Abstract Aim: To review the effects of multicomponent exercise training on the domains of the intrinsic capacity of physically frail older adults: locomotion, vitality, cognition, psychological outcomes, and sensory function. Methods: The search for the studies was carried out in the MEDLINE, Cochrane CENTRAL, and PEDro databases, along with manual search, delimiting the period of publication as the last 10 years. The initial search identified 338 studies and 18 among them were analyzed qualitatively. Results: From the analysis of the included studies, great variability was evidenced between the intervention protocols, as well as between the results. As for the effectiveness of multicomponent exercise training, it has been shown to induce a positive effect on most of the analyzed outcomes. Conclusion: In summary, the present review suggests that multicomponent physical training can be effective to improve aspects of locomotion, cognition, and psychological aspects in frail older populations. Nevertheless, more studies are needed to specify the time needed to achieve such adaptations, the magnitude of these adaptations, and the design of the most appropriate training program for each outcome related to intrinsic capabilities.

SUMMARY: There is evidence demonstrating the presence of functional compartmentalisation (FC) in some skeletal muscles. This means that the motor units (MU), grouped in certain areas of the muscle, show different levels of activation in comparison to those located in other zones. This has only been described in large muscles whose morphology proves the existence of a FC. However, there is no background information about small muscles, such as the Abductor digiti minimi manus (ADM). The objective of this study was to compare the activation of the MU in different zones of the ADM to support the hypothesis of the existence of a FC in the ADM. By using a cross- sectional, analytical, observational study, the activity of the MUs in the ADM was assessed in 12 volunteers (age 21 ± 1.6 years old; weight 75.3 ± 8 kg; height 176.2 ± 7.3 cm; average ± standard deviation). The activity of MUs was evaluated using high-density surface electromyography (HD-sEMG) with an array of 64 electrodes arranged two-dimensionally. This allowed us to record the activity of the MUs in three zones of the ADM (Z1: dorsal zone; Z2: dorsal-palmar zone and Z3: palmar zone). Electromyographic recordings were obtained during voluntary isometric contractions of the ADM at 20, 40, 60 and 80 % of the maximum voluntary contraction (MVC). The comparison of the activation levels of MUs between the three zones was carried out using a mixed model analysis of covariance. The results showed a significant difference between the dorsal and palmar zones at 40 % of the MVC (p= 0.03), and between the dorsal and dorsal- palmar zone at 80 % of the MVC (p= 0.03). The results obtained in the evaluated sample support the hypothesis of the existence of FC in the ADM. However, further research is needed to determine with greater certainty the presence of this compartmentalisation in the ADM.

RESUMEN: Existe evidencia que demuestra la presencia de una compartimentalización funcional (CF) en algunos músculos esqueléticos. Aquello se traduce en que las unidades motoras (UM) agrupadas en ciertas zonas del músculo, presentan diferentes niveles de activación a las ubicadas en otras regiones. Esto solo ha sido descrito en músculos grandes, cuya morfología justifica la existencia de una CF. Sin embargo, no existen antecedentes de aquello en músculos pequeños, tales como el abductor digiti minimi manus (ADM). El objetivo de este estudio fue comparar la activación de las UM en distintas zonas del ADM, con la finalidad sostener la hipótesis de la existencia de una CF en el ADM. Mediante un estudio observacional analítico transversal se evaluó la actividad de las UM del ADM en 12 voluntarios (edad 21±1,6 años; peso 75,3±8 kg; altura 176,2 ± 7,3 cm; promedio ± desviación estándar). La actividad de las UM, se evaluó mediante electromiografía de superficie alta densidad usando una matriz de 64 electrodos dispuestos bidimensionalmente. Esta permitió registrar la actividad de las UM en tres zonas del ADM (Z1: zona dorsal; Z2: zona dorso-palmar y Z3: zona palmar). Los registros electromiográficos fueron obtenidos durante contracciones isométricas voluntarias del ADM al 20, 40, 60 y 80 % de la contracción voluntaria máxima (CVM). La comparación de los niveles de activación de las UM entre las tres zonas fue realizada mediante un análisis de modelos mixtos de covarianza. Los resultados indicaron que existió diferencia significativa entre la zona dorsal y palmar al 40 % de la CVM (p=0,03), y entre la zona dorsal y dorso-palmar al 80 % de la CVM (p=0,03). Los resultados obtenidos en la muestra evaluada sostienen la hipótesis de la existencia de una CF en el ADM. Sin embargo, son necesarias más investigaciones para establecer con mayor certeza la presencia de esta compartimentalización en el ADM.

SUMMARY: Anatomical studies describe the vastus medialis (VM) as being subdivided into two morphologically distinct components, the vastus medialis obliquus (VMO) and the vastus medialis longus (VML). However, there are discrepancies regarding the functional differentiation of these components. The aim of this study was to compare the levels of activation of the VMO and the VML by high density surface electromyography. Twelve healthy young women (age: 21.4 ± 2.0 years; weight: 58.1 ± 7.5 kg; height: 1.6 ± 0.1 m), performed an open kinetic chain knee exercise during which the EMG activity of the VMO and the VML was recorded with two- dimensional matrices of 32 surface electrodes. The exercises were performed with three levels of resistance (5, 10 and 15 % of the body weight (BW)), considering three phases: concentric, isometric and excentric. In the isometric phase the VMO had greater activation than the VML with the three levels of resistance (p<0.05). In the excentric phase, the VMO also showed greater activation than the VML with the 10 and 15 % BW resistance levels, while in the concentric phase, the VMO showed greater activity than the VML with only the 15 % BW resistance. The results indicated significant differences in the activation level of the two components of the VM. This bears importance in the development of exercises intended to achieve a greater or more selective activation of the VMO. In the sample subjected to evaluation, the EMG recordings describe a greater activation of the VMO in comparison to the VML, which is more important in the isometric and excentric phases of the flexion/extension of the knee in an open kinetic chain. These findings suggest a functional compartmentalization of the VM.

RESUMEN: Los estudios anatómicos describen que el músculo vasto medial (VM) se subdivide en dos componentes morfológicamente distintos, el vasto medial obliquus (VMO) y el vasto medial largo (VML). Sin embargo, existen discrepancias con respecto a la diferenciación funcional de estos componentes. El objetivo de este estudio fue comparar los niveles de activación del VMO y el VML mediante electromiografía de superficie de alta densidad. Doce mujeres jóvenes sanas (edad: 21,4 ± 2,0 años; peso: 58,1 ± 7,5 kg; altura: 1,6 ± 0,1 m), realizaron un ejercicio de rodilla de cadena cinética abierta durante el cual se registró la actividad EMG de la VMO y la VML con dos matrices dimensionales de 32 electrodos de superficie. Los ejercicios se realizaron con tres niveles de resistencia (5, 10 y 15% del peso corporal (PC)), considerando tres fases: concéntrica, isométrica y excéntrica. En la fase isométrica el VMO tuvo mayor activación que el VML con los tres niveles de resistencia (p <0,05). En la fase excéntrica, el VMO también mostró mayor activación que el VML con los niveles de resistencia de 10 y 15% BW, mientras que en la fase concéntrica, el VMO mostró mayor actividad que el VML con solo el 15 % de resistencia al BW. Los resultados indicaron diferencias significativas en el nivel de activación de los dos componentes de la VM. Esto tiene importancia en el desarrollo de ejercicios destinados a lograr una activación mayor o más selectiva del VMO. En la muestra sometida a evaluación, los registros EMG describen una mayor activación del VMO en comparación con el VML, que es más importante en las fases isométrica y excéntrica de la flexión / extensión de la rodilla en cadena cinética abierta. Estos hallazgos sugieren una compartimentación funcional de la VM.

Objective: To evaluate the antidepressant effects of exercise in older adults, using randomized controlled trial (RCT) data. Methods: We conducted a meta-analysis of exercise in older adults, addressing limitations of previous works. RCTs of exercise interventions in older people with depression (≥ 60 years) comparing exercise vs. control were eligible. A random-effects meta-analysis calculating the standardized mean difference (SMD) (95% confidence interval [95%CI]), meta-regressions, and trim, fill, and fail-safe number analyses were conducted. Results: Eight RCTs were included, representing 138 participants in exercise arms and 129 controls. Exercise had a large and significant effect on depression (SMD = -0.90 [95%CI -0.29 to -1.51]), with a fail-safe number of 71 studies. Significant effects were found for 1) mixed aerobic and anaerobic interventions, 2) at moderate intensity, 3) that were group-based, 4) that utilized mixed supervised and unsupervised formats, and 5) in people without other clinical comorbidities. Conclusion: Adjusting for publication bias increased the beneficial effects of exercise in three subgroup analysis, suggesting that previous meta-analyses have underestimated the benefits of exercise due to publication bias. We advocate that exercise be considered as a routine component of the management of depression in older adults.

O objetivo do presente estudo foi verificar alterações no sinal eletromiográfico (EMG) durante contrações isométricas realizadas nos meios aquático e terrestre. Oito mulheres (23 ± 1 anos) realizaram contrações isométricas voluntárias máximas em um dinamômetro isocinético para o registro do pico do torque dos extensores do joelho e do sinal EMG do músculo vasto lateral (flexão do joelho em 90°) com e sem isolamento sobre os eletrodos de superfície. Em seguida, outra contração voluntária máxima foi realizada contra resistência fixa nos meios terrestre e aquático. Para a análise estatística utilizou-se o Teste T pareado, com a=0,05 (SPSS versão 11.0). Nenhuma diferença significativa foi encontrada entre os valores rmsEMG para o vasto lateral nas situações com (0,560 ± 0,118 mV) e sem (0,538 ± 0,110 mV) isolamento (p=0,306), para valores de pico de torque similares (p=0,191). Os mesmos resultados foram encontrados comparando os meios terrestre (0,428 ± 0,054 mV) e aquático (0,388 ± 0,105 mV) (p=0,446). O uso de adesivos resistentes à água não alterou o sinal EMG. Além disso, não houve diferenças nos valores rmsEMG durante a contração voluntária máxima realizada nos meios aquático e terrestre, sugerindo que o meio não influenciou a amplitude do rmsEMG.

The objective of the present study was to verify the electromiographic (EMG) signal alterations during isometric actions performed in water and on land. Firstly, 8 women (23 ± 1 yrs) performed maximal voluntary isometric actions in a isokinetic dynamometer to record the peak torque for knee extensors and the EMG signal of the vastus lateralis muscle (90° knee flexion) with and without superficial electrodes isolation. Subsequently, another maximal isometric action was performed against fixed resistance on land and in water immersion. For statistical analysis a paired T-Test was used, with a=0.05 (SPSS vs 11.0). No significant difference was found between vastus lateralis rmsEMG values for situations with (0.560 ± 0.118 mV) and without (0.538 ± 0.110 mV) isolation (p=0.306), for similar peak torque values (p=0.191). The same results were found comparing on land (0.428 ± 0.054mV) and in water immersion (0.388 ± 0.105 mV) situations (p=0.446). The water-resistant adhesive taping did not alter the EMG signal. Based in this finding, we found no differences on rmsEMG values during maximal isometric actions performed both in water and on land, suggesting that the environment did not influence the rmsEMG amplitude.

A amplitude do sinal eletromiográfico (EMG) tem sido utilizada para relacionar a ativação das unidades motoras com sua produção de força, durante um período de treinamento. A validade dessas mensurações é discutida devido algumas limitações da técnica, da eletromiografia de superfície, que acarretariam na dificuldade de reproduzir o sinal EMG, em diferentes aquisições. Assim, o objetivo do estudo foi verificar a reprodutibilidade da amplitude do sinal EMG do músculo vasto lateral (VL) da coxa direita, em diferentes ocasiões, durante ações isométricas máximas e submáximas, dos extensores do joelho. Três indivíduos realizaram o seguinte protocolo: execução de 3 contrações voluntárias isométricas máximas (CVMs), durante 3 s cada, com posterior execução de contrações submáximas (20, 40, 60 e 80% da CVM), calculadas a partir da CVM de maior pico de torque. Cada contração submáxima (CS), teve a duração de 4 s e foi mantida através de um feedback visual (osciloscópio). Entre cada CVM e entre as CS foram ministrados 2min de intervalo. Paralelamente às contrações, o sinal EMG do músculo VL foi obtido através de eletrodos de superfície colocados no ventre muscular, longitudinalmente à direção das fibras. Um eletrodo de referência foi posicionado na tuberosidade da tíbia. Para certificar o mesmo posicionamento entre as coletas, o local dos eletrodos foi marcado com caneta tipo "retroprojetor". O mesmo protocolo de teste foi realizado após 48hs para análise da reprodutibilidade. Tal análise foi realizada através da correlação de Pearson, com significância, p<0,05. Após o processamento do sinal e comparação dos seus valores root mean square, obtidos no teste e re-teste, verificou-se uma alta correlação entre esses valores (r=0,972, p<0,01). Esses resultados sugerem a reprodutibilidade do sinal EMG, o que possibilitaria a sua utilização em investigações que visem à comparação de sua amplitude em aquisições realizadas em diferentes ocasiões.

The objective of this paper was to verify the reliability of the amplitude of the EMG signal of the vastus lateralis muscle (VL) in the right thigh, in different occasions, during maximum and submaximum knee extensors isometric actions. Three people performed the following protocol: execution of 3 maximum voluntary isometric contractions (MVCs) during 3 s each, with later execution of submaximum actions (20, 40, 60 and 80% of the MVC), calculated considering the MVC of the highest torque peak. Each submaximum contraction (SC) lasted 4 s and was kept through a visual feedback (oscilloscope). Between each MVC and among the SC a 2 min gap was given.Parallel to the actions, EMG signal of the VL muscle was obtained through the surface electrodes put on the muscle venter longitudinally to the direction of the fibers. A reference electrode was positioned in the tuberosity of the tibia. To attest the same position among the sampling the site of the electrodes was marked with a pen for retroprojector. The same protocol was performed after 48hs for reliability analysis. Such analysis was made through Pearson correlation, with significance p<0.05. After signal processing and comparison of root mean square values, obtained in the test and re-test, it was found a high correlation among these values (r=0.972, p<0.01). These results suggest the reliability of the EMG signal, which would make its usage available for investigations that aim at comparing its amplitude in acquisitions performed in different occasions.