El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / OBJECTIVE: To assess the relationship between physical performance (PP) and muscle strength (MS) in elderly subjects with and without diabetes in a public hospital of Lima, Peru. SUBJECTS AND METHOD: A cross-sectional analysis of subjects aged 60 years or older with and without diabetes. MS was measured with a handheld dynamometer, and PP with the «timed get-up-and-go» test. Nutritional status was determined using body mass index, body fat percentage measured with a handheld fat loss monitor and protein intake based on the 24-hour recall. Age, sex, and history of hospitalization and supplementation were also recorded. The association was assessed using adjusted prevalence ratios. RESULTS: Overall, 139 patients with diabetes (26.6% with low PP and 13.7% with decreased MS) and 382 subjects without diabetes (36.6% with low PP and 23.0% with decreased MS) were evaluated. No association was found between T2DM and MS (aPR: 0.99; 95% CI: 0.67-1.57) or PP (aPR: 1.13; 95% CI: 0.84-1.52). Protein and supplement consumption was also unrelated (P>.05); however, history of hospitalization, age, sex, nutritional status, and body fat percentage were related (P>.05). CONCLUSIONS: No association was found between T2DM, MS, and PP. However, low PP was associated to female sex and overweight/obesity, and decreased MS was associated to high body fat percentage and underweight. Moreover, MS and PP were related to older age and history of hospitalization. / Revisión por pares

Este tesis fue publicado como artículo científico en la Revista Endocrinología y Nutrición (DOI: 10.1016/j.endonu.2015.12.008) / Objetivo: Evaluar la asociación entre la fuerza muscular (FM) y rendimiento físico (RF) en adultos mayores con y sin diabetes de un hospital público de Lima, Perú. Pacientes y método: Estudio transversal en pacientes ≥ 60 años con y sin diabetes. Se midió FM con dinamómetro manual y RF con prueba “Timed get-up-and-go”. Se determinó el estado nutricional con el índice de masa corporal, el porcentaje de grasa corporal con bioimpedanciómetro manual y se evaluó el consumo proteico mediante recordatorio de 24 horas. Además, se registró edad, género, antecedente de hospitalización y suplementación. Se evaluó la asociación con razones de prevalencias ajustadas (RPa). Resultados: Se evaluaron 139 pacientes con diabetes (26,6% con bajo RF y 13,7% con FM disminuida) y 382 sin diabetes (36,6% con bajo RF y 23,0% con FM disminuida). No se halló asociación de DM2 con FM (RPa: 0,99; IC95%: 0,67-1,57) ni RF (RPa: 1,13; IC95%: 0,84-1,52). Tampoco se asoció el consumo proteico ni de suplementos (p> 0,05), pero sí el antecedente de hospitalización, la edad, el género, el estado nutricional y el porcentaje de grasa corporal (p< 0,05). Conclusiones: No se encontró asociación entre DM2, FM y RF. Sin embargo, el bajo RF se asoció con ser mujer y presentar sobrepeso/obesidad; y la FM disminuida con tener alto porcentaje de grasa corporal y bajo peso. Además, ambos se relacionaron con el aumento de edad y tener antecedente de hospitalización. / Objective: To compare the association between physical performance (PP) and muscle strength (MS) in older people with and without diabetes in a public hospital of Lima, Peru. Patients and methods: Cross sectional analysis of 60 years and older patients with and without diabetes. MS was measured with a handheld dynamometer and PP with the “Timed get-up-and-go” Test. The nutritional status was determined using the body mass index, the body fat percentage using a handheld fat loss monitor and the protein intake using the 24 hours Recall. Furthermore, age, gender, history of hospitalization and supplementation were registered. The association was evaluated with adjusted prevalence ratios. Results: 139 patients with diabetes (26.6% had low PP and 13.7% diminished MS) and 382 counterparts without diabetes (36.6% had low PP and 23.0% diminished MS) were evaluated. No association was found between MS and T2D (aPR: 0.99; IC95%: 0.67- 1.57), nor with PP (aPR: 1.13; IC95%: 0.84-1.52). Protein and supplement consumption were not related either (p> 0.05); however, age and history of hospitalization, gender, nutritional status and body fat percentage were linked (p< 0.05). Conclusions: No association was found between T2D, MS and PP. Nevertheless, low PP was associated with female sex and overweight/obesity; and diminished MS was linked to high body fat percentage and underweight. Moreover, MS and PP were related to age and history of hospitalization.

Introduction: In elderly seniors (>80 years), respiratory function may be compromised when, in addition to the presence of comorbidity and loss of mobility, there is also reduced respiratory muscle (RM) strength. The literature has shown that RM training could be an effective method to improve RM function and prevent clinical deterioration, particularly in population with RM weakness.The main purpose of this paper was to assess the effectiveness of RM training on the respiratory muscle strength and endurance of institutionalized elderly women with functional impairment. Method: Fifty-four residents (mean=85 years, SD=6.7) were randomly assigned to either a control (n=27) or training (n=27) group. A supervised training program was developed with Threshold®IMT, five times per week for 6-weeks. The main variables of the intervention were: maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax) and maximal voluntary ventilation (MVV), all of which were measured at weeks 0, 4, 7 and 10. Results: Statistical analysis revealed no significant differences in PImax (F3,114=1.04, p=0.368, R2=0.027), PEmax (F3,114=1.86, p=0.14, R2=0.047) and MVV (F3,114=1.74, p=0.162, R2=0.044) between the two groups after the intervention. However, the workload significantly improved with the training sessions (F5,100=72.031, p<0.001, R2=0.791). Conclusion: In a 6-week interval-based training program, the threshold loading device does not significantly improve parameters related to RM strength and endurance of the study population.

Introduction: In elderly seniors (>80 years), respiratory function may be compromised when, in addition to the presence of comorbidity and loss of mobility, there is also reduced respiratory muscle (RM) strength. The literature has shown that RM training could be an effective method to improve RM function and prevent clinical deterioration, particularly in population with RM weakness.The main purpose of this paper was to assess the effectiveness of RM training on the respiratory muscle strength and endurance of institutionalized elderly women with functional impairment. Method: Fifty-four residents (mean=85 years, SD=6.7) were randomly assigned to either a control (n=27) or training (n=27) group. A supervised training program was developed with Threshold®IMT, five times per week for 6-weeks. The main variables of the intervention were: maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax) and maximal voluntary ventilation (MVV), all of which were measured at weeks 0, 4, 7 and 10. Results: Statistical analysis revealed no significant differences in PImax (F3,114=1.04, p=0.368, R2=0.027), PEmax (F3,114=1.86, p=0.14, R2=0.047) and MVV (F3,114=1.74, p=0.162, R2=0.044) between the two groups after the intervention. However, the workload significantly improved with the training sessions (F5,100=72.031, p<0.001, R2=0.791). Conclusion: In a 6-week interval-based training program, the threshold loading device does not significantly improve parameters related to RM strength and endurance of the study population.