or sports. The TP group demonstrated lower peak torque for all movements than the CG.
Talita Molinari, Tainara Steffens, Cristian Roncada, Rodrigo Rodrigues and Caroline P. Dias
Eccentric-focused training promotes greater gains in muscle strength compared with other types of training in adults. However, for older adults, these findings are still not well understood. A systematic review and meta-analysis were performed using manuscripts that performed eccentric-focused and conventional resistance training for at least 4 weeks and evaluated maximum muscle strength through tests of maximum repetitions in weight machine exercises (knee extension and leg press exercises). Five studies were included (n = 138). Increases in muscle strength were found in both resistance training groups, without a difference between them through meta-analysis. However, a large effect size has been observed only in eccentric-focused training. The findings suggest that resistance training protocols are similar for improving maximal strength in older adults, despite larger effect sizes for eccentric-focused training.
Rodrigo Siqueira Reis, Adriano Akira Ferreira Hino, Alex Antonio Florindo, Ciro Romélio Rodriguez Añez and Marlos Rodrigues Domingues
The purpose of this study was to analyze the relationship between adolescents’ physical activity practice and their perception about the environment of urban parks.
A school-based representative sample (n = 1,718; boys = 40.4%) of teenagers of Curitiba, Southern region of Brazil. A questionnaire was employed to identify perceived parks environmental features as well as physical activity practice in the parks (PAP), habitual physical activity (HPA) and demographics. The relationship between PAP and parks environments was analyzed through multivariate logistic regression controlling for age and socioeconomic status, HPA and parks distance.
After controlling for confounders PAP was associated with lack of space to be physically active, activities to choose from and equipments for both boys and girls, (odds ratio (OR)—ranging from 1.5 to 1.8). Among boys, having people of same age (OR = 1.5) and accessibility (OR = 2.0) showed association with PAP only in crude analysis. However, among girls, to be bulled or teased (OR = 1.4) and accessibility (OR = 1.7) were associated with PAP after confounding control.
The results showed that specific attributes in parks may be considered and offered to increase the likelihood of physical activity practice among adolescents in such locations.
Bruno Manfredini Baroni, Jeam Marcel Geremia, Rodrigo Rodrigues, Marcelo Krás Borges, Azim Jinha, Walter Herzog and Marco Aurélio Vaz
It is not known if a physically active lifestyle, without systematic training, is sufficient to combat age-related muscle and strength loss. Therefore, the purpose of this study was to evaluate if the maintenance of a physically active lifestyle prevents muscle impairments due to aging. To address this issue, we evaluated 33 healthy men with similar physical activity levels (IPAQ = 2) across a large range of ages. Functional (torque-angle and torque-velocity relations) and morphological (vastus lateralis muscle architecture) properties of the knee extensor muscles were assessed and compared between three age groups: young adults (30 ± 6 y), middle-aged subjects (50 ± 7 y) and elderly subjects (69 ± 5 y). Isometric peak torques were significantly lower (30% to 36%) in elderly group subjects compared with the young adults. Concentric peak torques were significantly lower in the middle aged (18% to 32%) and elderly group (40% to 53%) compared with the young adults. Vastus lateralis thickness and fascicles lengths were significantly smaller in the elderly group subjects (15.8 ± 3.9 mm; 99.1 ± 25.8 mm) compared with the young adults (19.8 ± 3.6 mm; 152.1 ± 42.0 mm). These findings suggest that a physically active lifestyle, without systematic training, is not sufficient to avoid loss of strength and muscle mass with aging.
Renato Sobral Monteiro-Junior, Paulo de Tarso Maciel-Pinheiro, Eduardo da Matta Mello Portugal, Luiz Felipe da Silva Figueiredo, Rodrigo Terra, Lara S. F. Carneiro, Vinícius Dias Rodrigues, Osvaldo J. M. Nascimento, Andrea Camaz Deslandes and Jerson Laks
Background: Inflammatory cytokines and acute phase proteins increase with aging, promoting a chronic low-grade inflammation. Studies have shown a positive effect of exercise on inflammatory markers in older persons. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) are the main biomarkers investigated. However, it is unclear if exercise could decrease all these biomarkers. Purpose: The aim was to analyze the effect of chronic exercise on IL-6, TNF-α, and CRP levels in older persons. Methods: Preferred Reporting Items in Systematic Reviews and Meta-analyses guidelines were adopted. Original articles that investigated the effect of chronic exercise on inflammatory profile of the elderly persons were eligible for this review. The databases PubMed, PEDro, EBSCO, and BioMed Central were searched. Three reviewers evaluated each publication for reducing bias. Data about IL-6, TNF-α, and CRP were collected and analyzed. A standardized mean difference based on estimated pooled effect size was calculated considering heterogeneity index (I 2) and random effect. Results: Seventy-six studies were retrieved from databases, and 8 of them were analyzed. IL-6 and CRP levels decreased after chronic exercise (overall effect P < .05). Conclusion: Regular exercise decreases IL-6 and CRP levels in older persons. The effect of exercise on TNF-α remains unclear.
Poliana Alves de Oliveira, Juscelino Castro Blasczyk, Gerson Souza Junior, Karina Ferreira Lagoa, Milene Soares, Ricardo Jacó de Oliveira, Paulo José Barbosa Gutierres Filho, Rodrigo Luiz Carregaro and Wagner Rodrigues Martins
Elastic Resistance Exercise (ERE) has already demonstrated its effectiveness in older adults and, when combined with the resistance generated by fixed loads, in adults. This review summarizes the effectiveness of ERE performed as isolated method on muscle strength and functional performance in healthy adults.
A database search was performed (MEDLine, Cochrane Library, PEDro and Web of Knowledge) to identify controlled clinical trials in English language. The mean difference (MD) with 95% confidence intervals (CIs) and overall effect size were calculated for all comparisons. The PEDro scale was used assess the methodological quality.
From the 93 articles identified by the search strategy, 5 met the inclusion criteria, in which 3 presented high quality (PEDro > 6). Meta-analyses demonstrated that the effects of ERE were superior when compared with passive control on functional performance and muscle strength. When compared with active controls, the effect of ERE was inferior on function performance and with similar effect on muscle strength.
ERE are effective to improve functional performance and muscle strength when compared with no intervention, in healthy adults. ERE are not superior to other methods of resistance training to improve functional performance and muscle strength in health adults.