OBJECTIVE: The aim of this study was to evaluate the intra and inter-rater reliability of pelvic floor muscle (PFM) dynamometric measurements for maximum and average strengths, as well as endurance. METHOD: A convenience sample of 18 nulliparous women, without any urogynecological complaints, aged between 19 and 31 (mean age of 25.4±3.9) participated in this study. They were evaluated using a pelvic floor dynamometer based on load cell technology. The dynamometric evaluations were repeated in three successive sessions: two on the same day with a rest period of 30 minutes between them, and the third on the following day. All participants were evaluated twice in each session; first by examiner 1 followed by examiner 2. The vaginal dynamometry data were analyzed using three parameters: maximum strength, average strength, and endurance. The Intraclass Correlation Coefficient (ICC) was applied to estimate the PFM dynamometric measurement reliability, considering a good level as being above 0.75. RESULTS: The intra and inter-raters' analyses showed good reliability for maximum strength (ICCintra-rater1=0.96, ICCintra-rater2=0.95, and ICCinter-rater=0.96), average strength (ICCintra-rater1=0.96, ICCintra-rater2=0.94, and ICCinter-rater=0.97), and endurance (ICCintra-rater1=0.88, ICCintra-rater2=0.86, and ICCinter-rater=0.92) dynamometric measurements. CONCLUSIONS: The PFM dynamometric measurements showed good intra- and inter-rater reliability for maximum strength, average strength and endurance, which demonstrates that this is a reliable device that can be used in clinical practice.

Fenótipo de fragilidade: influência de cada item na determinação da fragilidade em idosos comunitários -Rede FibraPhenotype of frailty: the influence of each item in determining frailty in community-dwelling elderly -The Fibra Study (OR = 10,50, IC95%8,90, p < 0,001) e a fraqueza muscular (OR = 7,31, IC95%6,(2)(3)(4)(5)(6)(7)(8)86, p < 0,001 (OR = 10.50, p <0.001) and muscular weakness (OR = 7.31, 95%CI 6,(2)(3)(4)(5)(6)(7)(8)86, p <0.001

A síndrome da fragilidade é uma condição associada ao envelhecimento, com desfechos de saúde nos idosos como quedas, medo de cair e incapacidade. Os objetivos deste estudo foram determinar a freqüência de fragilidade e verificar a existência de correlação desta com quedas, medo de cair e funcionalidade, em 30 idosos (média de 75,7±7,6 anos) cadastrados em um serviço interdisciplinar de Geriatria e Gerontologia. Foram avaliados quanto à fragilidade, por características sugeridas pela literatura, e quanto aos desfechos quedas, funcionalidade e medo de cair. A análise descritiva identificou 20% de idosos frágeis, 46,7% pré-frágeis e 33,3% não-frágeis. Foram encontradas diferenças significativas entre os grupos frágeis e pré-frágeis e frágeis e não-frágeis em relação à funcionalidade mensurada pela escala de Lawton (p=0,000) e medo de cair, avaliada pela escala internacional de eficácia de quedas (FES-I, na sigla em inglês). Foi encontrada correlação significativa e moderada entre a pontuação na FES-I e o número de quedas; e correlação significativa, moderada e inversa, entre as pontuações da FES-I e de Lawton. A freqüência de fragilidade foi maior na amostra do estudo do que a encontrada em estudos prévios; e foram encontradas diferenças significativas entre os grupos de idosos, de acordo com as características de fragilidade, indicando que os mais frágeis apresentavam maior incapacidade para atividades de vida diária e mais medo de cair.

Background: Gait parameters such as gait speed (GS) are important indicators of functional capacity. Frailty Syndrome is closely related to GS and is also capable of predicting adverse outcomes. The cognitive demand of gait control is usually explored with dual-task (DT) methodology. Objective: To investigate the effect of DT and frailty on the spatio-temporal parameters of gait in older people and identify which variables relate to GS. Method: The presence of frailty was verified by Fried's Frailty Criteria. Cognitive function was evaluated with the Mini-Mental State Exam (MMSE) and gait parameters were analyzed through the GAITRite(r) system in the single-task and DT conditions. The Kolmogorov-Smirnov, ANOVA, and Pearson's Correlation tests were administered. Results: The participants were assigned to the groups frail (FG), pre-frail (PFG), and non-frail (NFG). During the DT, the three groups showed a decrease in GS, cadence, and stride length and an increase in stride time (p<0.001). The reduction in the GS of the FG during the DT showed a positive correlation with the MMSE scores (r=730; p=0.001) and with grip strength (r=681; p=0.001). Conclusions: Gait parameters are more affected by the DT, especially in the frail older subjects. The reduction in GS in the FG is associated with lower grip strength and lower scores in the MMSE. The GS was able to discriminate the older adults in the three levels of frailty, being an important measure of the functional capacity in this population.

Background:The identification of the occurrence of falls is an important step for screening and for rehabilitation processes for the elderly. The methods of monitoring these events are susceptible to recording biases, and the choice of the most accurate method remains challenging. Objectives:(i) To investigate the agreement between retrospective self-reporting and prospective monitoring of methods of recording falls, and (ii) to compare the retrospective self-reporting of falls and the prospective monitoring of falls and recurrent falls over a 12-month period among older women at high risk of falls and fractures. Method:A total of 118 community-dwelling older women with low bone density were recruited. The incidence of falls was monitored prospectively in 116 older women (2 losses) via monthly phone calls over the course of a year. At the end of this monitoring period, the older women were asked about their recall of falls in the same 12-month period. The agreement between the two methods was analyzed, and the sensitivity and specificity of self-reported previous falls in relation to the prospective monitoring were calculated. Results:There was moderate agreement between the prospective monitoring and the retrospective self-reporting of falls in classifying fallers (Kappa=0.595) and recurrent fallers (Kappa=0.589). The limits of agreement were 0.35±1.66 falls. The self-reporting of prior falls had a 67.2% sensitivity and a 94.2% specificity in classifying fallers among older women and a 50% sensitivity and a 98.9% specificity in classifying recurrent fallers. Conclusion:Self-reporting of falls over a 12-month period underestimated 32.8% of falls and 50% of recurrent falls. The findings recommend caution if one is considering replacing monthly monitoring with annual retrospective questioning.