RESUMO
BACKGROUND: Aging is associated with chronic low-grade inflammatory activity with an elevation of cytokine levels. An association between regular physical activity and reduction of blood levels of anti-inflammatory cytokines is demonstrated in the literature pointing to an anti-inflammatory effect related to exercise. However, there is no consensus regarding which type of exercise and which parameters are the most appropriate to influence inflammatory markers. Evidence indicates that the single nucleotide polymorphism (SNP) can influence the synthesis of those cytokines affecting their production. METHODS/DESIGN: The design of this study is a randomized controlled trial. The aim of this study is to investigate the interaction between the cytokine genes SNP and the effect of physical activity on older women. The main outcomes are: serum levels of sTNFR-1, sTNFR-2, interleukin (IL)-6, IL-10, measured by the ELISA method; genotyping of tumor necrosis factor- (TNF)-alpha (rs1800629), IL6 (rs1800795), IL10 (rs1800896) by the TaqMan Method (Applied Biosystems, Foster City, CA, USA); and physical performance assessed by Timed Up and Go and 10-Meter Walk Tests. Secondary outcomes include: Geriatric Depression Scale, Perceived Stress Scaleand aerobic capacity, assessed by the six-minute walk; and lower limb muscle strength, using an isokinetic dinamometer (Biodex Medical Systems, Inc., Shirley, NY,USA). Both exercise protocols will be performed three times a week for 10 weeks, 30 sessions in total. DISCUSSION: Investigating the interaction between genetic factors and exercise effects of both protocols of exercise on the levels of inflammatory cytokine levels can contribute to guide clinical practice related to treatment and prevention of functional changes due to chronic inflammatory activity in older adults. This approach could develop new perspectives on preventive and treatment proposals in physical therapy and in the management of the older patient. TRIAL REGISTRATION: (ReBEC) RBR9v9cwf.
Assuntos
Envelhecimento/genética , Citocinas/genética , Terapia por Exercício , Mediadores da Inflamação , Inflamação/genética , Inflamação/prevenção & controle , Polimorfismo de Nucleotídeo Único , Projetos de Pesquisa , Fatores Etários , Idoso , Envelhecimento/sangue , Envelhecimento/imunologia , Biomarcadores/sangue , Brasil , Citocinas/sangue , Ensaio de Imunoadsorção Enzimática , Teste de Esforço , Terapia por Exercício/métodos , Feminino , Avaliação Geriátrica , Humanos , Inflamação/sangue , Inflamação/imunologia , Inflamação/fisiopatologia , Mediadores da Inflamação/sangue , Interleucina-10/genética , Interleucina-6/genética , Reação em Cadeia da Polimerase , Receptores Tipo I de Fatores de Necrose Tumoral/sangue , Receptores Tipo II do Fator de Necrose Tumoral/sangue , Fatores Sexuais , Fatores de Tempo , Resultado do Tratamento , Fator de Necrose Tumoral alfa/genéticaRESUMO
CONTEXTUALIZAÇÃO: Idosos diabéticos tendem a ter declínio da funcionalidade motora e a apresentar déficits cognitivos relacionados a processos mais complexos, como a função executiva, o que pode levar a um maior risco de quedas. OBJETIVOS: Comparar idosos com e sem diabetes tipo 2 quanto à mobilidade funcional, ao risco de quedas e à função executiva e verificar a correlação entre essas variáveis. MÉTODOS: Participaram do estudo 40 idosos da comunidade, divididos em dois grupos: G1, idosos com diabetes tipo 2 e G2, idosos sem diabetes, sendo os grupos semelhantes quanto ao gênero, idade e índice de massa corporal. A mobilidade funcional e o risco de quedas foram avaliados pelo Timed Up and Go (TUG e TUGcognitivo), e a função executiva, pelo teste de fluência verbal (categoria animal). RESULTADOS: Os diabéticos apresentaram pior desempenho no teste de fluência verbal (G1:14,9±4,5; G2:17,7±5,6; p=0,031). Uma diferença estatisticamente significativa foi observada entre os grupos em relação à mobilidade funcional, sendo que o G1 apresentou pior desempenho no TUG (G1:10,5±1,8s; G2:8,9±1,9s; p=0,01) e noTUGcognitivo (G1:13,9±3,2s; G2:10,9±2,3s; p=0,004). Uma correlação siginificativa foi observada entre o TUGcognitivo e o teste de fluência verbal apenas no G1 (G1: Spearman's rho = -0,535; p=0,015; G2: Spearman's rho = -0,250; p=0,288). CONCLUSÕES: Os diabéticos apresentaram um pior desempenho nos testes de mobilidade funcional e de fluência verbal que os idosos sem a doença, sugerindo um maior risco de quedas para idosos diabéticos. A inclusão desses parâmetros de avaliação para diabéticos na prática clinica da fisioterapia é fundamental para preservar a funcionalidade e evitar quedas.
BACKGROUND: Elderly diabetics tend to show cognitive deficits related to more complex processes such as the executive function, which can lead to a greater risk of falls. OBJECTIVES: The aims of this study were to compare the functional mobility, the risk of falls and the executive function among elderly with and without type 2 diabetes, and to check the correlation between these variables. METHODS: Forty community elderly participated in the study and were divided into two groups: G1 elderly with type 2 diabetes and G2 elderly without diabetes, being the variables age, body mass index and gender similar between the groups. The functional mobility and the risk of falls were assessed by the "Timed Up and Go" test (TUG and cognitive TUG) and the executive function was assessed by the Verbal Fluency Test (VFT) (animal category). RESULTS: Elderly with diabetes showed worse performance in the verbal fluency test (G1:14.9±4.5; G2:17.7±5.6; p=0.031). A statistically between-group difference was observed regarding the functional mobility; being the G1 presenting worse performance in TUG (G1:10.5±1.8sec; G2:8.9±1.9sec; p=0.01) and cognitive TUG (G1:13.9±3.2sec; G2:10.9±2.3sec; p=0.004) tests. A significant correlation was observed between the cognitive TUG and VFT only in G1 (G1: Spearman's rho = -0.535; p=0.015; G2: Spearman's rho =-0.250; p=0.288). CONCLUSIONS: Diabetics presented worse performance in the functional mobility and in the verbal fluency test than non-diabetics elderly that suggests a greater risk of falls for the elderly with diabetes. The inclusion of these evaluation parameters for diabetics on the physical therapy clinical practice is crucial in order to maintain the functionality and to prevent falls.
Assuntos
Idoso , Feminino , Humanos , Masculino , Diabetes Mellitus/fisiopatologia , Função Executiva , Movimento , Estudos TransversaisRESUMO
BACKGROUND: Elderly diabetics tend to show cognitive deficits related to more complex processes such as the executive function, which can lead to a greater risk of falls. OBJECTIVES: The aims of this study were to compare the functional mobility, the risk of falls and the executive function among elderly with and without type 2 diabetes, and to check the correlation between these variables. METHODS: Forty community elderly participated in the study and were divided into two groups: G1 elderly with type 2 diabetes and G2 elderly without diabetes, being the variables age, body mass index and gender similar between the groups. The functional mobility and the risk of falls were assessed by the "Timed Up and Go" test (TUG and cognitive TUG) and the executive function was assessed by the Verbal Fluency Test (VFT) (animal category). RESULTS: Elderly with diabetes showed worse performance in the verbal fluency test (G1:14.9 ± 4.5; G2:17.7 ± 5.6; p = 0.031). A statistically between-group difference was observed regarding the functional mobility; being the G1 presenting worse performance in TUG (G1:10.5 ± 1.8 sec; G2:8.9 ± 1.9 sec; p = 0.01) and cognitive TUG (G1:13.9 ± 3.2 sec; G2:10.9 ± 2.3 sec; p = 0.004) tests. A significant correlation was observed between the cognitive TUG and VFT only in G1 (G1: Spearman's rho = -0.535; p = 0.015; G2: Spearman's rho =-0.250; p = 0.288). CONCLUSIONS: Diabetics presented worse performance in the functional mobility and in the verbal fluency test than non-diabetics elderly that suggests a greater risk of falls for the elderly with diabetes. The inclusion of these evaluation parameters for diabetics on the physical therapy clinical practice is crucial in order to maintain the functionality and to prevent falls.
Assuntos
Diabetes Mellitus/fisiopatologia , Função Executiva , Movimento , Idoso , Estudos Transversais , Feminino , Humanos , MasculinoRESUMO
INTRODUCTION: Patients with diabetes for more than 10 years may have an increase in peak plantar pressure, considerable postural oscillation, balance deficit, alterations in gait pattern and an increased risk of falls. The aim of the present study was to assess the correlation between plantar pressure distribution and balance in patients with diabetes using a pressure platform (Footwork). MATERIAL AND METHODS: The study was carried out at the Human Movement Clinic of the Centro Universitário de Belo Horizonte (Brazil). The sample was made up of 18 right-handed individuals with type 2 diabetes - 14 females and 4 males - with an average age of 58.72 ±9.54 and an average of 18.56 ±6.61 years since diagnosis. RESULT: Data analysis revealed that greater peak plantar pressure on the right hindfoot led to greater radial displacement (Rd) (r = 0.2022) and greater displacement velocity (r = 0.2240). Greater peak plantar pressure on the left hindfoot also led to greater displacement velocity (P) (r = 0.5728) and radial displacement (RD) (r = 0.1972). A positive correlation was found between time elapsed since diagnosis and peak midfoot pressure (r = 0.3752) on the right and left side as well as between BMI and plantar pressure on all regions of the foot. CONCLUSIONS: The data reveal a correlation between postural oscillation and peak plantar pressure on the hindfoot.