Resumo
A atividade fisica pode representar um importante fator na manutencao da capacidade funcional do idoso para viver em condicoes de independencia, porem, os resultados desta pratica sao limitados quando estao associados a defiCiência de nutrientes, tais como a vitamina D (vitD25OH). O presente estudo teve como objetivo analisar a relacao dessa vitamina com a forca muscular, o equilibrio corporal e a capacidade funcional de idosas praticantes e nao praticantes de atividade fisica. Foram selecionadas 299 idosas, com idades ≥ 60 anos (675 anos), praticantes de Hidroginastica (HD) e Ginastica Multifuncional (GMF) no SESC (Servico Social do Comercio - Santana/SP), ha pelo menos um ano, bem como um grupo controle formado por 162 idosas sedentarias (SED). Foram realizados: marcha estacionaria de 2 minutos (ME), timed up-and-go (TUG), levantar da cadeira em 30 segundos (LC), flexao de cotovelo (FC), reach test (RT), equilibrio estatico com controle visual (FLA), preensao manual (PM), forca dos musculos flexores de quadril (Lafay quadril) e extensores de joelho (Lafay joelho); densitometria ossea (DEXA); dosagem serica de vitD25OH, paratormonio intacto (PTH), marcador de remodelacao ossea - beta cross laps (CTX), propeptideo amino-terminal do procolageno tipo I (P1NP), calcio total (Ca), fosfatase alcalina (FA) e creatinina (C). Foi adotado o nivel de significancia α igual a 5%, a analise de variancia com um fator fixo e o teste de Kruskal-Wallis. Observamos insufiCiência da vitamina D em todos os grupos: HD= 18,47 ng/ml; GMF= 19,25 ng/ml e SED= 16,49 ng/ml (p=0,002); FA: HD= 79,37 U/L; GMF= 79,54 U/L e SED= 88,63 U/L (p=0,003) e P1NP: HD= 39,04 ng/ml; GMF=40,23 ng/ml e SED= 45,76 ng/ml (p=0,026). O mesmo comportamento nao foi observado para C (p=0,211), PTH (p=0,450), CTX (p=0,330) e Ca (p=0,142). Mais da metade das idosas dos grupos HD, GMF e SED apresentaram osteopenia (52,2%, 54,3% e 57,3%, respectivamente). Os testes fisicos e funcionais mostraram diferencas entre os tres grupos (ME; TUG; LC; FC; RT e FLA = p<0,001), com excecao para os testes Lafay quadril (p=0,360), Lafay joelho (p=0,562), PM braco direito, (p=0,089) e PM braco esquerdo (p=0,214). Os baixos niveis de vitD25OH influenciaram no desempenho do TUG (p=0,010). Concluimos que houve associacao do nivel serico da 25OHD com o equilibrio dinamico nos tres grupos analisados e os niveis sericos de vitamina D, a forca muscular e o equilibrio corporal foram mais comprometidos no grupo SED
To evaluate the conditions where the individual lives his last years was created a variant denominated “active life expectancy, healthy or functional”. Physical activity may represent an important factor in maintaining the functional capacity of the elderly to live in conditions of independence however, the results of this practice are limited when they are associated with deficiency of nutrients such as vitamin D (vitD25OH). The present study aimed to analyze the relationship of this vitamin with muscle strength, body balance and functional capacity of older practitioners and non-practitioners of physical activity We selected 299 elderly aged ≥ 60 years (67 5 years) engaged in AT and MF at SESC (Social Service of Commerce - Santana/São Paulo) for at least one year and a control group of 162 sedentary women (SED). Were performed: 2-Minute Step test - ST, Timed Up-and-Go - TUG, 30-second Chair Stand - CS, Arm Curl – AC, Functional Reach – FR, Static Balance perform with eyes open – SB, Handgrip and Portable Lafayette Dynamometer for muscle strength hip flexors - Lafay hip and knee extensors - Lafay knee), and bone densitometry - (DEXA), serum vitD25OH, intact parathyroid hormone (PTH), a marker of bone remodeling - beta cross laps (CTX), amino-terminal propeptide of procollagen type I (P1NP), total calcium (Ca), alkaline phosphatase (ALP) and creatinine (C). We adopted the significance level α = 5%, analysis of variance with a fixed factor and the Kruskal-Wallis test. We observe insufficiency of vitamin D in all groups: HD = 18.47 ng/ml; GMF= 19.25 ng/ml and SED= 16.49 ng/ml. The inferential results showed that all three groups showed statistically significant differences in levels of vitamin D - 25OHD (p=0.002); ALP: HD = 79.37 U/L; GMF=79.54 U/L and SED=88.63 U/L (p=0.003) and P1NP: HD=39.04 ng/ml; GMF=40.23 ng/mL and SED=45.76 ng/ml (p=0.026), (p=0.003). The same behavior was not observed for C (p=0.211), PTH (p=0.450), CTX (p=0.330) and Ca (p= 0.142). More than half of elderly women groups HD, GMF and SED had osteopenia (52.2%, 54.3% and 57.3%, respectively). The physical and functional tests showed differences between the three groups (ST; TUG, CS, AC, FR and SB = p <0.001), except for the tests: Lafay hip (p=0.360), Lafay knee (p=0.562), PM right arm (p= 0.089) and PM left arm (p=0.214). Low levels of vitamin D had no effect on the results of performance tests, with statistically significant only for the TUG test (p=0.010). Low levels of vitD25OH influenced the performance of the TUG (p=0.010). We conclude that there was an association of serum 25OHD with the dynamic equilibrium in the three groups and analyzed the serum levels of vitamin D, muscle strength and body balance were more involved in the SED group.
