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- Virtual reality gaming in rehabilitation after musculoskeletal injur: user experience pilot studyPublication . Gouveia, Élvio Rúbio; Campos, Pedro; França, Cristiano S.; Rodrigues, Louis M.; Martins, Francisco; França, Cíntia; Gonçalves, Frederica; Teixeira, Fernando; Ihle, Andreas; Gouveia, Bruna R.The purposes of this study were twofold: (1) to describe a new technological solution for the rehabilitation of musculoskeletal injuries based on virtual reality (VR) gaming, and (2) to analyze the variation in rated perceived exertion (RPE) and heart rate (HR) of the participants when undergoing a rehabilitation session based on different VR games. Thirty-seven participants aged 23.7 ± 7.0 years tested during five customized VR games to provide a complete rehabilitation session after a musculoskeletal injury. The results of the Friedman test indicated a statistically significant difference in RPE scale and HR across the five VR games throughout a complete rehabilitation session (χ2 (4, n = 35) = 75.59; p < 0.001 and χ2 (4, n = 35) = 27.75, p < 0.001, respectively). RPE and HR increased significantly from Game 1 to Game 2 (z = –5.16, p < 0.001), from Game 1 to Game 3 (z = – 5.05, p < 0.001), from Game 1 to Game 4 (z = –4.87, p < 0.001), and from Game 1 to Game 5 (z = –3.61, p < 0.001). Moreover, the results showed a high perceived usability of the system, greater intrinsic motivation to perform the rehabilitation exercises, a high level of immersion, and a good experience in the VR gaming environment. Our study stimulates extended intervention programs following up on this immersive virtual reality rehabilitation system to support soccer players recovering from musculoskeletal injuries.
- Muscle strength and balance as mediators in the association between physical activity and health-related quality of life in community-dwelling older adultsPublication . Maio Nascimento, Marcelo de; Gouveia, Bruna R.; Gouveia, Élvio Rúbio; Campos, Pedro; Marques, Adilson; Ihle, AndreasLower extremity muscle strength (LEMS) and body balance (BB) are essential for older adults to maintain an upright posture and autonomously perform their basic activities of daily living. This study aimed to examine whether LEMS and BB mediate the relationship between physical activity (PA) and health-related quality of life (HRQoL) in a large sample of community-dwelling older adults. This is a cross-sectional study carried out with 802 individuals, 401 males and 401 females (69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. PA and HRQoL were assessed by the Baecke Questionnaire and e SF-36, respectively. LEMS was assessed by the Senior Fitness Test and BB by the Fullerton Advance Balance (FAB). The serial mediation pathway model pointed out that LEMS and BB partially mediated the association between PA and HRQoL in approximately 39.6% and 47%, respectively. The total variance in HRQoL explained by the entire model was 98%. Our findings may indicate the role that LEMS and BB play in the relationship between PA and HRQoL in the older population.
- Exploring the Role of Physical Activity in Mediating the Association between Educational Level and Health-Related Quality of Life in an Adult Lifespan Sample from Madeira IslandPublication . García-Mayor, Jesús; Gouveia, Élvio Rúbio; Marques, Adilson; De la Cruz-Sánchez, Ernesto; Moreno-Llamas, Antonio; França, Cíntia; Gouveia, Bruna R.; Ihle, AndreasPeople more socioeconomically vulnerable tend to have a poorer health related quality of life (HRQoL). Studies are trying to analyse the factors that may condition this relationship, including physical activity (PA), which may influence the relationship between socioe conomic status (SES) and HRQoL. This study aimed to analyse the relationship between SES and HRQoL through specific domains of PA. Methods: A total of 381 adults (≥18 years) from the Au tonomous Region of Madeira completed the measurements. Mediation analyses using bootstrapping methods adjusted for confounding variables were performed to relate SES and HRQoL; the latter was evaluated using the physical component score (PCS) of the SF-12, the mental component score (MCS) of the SF-12, and the total score in the SF-12 questionnaire (SF-12 score), through physical activity. Results: Educational level was positively related to PCS and SF-12 score. Leisure-time PA (not including sports PA) and PA at work, as single mediating variables, did not mediate the relationship between SES and HRQoL. The total PA suppressed the socioeconomic gradient of HRQoL by 8–10%, 39–46%, and 15–16%, respectively, for the PCS, MCS, and the SF-12 score; sports PA mediated the relationship by 13–16%, 50%, and 15–21%, respectively. Conclusions: The results suggest that sports PA contributes to reducing the socioeconomic gradient of HRQoL.
- The Cognitive Telephone Screening Instrument (COGTEL): a reliable and valid tool for the assessment of cognitive functioning in the Brazilian elderlyPublication . Tinôco, Maria Antonieta; Gouveia, Élvio Rúbio; Ihle, Andreas; Marques, Adilson; Gouveia, Bruna R.; Kliegel, MatthiasObjectives: To study the reliability/stability of the Cognitive Telephone Screening Instrument (COGTEL) for the assessment of cognitive functions, and to investigate the concurrent validity (that is, the relationship between the COGTEL scores and external variables, such as level of education and MMSE results) in a pilot study of elderly persons residing in the community in the municipal regions of Apuí, Fonte Boa and Manaus (Amazonas, Brazil). Method: This pilot study included 90 elderly persons (29 men and 61 women) aged 60-85 years of age [68.2 (± 6.7)]. The COGTEL, the MMSE and socio-economic survey were applied in the form of two interviews, a week apart and under the same conditions. Results: The test-retest intraclass correlation coefficient of the COGTEL total score (and respective six subtests), MMSE and educational level ranged from acceptable to high (0.708 < R <0.946). There was a strong positive correlation between the total score of the COGTEL with the MMSE (r =0.682; p <0.001), as well as with educational level (r =0.604; p <0.001). Conclusion: This study presents preliminary evidence of the reliability/ stability and concurrent validity of the COGTEL in the evaluation of cognitive functions in elderly persons residing in the community. The results of this study support the use of COGTEL as a short, reliable and valid instrument for analyzing differences in cognitive functioning in inter-individual studies with elderly persons.
- The Mediating Role of Physical Activity and Physical Function in the Association between Body Mass Index and Health-Related Quality of Life: A Population-Based Study with Older AdultsPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Gouveia, Bruna R.; Marques, Adilson; Campos, Pedro; García-Mayor, Jesús; Przednowek, Krzysztof; Ihle, AndreasThis study aimed (1) to investigate the association between body mass index (BMI), physical activity (PA), and physical function (PF) with health-related quality of life (HRQoL), and (2) to examine in-depth whether PA and PF mediate the relationship between BMI and HRQoL in older adults. We investigated 802 individuals (mean age 69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. Harmol and PA were assessed using the SF-36 and Baecke questionnaires, respectively, and PF by the Senior Fitness Test. The prevalence of overweight was 71.3%, 26.5% for normal weight, and 2.1% for underweight. We verified a small correlation between age and sex with BMI, PA, PF, and medium borderline with HRQoL. After adjusting for covariates (i.e., sex, age, comorbidities), the multivariate regression analysis indicated a 93.1% chance of improvement in HRQoL for low BMI, while PA and PF revealed a chance of increasing HRQoL by 91.8% and 60.0%, respectively. According to the serial mediation pathway, PA and PF partially mediated the association between BMI and HRQoL by 32.3% and 81.5%, respectively. The total variance of the model was 90%. It was concluded that BMI can negatively affect HRQoL. On the other hand, PA and PF are able to increase HRQoL levels during the aging process.
- Differential Patterns in Motivations for Practicing Sport and Their Effects on Physical Activity Engagement across the LifespanPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Gouveia, Bruna R.; Marques, Adilson; França, Cíntia; Campos, Pedro Filipe Pereira; Martins, Francisco; García-Mayor, Jesús; Ihle, AndreasThis study aims to report what motivates individuals to be physically active, to determine whether motivating factors influence physical activity (PA) levels, and whether this differs across the lifespan. This is a cross-sectional study with 498 individuals: 117 adolescents, 306 adults, and 75 older adults. PA was assessed using Baecke’s questionnaire, and motivating factors for practicing sports were investigated using a scale with twelve questions. The factor analysis identified three motivating factors for sports practice: psychosocial, bodily, and well-being. The scale’s overall reliability and internal consistency indicated a Cronbach’s alpha of 0.885. The analysis of covariance (ANCOVA) adjusted for sex indicated the three factors as having a significant effect on PA (p < 0.050); however, only the well-being factor showed a significant interaction with age groups (p = 0.023, ηp 2 = 0.030). Subsequently, the effect of the well-being factor on PA scores in each age group was explored through regression analyses. Only older adults showed a significant association in the unadjusted [OR = 0.378, p = 0.001, R2 = 0.243] and the sex-adjusted analysis [OR = 0.377, p = 0.001, R2 = 0.288]. These results help us to better understand the underlying motivational reasons in different age groups for engaging in sports.
- Predictors of metabolic syndrome in adults and older adults from Amazonas, BrazilPublication . Gouveia, Élvio Rúbio; Gouveia, Bruna R.; Marques, Adilson; Peralta, Miguel; França, Cíntia; Lima, Alex; Campos, Alderlane; Jurema, Jefferson; Kliegel, Matthias; Ihle, Andreas: Metabolic syndrome has been considered a factor of vulnerability and a major public health problem because it increases the risk of cardiovascular disease and type 2 diabetes. The present study from Amazonas, Brazil aimed to estimate the prevalence of the individual and general components of metabolic syndrome in adults and older adults and identify the independent predictors of metabolic syndrome. The sample of the present cross-sectional study comprised 942 participants (590 women), with a mean age of 59.8 ± 19.7 (range: 17.5 to 91.8). Blood pressure in men (62.5%), abdominal obesity in women (67.3%), and lower high-density lipoprotein cholesterol (HDL-C) in both (52.2% in men and 65.0% in women) were the most prevalent individual risk factors for metabolic syndrome. Women had a higher prevalence of abdominal obesity (p < 0.001), low HDL-C (p < 0.001), and metabolic syndrome (p < 0.001) than men; however, opposite results were seen in men for blood pressure (p < 0.001). The overall prevalence of metabolic syndrome was 47.5%. Advanced age, being female, having a higher body mass index, and a having lower educational level independently increased the odds of metabolic syndrome. Due to the association of metabolic syndrome with deterioration of health status and increased vulnerability, this study sustains the need for early public health interventions in the Amazonas region.
- Sarcopenia and Physical Activity Predict Falls in Older Adults from Amazonas, BrazilPublication . Ihle, Andreas; Kliegel, Matthias; Jurema, Jefferson; Tinôco, Antonieta; Campos, Pedro; Marques, Adilson; Gouveia, Bruna; Gouveia, Élvio Rúbio; Miranda, Kessketlen Alvest. Introduction: Sarcopenia is a progressive and widespread skeletal muscle disorder involving loss of muscle mass and function, and is associated with several outcomes, including falls, functional decline, frailty, and mortality. Therefore, this study aimed: (1) to estimate the prevalence of sarcopenia, falls, and the risk of falls considering age, sex, and the level of physical activity (PA), and (2) to identify which of these predictors better explained the likelihood that participants present risk of fall. A total of 701 participants (433 women) with a mean age of 70.4±6.9. Sarcopenia was determined according to the most recent guidelines from the European Working Group (EWGSOP2). The prevalence of falls and the level of physical activity were assessed by questionnaires. The risk of falls was assessed using the Fullerton Advance Balance (FAB) scale. This study provides evidence that women (OR: 2.5, p<0.001), the oldest people (OR: 1.1 p<0.001), and people who had identified sarcopenia (OR: 2.9 p<0.001), and lower level of physical activity (OR: 2.9 p<0.001), were more likely to present the risk of falls. Implications for vulnerable aging are discussed.
- The Role of Physical Function in the Association between Physical Activity and Gait Speed in Older Adults: A Mediation AnalysisPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Marques, Adilson; Gouveia, Bruna R.; Marconcin, Priscila; França, Cíntia; Ihle, AndreasAdequate levels of physical function (PF) are essential for vulnerable older adults to perform their daily tasks safely and remain autonomous. Our objective was to explore the mediating role of PF in the relationship between physical activity (PA) and gait speed (GS) in a large sample of older adults from the north of Brazil. This is a cross-sectional study that analyzed 697 older adults (mean age 70.35 ± 6.86 years) who participated in the project “Health, Lifestyle, and Physical Fitness in Older Adults in Amazonas” (SEVAAI). PA was assessed using the Baecke Questionnaire, PF using the Senior Fitness Test, and GS using the 50-foot Walk Test. Mediation pathways were analyzed to test the possible mediating role of PF between specific PA domains (PA-total score, PA-housework, PA-sport, PA-leisure) and GS. Regarding PA-total, the analysis showed that high-performance GS was partially mediated in approximately 19% by better PF performance. Moreover, the PF could partially mediate the association between PA-sport and PA-leisure with GS, at levels of approximately 9% and 46%, respectively. An inverse relationship was observed between PA-housework (sedentary lifestyle) and GS. This association was partially mediated to an extent of approximately 9% by better PF performance. We conclude that PF plays a crucial role in mediating the association between PA and GS among vulnerable older adults.
- Digital health in schools: a systematic reviewPublication . França, Cíntia; Santos, Francisco; Martins, Francisco; Lopes, Helder; Gouveia, Bruna; Gonçalves, Frederica; Campos, Pedro; Marques, Adilson; Ihle, Andreas; Gonçalves, Tatiana; Gouveia, Élvio RúbioWorldwide, the growing digitalization process and increase in smartphone usage have contributed to promoting mobile health (mHealth) services. This study provides an overview of the research targeting the effectiveness of mHealth interventions among children and adolescents in the school environment. A systematic literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in the PubMed, Web of Science, and Scopus databases. The results show that physical activity and nutrition are the main intervention topics. Health literacy, mental health, productive health, vaccination rates, and social interaction were also considered in mHealth interventions. Of the 13 studies that remained for analysis, 12 described positive outcomes in at least one health variable after using an mHealth tool. Overall, interventions ranged between four and 24 weeks. Only seven studies managed to have at least 80% of the participants from the baseline until completion. Adding personal information, user interaction, and self-reference comparisons of performance seems crucial for designing successful health digital tools for school-aged children and adolescents.
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