The effects of a muscle resistance program on the functional capacity, knee extensor muscle strength and plasma levels of IL-6 and TNF-α in pre-frail elderly women: a randomized crossover clinical trial - a study protocol

<p>Abstract</p> <p>Background</p> <p>With the increase in the elderly population, a growing number of chronic degenerative diseases and a greater dependency on caregivers have been observed. Elderly persons in states of frailty remain more susceptible to significant health complications. There is evidence of an inverse relationship between plasma levels of inflammatory mediators and levels of functionality and muscle strength, suggesting that muscle-strengthening measures can aid in inflammatory conditions. The purpose of this study will be verified the effect of a muscle-strengthening program with load during a ten-week period in pre-frail elderly women with attention to the following outcomes: (1) plasma levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α), (2) functional capacity and (3) knee extensor muscle strength.</p> <p>Methods/Design</p> <p>The study design is a randomized crossover clinical trial evaluating 26 elderly women (regardless of their race and/or social condition) who are community residents, older than 65, and classified as pre-frail according to the criteria previously described by Fried et al. (2004). All subjects will be assessed using the Timed up and go and 10-Meter Walk Test functional tests. The plasma levels of IL-6 and TNF-α will be assessed by ELISA (<it>enzyme-linked immunosorbent assay</it>) with high sensitivity kits (Quantikine^®HS, R&D Systems Minneapolis, MN, U.S.). Knee extensor muscle strength will be assessed using the <it>Byodex System 3 Pro</it>^{<it>® </it>}isokinetic dynamometer at angular speeds of 60 and 180°/s. The intervention will consist of strengthening exercises of the lower extremities at 50 to 70% of 1RM (maximal resistance) three times per week for ten weeks. The volunteers will be randomized into two groups: group E, the intervention group, and group C, the control group that did not initiate any new activities during the initial study period (ten weeks). After the initial period, group C will begin the intervention and group E will maintain everyday activities without exercising. At the end of the total study period, all volunteers will be reassessed.</p> <p>Discussion</p> <p>To demonstrate and discuss possible influences of load-bearing exercises on the modification of plasma levels of IL-6 and TNF-α and in the functional performance of pre-frail elderly women.</p> <p>Trial Registration</p> <p>ISRCTN62824599</p

Capacidade funcional e uso de serviços de saúde por idosos da Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil: um estudo de base populacional

O presente trabalho investigou a associação entre a capacidade funcional e utilização de serviços de saúde entre idosos residentes na Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil. Participaram do estudo 1.624 idosos (≥ 60 anos) selecionados por meio de amostra probabilística. A variável dependente foi a utilização de serviços de saúde, baseada em três descritores: número de consultas médicas, consultas domiciliares e hospitalizações. A variável independente de interesse foi a capacidade funcional, medida pelo relato de dificuldade em realizar atividades instrumentais (AIVD) e básicas (ABVD) de vida diária. A primeira esteve associada apenas à hospitalização (RP = 1,62; IC95%: 1,16-2,26) e a segunda apresentou-se associada à hospitalização (RP = 1,73; IC95%: 1,24-2,42) e à consulta domiciliar (RP = 8,54; IC95%: 4,22-17,27). Os resultados mostraram maior utilização de serviços de saúde, sobretudo aqueles mais onerosos, entre idosos com incapacidade funcional, e que a dimensão funcional não tem sido balizadora da atuação dos serviços, ainda condicionada à presença de doenças