Moderately intense physical exercise alleviates electrocardiographic changes induced by cisplatin in rats.

INTRODUCTION AND OBJECTIVE: Cisplatin induces many collateral effects such as gastrointestinal disorders, nephrotoxicity, and dysautonomia. Recently our group showed that cisplatin treatment induces gastric emptying delay and that physical exercise and treatment with pyridostigmine prevent this change. In the current study, we investigated the role of moderate exercise on cardiac activity and autonomic balance in rats treated with cisplatin. METHODS: Male Wistar rats were divided into saline, cisplatin, exercise, and exercise+cisplatin groups. Cardiac and autonomic disorders were induced by (cisplatin - 3 mg/kg, i.p. once a week/per 5 weeks). Exercise consists of swimming (1 hour per day/5× day per week/per 5 weeks without overload). Forty-eight hours after the last session of the training or treatment, we assessed the cardiac activity and HRV via electrocardiogram analysis in DII derivation. RESULTS: Cisplatin increase (p<0.05) R-R' interval and decrease (p<0.05) heart rate vs. saline. Exercise+cisplatin prevented (p<0.05) changes in R-R' interval. Exercise per se induced bradycardia vs. saline group. We observed an increase in LF (nu) and a decrease in HF (nu) in the cisplatin group vs. saline. These changes were not significant. Moreover, cisplatin treatment increased (p<0.05) QT, QTc, and JT intervals compared with the saline group. In the exercise+cisplatin groups these increases were prevented significantly (p<0.05). CONCLUSION: In the current study, chronic use of cisplatin induced electrocardiographic changes without altering autonomic balance. Moderate physical exercise prevented this phenomenon indicating that exercise can be beneficial in patients in chemotherapy.

Cardiovascular benefits of resistance exercise: It's time to prescribe.

Despite the well-known health benefits of regular physical activity, sedentary behavior and physical inactivity remain a real global pandemic. Exercise is associated with increased life expectancy, improved quality of life and prevention of multiple diseases. Although less implemented in practice compared to aerobic exercise, recent evidence shows that resistance exercise (RE) is also responsible for various benefits, including improvements in body composition, control of several cardiovascular (CV) risk factors, and reduction of CV outcomes. RE increases strength and muscle mass, is effective in controlling type 2 diabetes, and improves the management of obesity, lipids, and blood pressure profiles. In this setting, clinical guidelines recommend the inclusion of RE for primary and secondary CV risk prevention, particularly in combination with aerobic exercise, in which the benefits are most pronounced. Prescription of RE should follow a methodology that includes key variables such as frequency, intensity, type, time, and progression. Despite challenges, professionals in the CV field should be familiar with RE prescription in order to maximize its referral in clinical practice. This review aims to analyze the CV effects of RE and current recommendations regarding the prescription of this type of exercise.

The prognostic value of the cardiorespiratory optimal point during submaximal exercise testing in heart failure.

INTRODUCTION: Peak oxygen consumption (pVO2) is a key parameter for assessing the prognosis of heart failure with reduced ejection fraction (HFrEF). However, it is less reliable when the cardiopulmonary exercise test (CPET) is not maximal. OBJECTIVE: To compare the prognostic power of various exercise parameters in submaximal CPET. METHODS: Adult patients with HFrEF undergoing CPET in a tertiary center were prospectively assessed. Submaximal CPET was defined as a respiratory exchange ratio ≤1.10. Patients were followed for one year for the primary endpoint of cardiac death and urgent heart transplantation (HT). Various CPET parameters were analyzed as potential predictors of the combined endpoint and their prognostic power (area under the curve [AUC]) was compared using the Hanley-McNeil test. RESULTS: CPET was performed in 442 HFrEF patients (mean age 56±12 years, 80% male), of whom 290 (66%) had a submaximal CPET. Seventeen patients (6%) reached the primary endpoint. The cardiorespiratory optimal point (COP) had the highest AUC value (0.989, p<0.001), and significantly higher prognostic power than other tested parameters, with pVO2 presenting an AUC of 0.753 (p=0.001). COP ≥36 had significantly lower survival free of HT during follow-up (p<0.001) and presented a sensitivity of 100% and a specificity of 89% for the primary endpoint. CONCLUSION: COP had the highest prognostic power of all parameters analyzed in a submaximal CPET. This parameter can help stratify HFrEF patients who are physiologically unable to reach a maximal level of exercise.

Facemasks during aerobic exercise: Implications for cardiac rehabilitation programs during the Covid-19 pandemic.

INTRODUCTION AND OBJECTIVES: During the COVID-19 pandemic, among the safety measures adopted, use of facemasks during exercise training sessions in cardiac rehabilitation programs raised concerns regarding possible detrimental effects on exercise capacity. Our study examined the cardiorespiratory impact of wearing two types of the most common facemasks during treadmill aerobic training. METHODS: Twelve healthy health professionals completed three trials of a symptom-limited Bruce treadmill protocol: Without a mask, with a surgical mask and with a respirator. Perceived exertion and dyspnea were evaluated with the Borg Scale of Perceived Exertion and the Borg Dyspnea Scale, respectively. Blood pressure, heart rate and arterial oxygen saturation (SpO2) were measured at each 3-minute stage. RESULTS: Using a surgical mask or a respirator resulted in a shorter duration of exercise testing. At peak capacity, using a respirator resulted in higher levels of dyspnea and perceived exertion compared to not wearing a facemask. A significant drop in SpO2 was present at the end of exercise testing only when using a respirator. There were no differences in either chronotropic or blood pressure responses between testing conditions. CONCLUSIONS: Professionals involved in cardiac rehabilitation should be aware of the cardiorespiratory impact of facemasks. Future studies should assess whether exposure to these conditions may impact on the overall results of contemporary cardiac rehabilitation programs.

Caffeine slows heart rate autonomic recovery following strength exercise in healthy subjects.

INTRODUCTION AND OBJECTIVES: Studies assessing the effects of caffeine (CAF) on the cardiovascular system have demonstrated that CAF can delay cardiac recovery following exercise. This study intended to assess the impact of CAF intake before physical exercise on heart rate variability (HRV) and cardiovascular parameters. METHODS: This is a prospective, crossover, controlled clinical trial conducted at the University of Pernambuco, Petrolina, PE, Brazil. The experimental protocol was split into three stages with a minimum of 48 hours between them. Exercises intensity was standardized based on the one repetition maximum test (1RM), obtaining the load of each volunteer for the intensity of 75% of 1RM. In the second and third phases, the control protocols were applied and 300 mg caffeine was given 45 minutes before training. HRV indices were determined at the subsequent times: 0 to 5 minutes of rest (before) and during 30 minutes of recovery (Rec) (after exercise), divided into six intervals, each of 5 minutes. RESULTS: The final sample involved 30 volunteers. CAF delayed HRV recovery after resistance exercise. In general, CAF impaired recovery of HRV after resistance exercise. Significant changes were observed in the RMSSD, SDNN, TINN, SD1, low frequency and high frequency indices between the control and CAF group. CONCLUSION: CAF protocol delayed parasympathetic regulation of heart rhythm following exercise, slowing recovery of HR, blood pressure and HRV indices after exercise.

Cardiac rehabilitation in older patients: Indication or limitation?

OBJECTIVE: To assess the clinical impact of a cardiac rehabilitation program in an older population. METHODS: This is a retrospective analysis of 731 coronary patients who attended phase 2 of a cardiac rehabilitation program between January 2009 and December 2016. We compared the response to the program of older (≥65 years) and younger (<65 years) patients, analyzing changes in metabolic profile (including body mass index, waist circumference and lipid profile), exercise capacity, cardiac autonomic regulation parameters (such as chronotropic index and resting heart rate), and health-related quality of life scores. RESULTS: Older patients represented 15.9% of our cohort. They showed significant reductions in waist circumference (male patients: 98.0±7.9 cm vs. 95.9±7.9 cm, p<0.001; female patients: 90.5±11.4 cm vs. 87.2±11.7 cm, p<0.001), LDL cholesterol (102.5 [86.3-128.0] mg/dl vs. 65.0 [55.0-86.0] mg/dl, p<0.001) and triglycerides (115.0 [87.8-148.5] mg/dl vs. 97.0 [81.8-130.0] mg/dl, p<0.001). Post-training data also showed a noticeable improvement in older patients' exercise capacity (7.6±1.8 METs vs. 9.3±1.8 METs, p<0.001), along with a higher chronotropic index and lower resting heart rate. Additionally, health-related quality of life indices improved in older subjects. However, our overall analysis found no significant differences between the groups in changes of the studied parameters. CONCLUSION: Older coronary patients benefit from cardiac rehabilitation interventions, similarly to their younger counterparts. Greater involvement of elderly patients in cardiac rehabilitation is needed to fully realize the therapeutic and secondary preventive potential of such programs.

Thermoregulatory and perceptual responses of lean and obese fit and unfit girls exercising in the heat.

OBJECTIVE: To verify the thermoregulatory and perceptual responses of obese and lean girls, either fit or unfit, exercising in the heat at a similar rate of metabolic heat production per unit body mass. METHODS: A total of 34 pubescent girls were allocated in four groups: 12 obese fit, 9 obese unfit, 5 lean fit, and 8 lean unfit. The obese groups (13.2±1.4 years, 40.5%±5.8% fat by DXA) differed in their aerobic fitness (V˙O2peak 76.0±8.1 vs. 56.6±5.8mL.kgmusclemass-1.min-1), as well as the lean groups (13.1±1.6 years, 24.0%±4.8% fat) (V˙O2peak 74.5±2.9 vs. 56.2±5.0mL.kgmuscle mass-1min-1). Girls cycled two bouts of 25min with a 10min rest in between, at ∼5.4W.kg-1 in the heat (36°C and 40% relative humidity) and they were kept euhydrated. Rectal and skin temperatures and heart rate were measured every 5min. Perceptual responses were evaluated throughout the exercise. RESULTS: Initial rectal temperature was higher in the obese subjects compared to the lean subjects (37.5±0.3 and 37.2±0.3°C). No difference was observed among the girls whom were obese (eight fit or unfit) and lean (also fit or unfit) throughout the exercise in rectal temperature (37.6±0.2, 37.5±0.3, 37.5±0.3, 37.4±0.3°C, respectively), skin temperature (34.8±0.8, 35.1±1.0, 34.4±0.9, 35.2±0.9°C), and heart rate (128±18; 118±12, 130±16, 119±16beatsmin-1). No differences were observed in perceptual responses among groups. CONCLUSION: Regardless of the adiposity or aerobic fitness, pubescent girls had similar thermoregulatory and perceptual responses while cycling in the heat at similar metabolic heat production.

Prevalence and impact of asthma in schoolchildren in the city of Caxias do Sul-RS.

OBJECTIVE: To analyze the prevalence and impact of asthma in schoolchildren from the city of Caxias do Sul, RS, Brazil. METHODS: Cross-sectional observational and case-control study with children and adolescents between 7 and 15 years old, from public schools in Caxias do Sul, RS. The study is composed of two phases: Phase I analyzed the prevalence of asthma in the delimited population, investigating 1915 schoolchildren; Phase II quality of life questionnaires, asthma control and classification (for the asthmatic group), physical activity, school performance, pulmonary function tests and anthropometric measures were applied to 266 asthmatics and 288 controls. RESULTS: The estimated prevalence of asthma was 16.1%. In the comparison between asthmatics and nonasthmatics premature birth (p<0.001) and diagnosis of another chronic disease at birth (p<0.001) were found. Regarding pulmonary function, significant differences were found in the values between groups in FEV1, FEV1/FVC and forced expiratory flow in the 25 and 75% (FEF25-75%), being that asthmatics presented lower values. Among asthmatics, 133 (50.8%) did not have the disease controlled. In the anthropometric variables, significant differences were observed, with higher values in controls, in the the waist-to-height ratio (p=0.009) and in the perception of health (p<0.001). Quality of life is lower in asthmatics in the physical well-being domain (p=0.001) and in the total score (p=0.016). The total school performance score did not present a statistically significant difference between the groups. CONCLUSION: The prevalence of asthma is similar to that of other industrialized urban centers and may negatively affect some areas of the development of schoolchildren.

Festival ou campeonato? experiências na ginástica para todos / Festival or championship? gymnastics for all experiences

RESUMO Modelos de formação de atletas primam pela ampliação de experiências esportivas, incluindo os eventos esportivos. Assume-se que a variabilidade de propostas incute na vivência de situações paradoxais, importantes na permanência no esporte e/ou vida ativa. Este trabalho discute a percepção da experiência vivida em dois eventos de ginástica para todos com distintos vieses: um com caráter competitivo e outro com caráter demonstrativo. Protagonizaram o estudo 29 crianças participantes de um projeto de extensão universitária. Para a coleta de dados, realizaram-se 8 Grupos Focais, sendo utilizada a Análise Temática. Diários de campo e texto reflexivo do mediador dos GF foram considerados para a triangulação dos dados. Dois eixos foram evidenciados em ambos os eventos: a) aspectos intersubjetivos, cujo comprometimento, o componente estético e a ansiedade perpassaram ambos os eventos e a superação e o nervosismo tiveram maior destaque na competição; e b) inter-relações pessoais, nas quais a importância do outro/grupo foi evidente, com maior relação ao tipo de apresentação coreográfica de grupo, do que especificamente ao tipo de evento. Reconhece-se, então, o fomento a eventos de diferentes naturezas, uma vez que os praticantes de base podem presumir o alto rendimento ou a vida ativa pelo esporte.

ABSTRACT Models for athlete development have prioritized sports experiences, including events. It is assumed that the variety of events instills in the experience of paradoxical situations, important in the permanence in sport and/or active life. This article discusses the lived experience perception by children in two gymnastics for all events with different biases: one competitive and the other demonstrative. Based on qualitative research, 29 children were interviewed using Focus Groups (n=8), and data analysis using Thematic Analysis. Furthermore, field notes by 4 coaches and reflective narrative from the Focus Group interviewer were considered for triangulation. Two themes were highlighted: a. intersubjective aspects and b. interrelationships. These themes were addressed in both events to a greater or lesser extent. In item a, commitment, aesthetic components, and anxiety were in both events, but overcoming and nervousness more prominent in the competition. In item b, the importance of the other/ group was evident, mostly because of the presentation than the type of event. Recognizing the sporting bias of a practice is, therefore, promoting events of different natures, as practitioners can presume high performance or an active life through sport.

Efeitos do treinamento multicomponente na capacidade intrínseca de idosos residentes na comunidade: protocolo de estudo quase-experimental / Effects of multicomponent training on the intrinsic capacity of communitydwelling older adults: quasi-experimental study protocol

Objetivo: Protocolo para avaliar os efeitos de exercícios multicomponentes na capacidade intrínseca de idosos. Metodologia: Pessoas idosas (≥ 60 anos) cadastradas em um programa de treinamento multicomponente de Porto Alegre (RS) serão selecionados para avaliação da capacidade intrínseca nos seus cinco domínios: vitalidade (teste de força de preensão manual (FPM), índice de massa corpórea (IMC) e nutrição) sensorial (perguntas autorrelatadas), psicológico (Escala de Depressão Geriátrica, GDS-15), cognitivo (MoCA teste) e locomotor (teste de sentar e levantar e TUG). A pontuação composta da capacidade intrínseca será realizada por meio da soma dos domínios em escore de 0 a 10 pontos. Ao fim de 12 semanas de intervenção com exercícios multicomponentes, os participantes serão reavaliados. Para comparar os efeitos do treinamento multicomponente na capacidade intrínseca composta e por domínio serão utilizados os testes t de Student e ANOVA para comparar os efeitos de diversos tipos de treinamento. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa sob parecer no 5.517.315. Resultados esperados: Ao fim de 12 semanas de intervenção com os exercícios multicomponentes, esperamos um aumento na pontuação composta da capacidade intrínseca e em seus domínios, especialmente o locomotor. Relevância: O risco de dependência, quedas e mortalidade aumenta com o declínio da capacidade intrínseca, suscitando a necessidade de implementar intervenções para limitar esses desfechos negativos. A prática de exercícios multicomponentes é uma estratégia simples, eficaz, com boa adesão e amplamente recomendada para evitar o declínio da capacidade intrínseca e melhorar a saúde e a funcionalidade das pessoas idosas. (AU)

Objective: This is a protocol for assessing the effects of multicomponent exercise on the intrinsic capacity of older adults. Methods: Older adults (≥ 60 years old) will be selected for a multicomponent training program in Porto Alegre, RS, Brazil to evaluate the 5 domains of intrinsic capacity: vitality (handgrip strength, body mass index, and nutrition) sensory perception (self-reported questions), psychology (the 15-item Geriatric Depression Scale), cognition (the Montreal Cognitive Assessment) and locomotion (the sit-to-stand test and the Timed Up and Go test). The composite intrinsic capacity score will be obtained by summing the domains, with total scores ranging from 0 to 10 points. After 12 weeks of the multicomponent exercise intervention, the participants will be reassessed. Student's t-test and ANOVA will be used to compare the effects of different types of training on intrinsic capacity. This study was approved by the research ethics committee of the involved institution. Expected results: After the 12-week multicomponent exercise intervention, we expect scores for composite intrinsic capacity and its domains, especially locomotion, to increase. Relevance: The risk of dependence, falls, and mortality increases with reduced intrinsic capacity, indicating a need for interventions to limit these negative outcomes. Multicomponent exercise, a simple, widely recommended, and effective strategy with good adherence, is designed to prevent intrinsic capacity decline in older people and improve their health and functionality. (AU)

Barriers to physical activity practice and associated factors in patients with hypertension / Barreiras para a prática de atividade física e fatores associados em pacientes com hipertensão arterial

Abstract The identification of barriers to regular physical activity (PA) is a form of an initial and effective strategy to encourage behavior modification and adherence to a more active lifestyle in hypertensive patients. This cross-sectional study aimed to identify the barriers to PA practice in patients with hypertension classified as physically inactive and to analyze the association of the number of these barriers with sociodemographic factors and health indicators. Two hundred one hypertensive patients of both sexes (61.7±12.7 years) answered an anamnesis with health information and sociodemographic data, a PA level questionnaire, and a barrier questionnaire for the practice of PA. Regarding the level of PA of the participants, 48.8% were classified as physically inactive and reported, on average, 6.1 (±3.8) barriers to PA practice, with the barrier "fear of falling or getting hurt" the most commonly reported. Furthermore, women and patients with low education, negative perception of health, and a greater presence of comorbidities reported a greater number of barriers to PA practice. PA practice as a non-pharmacological tool for the treatment of hypertension should focus on women and patients with low education, negative perception of health, and a greater presence of associated comorbidities.

Resumo A identificação de barreiras à atividade física regular (AF) é uma forma de estratégia inicial e eficaz para encorajar a modificação do comportamento e a adesão a um estilo de vida mais ativo em pacientes hipertensivos. Este estudo transversal visou identificar as barreiras à prática de AF em pacientes com hipertensão classificados como fisicamente inativos e analisar a associação do número destas barreiras com fatores sociodemográficos e indicadores de saúde. Duzentos e um pacientes hipertensos de ambos os sexos (61.7±12.7 anos) responderam a uma anamnese com informações de saúde e dados sociodemográficos, um questionário de nível de AF, e um questionário de barreira para a prática de AF. Relativamente ao nível de AF dos participantes, 48,8% foram classificados como fisicamente inativos e reportaram, em média, 6,1 (±3,8) barreiras à prática de AF, sendo a barreira "medo de cair ou de se magoar" a mais frequentemente reportada. Além disso, mulheres e pacientes com baixa educação, percepção negativa da saúde, e uma maior presença de comorbidades reportaram um maior número de barreiras à prática de AF. A prática de AF como ferramenta não farmacológica para o tratamento da hipertensão deve ter como foco mulheres e pacientes com baixa escolaridade, percepção negativa de saúde e maior presença de comorbidades associadas.

Effects of exercise training and stem cell therapy on the left ventricle of infarcted rats.

INTRODUCTION AND OBJECTIVES: Stem cell therapy and aerobic exercise are non-pharmacological therapies following myocardial infarction. The aim of this study was to test whether aerobic exercise training enhances the benefits of mesenchymal stem cell (MSC) therapy on remodeling of the extracellular matrix and fetal gene expression in the left ventricle of infarcted rats. METHODS: Myocardial infarction was surgically induced in six-week old male Wistar rats. Animals were divided into four groups: sedentary control (SC) and sedentary and stem cell treated (SCMSC); exercised (EX) and exercised and stem cell treated (EXMSC). Bone marrow-derived MSCs were immediately transplanted via the tail vein (concentration: 1×106 cells). Exercise training (five days/week, 60 min/day; 60% of maximal running speed) started 24 hours after myocardial infarction and lasted for 12 weeks. RESULTS: Exercise capacity was higher in exercised than in sedentary groups. Animals in the SCMSC, EX and EXMSC groups exhibited better cardiac function than those in SC. Collagen content was lower in the SCMSC, EX and EXMSC groups than in SC and skeletal α-actin expression was lower in EX and EXMSC than in SC. The α/ß-MHC ratio was higher in EX and EXMSC than in SC. The combination of therapies further reduced collagen content in the remote region of the infarct (∼24%) and skeletal α-actin expression (∼30%). CONCLUSION: Aerobic exercise training appears to enhance the beneficial effects of stem cell therapy on remodeling of the extracellular matrix and fetal gene expression in the left ventricle of rats with moderate infarction.

Progression of aerobic exercise intensity in a cardiac rehabilitation program.

INTRODUCTION AND OBJECTIVES: To describe the progression of aerobic exercise intensity in patients on a cardiac rehabilitation (CR) program. METHODS: We conducted a retrospective analysis of a random sample of patients referred for CR after acute coronary syndrome between 2008 and 2016. The weekly peak exercise intensity achieved during aerobic exercise was estimated by treadmill speed and grade at peak effort and the corresponding perception of effort was assessed using the Borg scale. Initial exercise intensity was prescribed as 60-80% of reserve heart rate plus resting heart rate, and was modified according to perceived exertion. Peak heart rate/intensity and perceived exertion index were used as variables to characterize the response to the intensity achieved. Variables were compared at different time points: T1 (1st week), T2 (4th week) and T3 (8th week). RESULTS: Of the total of 868, 238 patients were randomly selected. At peak heart rate during the session, exercise intensity (in metabolic equivalents) was: T1: 7.2±2.0, T2: 9.0±2.2, and T3: 9.4±2.2 (p<0.01). The peak heart rate/intensity index was T1: 16.8±5.4, T2: 13.4±3.6 and T3: 13.1±3.8 (p<0.01) and the perceived exertion index was T1: 1.8±0.6; T2: 1.4±0.5; T3: 1.4±0.5 (p<0.01). CONCLUSIONS: Increasing exercise intensity during CR, associated with lower perception of effort and lower heart rate necessary to achieve such intensity, leads to significant improvement in functional capacity.

Evaluation of respiratory dynamics by volumetric capnography during submaximal exercise protocol of six minutes on treadmill in cystic fibrosis patients.

OBJECTIVES: Volumetric capnography provides the standard CO2 elimination by the volume expired per respiratory cycle and is a measure to assess pulmonary involvement. Thus, the objective of this study was to evaluate the respiratory dynamics of healthy control subjects and those with cystic fibrosis in a submaximal exercise protocol for six minutes on the treadmill, using volumetric capnography parameters (slope 3 [Slp3], Slp3/tidal volume [Slp3/TV], and slope 2 [Slp2]). METHODS: This was a cross-sectional study with 128 subjects (cystic fibrosis, 64 subjects; controls, 64 subjects]. Participants underwent volumetric capnography before, during, and after six minutes on the treadmill. Statistical analysis was performed using the Friedman, Mann-Whitney, and Kruskal-Wallis tests, considering age and sex. An alpha=0.05 was considered. RESULTS: Six minutes on the treadmill evaluation: in cystic fibrosis, volumetric capnography parameters were different before, during, and after six minutes on the treadmill; the same was observed for the controls, except for Slp2. Regarding age, an Slp3 difference was observed in cystic fibrosis patients regardless of age, at all moments, and in controls for age≥12 years; a difference in Slp3/TV was observed in cystic fibrosis and controls, regardless of age; and an Slp2 difference in the cystic fibrosis, regardless of age. Regarding sex, Slp3 and Slp3/TV differences were observed in cystic fibrosis regardless of sex, and in controls in male participants; an Slp2 difference was observed in the cystic fibrosis and female participants. The analysis between groups (cystic fibrosis and controls) indicated that Slp3 and Slp3/TV has identified the CF, regardless of age and sex, while the Slp2 showed the CF considering age. CONCLUSIONS: Cystic fibrosis showed greater values of the parameters before, during, and after exercise, even when stratified by age and sex, which may indicate ventilation inhomogeneity in the peripheral pathways in the cystic fibrosis.

Effects of physical activity on children's growth.

OBJECTIVE: To describe the current scientific knowledge on the effects of physical exercise on the growth of children and adolescents since intrauterine life. SOURCE OF DATA: A search was carried out in the Medline, Embase, Scielo, and Cochrane databases of studies published from 1990 to 2018. The authors included studies with different designs: clinical trials, cohort, cross-sectional and review studies. SYNTHESIS OF DATA: Studies that addressed the subject of physical exercise or physical activity, and weight-height growth or bone or muscle tissue growth were identified. These studies were analyzed, classified, and presented by age group: fetuses, preterm newborns, preschoolers, schoolchildren, and adolescents. It was observed that almost all studies indicated the safety of physical exercises, of mild to moderate intensity, for pregnant women, as well as children and adolescents, including both aerobic and anaerobic exercises. The retrieve studies did not demonstrate that the practice of physical exercises or certain sports, especially basketball and floor gymnastics, influenced the linear growth of children or adolescents. Some studies showed an increase in bone and muscle tissue growth in child and adolescent athletes. CONCLUSIONS: Despite the small number of studies with adequate methodology, especially randomized clinical trials, evidence appears to indicate that physical exercise is safe for both the pregnant woman and the child, from fetal life to adolescence. Physical exercise does not appear to impair the child's linear growth and contributes to the ideal shaping of bone and muscle tissues, ensuring possible beneficial effects throughout life.

Feasibility, safety, and adherence of a remote physical and cognitive exercise protocol for older women / Viabilidade, segurança e aderência de um protocolo remoto de exercícios físicos e cognitivos para mulheres idosas

Abstract Background Population aging and the consequences of social distancing after the COVID-19 pandemic make it relevant to investigate the feasibility of remote interventions and their potential effects on averting functional decline. Objective (1) To investigate the feasibility, safety, and adherence of a remote protocol involving physical and cognitive exercises for older women with normal cognition; (2) to examine its effects on cognitive and well-being variables. Methods Twenty-nine women (age ≥ 60 years old) were randomized into experimental group (EG; n= 15) and control group (CG; n= 14). The EG performed a 40-minute session of cognitive and physical exercises, and CG performed a 20-minute stretching session. Both groups performed 20 sessions via videoconference and 20 on YouTube twice a week. The Mini-Mental State Examination, Verbal Fluency Test, Digit Span (direct an inverse order), Geriatric Depression Scale (GDS), and Well-being Index (WHO-5) were applied in pre- and post-interventions by phone. Results Overall adherence was 82.25% in EG and 74.29% in CG. The occurrence of adverse events (mild muscle pain) was 33.3% in EG and 21.4% in CG. The EG improved verbal fluency and attention (p ≤ 0.05); both groups had improved depressive symptoms. Conclusion The present study met the pre-established criteria for feasibility, safety, and adherence to the remote exercise protocol among older women. The results suggest that a combined protocol has more significant potential to improve cognitive function. Both interventions were beneficial in improving the subjective perception of well-being.

Resumo Antecedentes O envelhecimento populacional e as consequências do isolamento social após a pandemia de COVID-19 tornaram relevante investigar a viabilidade, segurança e aderência de intervenções remotas e potenciais efeitos para prevenir declínios funcionais. Objetivo (1) Investigar a viabilidade, segurança e aderência de um protocolo remoto de exercícios físicos e cognitivos; (2) investigar os possíveis efeitos sobre variáveis de cognição e de bem-estar. Métodos Vinte e nove mulheres foram randomicamente divididas em grupo experimental (GE; n= 15) e grupo controle (GC; n= 14). O GE realizou sessões de 40 minutos de exercícios físicos e cognitivos e o GC, 20 minutos de alongamentos. Totalizaram 20 sessões por videoconferência e 20 pelo YouTube, duas vezes por semana. O Teste de Fluência Verbal, o Teste de Dígitos (ordem direta e inversa), a Escala de Depressão Geriátrica (GDS) e o Índice de Bem-Estar (WHO-5) foram aplicados no pré e pós-intervenção, por telefone e formulário digital. Resultados A aderência geral média foi de 82,25% no GE e 74,29% no GC. A ocorrência de eventos adversos (dores musculares leves) foi de 33,3% no GE e 21,4% no GC. O GE teve melhora em fluência verbal e atenção (p ≤ 0.05) e ambos os grupos tiveram melhora significativa nos sintomas depressivos. Conclusão O presente estudo atendeu aos critérios preestabelecidos para a viabilidade, segurança e aderência do programa oferecido entre idosas. Os resultados sugerem que o protocolo combinado tenha maior potencial de aprimorar funções cognitivas. Ambas as intervenções foram benéficas para a percepção subjetiva de bem-estar.

Exercise induction at expression immediate early gene (c-Fos, ARC, EGR-1) in the hippocampus: a systematic review / Indução de exercício físico na expressão do gene precoce imediato (c-Fos, ARC, EGR-1) no hipocampo: uma revisão sistemática

ABSTRACT. The immediate early gene exhibits activation markers in the nervous system consisting of ARC, EGR-1, and c-Fos and is related to synaptic plasticity, especially in the hippocampus. Immediate early gene expression is affected by physical exercise, which induces direct ARC, EGR-1, and c-Fos expression. Objective: To assess the impact of exercise, we conducted a literature study to determine the expression levels of immediate early genes (ARC, c-Fos, and EGR-1). Methods: The databases accessed for online literature included PubMed-Medline, Scopus, and ScienceDirect. The original English articles were selected using the following keywords in the title: (Exercise OR physical activity) AND (c-Fos) AND (Hippocampus), (Exercise OR physical activity) AND (ARC) AND (Hippocampus), (Exercise OR physical activity) AND (EGR-1 OR zif268) AND (Hippocampus). Results: Physical exercise can affect the expression of EGR-1, c-Fos, and ARC in the hippocampus, an important part of the brain involved in learning and memory. High-intensity physical exercise can increase c-Fos expression, indicating neural activation. Furthermore, the expression of the ARC gene also increases due to physical exercise. ARC is a gene that plays a role in synaptic plasticity and regulation of learning and memory, changes in synaptic structure and increased synaptic connections, while EGR-1 also plays a role in synaptic plasticity, a genetic change that affects learning and memory. Overall, exercise or regular physical exercise can increase the expression of ARC, c-Fos, and EGR-1 in the hippocampus. This reflects the changes in neuroplasticity and synaptic plasticity that occur in response to physical activity. These changes can improve cognitive function, learning, and memory. Conclusion: c-Fos, EGR-1, and ARC expression increases in hippocampal neurons after exercise, enhancing synaptic plasticity and neurogenesis associated with learning and memory.

RESUMO. O gene precoce imediato (GPI) exibe marcadores de ativação no sistema nervoso constituídos por ARC, EGR-1 e c-Fos e está relacionado à plasticidade sináptica, especialmente no hipocampo. A expressão do GPI é afetada pelo exercício físico, que induz a expressão direta de ARC, EGR-1 e c-Fos. Objetivo: Para avaliar o impacto do exercício físico, realizamos um estudo de literatura para determinar os níveis de expressão dos GPIs (ARC, c-Fos e EGR-1). Métodos: A base de dados utiliza literatura on-line, PubMed-Medline, Scopus e ScienceDirect. O artigo original em inglês usa as seguintes palavras-chave em seu título: (Exercise) AND (c-Fos) AND (Hippocampus), (Exercise) AND (ARC) AND (Hippocampus), (Exercise) AND (EGR-1) AND (Hippocampus). Resultados: O exercício físico pode afetar a expressão de EGR-1, c-fos e ARC no hipocampo, uma parte importante do cérebro envolvida na aprendizagem e na memória. O exercício físico aumenta a expressão do gene c-Fos; sua alta intensidade pode aumentar a expressão de c-Fos, indicando ativação neural. Além disso, a expressão do gene ARC aumentou devido ao exercício físico, onde ARC é um gene que desempenha um papel na plasticidade sináptica e na regulação da aprendizagem e da memória, nas mudanças na estrutura sináptica e no aumento das conexões sinápticas, enquanto o EGR-1 também desempenha um papel na plasticidade sináptica, uma mudança genética que afeta o aprendizado e a memória. De maneira geral, o exercício físico regular pode aumentar a expressão de ARC, c-fos e EGR-1 no hipocampo. Isso reflete as mudanças na neuroplasticidade e na plasticidade sináptica que ocorrem em resposta à atividade física. Essas mudanças podem melhorar a função cognitiva, o aprendizado e a memória. Conclusão: A expressão de c-Fos, EGR-1 e ARC aumenta após o exercício físico nos neurônios do hipocampo, para aumentar a plasticidade sináptica, a neurogênese associada ao aprendizado e à memória.

Métodos de exercícios físicos para pessoas idosas com Alzheimer e os fatores que dificultam a sua prática: uma revisão sistemática / Methods of physical exercise for older adults with Alzheimer's and the factors that hinder its practice: a systematic review

Resumo Objetivo Verificar o impacto da participação de programas de exercícios físicos em pessoas idosas com doença de Alzheimer (DA) e os fatores que comprometem a sua prática. Método Trata-se de uma revisão sistemática nas bases de dados United States National Library of Medicine (PubMed), Web of Science, Scopus, Biblioteca Scientific Electronic Library Online (SciELO); LILACS e Embase, a partir de 2014. Utilizaram-se as diretrizes do PRISMA - 2020 e a análise de risco de viés com o apoio da ferramenta Cochrane (RoB2). Resultados Foram incluídos onze estudos para análise qualitativa. O comprometimento da memória episódica ocasiona um declínio na DA e envolve uma complexidade de processos cognitivos contendo múltiplos aspectos do sistema neural Conclusão A depressão, a ansiedade e a dificuldade de compreensão são os principais fatores que comprometem a participação da pessoa idosa com Alzheimer aos exercícios com o propósito de estímulo físico, e são os principais preditores que dificultam o desenvolvimento perceptivo-motor. Os protocolos com exercícios combinados parecem favorecer melhor a função executiva no paciente com DA. A conscientização do exercício físico é fundamental desde o início dos tratamentos, com a sugestão de se priorizar melhorias na atenção das pessoas idosas com DA. As particularidades da relação entre as atividades da vida diária e a capacidade funcional do paciente com Alzheimer ainda correspondem a uma lacuna a ser explorada, assim como a prescrição de exercícios específicos que considerem tanto o grau de atenção quanto o nível da doença.

Abstract Objective To assess the impact of participation in physical exercise programs among older adults with Alzheimer's disease (AD) and the factors that compromise its practice. Method This study constitutes a systematic review conducted across the databases of the United States National Library of Medicine (PubMed), Web of Science, Scopus, Scientific Electronic Library Online (SciELO), LILACS, and Embase, starting from 2014. The PRISMA - 2020 guidelines were employed, alongside bias risk analysis supported by the Cochrane (RoB2) tool. Results Eleven studies were included for qualitative analysis. The impairment of episodic memory leads to a decline in AD and involves a complexity of cognitive processes encompassing multiple aspects of the neural system. Conclusion Depression, anxiety, and difficulty in comprehension are the primary factors that compromise the participation of older adults with Alzheimer's in exercises aimed at physical stimulation, and they are the main predictors hindering perceptual-motor development. Protocols involving combined exercises appear to better promote executive function in patients with AD. Awareness of physical exercise is fundamental from the outset of treatments, with the suggestion to prioritize improvements in attention for older adults with AD. The particularities of the relationship between activities of daily living and the functional capacity of Alzheimer's patients still represent a gap to be explored, as well as the prescription of specific exercises that consider both the level of attention and the stage of the disease.

People's perception of the impact of parks on increasing physical activity in the community / Percepção das pessoas acerca do impacto dos parques no aumento da atividade física da comunidade

The present study aimed to analyze the probability of people's responses about the impact of parks on increasing physical activity in the community. Data was collected with park goers and a total of 427 participants responded to the structured questionnaire with a scale ranging from 1 (not at all) to 10 (totally). Data was analyzed using multilevel ordinal regression analysis considering the variability by gender, civil state, distance from the park, education, age group, living time in the city, time spent by the users in the park and wage. Participants presented similar probabilities of responses. There were found tendencies of lower impact of the parks in older (> 60 years old) and single people as well as in people living further from the parks (> 6km). The high probabilities of responses were for values 8, 9 and 10. We can conclude people have a perception of the high impact of the parks on increasing physical activity in the community. This study contributes to encourage stakeholders to act in favor of public open spaces and to develop more action in the spaces that already exist.

O presente estudo teve como objetivo analisar a probabilidade de respostas das pessoas sobre o impacto dos parques no aumento da atividade física na comunidade. Os dados foram coletados com frequentadores do parque e um total de 427 participantes responderam ao questionário estruturado (escala que varia de 1 a 10). Os dados foram analisados por meio de análise de regressão ordinal multinível considerando a variabilidade por gênero, estado civil, distância do parque, escolaridade, faixa etária, tempo de residência na cidade, tempo de permanência dos usuários no parque e salário. Os participantes apresentaram probabilidades de respostas semelhantes. Foram encontradas tendências de menor impacto dos parques em pessoas mais velhas (> 60 anos) e solteiras, bem como em pessoas que vivem mais longe dos parques (> 6km). As maiores probabilidades foram de responder os maiores valores do questionário (valores 8, 9 e 10). Podemos concluir que as pessoas têm uma percepção do alto impacto dos parques no aumento da atividade física na comunidade. Este estudo contribui para incentivar as partes interessadas a agir em prol dos espaços públicos abertos e desenvolver mais ações nos espaços já existentes.

O benefício da atividade/exercício físico regular na gestação de alto risco: uma revisão bibliométrica / The benefits of regular physical activity/exercise in high-risk pregnancies: a bibliometric review / Los beneficios de la actividad física/ejercicio regular en el embarazo de alto riesgo: una revisión bibliométrica

Objetivo: quantificar e analisar as principais características da produção científica sobre o benefício da atividade/ exercício físico durante a gestação de alto risco entre os anos de 2013 e 2023. Método: trata-se de um estudo quantitativo, do tipo bibliométrico, cuja proposta principal é analisar a produção científica através da observação quantitativa das publicações, desenvolvendo indicadores estatísticos confiáveis para determinada temática estudada. Resultados: foram analisados 316 artigos. Observou-se que o maior número de publicações sobre o tema foram realizadas no ano de 2022 com 51 (16,13%) artigos, seguido do ano de 2021 com 38 (12%) artigos e 2020 com 37 (11,7%) artigos publicados, o que corresponde a uma taxa de crescimento anual de publicação de 4,62%. Conclusão: os estudos precisam continuar sendo desenvolvidos para que as recomendações sejam constantemente atualizadas e contribuindo para a qualidade de vida materno infantil.

Objective: to quantify and analyze the main characteristics of scientific production on the benefits of physical activity/exercise during high-risk pregnancies between 2013 and 2023. Method: this is a quantitative bibliometric study, the main purpose of which is to analyze scientific production through the quantitative observation of publications, developing reliable statistical indicators for a given subject. Results: 316 articles were analyzed. It was observed that the largest number of publications on the subject were made in 2022 with 51 (16.13%) articles, followed by 2021 with 38 (12%) articles and 2020 with 37 (11.7%) articles published, which corresponds to an annual publication growth rate of 4.62%. pregnancies over the years. Conclusion: studies need to continue to be developed so that recommendations are constantly updated and contribute to maternal and child quality of life.

Objetivo: cuantificar y analizar las principales características de la producción científica sobre los beneficios de la actividad física/ejercicio durante los embarazos de alto riesgo entre 2013 y 2023. Metodo: se trata de un estudio bibliométrico cuantitativo, cuyo objetivo principal es analizar la producción científica a través de la observación cuantitativa de las publicaciones, desarrollando indi-cadores estadísticos fiables para un tema determinado. Resultados: se analizaron 316 artículos. Se observó que el mayor número de publicaciones sobre el tema se realizó en 2022 con 51 (16,13%) artículos, seguido de 2021 con 38 (12%) artículos y 2020 con 37 (11,7%) artículos publicados, lo que corresponde a una tasa de crecimiento anual de publicación de 4,62%. Conclusión: es necesario continuar desarrollando estudios para que las recomendaciones sean constantemente actualizadas y contribuyan para la calidad de vida materna e infantil.