IJCS | Volume 32, Nº6, November / December 2019

555 Figure 1 - Study flow chart. 165 elderly individuals were invited Excluded: 51: lack of medical clearance 22: declined to participate 19: lack of answer 04: functional impairment 69 elderly individuals were included Training group Control group The values of the six domains or the sum of the 24 questions may be combined to produce an overall score. However, there is no cut-off point, the greater the score, the better the QOL. 25 Considering that the WHO recommends that the WHOQOL-OLD should not be administered alone, 25 we used the WHOQOL-BREF also. The WHOQOL- BREF is a short version of the WHOQoL-100, used in situations when the time available for application is short and when the number of respondents is large. The WHOQOL-BREF is composed of 26 questions, two of them related to QOL. The questions are organized in four domains: physical, psychological, social relationships and environment, and are positively correlated with the WHOQOL-100 overall score. 26 Geriatric depression scale (GDS) Depressive symptoms were assessed by the short version of the GDS, composed of 15 questions about feelings, and frequency of feelings in relation to life situations. The answers to the GDS questions are based on a binary code: yes or no. 27,28 Visual analogue scale (VAS) VAS is a widely used instrument to evaluate pain intensity in different populations, including the elderly. It contains a continuous scale consisting of a 10 cm horizontal line. The respondents place a line perpendicular to the VAS line at the point that represents their pain intensity. Quantification of pain intensity, volunteers were asked about the intensity of physical pain during the last week. A zero (0) means ‘no pain’ and a ten (10) means the worst pain imaginable. VAS score is positively associated with pain intensity. 29 Incremental exercise test Before the cardiac stress test, remained seated for 20 minutes. A resting electrocardiogram was performed to evaluate heart pressure, heart rate and lactate. Then, incremental test was performed using an electronic treadmill (Life Fitness ® , model 9700HR ® , Fort Mill, Tennessee, USA), according to the modified Bruce protocol, composed of six stages of three minutes each, characterized by both speed (2.7-6.8 km/h) and slope (0-16º) increments. The gases produced were analyzed during the incremental test using an analyzer (Cosmed ® , Cosmed Quarker CPET ® , Rome, Italy), previously calibrated, with a 3L syringe (flow calibration) and a standard gas mixture containing 4.9% CO 2 and 17.0% O 2 (gas calibration). Ventilation (VE), oxygen consumption (VO 2 ) and carbon dioxide production (VCO 2 ) were evaluated in the last 20 minutes of each 3-minute stage. Alabarse et al. Depression and pain in healthy active elderly Int J Cardiovasc Sci. 2019;32(6):553-562 Original Article