Effect of Telerehabilitation on Pulmonary Function, Functional Capacity, Physical Fitness, Dyspnea, Fatigue, and Quality of Life in COVID-19 Patients: A Systematic Review and Metanalysis.

Background: This study aimed to demonstrate the technological means used to offer telerehabilitation and to evaluate the effect of physical exercise on the population affected by COVID-19. Methods: Clinical trials were searched in the electronic databases Cochrane Library, PubMed/MEDLINE, EBSCO (CINAHL), PEDro, and Web of Science from January 16 to 19, 2023. The effect measure was estimated as mean difference (MD) or standard MD (SMD) with 95% confidence intervals (CI). Subgroup analysis was used to study potential moderating factors. Results: Twenty-four articles, describing trials with a total of 1,344 individuals affected by COVID-19, were included in the qualitative synthesis and 14 articles in the meta-analysis. The pooled results revealed that telerehabilitation improves the functional capacity (MD 79.65 [63.57, 95.73]m, p < 0.00001), agility (MD -0.69 [-1.33, -0.04] s, p = 0.04), lower limb strength and endurance (SMD 0.74 [0.52, 0.96], p < 0.00001), forced expiratory volume in 1 s (MD 0.22 [-0.04, 0.49] L, p = 0.10), and dyspnea (SMD -0.94 [-1.64, -0.24], p = 0.009). The dynamic muscular resistance training associated or not with other exercise modalities led to improvements in muscular strength (MD 4.69 [0.44, 8.94] kg, p = 0.03) and fatigue (SMD -0.97 [-1.74, -0.20], p = 0.01). In addition, telerehabilitation showed improvements in the quality of life in the contagious-phase COVID-19 patients. Although this intervention improved inspiratory muscle strength (MD 13.71 [5.41, 22.0] cmH2O, p = 0.001), it did not favor forced vital capacity. Conclusions: Telerehabilitation contributed to improving functional capacity, inspiratory muscle strength, physical fitness, and quality of life, and reducing dyspnea and fatigue in COVID-19 adult survivors.

Sono, ansiedade e depressão e atividade física em profissionais de saúde durante a pandemia de COVID-19 / Sleep, anxiety and depression and physical activity in healthcare professionals during COVID-19 pandemic

Verificar associações entre parâmetros do sono, sintomas de ansiedade e depressão e nível de atividade física (NAF) em profissionais de saúde da linha de frente COVID-19. Foram avaliados qualidade do sono (QS), sonolência diurna excessiva (SDE), sintomas de ansiedade e depressão e NAF. Houve correlações entre QS e ansiedade (p < 0,001) e depressão (p < 0,001) e entre SDE e ansiedade (p < 0,05) e depressão (p < 0,05). Não houve correlações entre o NAF e QS (p > 0,05) e SDE (p > 0,05). Houve associação entre QS e sintomas de ansiedade (p= 0,005) e depressão (0,014). Não houve associação entre a SDE e sintomas de ansiedade e depressão. Em profissionais de saúde na linha de frente durante a pandemia de COVID-19, os sintomas de ansiedade e depressão foram preditores da QS. Não foi observada associação entre SDE e sintomas de ansiedade e depressão.

To verify associations between sleep parameters, anxiety and depression symptoms and physical activity level in healthcare professionals during COVID-19 pandemic. We evaluated sleep quality (SQ), excessive daytime sleepiness (EDS), anxiety and depression symptoms and physical activity level (PAL) in healthcare professionals who worked during COVID-19 pandemic in Recife-Brazil. Correlations were observed between SQ and anxiety (p < 0.001) and depression (p < 0.001), as well between EDS and anxiety: p < 0.05) and depression (p < 0 .05). No correlations were found between PAL and sleep parameters (QS: p > 0.05) (EDS: p > 0.05). No association was observed between SQ and anxiety (p = 0.005) and depression (p = 0.014). No association was found between EDS and anxiety and depression symptoms. In healthcare professionals during COVID-19 pandemic, anxiety and depression symptoms are predictors of sleep quality. No association was found between anxiety and depression symptoms and EDS.

Atividade física, autocuidado e qualidade de vida em diabéticos Tipo 2 na pandemia de COVID-19 / Physical activity, self-care, and quality of life in Type 2 diabetic in the COVID-19 pandemic

Avaliar fatores associados ao nível de atividade física durante a pandemia daCOVID-19em indivíduos com diabetes mellitus tipo 2 (DM2).Estudo transversal, envolvendo 211 pessoas com DM2 e idade ≥ 45 anos, utilizando o Google Forms para coletar informações: dados pessoais,Questionário Internacional de Atividade Física (IPAQ), Inventário de Autocuidado (SCI-R) e Versão Brasileira da Escala PAID (B-PAID). Houve prevalência do diagnóstico do DM2 acima de 10 anos (42,1%); no geral, eram ativos (55,2%), com alto sofrimento emocional (52,6%) e com baixo autocuidado (71,6%). Foi observada associação do nível de atividade física e a percepção de saúde [IC 95% OR = 2,421-1,264;p < 0,008) e o nível de atividade física e a insônia (OR = 0,410-0,196;(p < 0,018). O maior nível de atividade física foi associado à autopercepção de saúde positiva e à insônia.

To evaluate factors associated with the level of physical activity during the COVID-19 pandemic in individuals with type 2 diabetes mellitus (DM2). Cross-sectional study, involving 211 people with DM2 aged ≥ 45 years, using Google Forms to collect information: personal data, International Physical Activity Questionnaire (IPAQ), Self-Care Inventory (SCI-R) and Brazilian version of the PAID Scale (B-PAID). There was a prevalence of DM2 diagnosis over 10 years (42.1%); in general, they were active (55.2%), with high emotional distress (52.6%) and low self-care (71.6%). There was an association between the level of physical activity and perceived health [95% CI OR = 2.421-1.264; p < 0.008) and the level of physical activity and insomnia (OR = 0.410-0.196; (p < 0.018). A higher level of physical activity was associated with positive self-perception of health and insomnia.

Associação entre parâmetros do sono e atividade física em corredores durante a pandemia de COVID-19 / Association between sleep parameters and physical activity in runners during the COVID-19 pandemic

Determinar associação entre qualidade do sono (QS), sonolência diurna excessiva (SDE) e a atividade física (AF) em corredores de rua durante a pandemia deCOVID-19. Em86 voluntários, as seguintes variáveis foram avaliadas: QS (pelo Índice de Qualidade do Sono de Pittsburgh, ESE (pelaEscala de Sonolência de Epworth) e a AF (pelo aplicativo Google Fit®).Utilizou-se o teste de correlação de Pearson ou teste de correlação de Spearman. A análise de regressão linear simples foi realizada entre as variáveis que apresentaram correlação. Consideraram-se significantes os valores de p<0,05. Houve correlação entre a SDE e a contagem de passos, bem como entre a SDE e a AF. Verificou-se associação entre a SDE e a AF, mas não entre a QS e a AF.

To determine the association between sleep quality (SQ), excessive daytime sleepiness (EDS) and physical activity (PA) in amateur street runners during the COVID-19pandemic. Eighty-six volunteers were evaluated, and the analyzed variables were: SQ (By Pittsburgh Sleep Quality Index), EDS (By Epworth Sleepiness Scale), and PA (By the Google Fit® app). The data was collected remotely, via email, using Google Forms. Pearson correlation test or Spearman correlation test was used for data correlation. Simple linear regression analysis was performed between variables that showed correlation. P values < 0.05 were considered significant. There was a correlation between EDS and step count [r (p) = 0.219 (0.042)], and only an association between PA and EDS was observed. Based on the results, an association was found between EDS and PA. However, no association was found between SQ and PA.

What do cochrane systematic reviews say about interventions for enuresis in children and adolescents? An overview of systematic reviews.

OBJECTIVE: To conduct an overview of Cochrane systematic reviews about treatment alternatives for children and/or adolescents with enuresis. SOURCES: An overview of Cochrane systematic reviews about interventions for enuresis in children/adolescents was developed between September/2021 and December/2021. The protocol was registered on PROSPERO and the search was conducted only in the Cochrane Library database without any restriction. Reviews involving any type of intervention for the treatment of enuresis in children/adolescents were included. The risk of bias was assessed using Risk of Bias in Systematic Reviews (ROBIS) and the quality of reviews was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2). SUMMARY OF THE FINDINGS: Seven systematic reviews were identified. Based on the ROBIS assessment, all reviews were classified as low risk of bias. According to the AMSTAR-2 assessment, the three oldest systematic reviews were rated as critically low quality, one review was moderate quality, and the three most recent systematic reviews were rated as high quality. No difference was shown between alarm and desmopressin for a complete response to therapy after treatment (RR = 1.30; 95%CI: 0.92 to 1.84), but alarm use is related to a lower risk of adverse events (RR = 0.38; 95%CI: 0.20 to 0.71). There is a moderate certainty that the association between imipramine and oxybutynin is better than placebo to reduce the risk of children who do not achieve 14 consecutive dry nights after treatment (RR = 0.43; 95%CI: 0.23 to 0.78). CONCLUSIONS: There is no difference between alarm and desmopressin for enuresis treatment. However, alarm therapy had fewer adverse events than desmopressin. Moreover, combination therapy between imipramine and oxybutynin is better than placebo.

Prevalence of predictive factors for obstructive sleep apnea in university students.

Objectives: To identify predictive factors for obstructive sleep apnea in university students. Material and Methods: Analytical, observational, cross-sectional study, conducted from August 2018 to February 2019. 144 students of both genders, informed of purposes and procedures, signed consent forms to participate. Procedures included measuring body mass index, abdominal, and neck circumference; inspecting tongue and oropharynx with Mallampati modified classification; answering Berlin questionnaire. Results: 63.9% had normal body mass index; 19.4% were overweight. 59.7% had normal abdominal circumference; 89.6%, normal neck circumference. 65.3% presented Mallampati class I V. 74.3% indicated no obstructive sleep apnea; 25.7% were at high risk. High risk for obstructive sleep apnea associated with body mass index (p<0.001), abdominal (p=0.006), and neck circumference (p<0.001). Discussion: Anthropometries were mostly normal, despite the high prevalence of changed Mallampati classification. Positively correlated predictive factors, also associated with high risk for obstructive sleep apnea, reinforce the need for such preventive measures in youth.

Clinical safety and hemodynamic, cardiac autonomic and inflammatory responses to a single session of inspiratory muscle training in obstructive sleep apnea.

PURPOSE: To determine clinical safety and cardiovascular, cardiac autonomic and inflammatory responses to a single session of inspiratory muscle training (IMT) in obstructive sleep apnea (OSA) subjects. METHODS: In a randomized controlled trial individuals of both sexes, aged between 30 and 70 years old with diagnosis of moderate to severe OSA were enrolled. Volunteers with OSA (n = 40) performed an IMT session with three sets of 30 repetitions with a 1-min interval between them. The IMT group (n = 20) used a load of 70% of the maximum inspiratory pressure (MIP), and the placebo group (n = 20) performed the IMT without load. Measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), heart rate variability (HRV), and inflammatory markers were performed pre, post-immediate and 1 h after the IMT session. RESULTS: No differences were shown in SBP, DBP, HRV, or inflammatory markers at any of the intervals analyzed. However, HR in the IMT group was lower ​​1 h after the IMT session compared to the pre-session values ​​(p = 0002). HR was higher in the placebo group when comparing pre × post-immediate (p < 0.001). HR decreased after the first hour in relation to the pre (p < 0.001) and post-immediate (p < 0.001) values. CONCLUSION: IMT sessions promote discreet hemodynamic, cardiac autonomic and inflammatory responses. Therefore, IMT is considered clinically safe and can be performed at home, guided but unsupervised, with lower cost and greater adherence to exercise program for subjects with OSA.

Oxygen uptake efficiency slope: A submaximal test evaluation tool that provides cardiopulmonary reserve data in individuals with Parkinson's disease.

BACKGROUND: Oxygen uptake efficiency slope (OUES) is a method for investigating cardiorespiratory fitness and is proposed as an alternative to overcome the limitations of traditional measures such as peak oxygen consumption (VO2peak) for patients who do not achieve a maximum response, such as in Parkinson's disease (PD). OBJECTIVE: To assess the performance of individuals with PD during the six-minute walk test (6MWT) using the OUES. METHODS: This is an observational cross-sectional study including 12 individuals with PD and 12 healthy controls. Participants performed the 6MWT along with an analysis of exhaled gas kinetics. The OUES was determined from the last 16 s of the walk test. Multiple linear regression analyses were computed to explore associations between the independent (OUES) and the dependent variables (VO2peak) controlled by group. RESULTS: The OUES was associated to VO2peak on the 6MWT (ß=0.24, p<0.01) in individuals with PD. The PD group had low performance on the 6MWT with a shorter distance walked (mean difference: -113.1 m; 95% CI: -203.2, -59.1) and worse cardiopulmonary condition with lower OUES values (mean difference: -0.52 [l/minO2]/[l/minVE]; 95% CI: -0.83, -0.21) found in this same group. CONCLUSIONS: Our results suggest that OUES is related to VO2peak during the 6MWT, and therefore it could be used as a submaximal test evaluation tool which provides cardiopulmonary reserve data in individuals with PD.

Inspiratory Muscle Training in the Severity of Obstructive Sleep Apnea, Sleep Quality and Excessive Daytime Sleepiness: A Placebo-Controlled, Randomized Trial.

PURPOSE: Exercise programs have been considered as an adjuvant treatment in obstructive sleep apnea (OSA). However, few studies have focused on the effects of the inspiratory muscle training (IMT) in reducing the severity and the symptoms of OSA. PATIENTS AND METHODS: A randomized controlled trial was conducted and approved by the local Ethics Committee. All subjects signed the informed consent form and were randomized into 2 groups: a) IMT group (n = 8), 8 weeks of IMT with 75% of maximal inspiratory pressure (MIP) and b) placebo group (n = 8): subjects performed IMT without load. RESULTS: IMT group showed reduction in the apnea-hypopnea index (AHI) (p = 0.01), in the Berlin questionnaire score (p = 0.001) and an increase in inspiratory muscle strength (p = 0.018). IMT group demonstrated a reduction in the AHI (31.7 ± 15.9 events/h vs 29.9 ± 15.8 events/h; p <0.001), in the Berlin questionnaire scores (2.6 ± 0.5 vs 1.2 ± 0.5; p = 0.016), Pittsburgh Sleep Quality Index (PSQI) score (7.2 ± 3.6 vs 3.7 ± 1.3; p = 0.008), in the Epworth Sleepiness Scale (ESS) (12.5 ± 4.0 vs 7.7 ± 3.0; p = 0.008) and increase in MIP (83.6 ± 26.5 cmH2O and 127.9 ± 32.5 cmH2O; p = 0.010). CONCLUSION: The IMT promotes discrete changes in the AHI and improves sleep quality and excessive daytime sleepiness in OSA. Moreover, IMT is a cheap, useful and simple home-based training program and can be considered as an adjunct therapy for OSA patients.

Construct validity and reproducibility of the six-minute step test in subjects with obstructive sleep apnea treated with continuous positive airway pressure.

OBJECTIVE: To evaluate the construct validity and reproducibility of the six-minute step test (6MST) in individuals with obstructive sleep apnea (OSA) treated with continuous positive airway pressure (CPAP). METHODS: We evaluated 48 volunteers diagnosed with OSA and treated with CPAP for at least two months. The volunteers underwent the six-minute walk test (6MWT) and the 6MST, in random order and on different days, with an interval of, at most, seven days between the two tests. RESULTS: A moderate positive correlation was found between the distance walked on the 6MWT and the number of steps climbed on the 6MST (r = 0.520; p < 0.001). There was no significant difference between the two 6MSTs in terms of the number of steps climbed (121.7 ± 27.1 vs. 123.6 ± 26.7). Reproducibility for performance on the 6MST and for cardiovascular variables was considered excellent (intraclass correlation coefficient > 0.8). Regarding cardiovascular responses, the 6MST produced higher values than did the 6MWT for HR at six minutes, percent predicted maximum HR, and leg fatigue at six minutes, as well as for systolic blood pressure at six minutes and at one minute of recovery. CONCLUSIONS: The 6MST is valid and reproducible, producing greater cardiovascular stress than does the 6MWT. However, the 6MST is also characterized as a submaximal test for the assessment of exercise tolerance in individuals with OSA treated with CPAP.

"Posterior Tibial Nerve" or "Tibial Nerve"? Improving the reporting in health papers.

AIMS: The primary objective of this study is to identify which term is the most appropriate to use according to anatomical nomenclature: "posterior tibial nerve" or "tibial nerve." Furthermore, this paper intends to show how the use of these terms in papers indexed in important health databases is numerous and to describe the anatomical characteristics of such nerve, to improve future scientific publications. METHODS: This is a descriptive study about the importance of standardizing the use of the terms "posterior tibial nerve" and "tibial nerve" and its anatomy. It comprises three phases: the first is a search in the main databases to identify the use of the terms "posterior tibial nerve" and "tibial nerve." The second phase refers to the consultation of international anatomical terminology to identify the most appropriate term to refer to the nerve, while the third phase is related to the study of the anatomy of this nerve. RESULTS: The term "tibial nerve" is more commonly used, but the use of the term "posterior tibial nerve" is still very substantial. According to international anatomical terminology, the correct term is "tibial nerve," which is a branch of the sciatic nerve. CONCLUSIONS: "Tibial nerve" is the term standardized by international anatomical terminology. The use of terms in accordance with Terminologia Anatomica is important to facilitate the process of teaching and learning, as well as to improve the reporting and interpretation of papers regarding health, and the evidence-based clinical practice.

Construct validity and reproducibility of the six-minute step test in subjects with obstructive sleep apnea treated with continuous positive airway pressure / Validação de constructo e reprodutibilidade do teste de degrau de seis minutos em indivíduos com apneia obstrutiva do sono tratados com pressão positiva contínua nas vias aéreas

ABSTRACT Objective: To evaluate the construct validity and reproducibility of the six-minute step test (6MST) in individuals with obstructive sleep apnea (OSA) treated with continuous positive airway pressure (CPAP). Methods: We evaluated 48 volunteers diagnosed with OSA and treated with CPAP for at least two months. The volunteers underwent the six-minute walk test (6MWT) and the 6MST, in random order and on different days, with an interval of, at most, seven days between the two tests. Results: A moderate positive correlation was found between the distance walked on the 6MWT and the number of steps climbed on the 6MST (r = 0.520; p < 0.001). There was no significant difference between the two 6MSTs in terms of the number of steps climbed (121.7 ± 27.1 vs. 123.6 ± 26.7). Reproducibility for performance on the 6MST and for cardiovascular variables was considered excellent (intraclass correlation coefficient > 0.8). Regarding cardiovascular responses, the 6MST produced higher values than did the 6MWT for HR at six minutes, percent predicted maximum HR, and leg fatigue at six minutes, as well as for systolic blood pressure at six minutes and at one minute of recovery. Conclusions: The 6MST is valid and reproducible, producing greater cardiovascular stress than does the 6MWT. However, the 6MST is also characterized as a submaximal test for the assessment of exercise tolerance in individuals with OSA treated with CPAP.

RESUMO Objetivo: Avaliar a validade do constructo e a reprodutibilidade do teste de degrau de seis minutos (TD6) em indivíduos com apneia obstrutiva do sono (AOS) tratados com continuous positive airway pressure (CPAP, pressão positiva contínua nas vias aéreas). Métodos: Foram avaliados 48 voluntários com diagnóstico de AOS e tratados com CPAP há, no mínimo, dois meses. Os voluntários foram submetidos ao teste de caminhada de seis minutos (TC6) e ao TD6, em ordem aleatória e em dias diferentes, com um intervalo de, no máximo, sete dias entre os dois testes. Resultados: Foi observada uma correlação positiva moderada entre a distância percorrida no TC6 e o número de subidas no TD6, (r = 0,520; p < 0,001). Não foram encontradas diferenças significativas no número de subidas entre os dois TD6 (121,7 ± 27,1 vs. 123,6 ± 26,7 degraus). A reprodutibilidade para o desempenho no TD6 e para as variáveis cardiovasculares foi considerada excelente (coeficiente de correlação intraclasse > 0,8). Com relação às respostas cardiovasculares, quando comparado ao TC6, o TD6 apresentou maiores valores em relação a FC no sexto minuto, percentual do predito da FC máxima, fadiga de membros inferiores no sexto minuto e pressão arterial sistólica no sexto minuto e no primeiro minuto da fase de recuperação. Conclusões: O TD6 é válido, reprodutível e causa maior estresse cardiovascular quando comparado ao TC6. No entanto, o TD6 também se caracteriza como um teste submáximo para a avaliação da tolerância ao esforço em indivíduos com AOS tratados com CPAP.

Influence of obesity in pulmonary function and exercise tolerance in obese women with obstructive sleep apnea.

OBJECTIVE: To evaluate the influence of obesity on pulmonary function and exercise tolerance in women with obstructive sleep apnea (OSA). SUBJECTS AND METHODS: A descriptive analytic cross- sectional study was carried out. Thirty-nine (39) sedentary climacteric women, aged 45 to 60 years, were evaluated and submitted to polysomnography. The participants were divided into 4 groups: a) 'eutrophic non-OSA' (n = 13); b) 'eutrophic OSA' (n = 5); c) 'obese non-OSA' (n = 6); d) 'obese OSA' (n = 15). All subjects underwent clinical and anthropometric evaluation, followed by pulmonary function tests and 6-minute walk test (6MWT). RESULTS: There was a significant difference in the predicted percentage values of FEV1/FVC when comparing 'eutrophic OSA' and 'obese OSA' (97.6% ± 6.1% vs. 105.7% ± 5.7%, respectively; p = 0.025). The other spirometric variables did not show any differences between the studied groups. There was no significant difference in the maximum distance walked when the 'eutrophic non-OSA', 'eutrophic OSA', 'obese non-OSA' and 'obese OSA' groups were compared. CONCLUSION: Considering the results of this study, OSA itself did not influence pulmonary function or functional capacity parameters compared to eutrophic women. However, not only isolated obesity but also obesity associated with OSA can negatively impact sleep quality and lung function.

Influence of obesity in pulmonary function and exercise tolerance in obese women with obstructive sleep apnea

ABSTRACT Objective: To evaluate the influence of obesity on pulmonary function and exercise tolerance in women with obstructive sleep apnea (OSA). Subjects and methods: A descriptive analytic cross- sectional study was carried out. Thirty-nine (39) sedentary climacteric women, aged 45 to 60 years, were evaluated and submitted to polysomnography. The participants were divided into 4 groups: a) 'eutrophic non-OSA' (n = 13); b) 'eutrophic OSA' (n = 5); c) 'obese non-OSA' (n = 6); d) 'obese OSA' (n = 15). All subjects underwent clinical and anthropometric evaluation, followed by pulmonary function tests and 6-minute walk test (6MWT). Results: There was a significant difference in the predicted percentage values of FEV1/FVC when comparing 'eutrophic OSA' and 'obese OSA' (97.6% ± 6.1% vs. 105.7% ± 5.7%, respectively; p = 0.025). The other spirometric variables did not show any differences between the studied groups. There was no significant difference in the maximum distance walked when the 'eutrophic non-OSA', 'eutrophic OSA', 'obese non-OSA' and 'obese OSA' groups were compared. Conclusion: Considering the results of this study, OSA itself did not influence pulmonary function or functional capacity parameters compared to eutrophic women. However, not only isolated obesity but also obesity associated with OSA can negatively impact sleep quality and lung function.

Comparison of nasal geometry among adults with obstructive sleep apnea: a preliminary study / Comparação da geometria nasal entre adultos com apneia obstrutiva do sono: estudo preliminar

ABSTRACT Purpose: to compare nasal geometry between two groups of patients with different degrees of obstructive sleep apnea and to correlate apnea-hypopnea index, apnea severity and degree of daytime sleepiness with nasal areas and volume. Methods: a total of 20 adults (15 women and 5 men, mean age of 52.0±11.4 years old) without nasal obstruction were submitted to polysomnography. The subjects were divided into two groups: a) 10 individuals without apnea or with mild-grade apnea; b) 10 with moderate or severe apnea. Nasal geometry was evaluated by acoustic rhinometry. The volume, comprising the distance from the nasal valve to the posterior part of the middle nasal turbinate, and the three sectional areas corresponding to nasal valve, anterior part of the inferior nasal turbinate and posterior part of the inferior nasal turbinate, were considered. The Shapiro-Wilk, Mann-Whitney, Student's t tests for independent samples and Spearman's correlation coefficient were used for the analysis, with a significance level lower than 5%. Results: group 2 presented lower values in the area corresponding to the nasal valve (on the right), and higher values in the nasal turbinate areas. There was no correlation between the drowsiness scale and nasal areas and volumes. Conclusion: the area of the nasal valve was unilaterally smaller in the group with moderate and severe apnea. There was no correlation between volumes and nasal areas and excessive daytime sleepiness.

RESUMO Objetivo: comparar a geometria nasal entre dois grupos de pacientes com diferentes graus de apneia obstrutiva do sono e correlacionar índice e gravidade da apneia e grau de sonolência diurna com áreas e volume nasais. Métodos: 20 adultos (15 mulheres e 5 homens - idade média de 52,0±11,4 anos) sem obstrução nasal, submetidos à polissonografia e divididos em dois grupos: a) dez indivíduos sem ou com apneia em grau leve; b) dez com apneia moderada ou grave. A geometria nasal foi avaliada por rinometria acústica. Foram considerados o volume (distância da válvula nasal até a parte posterior da concha nasal média) e as três áreas seccionais: válvula nasal, parte anterior e parte posterior da concha nasal inferior. Foram aplicados os testes de Mann-Whitney e t de Student para amostras independentes e coeficiente de correlação de Spearman, com nível de significância de 5%. Resultados: o grupo 2 apresentou valores menores na área da válvula nasal, à direita, e maiores valores nas áreas das conchas nasais. Não houve correlação entre escala de sonolência e geometria nasal. Conclusão: a área da válvula nasal foi menor, unilateralmente, no grupo com apneia moderada e grave. Não houve correlação entre volumes e áreas nasais e sonolência diurna excessiva.

O treinamento aeróbio melhora o sono de estudantes universitários? / Aerobic exercise training improves sleep in college students?

Introdução: O sono é um estado fisiológico complexo e essencial. A qualidade do sono pode ser melhorada através da prática regular de exercício. Objetivo: Determinar a eficácia do treinamento aeróbio sobre a qualidade do sono (QS) e a sonolência diurna excessiva (SDE) em estudantes universitários. Métodos: 16 voluntários, divididos em grupo controle (GC; n=8) e grupo treinado (GT; n=8). O GT realizou 8 semanas de treinamento aeróbio e em ambos os grupos foram avaliados a QS, utilizando o índice de qualidade do sono de Pittsburgh (PSQI) e a SDE, através da escala de sonolência de Epworth (ESE). Resultados: O GT apresentou menor escore de PSQI comparado ao GC. Sobre a SDE, na comparação intragrupos, não houve alteração em nenhum dos grupos. Conclusão: De acordo com os resultados, o treinamento aeróbio de intensidade moderada melhora a qualidade do sono, porém parece não afetar a sonolência diurna excessiva.

Introduction: Sleep is an essential and complex physiological state. Sleep quality can be improved through regular exercise practice. Objective: To determine the effectiveness of moderate aerobic training on sleep quality (SQ) and excessive daytime sleepiness (EDS) in college students. Methods: 16 volunteers, divided in 2 groups: control group (CG; n = 8), no intervention, and training group (TG; n = 8) that performed 8 weeks of moderate aerobic training. Pittsburgh sleep quality index (PSQI) was used to evaluate SQ and Epworth sleepiness scale (ESS) was used to assess EDS. Results: TG showed lower PSQI scores compared to the CG. In addition, TG improved SQ, but there was no change in CG. Regarding EDS, in intragroup comparison, there was no change in both groups. Conclusion: According to the results, aerobic training of moderate intensity improves SQ, but does not seem to affect EDS.

Correlation of lung function and respiratory muscle strength with functional exercise capacity in obese individuals with obstructive sleep apnea syndrome / Associação entre função pulmonar, força muscular respiratória e capacidade funcional de exercício em indivíduos obesos com síndrome da apneia obstrutiva do sono

ABSTRACT Objective: To evaluate lung function and inspiratory muscle strength, correlating them with exercise tolerance, in obese individuals with obstructive sleep apnea syndrome (OSAS). Methods: The sample comprised 31 adult subjects with moderate-to-severe OSAS diagnosed by polysomnography. We used spirometry to measure FVC, FEV1, and FVC/FEV1 ratio, using pressure manometry to measure MIP and MEP. The incremental shuttle walk test (ISWT) and the six-minute walk test (6MWT) were used in order to determine functional exercise capacity. Results: In this sample, the mean values for FVC (% of predicted), FEV1 (% of predicted): MIP, and MEP were 76.4 ± 12.3%, 80.1 ± 6.3%, 60.0 ± 21.9 cmH2O, and 81.3 ± 22.2 cmH2O, respectively. The mean distances covered on the ISWT and 6MWT were 221 ± 97 m and 480.8 ± 67.3 m, respectively. The ISWT distance showed moderate positive correlations with FVC (r = 0.658; p = 0.001) and FEV1 (r = 0.522; p = 0.003). Conclusions: In this sample of obese subjects with untreated OSAS, lung function, inspiratory muscle strength, and exercise tolerance were all below normal. In addition, we found that a decline in lung function, but not in respiratory muscle strength, was associated with exercise tolerance in these patients.

RESUMO Objetivo: Avaliar e correlacionar a função pulmonar e a força muscular inspiratória com a tolerância ao esforço em indivíduos obesos com síndrome de apneia obstrutiva do sono (SAOS). Métodos: Foram recrutados 31 adultos com diagnóstico de SAOS de moderada a grave através do exame de polissonografia. Os participantes foram submetidos à espirometria para a medida de CVF, VEF1 e relação CVF/VEF1, assim como à manovacuometria para a medida de PImáx e PEmáx. Para a determinação da capacidade funcional de exercício foram realizados o teste shuttle (TS) e o teste de caminhada de seis minutos (TC6). Resultados: Na amostra, as médias de CVF (% do previsto), VEF1 (% do previsto), PImáx e PEmáx foram de 76,4 ± 12,3%, 80,1 ± 6,3%, 60,0 ± 21,9 cmH2O e 81,3 ± 22,2 cmH2O, respectivamente. As médias das distâncias percorridas no TS e no TC6 foram de 221 ± 97 m e 480,8 ± 67,3 m, respectivamente. Houve correlações moderadas positivas entre a distância percorrida no TS e CVF (r = 0,658; p = 0,001) e entre a distância no TS e VEF1 (r = 0,522; p = 0,003). Conclusões: Nesta amostra de indivíduos obesos com SAOS não tratada, houve reduções na função pulmonar, força muscular inspiratória e capacidade física. Além disso, observou-se que o declínio da função pulmonar, mas não da força muscular respiratória, estava associado à tolerância ao esforço físico nestes pacientes.

Correlation of lung function and respiratory muscle strength with functional exercise capacity in obese individuals with obstructive sleep apnea syndrome.

OBJECTIVE: To evaluate lung function and inspiratory muscle strength, correlating them with exercise tolerance, in obese individuals with obstructive sleep apnea syndrome (OSAS). METHODS: The sample comprised 31 adult subjects with moderate-to-severe OSAS diagnosed by polysomnography. We used spirometry to measure FVC, FEV1, and FVC/FEV1 ratio, using pressure manometry to measure MIP and MEP. The incremental shuttle walk test (ISWT) and the six-minute walk test (6MWT) were used in order to determine functional exercise capacity. RESULTS: In this sample, the mean values for FVC (% of predicted), FEV1 (% of predicted): MIP, and MEP were 76.4 ± 12.3%, 80.1 ± 6.3%, 60.0 ± 21.9 cmH2O, and 81.3 ± 22.2 cmH2O, respectively. The mean distances covered on the ISWT and 6MWT were 221 ± 97 m and 480.8 ± 67.3 m, respectively. The ISWT distance showed moderate positive correlations with FVC (r = 0.658; p = 0.001) and FEV1 (r = 0.522; p = 0.003). CONCLUSIONS: In this sample of obese subjects with untreated OSAS, lung function, inspiratory muscle strength, and exercise tolerance were all below normal. In addition, we found that a decline in lung function, but not in respiratory muscle strength, was associated with exercise tolerance in these patients.

Correction to: Obstructive sleep apnea does not impair cardiorespiratory responses to progressive exercise performed until exhaustion in hypertensive elderly.

The original version of this article was published online containing two items that require correction, namely the abstract (Results section) and Table 3.