Cardiometabolic, functional, and psychosocial effects of a remotely supervised home-based exercise program in individuals with type 2 diabetes (RED study): study protocol for a randomized clinical trial.

BACKGROUND: Type 2 diabetes mellitus (T2D) is a serious global health problem, and exercise is considered an essential non-pharmacological tool in T2D prevention and treatment. During periods of social isolation experienced by the COVID-19 pandemic, home-based exercise programs were strongly recommended as a strategy to facilitate exercise practice and reduce the negative impacts of social isolation. Remotely supervised exercise stands out as an easily accessible strategy after the pandemic, as it is a tool that aims to facilitate access to exercise by this population. The purpose of the RED study is to verify the effects of a remotely supervised home-based exercise program compared to a control group on cardiometabolic, functional, and psychosocial outcomes in patients with T2D. METHODS: Participants are randomized into the control group (CG) and the intervention group (IG). Participants allocated to the CG receive recommendations for the practice of physical activity based on information from chapters of the Physical Activity Guide for the Brazilian Population, while the IG will perform a 12-week home-based exercise program supervised remotely by video call. The intervention has a weekly frequency of two sessions per week on non-consecutive days during the first 6 weeks and three sessions per week on non-consecutive days for the remaining 6 weeks. The RED study has HbA1c as the primary outcome, and the participants' cardiometabolic, functional, and psychosocial parameters are assessed at baseline (week 0) and post-intervention (week 13). DISCUSSION: Expected results of the proposed study will provide the knowledge base of health professionals and deliver more evidence for a growing area, i.e., home-based exercise and T2D. Additionally, this protocol aims to verify and demonstrate whether this program can be accessible and effective for different health outcomes in patients with T2D. TRIAL REGISTRATION: The RED study protocol was prospectively registered at ClinicalTrials.gov (NCT05362071). Date registered April 6, 2022. https://clinicaltrials.gov/ct2/show/NCT05362071 .

Reabilitação funcional e barreiras para atividade física na COVID-longa: um ensaio clínico randomizado / Functional rehabilitation and barriers to physical activity after COVID-19: a randomized clinical trial

O estudo teve como objetivo analisar as barreiras percebidas à prática de atividade física durante um programa de treinamento multicomponente em adultos e idosos pós infecção por COVID-19. Realizou-se um ensaio clínico randomizado com 40 participantes (19 grupo controle e 21 grupo intervenção). Foram coletadas informações sociodemográficas, de saúde e de barreiras para a prática de atividade física, antes, 12 e 24 semanas após o início da intervenção. A medida das barreiras para a prática de atividade física foi obtida por meio de uma escala válida composta por 16 itens. As diferen-ças de barreiras entre os grupos e ao longo de tempo foi analisada a partir das Equações de Estimativa Generalizada, α = 0,05. As barreiras mais citadas pelos dois grupos na linha de base foram "Preguiça, cansaço ou desânimo" (71%), "Dores, lesões ou incapacidade" (38%) e "Falta de motivação" (48%). As análises principais indicaram que ambos os grupos tiveram redução na frequência da barreira "Pre-guiça, cansaço ou desânimo" na 12ª semana (p = 0,003), porém voltando aos valores iniciais na 24ª semana (p = 0,441). Já a barreira "Por causa da epidemia de coronavírus" foi reduzida na 12ª semana (p = 0,704) e ainda mais reduzida na 24ª semana (p = 0,158), comportamento também similar entre os grupos. Como principal conclusão, barreiras para atividade física podem ser reduzidas pela parti-cipação em programas de exercício supervisionado e recomendação para a prática de atividade física

The study aimed to analyze perceived barriers to physical activity during a multicomponent training pro-gram in adults and seniors post-COVID-19 infection. A randomized clinical trial was conducted with 40 participants (19 control group and 21 intervention group). Sociodemographic, health, and barriers to physical activity information were collected before, 12 and 24 weeks after the start of the intervention. The measure of barriers to physical activity was obtained through a valid scale composed of 16 items. Differences in barriers between groups and over time were analyzed using Generalized Estimating Equations, α = 0.05. The most frequently mentioned barriers at baseline by both groups were "Laziness, fatigue, or lack of enthusiasm" (71%), "Pain, injuries, or disability" (38%), and "Lack of motivation" (48%). The main analyses indicated that both groups had a reduction in the frequency of the barrier "Laziness, fatigue, or lack of enthusiasm" at week 12 (p = 0.003), but returned to initial values at week 24 (p = 0.441). The barrier "Because of the coronavirus epidemic" was reduced in week 12 (p = 0.704) and further reduced in week 24 (p = 0.158), with a similar pattern between groups. The key conclusion is that barriers to physical activity can be reduced through participation in supervised exercise programs and recommendations for physical activity

Aquatic training improves HbA1c, blood pressure and functional outcomes of patients with type 2 diabetes: A systematic review with meta-analysis.

AIM: This study aimed to summarize the effects of aquatic training on the health outcomes of type 2 diabetes (T2D) patients. METHODS: This is a systematic review with meta-analysis that followed the PRISMA recommendations. Searches were performed in four databases in April 2021. The following eligibility criteria were adopted: adults with T2D; aquatic training (AT) intervention in an upright position; pre- and post-intervention assessments of the following outcomes: HbA1c, SBP and DBP, functional capacity, VO2peak. The random-effects meta-analysis results are presented as mean differences and 95% confidence intervals. RESULTS: Of the 375 studies, 12 studies were eligible and included in the meta-analysis. Favorable effects of AT post-intervention were observed in HbA1c (-0.62 %), VO2peak (2.16 mL.Kg-1.min-1), SBP (-5.55 mmHg), DBP (-4.99 mmHg), and the 6-minute walk test (76.64 m). AT also revealed superior effects when compared to the control group (CG) and similar effects to land training (LT) in HbA1c (AT vs CG = -0.67 % and AT vs LT = -0.40 %), VO2peak (AT vs CG = 3.78 mL.Kg-1.min-1; AT vs LT = -0.12 mL/Kg-1.min-1), SBP (AT vs LT = -0.85 mmHg), and DBP (AT vs LT = 2.12 mmHg). CONCLUSION: AT improves HbA1c, VO2peak, SBP, DBP, and functional capacity in T2D patients. Beneficial effects favored AT over CG, while similar effects were verified between AT and LT on HbA1c, VO2peak, and blood pressure.

Effects of physical training on functional, clinical, morphological, behavioural and psychosocial outcomes in post-COVID-19 infection: COVID-19 and REhabilitation study (CORE-study)-a study protocol for a randomised controlled clinical trial.

BACKGROUND: The COVID-19 pandemic remains ongoing, with a significant number of survivors who have experienced moderate to severe clinical conditions and who have suffered losses of great magnitude, especially in functional capacity, triggering limitations to daily autonomy and quality of life. Among the possibilities of intervention for disease rehabilitation, physical exercise training stands out, which can benefit several health outcomes and favours the adoption of healthier behaviours. Therefore, the aim of the study will be to analyse the effects of physical training on the functional, clinical, morphological, behavioural and psychosocial status in adults and the elderly following COVID-19 infection. METHODS: A randomised controlled clinical trial is to be conducted in parallel, with the experimental group undergoing an intervention involving a multicomponent physical rehabilitation programme, carried out at the Sports Center in partnership with the Academic Hospital of the Federal University of Santa Catarina, in Florianópolis, Brazil. Participants will be adults and the elderly, of both sexes, in a post-COVID-19-infection state, who were hospitalised during the infection. The intervention will have a total duration of 24 weeks and will include a multicomponent physical training programme, which will have gradual progression in frequency, duration and intensity over time. Regarding the outcomes, before, at the 12th and after 24 weeks of intervention, functional (primary outcome = functional index of aerobic capacity), clinical, morphological, behavioural and psychosocial outcomes will be assessed. DISCUSSION: This study will contribute to a greater understanding of the safety, adherence and benefits of physical training in the rehabilitation of post-COVID-19 patients. The results of this study will be disseminated through presentations at congresses, workshops, peer-reviewed publications and local and international conferences, especially with a view to proposing a post-COVID-19 rehabilitation care protocol. TRIAL REGISTRATION: ReBEC, RBR-10y6jhrs . Registered on 22 February 2022. 2015.

External Loads of Elite Soccer Referees: A Systematic Review with meta-analysis.

The objective of the present study was to describe the total and fragmented external loads, at different intensities, of soccer referees in European and South American competitions during official matches through a systematic review and meta-analysis of cross-sectional studies. A systematic review was conducted in April, 2020. In all, 32 studies were included, incorporating 578 referees evaluated in 3170 games through video analysis or a global positioning system. Regarding external loads, it was observed that the total average distance covered by the referees was 10,461.74 m, with running speeds predominantly below 13 km.h-1. The total distance covered by the referees in the European competitions was higher and more intense than that of the referees in the South American tournaments, being 11,187.02 m and 9319.61 m, respectively. We suggest that referees' training can be organized according to the distances found at different intensities, in which low-intensity races can be performed below 13 km.h-1 with distances of approximately 4500 m, while high-intensity training can be developed with speeds from 18 to 24 km.h-1 for approximately 800 m. In addition, planning must consider the competition characteristics.

Combined Training with Aerobic Exercise Performed Outdoors Can Promote Better Blood Pressure and Affective Responses in Individuals with Cardiovascular Risk Factors.

The purpose of the study was to compare the effects of two models of combined training (CT) (aerobic and resistance exercise realized in the same training session), with aerobic training performed in different environments (indoor or outdoor), on blood pressure (BP), heart rate (HR), and affective response in individuals with cardiovascular risk factors. Twenty-six participants were allocated, in a non-randomized design, into CT with aerobic exercise performed indoors (ICT) or outdoors (OCT). Both groups were submitted to three weekly CT sessions, with aerobic exercises performed on ergometers or an athletics track. Before and after nine weeks of training, BP and HR at rest were measured. In the last session of the training, the affective response was collected. The individuals were 65.8 ± 7.8 (ICT) and 67.3 ± 8.2 (OCT) years. Lower values of diastolic BP were observed for the OCT group at post-training (p < 0.001). Moreover, in OCT, a significant inverse correlation was identified between the affective response to training and changes in systolic BP (r = −0.60; p = 0.03) and mean BP (r = −0.62; p = 0.02). In conclusion, CT, with aerobic exercise performed outdoors, seems to be more effective in reducing BP with better affective responses to training.

Nine weeks of combined training improve functional and morphological outcomes in trained older people with cardiometabolic risk factors.

BACKGROUND: The study is characterized as a single group experiment, with the aim of verifying the responses of functional capacity and body composition, after a combined training program with undulating periodization, of low cost and easy applicability, in volunteers with cardiovascular risk factors. METHODS: Experimental study carried out with individuals of both sexes, with cardiometabolic risk factors, members of a Cardiorespiratory Rehabilitation Program (PROCOR) of the Federal University of Santa Catarina (UFSC). A combined physical training program (aerobic and strength) with load training progression was used, performed at a frequency of three weekly sessions, on alternate days, for nine weeks and using shin guards, elastic bands or just body weight. Functional capacity, anthropometric profile and body composition of individuals were evaluated before and after the intervention. The comparison of data before and after the intervention period was performed using the Student's t-test for paired samples and the Wilcoxon test. RESULTS: Improvements statistically significant were observed in the tests related to functional capacity, "Sit and Stand", "8-foot-up-and-go" at usual and maximum speeds and "March", along with a decrease in anthropometric measurements of hip circumference, body fat percentage, waist-to-hip ratio, and fat mass in the android region. In addition, the program was well-tolerated with a low rate of sample losses. CONCLUSION: The results of this study suggest that only 9 weeks of combined training at low cost and easy applicability is able to promote improvement in parameters related to functional capacity, anthropometric profile, and body composition of trained older people with cardiovascular risk factors.

Aquatic Aerobic and Combined Training in Management of Type 2 Diabetes: The Diabetes and Aquatic Training Study (DATS): A Randomized Clinical Trial.

BACKGROUND: To compare the effects of aquatic aerobic and combined (aerobic more resistance) training on glycemic control and other cardiometabolic outcomes in patients with type 2 diabetes. METHODS: Patients were randomized to an aquatic aerobic training (AERO, n = 19; 57.5 [7.4] y; 9 [47%] women), or an aquatic combined training (COMBI, n = 19; 60.9 [7.4] y; 10 [53%] women), or an aquatic active procedure control (n = 19; 58.6 [9.7] y; 10 [53%] women) in 3 weekly sessions (50 min each), during 15 weeks. Glycated hemoglobin was the primary outcome, whereas insulin resistance markers, lipid profile, systemic inflammation, renin concentration, blood pressure, physical activity levels, and sitting time were secondary outcomes. RESULTS: Glycated hemoglobin was reduced in all groups (P = .021), although changes were more marked in AERO (-0.36%) and COMBI (-0.44%) than in active control (-0.26%) group. Lipid profile was similarly modified in all groups. Diastolic blood pressure and renin concentration were also reduced in all groups; however, renin showed more marked reductions in AERO (-17.7 uIU/mL) and COMBI (-15.1 uIU/mL) than in active control (0.2 uIU/mL) group. Fasting insulin, triglycerides, C-reactive protein, systolic blood pressure, walking time, and sitting time on weekends were not modified. CONCLUSION: AERO and COMBI presented similar effect to improve glycemic control and some cardiometabolic risk factors in patients with type 2 diabetes.

Association between simultaneity of health-risk behaviours and self-rated health in Brazilian adolescents.

INTRODUCTION: This study examined the association between simultaneity of four health-risk behaviours, namely, low levels of moderate-to-vigorous physical activity (insufficient MVPA: <420 min/week), tobacco use, alcohol consumption, and excessive television (TV)-(>2 h/d of TV viewing) and self-rated health (SRH) in Brazilian adolescents. METHODS: We used data of 100,551 adolescents from the National School Health Survey, a national cross-sectional study carried out in 2015. Association between simultaneity of health risk behaviours (i.e. the ratio between observed and expected prevalence rates) and SRH was examined using logistic regression models. RESULTS: The majority of the participants were female (51.9%) and 14 years of age (50.6%), and 26% of the participants' SRH ranged from 'average' to 'extremely poor'. Those who engaged in the following combinations of health-risk behaviours had higher odds of worse SRH than their healthier counterparts: insufficient MVPA and tobacco use (odds ratio-OR: 2.0, 95% confidence interval [CI]: 1.4 to 3.0); insufficient MVPA and alcohol consumption (OR: 1.6, 95%CI: 1.3 to 1.9); insufficient MVPA and >2 h/day of TV viewing (OR: 1.3, 95%CI: 1.1 to 1.6); insufficient MVPA, tobacco use and alcohol consumption (OR: 2.1, 95%CI: 1.7, to 2.7); and insufficient MVPA, alcohol consumption and >2 h/day of TV viewing (OR: 1.6, 95%CI: 1.4 to 2.0). CONCLUSIONS: Insufficient MVPA, alcohol consumption, and other health-risk behaviours were associated with worse SRH in Brazilian adolescents.

Blood Pressure and Blood Glucose Responses to Combined Exercise Sessions of Different Intensities in Individuals with Cardiovascular Risk Factors.

OBJECTIVE: The purpose of the present study was to verify the acute effects of blood pressure and blood glucose after two sessions of combined exercise sessions performed at two levels of intensity in trained individuals with cardiovascular risk factors. METHODS: Eighteen individuals (66.22 ± 8.61 years) of both sexes (6 women/12 men) with cardiovascular risk factors performed two sessions of combined exercises at different levels of intensity: moderate (MOD) and high (HI). To control the intensity of the aerobic training, the Borg Rating of Perceived Exertion (RPE) Scale was used. For the strength training, the maximum number of repetitions was carried out within a predetermined duration of sets. Blood pressure and blood glucose measurements were collected before and 20 minutes after the sessions. The data were analyzed using Generalized Estimating Equations, α 5%. RESULTS: Reductions were observed in systolic blood pressure (MOD - Δ = -4.95 mmHg; HI - Δ = -3.31 mmHg) and blood glucose (MOD - Δ = -16.06 mg/dL; HI - Δ = -29.45 mg/dL) after the two sessions, with no difference between sessions. Diastolic blood pressure did not change (p < .05). CONCLUSION: Combined exercises sessions of moderate or high intensity can promote an acute reduction in systolic blood pressure and glycemia in individuals with cardiovascular risk factors.

Active commuting among workers in the Southern of Brazil: a comparative analysis between 2006 and 2016.

This article aims to compare the prevalence of active commuting to work in adults in the Southern region of Brazil between 2006 and 2016 according to sociodemographic and labor characteristics. The data from the Brazilian System for the Surveillance of Risk and Protection Factors for Chronic Diseases - VIGITEL were compared in 2006 and 2016 (≥18 years). Active commuting to work, sex, age group, education and job characteristics were collected by telephone survey and transportation in the cities of Florianópolis, Curitiba and Porto Alegre, using absolute and relative frequencies with their respective 95% confidence intervals. Active commuting increased significantly in 2016 compared to 2006. Florianópolis had the highest prevalence in the two years analyzed. In all capitals, there was a significant increase in the prevalence of the outcome, mainly for women, with secondary education and only in Florianópolis for men, with low schooling. The prevalence has also increased for job characteristics in all capitals. Active commuting to work increased significantly among adults living in southern Brazil, with emphasis on Florianópolis. Expanding interventions in this context is a necessity in Brazil.

Active commuting among workers in the Southern of Brazil: a comparative analysis between 2006 and 2016 / Deslocamento ativo entre trabalhadores da região Sul do Brasil: uma análise comparativa entre 2006 e 2016

Abstract This article aims to compare the prevalence of active commuting to work in adults in the Southern region of Brazil between 2006 and 2016 according to sociodemographic and labor characteristics. The data from the Brazilian System for the Surveillance of Risk and Protection Factors for Chronic Diseases - VIGITEL were compared in 2006 and 2016 (≥18 years). Active commuting to work, sex, age group, education and job characteristics were collected by telephone survey and transportation in the cities of Florianópolis, Curitiba and Porto Alegre, using absolute and relative frequencies with their respective 95% confidence intervals. Active commuting increased significantly in 2016 compared to 2006. Florianópolis had the highest prevalence in the two years analyzed. In all capitals, there was a significant increase in the prevalence of the outcome, mainly for women, with secondary education and only in Florianópolis for men, with low schooling. The prevalence has also increased for job characteristics in all capitals. Active commuting to work increased significantly among adults living in southern Brazil, with emphasis on Florianópolis. Expanding interventions in this context is a necessity in Brazil.

Resumo O objetivo deste artigo é comparar a prevalência de deslocamento ativo para o trabalho em adultos na região Sul do Brasil entre 2006 e 2016 de acordo com características sociodemográficas e laborais. Os dados do Sistema Brasileiro de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas (VIGITEL) foram comparados em 2006 e 2016 (≥18 anos). Deslocamento ativo para o trabalho, sexo, faixa etária, escolaridade e características laborais foram coletados por inquérito telefônico e analisados nas cidades de Florianópolis, Curitiba e Porto Alegre, utilizando as frequências absolutas e relativas com seus respectivos intervalos de confiança de 95%. O deslocamento ativo aumentou significativamente em 2016 em relação a 2006. Florianópolis apresentou as maiores prevalências nos dois anos analisados. Em todas as capitais houve aumento significativo na prevalência do desfecho, principalmente para mulheres, com ensino médio e apenas em Florianópolis para homens, com baixa escolaridade. A prevalência também aumentou para características laborais em todas as capitais. O deslocamento ativo para o trabalho aumentou expressamente entre os adultos que vivem no Sul do Brasil, com destaque para Florianópolis. Ampliar intervenções nesse contexto é uma necessidade no Brasil.

Effects of Aerobic Training Progression on Blood Pressure in Individuals With Hypertension: A Systematic Review With Meta-Analysis and Meta-Regression.

INTRODUCTION: Aerobic training of moderate intensity is the primary modality recommended in the management of hypertension. The manipulation of training variables can be an important strategy for the continuity of health benefits; however, little is known about the effects of the progression of aerobic training variables in the adaptations of blood pressure in hypertensive adults. OBJECTIVE: To analyze, through a systematic review with meta-analysis, the effects of aerobic training with and without progression on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive adults. METHOD: The search for the studies was carried out in the PubMed, Cochrane Central, SPORTDiscus and LILACS databases. Clinical trials that analyzed the effect of aerobic training, lasting at least six weeks, on blood pressure in hypertensive individuals comparing with a control group without intervention were selected. The selection of studies and data extraction were carried out independently by two pairs of researchers. The results are presented as mean difference and 95% confidence interval. Statistical significance was considered with p < 0.05. RESULTS: Of the 13,028 studies found, 24 were selected and included in this review, 12 with progression of training variables and 12 without progression, with a total of 1,207 participants analyzed. There was a reduction in SBP after aerobic training with progression (-10.67 mmHg; 95% CI -15.421, -5.926; p < 0.001) and without progression (-10.17 mmHg; CI -12.213, -8.120; p < 0.001). DBP also decreased after aerobic training with progression (-5.49 mmHg; 95% CI -8.663, -2.310; p < 0.001) and without progression (-6.51 mmHg; 95% CI -9.147, -3.868; p < 0.001). According to the results of the meta-regression analyses, only age showed an association with the reduction of SBP (ß: -0.323; CI -0.339, -0.307; p < 0.001). CONCLUSION: Aerobic training promotes a reduction in the SBP and DBP levels of adults with hypertension, regardless of whether or not the training variables progression.

Techniques to promote motivation for physical activity in the context of primary healthcare / Estratégias para promover motivação para a atividade física no contexto da atenção primária à saúde

Health promotion and physical activity behavior change involve affective and cognitive aspects such as motivation. Thus, greater attention is needed to individuals' motivation to adhere to and maintain physical activity in the Primary Health Care context. This essay aims to present the initial step of a theoretical-methodological intervention model for physical activity behavior change (based on basic psychological needs support) in the Primary Health Care context. The overall research project was organized under three steps: development (discussed in this essay), validation, and evaluation/appli-cation. From the literature analysis, 17 strategies were abducted to promote motivation for physical activity. We offered ways to implement such strategies in the context of Primary Health Care. This work set education to democratize and encourage the appreciation of motivational regulations of physical activity by professionals, researchers, and policymakers interested in health promotion

A promoção da saúde envolve aspectos afetivos e cognitivos para mudanças de comportamento, assim destaca--se a necessidade de maior atenção voltada aos aspectos motivacionais relacionados à adesão e manutenção das pessoas à prática de atividade física no contexto da Atenção Primária à Saúde (APS). Este ensaio tem como objetivo apresentar a etapa inicial de um modelo teórico-metodológico de intervenção para a atividade física no contexto da APS, que considerem os processos regulatórios da motivação. O macroprojeto foi organizado sob três processos: desenvolvimento (foco exclusivo deste ensaio); validação e avaliação/aplicação. A partir da análise bibliográfica foram extraídas 17 estratégias para promover motivação para a atividade física. Após, foi sugerido formas de implementar tais estratégias no contexto da atividade física da APS. Este trabalho visa democratizar e encorajar a apreciação dos aspectos afetivos e cognitivos por profissionais, pesquisadores e gestores interessados na promoção da prática de atividade física para a saúde no contexto da APS.

Techniques to promote motivation for physical activity in the context of primary healthcare / Estratégias para promover motivação para a atividade física no contexto da atenção primária à saúde

Health promotion and physical activity behavior change involve affective and cognitive aspects such as motivation. Thus, greater attention is needed to individuals' motivation to adhere to and maintain physical activity in the Primary Health Care context. This essay aims to present the initial step of a theoretical-methodological intervention model for physical activity behavior change (based on basic psychological needs support) in the Primary Health Care context. The overall research project was organized under three steps: development (discussed in this essay), validation, and evaluation/appli-cation. From the literature analysis, 17 strategies were abducted to promote motivation for physical activity. We offered ways to implement such strategies in the context of Primary Health Care. This work set education to democratize and encourage the appreciation of motivational regulations of physical activity by professionals, researchers, and policymakers interested in health promotion

A promoção da saúde envolve aspectos afetivos e cognitivos para mudanças de comportamento, assim destaca--se a necessidade de maior atenção voltada aos aspectos motivacionais relacionados à adesão e manutenção das pessoas à prática de atividade física no contexto da Atenção Primária à Saúde (APS). Este ensaio tem como objetivo apresentar a etapa inicial de um modelo teórico-metodológico de intervenção para a atividade física no contexto da APS, que considerem os processos regulatórios da motivação. O macroprojeto foi organizado sob três processos: desenvolvimento (foco exclusivo deste ensaio); validação e avaliação/aplicação. A partir da análise bibliográfica foram extraídas 17 estratégias para promover motivação para a atividade física. Após, foi sugerido formas de implementar tais estratégias no contexto da atividade física da APS. Este trabalho visa democratizar e encorajar a apreciação dos aspectos afetivos e cognitivos por profissionais, pesquisadores e gestores interessados na promoção da prática de atividade física para a saúde no contexto da APS

Effects of Combined Training With Linear Periodization and Non-Periodization on Sleep Quality of Adults With Obesity.

Background: Combined exercise training has proven effective in preventing and treating sleep disorders among obese adults. However, structured progression of intensity in sleep parameters remains poorly investigated within this population. Purpose: To verify the effects of non-periodized and linear periodization combined training on the sleep quality of obese adults. Methods: This was a randomized controlled trial involving adults with body mass index ≥ 30 kg/m2, allocated to 3 groups: control (CG; n = 13), non-periodized training (NG; n = 9), and with linear periodization (PG; n = 13). Groups PG and NG trained for 16 weeks in 3 weekly sessions lasting of 60 minutes. The NG trained in 50-59% heart rate reserve (HRR) e 2 × 10-12 repetition maximum (RM) and the PG with progression in 3 mesocycles: 40-49%;50-59%; 60-69% HRR e 2x12-14; 2x10-12; 2 × 8-10 RM, with the total volume equated. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index. For statistics, we used Generalized Estimation Equations considering p ≤ 0.05. Results: Sleep latency was reduced in both training groups after intervention (NG-Δ = -25.56 minutes p = .028; PG-Δ = -22.23 minutes p = .035), while significant improvements in sleep efficiency were found only in the NG (Δ = 20.67%; p = .042). Conclusion: Despite the NG's apparent superiority, which model has the best sleep effects on obese adults cannot be stated. Hence, caution is needed while extrapolating the results.

Metabolic Cost and Performance of Athletes With Lower Limb Amputation and Nonamputee Matched Controls During Running: A Systematic Review.

ABSTRACT: The elastic function of running-specific prostheses likely contributes to a lower metabolic cost of running. However, it remains unclear whether running-specific prostheses provide advantages concerning the metabolic cost of running in relationship with nonamputee runners. This study aimed to systematically review the scientific literature to examine the peak performance (peak oxygen consumption-VO2peak and peak speed) and the metabolic cost between paired amputees and nonamputees during running and between amputee runners with traditional prostheses and running-specific prostheses. A literature search on three databases (MEDLINE/PubMed, Scopus, and Web of Science) was conducted using the following key words: (amputation OR amputee) AND (run OR running OR runner) AND (prosthesis OR prosthetics), resulting in 2060 records and 4 studies within the inclusion criteria. A methodological quality assessment was carried out using a modified version of the Downs and Black checklist. VO2peak of the amputees athletes (54 ± 2 mL kg-1 min-1) is similar (mean difference = -0.80 mL kg-1 min-1, confidence interval = -4.63 to 3.03) to nonamputees athletes (55 ± 2 mL kg-1 min-1). The average metabolic cost of the paired amputee athletes (4.94 ± 1.19 J kg-1 m-1) also does not differ (mean difference = 0.73 J kg-1 m-1, confidence interval = -0.74 to 2.20) from nonamputee runners (4.21 ± 0.16 J kg-1 m-1). The research on running in amputee and nonamputee athletes is limited. The few existing studies have limited methodological quality. The metabolic cost data from amputee athletes running with running-specific prostheses are within the range of nonamputee data.

Effect of the execution order from concurrent exercise session on blood pressure responses in hypertensive older men

Abstract Aim: To compare blood pressure (BP) responses among the different orders of execution of concurrent exercise (CE) sessions in controlled hypertensive older men. Methods: Fifteen older men (64 ± 5 years) participated in three randomized crossover sessions: control session (C), CE in aerobic-resistance order (AR), and resistance-aerobic order (RA). The CE was performed for 1 h, in which 30 min were for the resistance exercise with 5 exercises at 70% of 1RM and 30 min for the aerobic exercise on a treadmill with intensity corresponding to the first ventilatory threshold. Clinical systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) were measured at rest and over 2 h and 24 h after the session. For analysis, the Generalized Estimating Equations (GEE) test was used with Bonferroni's complimentary test (α = 0.05). Results: The SBP decreased by 30 min after AR, while after RA we obtained reductions during 1 h after a session concerning rest. Between sessions, we found lower values in both CE compared to the C at 30 min, 45 min, and 90 min. In the RA there was a lower pressure in relation to the C at minute 60. The DBP reduced 30 min after the AR regarding the pre-session, however with no difference between sessions. The MBP was lower in relation to 30 min rest after AR. Among sessions, a pressure drop was observed in the AR compared to the C at 30 min and 45 min. Conclusion: We can conclude that the CE was effective in generating post-exercise hypotension regardless of the order in controlled hypertensive older men.

Prevalência e Fatores Associados à SRAG por COVID-19 em Adultos e Idosos com Doença Cardiovascular Crônica / Prevalence and Associated Factors of SARS by Covid-19 in Adults and Aged People with Chronic Cardiovascular Disease

Resumo Fundamento A presença de Doença Cardiovascular (DCV) em indivíduos infectados pela COVID-19 pode implicar em um pior prognóstico. Objetivo Descrever a prevalência da Síndrome Respiratória Aguda Grave (SRAG) por COVID-19 e analisar os fatores associados a essa condição em adultos e idosos com doença cardiovascular no Brasil até a 30ª Semana Epidemiológica de 2020. Métodos Estudo transversal realizado com dados do Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe), referente às fichas de notificação de SRAG de indivíduos hospitalizados no Brasil, entre a 1a e 30a Semana Epidemiológica de 2020. Foram incluídos adultos e idosos (≥ 18 anos) com DCV. A variável dependente foi a confirmação de SRAG por COVID-19 e foram analisados fatores relacionados a características sociodemográficas, sinais e sintomas e fatores clínicos. Aplicou-se a regressão de Poisson com variância robusta. O nível de significância adotado foi de 5%. Resultados Foram analisadas as notificações de 116.343 indivíduos. Destes, 61,9% obtiveram diagnóstico de SRAG por COVID-19. A prevalência do desfecho foi 4% menor nas mulheres (IC95%: 0,94-0,99) e 18% menor em zonas rurais (IC95%: 0,77-0,87). Observou-se prevalência maior na faixa etária de 50 a 59 anos (IC95%: 1,09-1,48) e na região nordeste (IC95%: 1,72-1,91). Febre, tosse, internação em UTI, uso de suporte ventilatório e caso nosocomial também foram significativamente associados a uma maior probabilidade de SRAG por COVID-19 nesses indivíduos. Conclusão Há alta prevalência de SRAG por COVID-19 em adultos e idosos com DCV no Brasil. Associaram-se fatores relacionados a características sociodemográficas, clínicas, sinais e sintomas.

Abstract Background The presence of Cardiovascular Disease (CVD) in individuals infected with COVID-19 may imply a worse prognosis. Objective To describe the prevalence of Severe Acute Respiratory Syndrome (SARS) by COVID-19 and to analyze the factors associated with this condition in adults and the elderly with cardiovascular disease in Brazil until the 30th Epidemiological Week of 2020. Methods Cross-sectional study conducted with data from the Influenza Epidemiological Surveillance Information System (Sistema de Informação de Vigilância Epidemiológica da Gripe - SIVEP-Gripe), referring to the SARS notification forms of hospitalized individuals in Brazil, between the 1st and 30th Epidemiological Week of 2020. Adults and the aged (≥ 18 years old) with CVD. The dependent variable was SRAG confirmation by COVID-19 and factors related to sociodemographic characteristics, signs and symptoms, and clinical factors were analyzed. Poisson regression with robust variance was applied. The level of significance adopted was 5%. Results Notifications from 116,343 individuals were analyzed. Of these, 61.9% were diagnosed with SARS by COVID-19. The prevalence of the outcome was 4% lower in women (95%CI: 0.94-0.99) and 18% lower in rural areas (95%CI: 0.77-0.87). There was a higher prevalence in the 50 to 59 age group (95%CI: 1.09-1.48) and in the northeast region (95%CI: 1.72-1.91). Fever, cough, admission to the ICU, use of ventilatory support, and nosocomial cases were also significantly associated with a higher probability of SRAS by COVID-19 in these individuals. Conclusion There is a high prevalence of SARS by COVID-19 in adults and aged people with CVD in Brazil. Factors associated with sociodemographic and clinical characteristics, signs, and symptoms were associated.