Is There a Relationship between Anthropometric Indices and Muscular, Motor, and Cardiorespiratory Components of Health-Related Fitness in Active European Older Adults?
Based on the aforementioned factors, the present research study was proposed with the objective of determining the following: is there an association between anthropometric indices and muscular, motor, and cardiorespiratory components of health-related fitness in active European older adults?
2. Materials and Methods
The examiners were experts in the use of anthropometric indices and the evaluation of body composition parameters through bioelectrical impedance analysis (BIA). During the measurements, participants were barefoot, wore minimal clothing, and conditions were strictly standardized as established by the manufacturer and previous research.
Muscle strength was evaluated through three tests:
Arm Curl: The participant is required to perform the maximum number of elbow flexion–extension repetitions with a dumbbell (2 kg for women and 4 kg for men) in 30 s. The test is performed with the dominant arm. The participant starts seated in a chair with a straight back and feet flat on the floor. They grasp the dumbbell with the dominant hand, placing it perpendicular to the ground, with the palm facing the body and the arm extended. They lift the weight from this position, gradually rotating the wrist (supination) until completing the arm flexion movement, with the palm facing upward. They return the arm to the starting position by performing a full extension of the arm, now rotating the wrist toward the body. At the “go” signal, the participant performs this complete movement as several times as possible within 30 s. At first, the exercise is demonstrated slowly for the participant to observe the correct execution, and then the speed is increased to illustrate the rhythm. For the correct execution, only the forearm should move, keeping the arm steady (keeping the elbow close to the body can help maintain this position);
Chair Stand Test: The participant starts sitting in the middle of the chair with his or her back straight, feet on the floor, and arms crossed over the chest. From this position and at the “go” signal, the participant should stand up completely and return to the initial position as several times as possible within 30 s. It is recommended that the exercise be demonstrated slowly first so that the participant can observe its correct execution, followed by a faster demonstration for better comprehension. Before starting the test, the participant shall perform the exercise one or twice to ensure the correct execution.
In addition to tests related to the Senior Fitness Test battery, muscle strength was assessed using a handgrip strength technique using isometric hand dynamometry:
Grip Strength Test: The reason for incorporating this test was because it is widely used in older adults as an indicator parameter of frailty syndrome, which is closely linked to health and changes in body weight among older adults . Grip strength is a simple and suitable measure to assess the muscle strength levels of older adults. Isometric dynamometry involves measuring the force or tension exerted against static resistance. Mechanical dynamometers designed to measure a single muscle group are used for this purpose. In this study, the manual dynamometry test was performed using a Jamar® Hydraulic dynamometer (J.A. Preston Corporation, Clifton, NJ, USA), recording force in kilograms, under the following conditions: Prior adjustment of the dynamometer grip was made according to the size of the hand. The grip was adjusted so that the subject’s proximal interphalangeal joint, when gripping the dynamometer, formed a 90° angle. The subject was seated with arms bent at 90° and supported on a table. They were instructed to exert as much force as possible without lifting the arm off the table. Three attempts were made, and the highest value was recorded. The test was performed on the dominant arm. Manual muscle strength equal to or greater than 30 kg for men and equal to or greater than 20 kg for women was considered normal; values below these were deemed inadequate [36,37].
Flexibility was evaluated through two tests:
Chair Sit and Reach: The participant sits on the edge of the chair with one leg flexed and the other fully extended. They perform trunk flexion without bouncing, attempting to touch the toes of the extended leg. Values are measured and recorded in centimetres; a positive result is achieved when the participant reaches beyond the tips of their toes, and a negative result when they do not reach them. The participant sits on the edge of the chair (the fold between the upper leg and the buttocks should rest on the front edge of the seat). One leg is bent with the foot on the floor, while the other leg is extended as straight as possible in front of the hip. With arms outstretched, hands together, and middle fingers aligned, the participant flexes at the hip slowly, attempting to reach their toes or surpass them. If the extended leg starts to flex, the participant returns to the starting position until the leg is fully extended. The participant must hold this position for at least 2 s. The participant performs the test on each leg to determine the better-performing leg (the final test is performed with the better of the two). Before starting the test, the participant will perform a brief warm-up with a couple of attempts using the preferred leg;
Back Scratch: The participant should touch their fingertips behind their back. The dominant arm passes over the shoulder, and the other under the shoulder. Values are measured and recorded in centimetres; a positive result is achieved when the fingertips touch each other, and a negative result when the fingertips do not touch. The participant stands with the preferred arm above the shoulder, palm down, and fingers extended. From this position, they bring the hand towards the middle of the back as far as possible, keeping the elbow up. The other arm is placed on the back, behind the waist, with the palm up and reaching as far as possible, attempting to touch the middle fingers of both hands. The participant should practice the test to determine the best side and may perform it twice before starting the actual test. They should ensure that the middle fingers of one hand are as closely aligned as possible with the middle fingers of the other hand; the examiner may guide the participant’s fingers (without moving their hands) to achieve proper alignment. Participants are not allowed to grasp and pull on their fingers.
Balance was evaluated through a single test:
Eight-Foot Up-and-Go: Starting from a seated position, the participant must stand up, walk 2.44 m, pass behind a cone, and sit down again as quickly as possible. The execution time of this action, performed at a fast walking pace, is measured. The participant will sit in the middle of the chair with his or her back straight, feet on the floor, and hands on their thighs. One foot will be slightly ahead of the other, and the trunk slightly bent forward. At the “go” signal, the participant will stand up and walk as fast as possible around the cone and sit down again. Time is counted from the moment we say “go”, even if the participant has not started moving. The time will stop when the participant is seated in the chair.
Cardiorespiratory endurance: aerobic resistance was evaluated through two tests:
Two-Minute Step Test: The subject must perform alternate knee lifts to the point marked on the wall (mid-thigh level) as several times as possible (repetitions) in two minutes. One repetition is counted once the right and then the left leg have been lifted. At the “go” signal, the participant begins to march in place as several times as possible for 2 min. If the participant does not reach this benchmark, they will be asked to slow down the pace to ensure the validity of the test without stopping the time.
Six-Minute Walk: This is a cardiorespiratory functional test that measures the maximum distance a subject can walk in 6 min. Widely used to assess the progression and quality of life of patients with cardiorespiratory diseases, it is considered an easy-to-administer, well-tolerated test that reflects the activities of daily living. This test will be conducted once all previously performed tests are completed. Each participant will start every 10 s. At the “go” signal, the participant will walk as fast as possible for 6 min following the marked circuit. To count the number of laps completed, the examiner will give a stick to the participant for each lap or mark it on the record sheet. At the 3 and 2 min marks, participants will be notified of the remaining time to regulate the pace of the test. After 6 min, the participant will move to the right and stand on the nearest mark while slowly raising their legs alternately to keep moving.
2.3. Statistical Analysis
All quantitative variables were described using the mean and standard deviation, and qualitative variables were presented as percentages. The normal distribution of continuous variables was tested using the Kolmogorov–Smirnov test (p > 0.05). The existence of significant differences (male vs. female) was analysed through the independent samples t-test (quantitative variables) and chi-square test (qualitative variables). The association between anthropometric indices and muscular, motor, and cardiorespiratory components of health-related fitness was visualized through the lowess fit plot. The z-scores of BMI, WHR, WHtR, BAI, and CI were used to standardize the anthropometric indices for comparability. The association between the anthropometric indices and muscular, motor, and cardiorespiratory components was analysed through linear regression with adjustment for age and gender since age and gender can influence levels of health-related fitness. Each linear regression analysis included the anthropometric index under study and the different variables (muscular, motor, and cardiorespiratory components). To conclude the statistical analysis, analysis of variance with the Tukey-B post hoc test was performed to assess the behaviour of each physical parameter based on the obesity levels determined by BMI, WHR, WHtR, BAI, and CI. All analyses were conducted using IBM-SPSS version 29 software (IBM Inc., Armonk, NY, USA). The significance level established for the tests was p < 0.05, with a confidence level of 95%.
Focusing on WHR analysis, we can observe that active older adults with higher WHR values (>0.90 for males; >0.85 for females) tend to be stronger and have better balance. On the contrary, those with lower WHR values (<0.90 for males; <0.85 for females) are more flexible and exhibit better cardiorespiratory endurance. The analysis of WHtR, BAI, and CI showed a similar tendency to that observed for BMI concerning the different physical parameters analysed.
The results obtained in this study reveal the relationship between anthropometric indices and the muscular, motor, and cardiorespiratory components of health-related fitness, with correlations of different degrees depending on the weight of older adults and the distribution of fat mass in their bodies. Based on our results, we recommend the use of the WHtR and BMI anthropometric indices in older adults, since alterations in these may be related to risk factors linked to cardiovascular pathologies.
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