Association between physical fitness and angular phase in older adults A pilot study

Main Article Content

Iván Toledo Rebolledo https://orcid.org/0009-0004-9455-6807
Cristina Frerk Ubilla https://orcid.org/0009-0009-0010-0873
Felipe Morales Gómez https://orcid.org/0009-0005-8608-275X
Raúl Muñoz Agostini https://orcid.org/0009-0004-9420-6989
Ricardo Martínez-Flores http://orcid.org/0000-0002-8435-2710
Fernando Rodríguez-Rodríguez http://orcid.org/0000-0002-4999-4857

Abstract

The diagnosis by bioimpedance (BIA) and the phase angle (PhA) are indicators, that allow monitoring of the physical health and nutritional status of older adults. The objective of this study was to establish the relationship between physical fitness and phase angle values by bioimpedance in a group of sedentary older adults. 24 elderly sedentary volunteers participated (21 women and 3 men). Each participant underwent bioimpedance, manual dynamometry, and the 6-minute Senior Fitness Test (SFT). Subsequently, the results were analyzed, making a correlation between PhA and cardiorespiratory physical condition, another between PhA and cardiorespiratory physical condition according to sex and finally an association between PhA and handgrip strength. R71% presented a PhA mean below the reference (4.5º ± 0.4), specifically 67% of men and 62% of women. The correlation between PhA and cardiorespiratory fitness showed a value of R2= 0.50; p<0.0001. The association between PhA and handgrip strength was R2=0.35; p=0.0023. A significant relationship was found between a cardiorespiratory fitness test and PhA and between handgrip strength and PhA. It is of clinical importance to include objective cellular assessment parameters in older adults such as PhA.



Article Details

Section
Research
References

Akamatsu, Y., Kusakabe, T., Arai, H., Yamamoto, Y., Nakao, K., Ikeue, K., Ishihara, Y., Tagami, T., Yasoda, A., Ishii, K., & Satoh-Asahara, N. (2022). Phase angle from bioelectrical impedance analysis is a useful indicator of muscle quality. Journal of Cachexia, Sarcopenia and Muscle, 13(1), 180-189. https://doi.org/10.1002/jcsm.12860


Alvero Cruz, J., Cabañas Armesilla, M. D., Herrero de Lucas, A., Martínez Riaza, L., Moreno, C., Manzañido, J., Quintana Sillero, M., & Sirvent Belando, J. (2009). Protocolo de valoración de la composición corporal para el reconocimiento médico-deportivo. Documendo de consenso del grupo español de cineantropometría de la federación española de medicina del deporte. Archivos de Medicina del Deporte, 26(131), 166-179. https://femede.es/documentos/ConsensoCine131.pdf





Arnold, M., Herrera, F., Massad, C. & Thumala, D. (2021). Sexta encuesta nacional inclusión y exclusión social de las personas mayores: Cómo observa la población el envejecimiento en Chile. https://biblioteca.digital.gob.cl/bitstream/handle/123456789/3793/SEXTA_ENCUESTA_NACIONAL_DE_INCLUSION_Y_EXCLUSION_SOCIAL_DE_LAS_PM2021.pdf?sequence=1&isAllowed=y


Arnold, M., Herrera, F., Massad, C., & Thumala, D. (2017). Quinta Encuesta Nacional Inclusión y Exclusión Social de las Personas Mayores en Chile: Opiniones de la población chilena respecto al envejecimiento poblacional. https://www.desarrollosocialyfamilia.gob.cl/storage/docs/SENAMA_libro_5ta_encuesta_BAJA,_libro_final.pdf


Buckinx, F., Reginster, J. Y., Dardenne, N., Croisiser, J. L., Kaux, J. F., Beaudart, C., Slomian, J., & Bruyère, O. (2015). Concordance between muscle mass assessed by bioelectrical impedance analysis and by dual energy X-ray absorptiometry: A cross-sectional study. BMC Musculoskeletal Disorders, 16, 60. https://doi.org/10.1186/s12891-015-0510-9


Buffa, R., Floris, G., & Marini, E. (2003). Migration of the bioelectrical impedance vector in healthy elderly subjects. Nutrition, 19(11-12), 917-921. https://doi.org/10.1016/S0899-9007(03)00180-1


Campa, F., Silva, A. M., & Toselli, S. (2018). Changes in Phase Angle and Handgrip Strength Induced by Suspension Training in Older Women. International Journal of Sports Medicine, 39(6), 442-449. https://doi.org/10.1055/a-0574-3166


Chávez, J., Lozano, M., Lara, A., & Velázquez, O. (2004). La actividad física y el deporte en el adulto mayor: bases fisiológicas. Asociación mexicana de actividad física y deporte para adultos y ancianos. http://www.salud.gob.mx/unidades/cdi/documentos/DOCSAL7516.pdf


Cheung, C. L., Lee, G. K. Y., Au, P. C. M., Li, G. H. Y., Chan, M., Li, H. L., Cheung, B. M. Y., Wong, I. C. K., Lee, V. H. F., Mok, J., Yip, B. H. K., Cheng, K. K. Y., & Wu, C. H. (2021). Systematic review and meta-analysis of lean mass and mortality: Rationale and study description. Osteoporosis and Sarcopenia, 7(Suppl 1), S3-S12. https://doi.org/10.1016/j.afos.2021.01.001


Cunha, P. M., Ribeiro, A. S., Tomeleri, C. M., Schoenfeld, B. J., Silva, A. M., Souza, M. F., Nascimento, M. A., Sardinha, L. B., & Cyrino, E. S. (2018). The effects of resistance training volume on osteosarcopenic obesity in older women. Journal of Sports Sciences, 36(14), 1564-1571. https://doi.org/10.1080/02640414.2017.1403413


Dittmar, M., Reber, H., & Kahaly, G. J. (2015). Bioimpedance phase angle indicates catabolism in Type 2 diabetes. Diabetic Medicine, 32(9), 1177-1185. https://doi.org/10.1111/dme.12710


Espinoza Oteiza, L., Rodríguez Rodríguez, F., & Mac Millan, N. (2019). Vida activa, ejercicio y salud. Ediciones Universitarias de Valparaíso.


Faria, T. C., Giannini, D. T., Gasparini, P. V. F., & Rocha, R. M. (2018). Heart Failure: Correlation between Anthropometric Parameters, Body Composition and Cell Integrity. International Journal of Cardiovascular Sciences, 31(3), 226-234. https://doi.org/10.5935/2359-4802.20180006


García López, M., González Montero de Espinosa, M., Romero Collazos, J. F., Prado Martínez, C., López-Ejeda, N., Villarino Marín, A., & Marrodán Serrano, M. D. (2017). Referencias para dinamometría manual en función de la estatura en edad pediátrica y adolescente. Nutrición clínica y Dietética Hospitalaria, 37(4), 135-139. https://doi.org/10.12873/374glopez


Geng, J., Wei, Y., Xue, Q., Deng, L., & Wang, J. (2022). Phase angle is a useful bioelectrical marker for skeletal muscle quantity and quality in hospitalized elderly patients. Medicine, 101(45), e31646. https://doi.org/10.1097/MD.0000000000031646


Hernández-Sampieri, R., Fernández Collado, C., & Baptista Lucio, P. (2014). Metodología de la investigación. Mc Graw Hill.


Ji, W., Liu, X., Zheng, K., Yang, H., Cui, J., & Li, W. (2021). Correlation of phase angle with sarcopenia and its diagnostic value in elderly men with cancer. Nutrition, 84, 111110. https://doi.org/10.1016/j.nut.2020.111110


Kwon, Y. E., Lee, J. S., Kim, J. Y., Baeg, S. I., Choi, H. M., Kim, H. B., Yang, J. Y., & Oh, D. J. (2023). Impact of sarcopenia and phase angle on mortality of the very elderly. Journal of Cachexia, Sarcopenia and Muscle, 14(1), 279-287. https://doi.org/10.1002/jcsm.13128


Landinez Parra, N. S., Contreras Valencia, K., & Castro Villamil, Á. (2012). Proceso de envejecimiento, ejercicio y fisioterapia. Revista Cubana de Salud Pública, 38(4), 562-580. https://www.scielosp.org/pdf/rcsp/2012.v38n4/562-580/es


Langer, R. D., da Costa, K. G., Bortolotti, H., Fernandes, G. A., de Jesus, R. S., & Gonçalves, E. M. (2020). Phase angle is associated with cardiorespiratory fitness and body composition in children aged between 9 and 11 years. Physiology & Behavior, 215, 112772. https://doi.org/10.1016/j.physbeh.2019.112772


Langhammer, B., & Stanghelle, J. K. (2015). The Senior Fitness Test. Journal of Physiotherapy, 61(3), 163. https://doi.org/10.1016/j.jphys.2015.04.001


Llames, L., Baldomero, V., Iglesias, M. L., & Rodota, L. P. (2013). Valores del ángulo de fase por bioimpedancia eléctrica: Estado nutricional y valor pronóstico. Nutrición Hospitalaria, 28(2), 286-295. https://doi.org/10.3305/nh.2013.28.2.6306


Lukaski, H. C. (2013). Evolution of bioimpedance: A circuitous journey from estimation of physiological function to assessment of body composition and a return to clinical research. European Journal of Clinical Nutrition, 67(Suppl 1), S2-9. https://doi.org/10.1038/ejcn.2012.149


Lukaski, H. C., Kyle, U. G., & Kondrup, J. (2017). Assessment of adult malnutrition and prognosis with bioelectrical impedance analysis: Phase angle and impedance ratio. Current Opinion in Clinical Nutrition and Metabolic Care, 20(5), 330-339. https://doi.org/10.1097/MCO.0000000000000387


Martins, P. C., de Lima, T. R., Silva, A. M., & Silva, D. A. S. (2022). Association of phase angle with muscle strength and aerobic fitness in different populations: A systematic review. Nutrition, 93, 111489. https://doi.org/10.1016/j.nut.2021.111489


Martins, P. C., de Lima, L. R. A., Berria, J., Petroski, E. L., da Silva, A. M., & Silva, D. A. S. (2020). Association between phase angle and isolated and grouped physical fitness indicators in adolescents. Physiology & Behavior, 217, 112825. https://doi.org/10.1016/j.physbeh.2020.112825


Martins, P. C., de Lima, L. R. A., Silva, A. M., Petroski, E. L., Moreno, Y. M. F., & Silva, D. A. S. (2019). Phase angle is associated with the physical fitness of HIV-infected children and adolescents. Scandinavian Journal of Medicine & Science in Sports, 29(7), 1006-1012. https://doi.org/10.1111/sms.13419


Mattiello, R., Amaral, M. A., Mundstock, E., & Ziegelmann, P. K. (2020). Reference values for the phase angle of the electrical bioimpedance: Systematic review and meta-analysis involving more than 250,000 subjects. Clinical Nutrition, 39(5), 1411-1417. https://doi.org/10.1016/j.clnu.2019.07.004


Mullie, L., Obrand, A., Bendayan, M., Trnkus, A., Ouimet, M. C., Moss, E., Chen-Tournoux, A., Rudski, L. G., & Afilalo, J. (2018). Phase Angle as a Biomarker for Frailty and Postoperative Mortality: The BICS Study. Journal of the American Heart Association, 7(17), e008721. https://doi.org/10.1161/JAHA.118.008721


Mundstock, E., Amaral, M. A., Baptista, R. R., Sarria, E. E., Dos Santos, R. R. G., Filho, A. D., Rodrigues, C. A. S., Forte, G. C., Castro, L., Padoin, A. V., Stein, R., Perez, L. M., Ziegelmann, P. K., & Mattiello, R. (2019). Association between phase angle from bioelectrical impedance analysis and level of physical activity: Systematic review and meta-analysis. Clinical Nutrition, 38(4), 1504-1510. https://doi.org/10.1016/j.clnu.2018.08.031


Norman, K., Wirth, R., Neubauer, M., Eckardt, R., & Stobäus, N. (2015). The bioimpedance phase angle predicts low muscle strength, impaired quality of life, and increased mortality in old patients with cancer. Journal of the American Medical Directors Association, 16(2), 173.e17-173.e22. https://doi.org/10.1016/j.jamda.2014.10.024


Norman, K., Smoliner, C., Valentini, L., Lochs, H., & Pirlich, M. (2007). Is bioelectrical impedance vector analysis of value in the elderly with malnutrition and impaired functionality? Nutrition, 23(7-8), 564-569. https://doi.org/10.1016/j.nut.2007.05.007


Player, E. L., Morris, P., Thomas, T., Chan, W. Y., Vyas, R., Dutton, J., Tang, J., Alexandre, L., & Forbes, A. (2019). Bioelectrical impedance analysis (BIA)-derived phase angle (PA) is a practical aid to nutritional assessment in hospital in-patients. Clinical Nutrition, 38(4), 1700-1706. https://doi.org/10.1016/j.clnu.2018.08.003


Pratt, J., Boreham, C., Ennis, S., Ryan, A. W., & De Vito, G. (2019). Genetic Associations with Aging Muscle: A Systematic Review. Cells, 9(1), 12. https://doi.org/10.3390/cells9010012


Ramakrishnan, R., He, J. R., Ponsonby, A. L., Woodward, M., Rahimi, K., Blair, S. N., & Dwyer, T. (2021). Objectively measured physical activity and all cause mortality: A systematic review and meta-analysis. Preventive Medicine, 143, 106356. https://doi.org/10.1016/j.ypmed.2020.106356


Ribeiro, A. S., Schoenfeld, B. J., Dos Santos, L., Nunes, J. P., Tomeleri, C. M., Cunha, P. M., Sardinha, L. B., & Cyrino, E. S. (2020). Resistance Training Improves a Cellular Health Parameter in Obese Older Women: A Randomized Controlled Trial. Journal of Strength and Conditioning Research, 34(10), 2996-3002. https://doi.org/10.1519/JSC.0000000000002773


Ribeiro, A. S., Schoenfeld, B. J., Souza, M. F., Tomeleri, C. M., Silva, A. M., Teixeira, D. C., Sardinha, L. B., & Cyrino, E. S. (2017). Resistance training prescription with different load-management methods improves phase angle in older women. European Journal of Sport Science, 17(7), 913-921. https://doi.org/10.1080/17461391.2017.1310932


Saad, M. A., Jorge, A. J., de Andrade Martins, W., Cardoso, G. P., Dos Santos, M. M., Rosa, M. L., Lima, G. A., de Moraes, R. Q., & da Cruz Filho, R. A. (2018). Phase angle measured by electrical bioimpedance and global cardiovascular risk in older adults. Geriatrics & Gerontology International, 18(5), 732-737. https://doi.org/10.1111/ggi.13241


Santomauro, F., Baggiani, L., Mantero, S., Olimpi, N., Comodo, N., & Bonaccorsi, G. (2008). Assessment of nutritional status in institutionalized elderly individuals through body impedance analysis. Igiene E Sanita Pubblica, 64(1), 67-78. https://pubmed.ncbi.nlm.nih.gov/18379607/


Sato, Y., Yoshimura, Y., & Abe, T. (2022). Phase Angle as an Indicator of Baseline Nutritional Status and Sarcopenia in Acute Stroke. Journal of Stroke and Cerebrovascular Diseases: The Official Journal of National Stroke Association, 31(1), 106220. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106220


Streb, A. R., Hansen, F., Gabiatti, M. P., Tozetto, W. R., & Del Duca, G. F. (2020). Phase angle associated with different indicators of health-related physical fitness in adults with obesity. Physiology & Behavior, 225, 113104. https://doi.org/10.1016/j.physbeh.2020.113104


Tomeleri, C. M., Ribeiro, A. S., Cavaglieri, C. R., Deminice, R., Schoenfeld, B. J., Schiavoni, D., dos Santos, L., de Souza, M. F., Antunes, M., Venturini, D., Barbosa, D. S., Sardinha, L. B., & Cyrino, E. S. (2018). Correlations between resistance training-induced changes on phase angle and biochemical markers in older women. Scandinavian Journal of Medicine & Science in Sports, 28(10), 2173-2182. https://doi.org/10.1111/sms.13232


Zhang, X. S., Liu, Y. H., Zhang, Y., Xu, Q., Yu, X. M., Yang, X. Y., Liu, Z., Li, H. Z., Li, F., & Xue, C. Y. (2017). Handgrip Strength as a Predictor of Nutritional Status in Chinese Elderly Inpatients at Hospital Admission. Biomedical and Environmental Sciences: BES, 30(11), 802-810. https://doi.org/10.3967/bes2017.108



How to Cite
Toledo Rebolledo, I., Frerk Ubilla, C., Morales Gómez, F., Muñoz Agostini, R., Martínez-Flores, R., & Rodríguez-Rodríguez, F. (2023). Association between physical fitness and angular phase in older adults. Revista Ciencias De La Actividad Física UCM, 24(2), 1-12. https://doi.org/10.29035/rcaf.24.2.10