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This study employed multivariate analysis to investigate the effects of a 14-week multicomponent training program on sedentary adults and older populations, focusing on improvements in physical fitness, health markers, and anthropometric measures. The data included 376 participants aged 30 to 84 years who had been inactive for at least 3 months. Results showed that participants aged 71 and above had lower systolic blood pressure, height, body mass, elbow flexion and extension, sitting and standing up from a chair, agility, 6-Minute Walk Test (6MWT), and handgrip strength values compared to younger age groups (p < 0.05). Initially, the 6MWT was inversely correlated with anthropometric measures and positively correlated with strength tests, but after the intervention, it remained correlated only with handgrip strength and agility. Interestingly, the elbow flexion and extension strongly correlated with other fitness measures pre-intervention, but these relationships weakened afterward. Agility became a key intermediary variable in the analysis. Despite improvements, anthropometric variables like body mass and waist circumference continued to have a strong relationship with fitness outcomes. Significant gains were observed in the 6MWT and elbow flexion and extension (p < 0.05), indicating improvements in aerobic fitness and strength. Multivariate analysis showed that hip circumference, chair stand test, handgrip strength, and agility significantly influenced 6MWT performance. Using multivariate analysis, we were able to highlight the importance of incorporating regular exercise into daily life to promote active and healthy aging. Furthermore, agility emerged as the most significant intermediate variable after the intervention. This insight suggests that improvements in agility may be crucial for physical fitness and overall health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This work was supported in part by a grant from Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) (23/08249-0)., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Abstract: da Silva, LSL, Gonçalves, LdS, Alves Campos, PH, Benjamim, CJR, Tasinafo Júnior, MF, de Lima, LCR, Bueno Júnior, CR, and Alves, CPdL. Comparison between eccentric vs. concentric muscle actions on hypertrophy: a systematic review and meta-analysis. J Strength Cond Res 39(1): 115-134, 2025-Different physiological mechanisms of sarcomere activity during eccentric (ECC) and concentric (CON) muscle actions led to investigations into muscle hypertrophy outcomes, but conclusions remain elusive. We aimed to investigate the effects of ECC vs. CON muscle actions on muscle hypertrophy in apparently healthy adults through a systematic review with meta-analysis. The searches were conducted on EMBASE, MEDLINE, Cochrane Library, Web of Science, Scopus, and SPORTDiscus databases. To be eligible for inclusion, studies had to: (a) be randomized/controlled trials; (b) investigate the effects of CON vs. ECC resistance training programs in apparently healthy adults; (c) assess hypertrophy outcomes using direct imaging for cross-sectional area, muscle thickness, or muscle volume. A total of 15,778 studies were identified, and 26 (682 subjects included in the meta-analysis) met the inclusion criteria. The main findings indicated no statistical difference between ECC vs. CON on hypertrophy measurements (0.285 [95% CI: -0.131 to 0.701]; p = 0.179; I2: 84.4%; GRADE: very low). Subgroup meta-analysis analyzing possible hypertrophy outcome moderators as age (18-59 years old and ≥60 years old) and weeks of intervention duration (>8 weeks) did not reveal differences between ECC vs. CON. Subgroup analysis revealed an effect favoring the ECC for the upper limb muscles (p = 0.018), ≤8 weeks of intervention (p = 0.046), muscle thickness assessment (p = 0.0352), and isokinetic contraction (p = 0.0251). Our findings suggest similar hypertrophy between ECC and CON muscle actions in apparently healthy adults. However, it appears that the muscles of the upper limbs, shorter interventions, hypertrophy assessment method, and the contraction type may favor ECC muscle actions., (Copyright © 2024 National Strength and Conditioning Association.)

Aim: This study examined the association of low handgrip strength (HGS) for falls in middle-aged adults and older adults every half-decade of life., Methods: This cross-sectional study was conducted using the public data from the first wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The participants were allocated into seven age groups 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, and ≥ 80 years. Binary logistic regression analysis was performed to identify the odds ratio (OR) of low HGS to the falls regardless of confounding variables such as sex, balance, gait speed, and total number of health conditions., Results: A total of 8,112 participants aged 50-105 years (median = 62.0 years): 3,490 males (median = 60.0 years) and 4,622 females (median = 63.0 years) attended the study. Altogether, 21.5% of participants experienced at least one fall. HGS gradually decreases over each half-decade of life. In addition, low HGS presented a significative OR (p < 0.05) for falls for age groups, until 80 s, even when considering confounding variables., Conclusions: Low HGS is associated with falls in middle-aged adults over their 50 s and remained a strong measure of falls across each subsequent half-decade of life, until 80 s., (© 2024. The Author(s).)

Background: There is a limited research on predictive models of fat mass ratio (FMR) in people living with human immunodeficiency virus (HIV) (PWH). This study aimed to develop models considering anthropometric and health-related factors to predict and validate FMR in PWH regardless of sex., Methods: One hundred and six Brazilian PWH (46.4±9.8 years) were evaluated for body composition using dual-energy X-ray absorptiometry (DXA), body circumference (BC), and skinfold thicknesses (SKs). FMR predictive models were developed using stepwise linear regression, and their agreement with DXA was assessed using Bland-Altman plots. Cross-validation was performed using the predicted residual error sum of squares (PRESS) method., Results: Six FMR estimation models were developed for PWH, with adjusted R 2 ranging from 0.43 to 0.72, standard error of the estimate (SEE) from 0.16% to 0.22%, and 95% confidence interval (CI) from 1.03 to 1.15. Model 6, including thigh SK, waist BC, therapy duration, subscapular SK, education years, and abdominal SK, exhibited the highest determination power (R 2 adjusted 0.72, SEE 0.16%, and 95% CI: 1.06-1.15). The agreement between DXA-based FMR and predictive models showed minimal bias (-0.03 to +0.04) and narrower limits of agreement, particularly for the top-performing model (-0.33 to +0.30). Model 6 exhibited a high adjusted Q 2 PRESS (0.70) and low SPRESS (0.17)., Conclusions: Our predictive models advance the study of body composition in PWH by consolidating the use of anthropometry for diagnosing and monitoring lipodystrophy regardless of sex., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-23-1946/coif). A.P.d.S. received a scholarship from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - (Finance Code 001, grant No. 88882.317622/2019-01), and from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (grant No. 201126/2022-2). Additionally, the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) will pay the article processing charges for this manuscript. The other authors have no conflicts of interest to declare., (2024 Annals of Translational Medicine. All rights reserved.)

This study investigated the associations of sarcopenic obesity (SO) with muscle strength and physical performance in sufficiently active older adults. Data from 72 older sarcopenic obese adults classified as sufficiently active were analyzed. Participants were categorized into four groups based on sex and SO status. Muscle strength/physical performance tests were compared using independent sample t-tests. Multiple linear regression and binary logistic regression were performed to examine the associations between SO and muscle strength and physical performance, adjusting for confounding variables. Only handgrip strength showed differences between SO groups, regardless of sex (p < 0.05). SO negatively explained the variability of handgrip strength (p < 0.05). An increase in handgrip strength values was associated with a decrease in the chances of older adults being classified as SO (p < 0.05). The findings suggest that even with SO, sufficiently active older adults did not present a significant reduction in muscle strength in the lower limbs and physical performance., (© 2024. The Author(s).)

Background: The increase in blood pressure (BP) levels in the postmenopausal period can be partly explained by the decrease in nitric oxide synthases (NOS)., Objective: To investigate the acute and one-week effects of beetroot juice nitrate-rich (BRJ-NO3 - rich) ingestion on cardiovascular and autonomic performance in response to submaximal aerobic exercise in postmenopausal women with systemic arterial hypertension (SAH) who are physically inactive., Methods: Fourteen postmenopausal women with SAH [mean (SD) age: 59(4) y; BMI (kg/m2): 29.2(3.1)] completed submaximal aerobic exercise bouts after an acute and a one-week intervention with BRJ in a placebo-controlled, randomized, triple-blind, crossover design. Participants ingested either BRJ (800 mg of NO 3 - ) or placebo acutely and drank either BRJ (400 mg of NO 3 - ) or placebo every day for the next six days. After two and ½ hours, they performed a session of aerobic submaximal aerobic exercise, and their systolic BP (SBP) and diastolic BP (DBP), flow-mediated dilation (FMD), heart rate (HR) recovery, and HR variability were measured., Results: In the post-exercise recovery period, SBP dropped significantly in the BRJ-NO 3 - rich group (-9.28 mmHg [95%CI: -1.68 to -16.88] ES: -0.65, p = 0.019) compared to placebo after acute ingestion. The FMD values increased after acute BRJ-NO 3 - rich on post-exercise (3.18 % [0.36 to 5.99] ES: 0.87, p = 0.031). After the one-week intervention, FMD values were higher in the BRJ-NO 3 - rich group before (4.5 % [1.62 to 7.37] ES: 1.21, p = 0.005) and post-exercise measurements (4.2 % [1.52 to 6.87] ES: 1.22, p = 0.004) vs. placebo. HRV indices with remarkable parasympathetic modulation to heart recovered faster on the BRJ-NO 3 - rich group than placebo group. No between-group differences were identified in values of HR post-exercise recovery in the 30s, 60s, 120s, 180s, and 300s., Conclusions: Acute and short-term BRJ-NO 3 - rich ingestion may enhance cardiovascular and autonomic behavior in response to aerobic exercise in postmenopausal women diagnosed with SAH., Clinical Trial Registry Number: https://clinicaltrials.gov/ct2/show/NCT05384340., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Appendicular skeletal muscle mass (ASM) obtained from dual-energy x-ray absorptiometry (DXA) is recommended to quantify sarcopenia, but has limited availability in disadvantaged-income countries, moreover in an epidemiological context. Predictive equations are easier and less costly to apply, but a review of all available models is still lacking in the scientific literature. The objective of this work is to map, with a scoping review, the different proposed anthropometric equations to predict ASM measured by DXA., Methods: Six databases were searched without restriction on publication date, idiom, and study type. A total of 2,958 studies were found, of which 39 were included. Eligibility criteria involved ASM measured by DXA, and equations proposed to predict ASM., Results: predictive equations (n = 122) were gathered for 18 countries. The development phase involves sample size, coefficient of determination (r 2 ), and a standard error of estimative (SEE) varying between 15 and 15,239 persons, 0.39 and 0.98, 0.07 and 3.38 kg, respectively. The validation phase involves a sample size, accuracy, and a SEE between 15 and 3,003 persons, 0.61 and 0.98, 0.09 and 3.65 kg, respectively., Conclusions: The different proposed predictive anthropometric equations of ASM DXA were mapped, including validated pre-existing equations, offering an easy-to-use referential article for clinical and research applications. It is necessary to propose more equations for other continents (Africa and Antarctica) and specific health-related conditions (e.g., diseases), once the equations can only have sufficient validity and accuracy to predict ASM generally when applied to the same population., Competing Interests: Declaration of Competing Interest None. All authors declare that they have no conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: The implementation of social distancing measures during covid-19 influenced health outcomes and population´s behaviors, and its rigidity was very different across countries. We aimed to verify the association between the rigidity of social distancing measures of covid-19 first wave with depression symptoms, quality of life and sleep quality in older adults., Methods: This is a cross-sectional study including 1023 older adults (90% women; 67.68 ± 5.92 years old) of a community-based program in Fortaleza (Brazil). Dependent variables (depression symptoms, sleep quality, and quality of life) were measured through phone calls along June 2020, during the first covid-19 wave. Confinement rigidity (non-rigorous and rigorous) was considered as independent variable. Sociodemographic characteristics (sex, marital status, scholarity, and ethnicity), number of health conditions, nutritional status, movement behavior (physical activity and sitting time), technological skills, and pet ownership were considered as confounding variables. A binomial logistic regression (odds ratio [OR]) was performed to verify the association of confinement rigidity and depression symptoms, sleep quality, and quality of life, adjusted by confounding variables., Results: Older adults who adopted a less rigid lockdown had a higher frequency of depression symptoms, worse perception of quality of life, and bad sleep quality (p < 0.001). Confinement rigidity was able to explain the probability of depression symptoms occurrence (OR: 2.067 [95% CI: 1.531-2.791]; p < 0.001), worse quality of life (OR: 1.488 [95% CI: 1.139-1.944]; p < 0.05), and bad sleep quality (OR: 1.839 [95% CI: 1.412-2.395]; p < 0.001). Even adjusted by confounding variables, confinement rigidity was able to explain the poor outcomes analyzed in older adults., Conclusion: Our findings showed that less rigid lockdown was associated with a superior frequency of depression symptoms, worse sleep quality, and lower perception of quality of life in older adults. Therefore, our study could improve comprehension regarding the impact of social distancing measures rigidity in health-related conditions and in the context of covid-19 and other similar pandemic situations., (© 2023. The Author(s).)

Background: Sarcopenic obesity (SO) is a clinical and functional disease characterized by the coexistence of obesity and sarcopenia. Resistance training (RT) characteristics for older adults with sarcopenia or obesity are already well established in the scientific literature. Nonetheless, we still do not know how detailed the RT protocols are described for older adults with SO. Therefore, we aimed to analyze the characteristics of RT programs, including each of their variables, recommended for older adults with SO., Methods: This is a scoping review study that was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews. The search was carried out until November 2022 in PubMed/MEDLINE, EMBASE, Cochrane Library, Web of Science, Scopus, LILACS, Google Scholar, and medRxiv databases. The studies included SO diagnosis and RT as an intervention strategy. The RT variables analyzed were as follows: exercise selection, the volume of sets, the intensity of load, repetition cadence, rest interval between sets, and weekly frequency., Results: A total of 1,693 studies were identified. After applying the exclusion criteria, 15 studies were included in the final analysis. The duration of the RT intervention ranged from 8 to 24 weeks. All studies included full-body routines, with single/multi-joint exercises. Regarding the volume of sets, some studies fixed it in three sets, whereas others varied between one and three sets. The load was reported by repetition range and the weight lifted, elastic-band color/resistance, percentage of one repetition maximum, or perceived exertion scale. Repetition cadence was fixed in some studies, while it was self-selected between concentric and eccentric phases in others. The interval between sets of rest varied from 30 to 180 s. All studies reported progression overload during the interventions. Not all studies reported how the exercise selection, repetition cadence, and rest interval were made., Conclusion: The characteristics of RT protocols and their variables prescribed in the literature for older adults with SO were mapped. The lack of detail on some training variables (i.e., exercise selection, repetition cadence, and rest interval) was identified. RT protocols are heterogeneous and described only partially among studies. The recommendations for RT prescription details in older adults with SO are provided for future studies., Systematic Review Registration: https://osf.io/wzk3d/., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Silva, Gonçalves, Abdalla, Benjamim, Tasinafo, Venturini, Bohn, Mota, Marcos-Pardo, Kemmler, dos Santos and Machado.)

Abstract: People living with HIV (PWH) experience an accelerated aging process. There is no anthropometric predictive model for appendicular skeletal muscle mass (ASM) in PWH. This study develops anthropometric models to predict and validate ASM measured by dual energy x-ray absorptiometry (DXA) in PWH; DXA scans were obtained for 125 PWH (male = 74; age >18 years) on antiretroviral therapy. Fat mass ratio was used for lipodystrophy diagnosis. A multiple stepwise linear regression considered ASM DXA as the dependent variable and validated by PRESS method. A high power of determination and low standard estimate error were found for ASM DXA -predicted (adjusted r2 = 0.84 to 0.87, standard estimate error = 1.7-1.6 kg) and high PRESS validation coefficients (Q 2PRESS = 0.84-0.86, S PRESS = 1.7-1.6 kg). The variables included were lipodystrophy diagnosis, medial calf circumference, sex, and total body weight. We present novel, reliable, and validated anthropometric models to predict ASM DXA in PWH., (Copyright © 2023 Association of Nurses in AIDS Care.)

Background: Handgrip strength (HGS) asymmetry is associated with slow gait speed. Both mark muscle dysfunction, potential risk of falls, and adverse health outcomes. This association was found in older adults from high-income countries, but not yet studied in low- and middle-income countries. Moreover, there is no HGS asymmetry referential to identify the disabling process. Thus, our study aims to verify the association of HGS asymmetry with slowness in older adults from six low- and middle-income countries and to propose cut points to slowness., Methods: A cross-sectional study with data from 12,669 older adults (≥60 years) of the Study on Global Aging and Adult Health (SAGE) conducted in six low- and middle-income countries were analyzed. Based in the difference between upper body sides HGS (asymmetry), participants were categorized in groups as 0.0-10.0% (reference group), 10.1-20.1%, 20.1-30.0% or >30.0%. Slow gait speed was established as <0.59 (men) and <0.51 (women) m/s. Associations of HGS asymmetry with gait speed were ascertained with logistic regression. HGS asymmetry index "[(HGS asymmetry*HGS)/(BMI*Age)]*100" cut points to identify slowness were generated with the ROC curve and Youden index (α = 5%)., Results: Compared to HGS reference group, those with HGS asymmetry of 10.1-20%, 20.1-30.0% and >30.0% had a superior odds for slowness [1.18(CI:1.02,1.42); 1.17(CI: 0.97; 1.44); and 1.21(CI:1.03;1.43), respectively]. HGS asymmetry index cut points to identify slowness were ≤1.14 (women) and ≤1.77 (men)., Conclusions: HGS asymmetry association with slowness is present in economically disadvantaged countries. We proposed a new index for impaired muscle function with acceptable sensibility and specificity., Competing Interests: Declaration of Competing Interest None. All authors declare that they have no conflict of interest., (Copyright © 2022. Published by Elsevier B.V.)

Background: There is no evidence of the use of beetroot juice with a previously recommended dose of nitrate (NO3) (> 300 mg) on the cardiovascular performance during and recovery following exercise in postmenopausal women with systemic arterial hypertension (SAH)., Methods: We will investigate the effects of beetroot juice rich in NO3 acutely (800 mg) and during a week with daily doses (400 mg) on blood pressure, heart rate (HR), cardiac autonomic control, endothelial function, inflammatory, hormonal, and stress biomarkers oxidative stress and enzymes involved in nitric oxide synthesis and mitochondrial regulation, under resting conditions, as well as mediated by submaximal aerobic exercise sessions. Through a randomized, crossover, triple-blind, placebo-controlled clinical trial, 25 physically inactive women with SAH will undergo an acute and 1-week trial, each with two intervention protocols: (1) placebo and (2) beetroot, in which will ingest beet juice with or without NO3 in its composition with a 7-day washout interval. On collection days, exercise will be performed on a treadmill for 40 min at a speed corresponding to 65-70% of VO2peak. The collection of variables (cardiovascular, autonomic, and blood samples for molecular analyses) of the study will take place at rest (135 min after ingestion of the intervention), during exercise (40 min), and in the effort recovery stage (during 60 min) based on previously validated protocols. The collections were arranged so that the measurement of one variable does not interfere with the other and that they have adequate intervals between them., Discussion: The results of this research may help in the real understanding of the nutritional compounds capable of generating safety to the cardiovascular system during physical exercise, especially for women who are aging and who have cardiovascular limitations (e.g., arterial hypertension) to perform physical exercise. Therefore, our results will be able to help specific nutritional recommendations to optimize cardiovascular health., Trial Registration: ClinicalTrials.gov NCT05384340. Registered on May 20, 2022., (© 2023. The Author(s).)

Background: Nutritional status, health risk behaviors, eating habits, and other comorbidities (such as diabetes) may be associated with recommended amounts of physical activity (PA) and exercise (EX) in healthy older adults. However, these associations are still unclear for older hypertensive adults, who require greater care from health professionals. The purpose of this study was to associate the nutritional status, health risk behaviors, eating habits, and the presence of diabetes with recommended amounts of physical activity and exercise practice of older hypertensive adults., Methods: Ten thousand seven hundred eighty-nine older hypertensive adults (70.9 ± 7.4 years) from the VIGITEL telephone survey were classified according to PA levels (insufficiently active/sufficiently active) and EX practice (non-practitioners/practitioners). Binary logistic regression was used to observe the odds ratio (OR) between independent variables (nutritional status [body mass index], sociodemographic characteristics [age/sex/years of study], risk behaviors [screen time/alcohol/tobacco consumption], eating habits [minimally/ultra-processed foods consumption score], and the presence of diabetes) with recommended amounts of PA/EX (dependent variable)., Results: Highest nutritional status (OR PA  = 0.975 [95%-CI: 0.965 - 0.985]; OR EX  = 0.981[95%-CI: 0.972 - 0.991]), age (OR PA  = 0.955 [95%-CI: 0.949 - 0.961]; OR EX  = 0.980[95%-CI: 0.975 - 0.986]), screen time (OR PA  = 0.909[95%-CI: 0.835 - 0.990]), alcohol consumption (OR PA  = 0.683[95%-CI: 0.621 - 0.758]; OR EX  = 0.702[95%-CI: 0.637 - 0.779]), tobacco (OR PA  = 0.601 [95%-CI: 0.492 - 0.736]; OR EX  = 0.464[95%-CI: 0.384 - 0.562]) ultra-processed foods consumption score (OR PA  = 0.896[95%-CI: 0.871 - 0.921]; OR EX  = 0.886[95%-CI: 0.863 - 0.909]) and having diabetes (OR PA  = 0.780[95%-CI: 0.708 - 0.859]; OR EX  = 0.831[95%-CI: 0.759 - 0.909]) reduced the odds of being sufficiently active/practicing exercise (p < 0.05). Male sex (OR PA  = 1.633[95%-CI: 1.491 - 1.789]; OR EX  = 1.247[95%-CI: 1.140 - 1.363]), years of study (OR PA  = 1.026[95%-CI: 1.018 - 1.035]; OR EX  = 1.050[95%-CI: 1.041 - 1.058]), and minimally processed foods consumption score increased the odds of being sufficiently active/practicing exercise (OR PA  = 1.132[95%-CI: 1.109 - 1.155]; OR EX  = 1.167[95%-CI: 1.145 - 1.191], respectively; p < 0.05)., Conclusion: Nutritional status, health risk behaviors, eating habits, and the presence of diabetes were associated with the odds of older hypertensive adults complying with PA and EX recommendations. The results may help health professionals understand how these factors are associated with the changes of older hypertensive adults participating in physical activity and exercise., (© 2022. The Author(s).)

The regular practice of physical activity helps in the prevention and control of several non-communicable diseases. However, evidence on the role of physical activity in mitigating worsening clinical outcomes in people with COVID-19 is still unclear. The aim of this study was to verify whether different levels of physical activity provide protection for clinical outcomes caused by SARS-CoV-2 infection. A cross-sectional study was conducted with 509 adults (43.8 ± 15.71 years; 61.1% female) with a positive diagnosis of COVID-19 residing in Ribeirão Preto, São Paulo, Brazil. Participants were interviewed by telephone to determine the severity of the infection and the physical activity performed. Binary logistic regression was used to indicate the odds ratio (OR) of active people reporting less harmful clinical outcomes from COVID-19. Active people had a lower chance of hospitalization, fewer hospitalization days, less respiratory difficulty and needed less oxygen support. The results suggest that active people, compared to sedentary people, have a lower frequency of hospitalization, length of stay, breathing difficulty and need for oxygen support. These results corroborate the importance of public policies to promote the practice of physical activity, in order to mitigate the severity of the clinical outcomes of COVID-19.

Resistance training with blood flow restriction (RTBFR) allows physically impaired people living with HIV (PWH) to exercise at lower intensities than traditional resistance training (TRT). But the acute and chronic cardiac and metabolic responses of PWH following an RTBFR protocol are unknown. The objective was to compare the safety of acute and chronic effects on hemodynamic and lipid profiles between TRT or RTBFR in PWH. In this randomized control trial, 14 PWH were allocated in RTBFR (G RTBFR ; n = 7) or TRT (G TRT; n = 7). Both resistance training protocols had 36 sessions (12 weeks, three times per week). Protocol intensity was 30% (G RTBFR ) and 80% (G TRT ). Hemodynamic (heart rate, blood pressure) and lipid profile were acutely (rest and post exercise 7th, 22nd, and 35th sessions) and chronically (pre and post-program) recorded. General linear models were applied to determine group * time interaction. In the comparisons between groups, the resistance training program showed acute adaptations: hemodynamic responses were not different (p > 0.05), regardless of the assessment session; and chronicles: changes in lipidic profile favors G RTBFR , which significantly lower level of total cholesterol (p = 0.024), triglycerides (p = 0.002) and LDL (p = 0.030) compared to G TRT . RTBFR and TRT induced a similar hemodynamic adaptation in PWH, with no significant risks of increased cardiovascular stress. Additionally, RTBFR promoted better chronic adequacy of lipid profile than TRT. Therefore, RTBFR presents a safe resistance training alternative for PWH.Trial registration: ClinicalTrials.gov ID: NCT02783417; Date of registration: 26/05/2016., (© 2022. The Author(s).)

Objectives: Absolute handgrip strength and adjusted by body mass index are useful to identify age-related conditions. However, these values are not accurate for older adults with extreme body size because of the nonlinear relationship between strength, height, and body mass. The purpose of this study was to determine cut-off points for age-related conditions of older adults using allometric coefficients to normalize grip strength by body size., Design: Cross-sectional study., Setting and Participants: Data from 13,235 older adults of Study on Global Aging and Adult Health conducted in 6 low- and middle-income countries were analyzed., Methods: Country- and sex-specific allometric exponents for body-size variables (mass and height) were computed with log-linear models. Partial correlation verified whether allometric normalization removed the effect of body size on grip strength. Cut-off points were established (<20th percentile) for low allometrically adjusted grip strength., Results: Allometric exponents for normalization of grip strength were provided for body-size variables, ranging from 0.19 to 2.45. Allometric normalization removed the effect of body size on grip strength (r < 0.30). Overall, frequencies of low muscle strength were overestimated with international criteria (absolute grip strength) compared with the cut-off points proposed in this study., Conclusions and Implications: The proposed allometric exponents normalized grip strength according to body-size variables. These exponents improved the accuracy in identifying age-related conditions in older adults with extreme body size. The variability between strength reveals the need for developing specific cut-off points for low- and middle-income countries. New cut-off points of low normalized grip strength with automatized applicability were proposed for health care providers use in clinical practice., (Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Background: To propose cut-off points for older adults' weakness for upper and lower limbs muscle strength normalized by body size with the ratio standard/muscle quality and allometric scaling., Methods: Ninety-four community-dwelling older adults (69.1% women) were assessed for 49 body-size variables (anthropometry, body composition and body indexes), handgrip strength (HGS), one maximum repetition measurement for knee extensors (1RM), isokinetic knee extension peak torque at 60°/s (PT), and six-minute walk test (6MWT). Ratio standard or muscle quality (muscle strength/body size) and allometric scaling (muscle strength/body size b ; when b is the allometric exponent) were applied for body-size variables significantly correlated with HGS, 1RM and PT. Cut-off points were computed according to sex based on mobility limitation (6MWT < 400 m) with ROC curve and Youden index., Results: Absolute HGS, 1RM and PT cut-off points were not adequate because they were associated with body size (r > 0.30). But it was corrected with muscle strength normalization according to body size-variables: HGS (n = 1); 1RM (n = 24) and PT (n = 24). The best cut-off points, with the highest area under the curve (AUC), were found after normalization for men: HGS/forearm circumference (1.33 kg/cm, AUC = 0.74), 1RM/triceps skinfold (4.22 kg/mm, AUC = 0.81), and PT/body mass*height 0.43 (13.0 Nm/kg*m 0.43 , AUC = 0.94); and for women: HGS/forearm circumference (1.04 kg/cm, AUC = 0.70), 1RM/body mass (0.54 kg/kg, AUC = 0.76); and PT/body mass 0.72 (3.14 Nm/kg 0.72 ; AUC = 0.82)., Conclusions: Upper and lower limbs muscle weakness cut-off points standardized according to body size were proposed for older adults of both sexes. Normalization removes the effect of extreme body size on muscle strength (both sexes) and improves the accuracy to identify weakness at population level (for women, but not in men), reducing the risk of false-negative/positive cases., (© 2021. The Author(s).)