Evaluation of respiratory and peripheral muscle training in individuals undergoing myocardial revascularization.

OBJECTIVES: To investigate the effect of peripheral muscle strength training (PMT) and respiratory muscle strength training (RMT) muscle strength training associated with conventional physical therapy on the respiratory muscle strength, functional capacity, and quality of life in the immediate postoperative period of patients undergoing coronary artery bypass graft (CABG). METHODS: This was a randomized controlled trial. Eighty-three patients undergoing CABG were divided into two groups: Intervention group, patients that received PMT and RMT associated with conventional physical therapy, one session a day for 5 days; control group, patients that received conventional physical therapy, one session a day for 5 days. All patients had respiratory muscle strength, peripheral muscle strength, functional capacity, and quality of life evaluated by manovacuometry, dynamometry, 6-min walking test, and 36-item Short-Form Health Survey Questionnaire, respectively, before and 5 days after CABG. RESULTS: Both groups showed a significantly reduced respiratory muscle strength after CABG; however, in the intervention group, the inspiratory muscle strength reduction was lower (confidence interval [CI] 95%: 2.29 [1.9; 27.54]). The quality of live domains for pain (CI 95%: 3.08 [5.21; 24.97]) and vitality perception (CI 95%: 2.51 [2.12; 19.53]) worsened in the control and improved in the intervention group (pain: CI 95%: 1.19 [-3.38; 13.09]; vitality CI 95%: 0.07 [-6.55; 7.04]). Both groups showed reduced functional capacity and expiratory muscle strength after CABG. CONCLUSION: Conventional physical therapy combined with PMT and RMT may reduce inspiratory muscle strength loss and improve pain and vitality perception in the immediate postoperative period after CABG.

Higher Waist Circumference Is Related to Lower Plasma Polyunsaturated Fatty Acids in Healthy Participants: Metabolic Implications.

OBJECTIVE: We evaluated whether the relationship between waist circumference (WC) and cardiometabolic risk is related to usual diet and plasma fatty acid composition. METHODS: This cross-sectional study included 226 health professionals from 20 to 59 years old. Anthropometric features, oxidative stress, inflammatory markers, and plasma fatty acid profile were assessed. Dietary intake was evaluated with a semi-quantitative food frequency questionnaire, the quality of dietary habits by Healthy Eating Index, and insulin resistance by homeostasis model assessment-insulin resistance and triglyceride-glucose index. RESULTS: Higher WC was associated with lower concentrations of high-density lipoprotein cholesterol (p = 0.000) and adiponectin (p = 0.000) and higher uric acid levels (p = 0.011). Plasma polyunsaturated fatty acid (PUFA) levels were negatively associated with weight (p = 0.046), systolic blood pressure (p = 0.035), fasting glucose (p = 0.000), triglyceride-glucose index (p = 0.023), and IL-1ß (p = 0.037). Individuals with elevated WC consumed more calories (p = 0.002), niacin (p = 0.002), and pyridoxine (p = 0.017), but less calcium (p = 0.001), phosphorus (p = 0.016), and vitamin B2 (p = 0.011). In addition, individuals with higher WC denoted lower PUFA concentrations (p = 0.036). CONCLUSION: The results suggest that participants with higher WC have lower plasma PUFA concentrations and higher levels of saturated fatty acids. This could be related to metabolic and inflammatory changes that could trigger increased risk of metabolic syndrome and cardiovascular disease.

Questionário Palmore-Neri-Cachioni de Conhecimentos Básicos sobre a Velhice: atualização e validação de conteúdo / Palmore-Neri-Cachioni Questionnaire on Basic Knowledge about Old Age: Update and content validation

RESUMO O objetivo do estudo foi atualizar e avaliar a validade de conteúdo do Questionário Palmore-Neri-Cachioni de Conhecimentos Básicos sobre a Velhice. A atualização contou com três especialistas em gerontologia. Realizou-se duas rodadas de validação de conteúdo. Utilizou-se o Índice de Validade de Conteúdo a nível de item, traduzido pelo Kappa modificado e a Razão de Validade de Conteúdo, adotando pontuações ≥ 0,78, 0,74 e 1,00, respectivamente. A validade de conteúdo global foi avaliada pelo Índice de Validade de Conteúdo a nível de escala de acordo com a média, assumindo ponto de corte de 0,90. Uma reunião com a autora da versão brasileira foi realizada para esclarecimentos. O estudo piloto foi conduzido com indivíduos da população alvo e avaliado pela taxa de concordância, com ponto de corte 80%. Atualizou-se as respostas de sete itens, 14 itens foram revisados e após a segunda rodada, a validade geral do instrumento foi de 0,96. Quatro itens e a instrução foram discutidos com a autora. O estudo piloto contou com 34 respondentes e alcançou satisfatoriedade. Foi possível obter o Questionário Palmore-Neri-Cachioni - Atualizado e Revisado (2022) que evidenciou validade de conteúdo e de face quando aplicado a uma amostra de profissionais e gestores de saúde.

ABSTRACT The aim of the study was to update and assess the content validity of the Palmore-Neri-Cachioni Questionnaire on Basic Knowledge of Old Age. Three gerontology specialists were involved in the update. Two rounds of content validation were carried out. The Content Validity Index at item level was used, translated by the modified Kappa and the Content Validity Ratio, adopting scores ≥ 0.78, 0.74 and 1.00, respectively. Overall content validity was assessed by the Content Validity Index at scale level according to the mean, assuming a cut-off point of 0.90. A meeting was held with the author of the Brazilian version for clarification. The pilot study was conducted with individuals from the target population and assessed by the agreement rate, with a cut-off point of 80%. The answers to seven items were updated, 14 items were revised and after the second round, the overall validity of the instrument was 0.96. Four items and the instruction were discussed with the author. The pilot study had 34 respondents and was satisfactory. It was possible to obtain the Palmore-Neri-Cachioni Questionnaire - Updated and Revised (2022), which showed content and face validity when applied to a sample of health professionals and managers.

A pilot observational study to identify reference values for the 6-minute walk test in Brazilian people with hypertension / Um estudo observacional piloto para identificar valores de referência para o teste de caminhada de 6 minutos em hipertensos brasileiros

Abstract Introduction Systemic arterial hypertension (SAH) is responsible for 9.5 million deaths in the global popu-lation. Lifestyle factors, including physical inactivity, are important modifiable risk factors in the development of SAH. Thus, physical exercise has been shown to be effective to control SAH and before the prescription, the six-minute walk test (6-MWT) has been commonly used to assess the physical capacity. Objective To propose reference values for the 6-MWT test in Brazilian people with SAH. Methods A cross-sectional observational study was conducted with 302 hypertensive subjects (62.61 + 10.93 years) admitted to a cardiac rehabilitation program. Participants were divided into different age quartiles and submitted to 6-MWT. The walking distance data was compared between the quartiles and adjusted by mul-tiple linear regression analysis. Results The hypertensive subjects walked 388.07 + 115.03 m during the 6-MWT. No significant difference between the genders was found. However, when the age quartiles were compared, for the 46-59 age group, the women walked less than the men. Intra-group comparisons showed that the distance walked in the 6-MWT decreased with the increase in age, in both men and women. Conclusion The present study provides reference values for the 6-MWT, both for Brazilian men and women of different age groups. This data may be an important parameter for future clinical studies, prevention strategies, and clinical intervention.

Resumo Introdução A hipertensão arterial sistêmica (HAS) é respon-sável por 9,5 milhões de mortes na população mundial. Con-dições do estilo de vida, incluindo a inatividade física, são importantes fatores de risco modificáveis no desenvolvimento da HAS. Desse modo, o exercício físico tem se mostrado eficaz no controle da HAS e, antes da prescrição, o teste de caminhada de seis minutos (TC6) tem sido comumente utilizado para ava-liar a capacidade física. Objetivo Propor valores de referência para o teste de TC6 em brasileiros com HAS. Métodos Realizou-se um estudo observacional transversal com 302 hipertensos (62,61 + 10,93 anos) admitidos em um programa de reabilitação cardíaca. Os participantes foram divididos em diferentes quartis de idade e submetidos ao TC6. Os dados de distância percorrida foram comparados entre os quartis e ajustados por análise de regressão linear múltipla. Resultados Os hipertensos caminharam 388,07 + 115,03 m durante o TC6. Não encontrou-se diferença significativa entre os gêneros. No entanto, quando comparados os quartis de idade, para a faixa etária de 46 a 59 anos, as mulheres caminharam menos do que os homens. As comparações intragrupo mostraram que a distância percorrida no TC6 diminuiu com o aumento da idade, tanto em homens quanto em mulheres. Conclusão O presente estudo fornece valores de referência para o TC6, tanto para homens quanto para mulheres brasileiras de diferentes faixas etárias. Esses dados podem ser um parâmetro importante para futuros estudos clínicos, estratégias de prevenção e intervenção clínica.

Triglyceride-glucose index is associated with poor sleep quality in apparently healthy subjects: A cross-sectional study

ABSTRACT Objectives: We aimed to evaluate the association between the triglyceride glucose index (TyG index) and sleep quality and to establish a cut-off value for the TyG index based on the prevalence of subjects with insulin resistance (IR). Materials and methods: This cross-sectional study involved Brazilian health professionals (20-59 years). A total of 138 subjects answered the Pittsburgh Sleep Quality questionnaire to evaluate sleep quality. They were categorized into two groups: good sleep quality (global score ≤ 5 points) and poor sleep quality (global score ≥ 6 points). Also, we classified the subjects as having a high (>8.08 or >4.38) or low TyG index (≤8.08 or ≤4.38). Results: The majority of the subjects (70%) with high TyG index values (>8.08 or >4.38) reported poor sleep quality (p ≤ 0.001). Those with poor sleep quality had a 1.44-fold higher prevalence of IR (TyG index >8.08 or >4.38) compared to those with good sleep quality, regardless of sex, total cholesterol, LDL/HDL ratio, insulin, complement C3, CRP, and adiponectin (p ≤ 0.001). Conclusion: Our data showed a positive and significant association between the TyG index and poor sleep quality. Thus, these findings support the association between poor sleep quality and IR.

Prevalence of metabolic syndrome and pre-metabolic syndrome in health professionals: LATINMETS Brazil study.

BACKGROUND: The metabolic syndrome (MS) is characterized by several cardiovascular risk factors and is associated with an increased incidence of diabetes, cardiovascular events and mortality. The prevalence of MS is increasing in epidemic proportions worldwide. The present study aimed to investigate the prevalence of MS and its components in health professionals in the municipality of Viçosa, Brazil. METHODS: Cross-sectional observational study in the frame of the LATIN America METabolic Syndrome (LATINMETS) multicenter study. The study sample consisted of 226 healthcare personnel (20-59 years). Weight, height, waist circumference and hip circumference were determined. The following anthropometric indices were calculated: body mass index (BMI), waist/hip ratio, waist/height ratio, body adiposity index (BAI) and conicity index. Body composition was assessed by tetrapolar bioelectrical impedance. The lipid profile, fasting glucose, insulin, uric acid, high-sensitive C-reactive protein (hs-CRP) and complement C3 were measured in fasting conditions. Insulin resistance was assessed by the Homeostasis Model Assessment Index of Insulin Resistance (HOMA-IR). RESULTS: Of the 226 healthcare individuals included in the study, 74.3% were female, 77.0% graduated and 23.0% students of the last two years of courses in health area, with a median age of 27 years. The overall prevalence of MS was 4.5%, and increased with age (20 to 29 years: 1.3%; 30 to 39 years: 5.6%; ≥ 40 years: 26.3%) (P < 0.01). The presence of pre-MS and MS was associated with several measures of adiposity, total cholesterol/HDL-c and LDL-c/HDL-c ratios and serum complement C3 concentrations. CONCLUSIONS: The LATINMETS Brazil study reported an association between MS prevalence and age, especially in those over 40 years. The presence of MS is associated with an increased prevalence of several cardiovascular risk factors.

Efeito da reabilitação cardíaca sobre o limiar nociceptivo aumentado de indivíduos hipertensos / Effect of cardiac rehabilitation on the nociceptive threshold increased of hypertensive subjects

Objetivos: Indivíduos hipertensos apresentam um limiar nociceptivo aumentado, o que pode contribuir para uma redução da percepção da dor. Assim, o objetivo deste estudo foi avaliar o efeito de um programa de reabilitação cardíaca (PRC) sobre limiar nociceptivo aumentados de indivíduos hipertensos. Métodos: Quarenta e um participantes foram divididos em dois grupos: grupo normotenso e grupo hipertenso. Nos dois grupos, foram avaliados a massa corporal, índice de massa corporal (IMC), circunferência abdominal, pressão arterial sistólica e diastólica, frequência cardíaca, limiar nociceptivo e a capacidade funcional pelo teste de caminhada de seis minutos (TC6). O PRC foi composto de exercícios aeróbicos em esteira com duração de 30 minutos, 3 vezes por semana, durante 7 semanas. Resultados: Após o PRC, houve uma significativa redução (p < 0,001) no limiar mecânico nociceptivo e um aumento na distância percorrida durante o TC6 (p < 0,001) no grupo composto por indivíduos hipertensos. Conclusão: Os resultados do presente estudo sugeriram que o exercício aeróbico é uma modalidade importante para normalizar o limiar nociceptivo e melhorar a capacidade funcional de indivíduos hipertensos.

Body mass index and waist circumference: association with cardiovascular risk factors.

OBJECTIVE: To evaluate the association between cardiovascular risk factors and the anthropometric values--body mass index (BMI) and waist circumference (WC). METHODS: It was studied 231 employees of Federal University of Viçosa, Brazil, 54.1% of them were men (21-76 years old). Glycemia, total cholesterol, LDL, HDL, triglycerides, blood pressure, BMI, WC, waist-to-hip ratio and body fatness were measured. It was also investigated smoking, alcohol consumption and physical activity. RESULTS: The prevalence of overweight/obesity in this population was high mainly in women. The abdominal obesity was observed in 74% of the women and 46.1% of the men. The average of BMI, body fatness, total cholesterol, HDL and triglycerides were significantly higher in men than in women. (p < 0,05). The sedentary lifestyle was a risk factor for obesity. Smoking and alcohol consumption were more common among men and normal weight volunteers. Most of the correlations between anthropometric indices and risk factors for cardiovascular diseases were significant, but weak and the WC was the index that had the strongest correlation and that associated with the largest number of variables. It was observed that with an increase of the BMI and the abdominal fat, there was also an increase of the glycemia, triglycerides and blood pressure and a decrease of HDL. The metabolic syndrome was more common among men and overweight and obese volunteers. CONCLUSION: In this study, the frequency of cardiovascular risk factors increased along with BMI and WC.

Índice de massa corporal e circunferência abdominal: associação com fatores de risco cardiovascular / Body mass index and waist circumference: association with cardiovascular risk factors

OBJETIVO: Determinar a associação entre índice de massa corporal (IMC) e circunferência abdominal (CA) com fatores de risco para doenças cardiovasculares. MÉTODOS: Estudou-se 231 servidores da Universidade Federal de Viçosa, sendo 54,1 por cento do sexo masculino (21-76 anos). Analisou-se glicemia de jejum, colesterol total e frações, triglicérides, pressão arterial, IMC, CA, relação cintura-quadril e percentual de gordura corporal. Informações sobre tabagismo, ingestão de bebidas alcoólicas e atividade física também foram obtidas. RESULTADOS: As freqüências de sobrepeso/obesidade foram bastante elevadas, principalmente em mulheres. A obesidade abdominal foi observada em 74 por cento das mulheres e 46,1 por cento dos homens. Os homens apresentaram valores médios e medianos de colesterol total, HDL, triglicérides, IMC e percentual de gordura corporal maiores do que as mulheres (p<0,05). O sedentarismo apresentou-se como fator de risco para obesidade e o tabagismo e o consumo de bebidas alcoólicas foram mais freqüentes entre homens e entre eutróficos. A maioria das correlações entre índices antropométricos e fatores de risco foram significativas, entretanto apresentaram-se fracas. A CA foi o indicador antropométrico que se correlacionou mais fortemente e com maior número de variáveis. Observou-se que com o aumento do IMC e da gordura abdominal houve elevação principalmente da glicemia, dos triglicérides, da pressão arterial e redução do HDL. A freqüência de síndrome metabólica foi maior no grupo sobrepeso/obesidade e em homens. CONCLUSÃO: Neste estudo, a freqüência de fatores de risco cardiovascular aumentou com aumento do IMC e CA.

OBJECTIVE: To evaluate the association between cardiovascular risk factors and the anthropometric values - body mass index (BMI) and waist circumference (WC). METHODS: It was studied 231 employees of Federal University of Viçosa, Brazil, 54,1 percent of them were men (21-76 years old). Glycemia, total cholesterol, LDL, HDL, triglycerides, blood pressure, BMI, WC, waist-to-hip ratio and body fatness were measured. It was also investigated smoking, alcohol consumption and physical activity. RESULTS: The prevalence of overweight/obesity in this population was high mainly in women. The abdominal obesity was observed in 74 percent of the women and 46,1 percent of the men. The average of BMI, body fatness, total cholesterol, HDL and triglycerides were significantly higher in men than in women. (p < 0,05). The sedentary lifestyle was a risk factor for obesity. Smoking and alcohol consumption were more common among men and normal weight volunteers. Most of the correlations between anthropometric indices and risk factors for cardiovascular diseases were significant, but weak and the WC was the index that had the strongest correlation and that associated with the largest number of variables. It was observed that with an increase of the BMI and the abdominal fat, there was also an increase of the glycemia, triglycerides and blood pressure and a decrease of HDL. The metabolic syndrome was more common among men and overweight and obese volunteers. CONCLUSION: In this study, the frequency of cardiovascular risk factors increased along with BMI and WC.

Perfil de saúde de idosas, praticantes de atividade física, cadastradas no Programa Municipal da Terceira Idade do município de Viçosa – MG / Elderly women health profile, who practices exercises regularly, registered in the Third Age Municipal Program in Viçosa - Minas Gerais State

Objetivo: Estudar o perfil de saúde de um grupo de idosas do Programa Municipal da Terceira Idade (PMTI) do município de Viçosa/ MG, praticantes de atividade física. Desenho do estudo: Estudo transversal, no qual se aplicou um questionário semi-estruturado a 53 mulheres idosas do grupo, analisando idade, morbidades informadas; realização de atividades diárias e de lazer; utilização de serviços de saúde. A avaliação antropométrica foi feita com peso e estatura para o cálculo do índice de Massa Corporal. Resultados: A faixa etária das idosas estudadas variava entre 60 a 80 anos (mediana: 68). Com relação à capacidade funcional e sociabilidade, 13.2% moravam sozinhas, 100% freqüentavam igreja, teatro ou cinema, 94,3% faziam compras, 73,6% faziam viagens de longa duração, 93% visitavam parentes e amigos, 56,6% participam de atividades de grupo e 82,5% preparavam seu próprio alimento. Todos os indivíduos do grupo praticavam atividades físicas regulares. Entre as enfermidades auto-informadas, a mais prevalente foi a hipertensão, seguida do colesterol sérico elevado e depressão. Diabetes e obesidade também foram relatadas com freqüência. Observou-se que 88.7% relataram pelo menos uma doença crônica. Avaliando o estado nutricional como fator de risco para algumas das doenças auto-referidas, não se observou relação deste com diabetes (OR: 0.56: 0.10-2.93: p=0,40) e hipertensão (OR: 3,18: 0.78-13, 48, p=0.06). Conclusão: No grupo estudado, embora a presença das enfermidades crônicas comuns dessa faixa etária tenha sido observada, a capacidade funcional parece preservada, o que pode estar relacionado à prática de atividade.

Objectives: To study the health profile of a group of elderly women, who practice exercises regularly and are part of the Third Age Municipal Program in Viçosa - Minas Gerais State. Study Design: Transversal study, in which a semi-structured questionnaire was applied to 53 elderly women, analyzing: age, informed disease, practice of regular and spare time physical activities and health care service utilization. Body mass index (- weight/[height]2) was evaluated. Results: the age range studied was: 60 to 20 years (average, 68). Regarding functional capability as well as sociability: 13.2% live alone, 100% often go to church, cinema or theater, 94.3% go shopping, 73.6% travel, 93.0% go out to visit friends and relatives, 56,6% participate in group activities and 82.5% prepare their own meals. All individuals practice exercises in regular basis. Among the informed diseases, the most common were hypertension, hypercholesterolemia, and depression. Diabetes and obesity were also reported. In addition, 88.7% of the studied group have already had at least one chronic disease. No correlation was found between nutritional status and the informed diseases, including diabetes and hypertension. Conclusion: In the studied group, the functional capability remains preserved, what can be explained by the regular exercise practice in spite of the occurrence of chronic disease related to aging.

Perfil clínico e antropométrico de pacientes portadores de hipertensão arterial sistêmica atendidos em um programa de atenção cardiovascular em Minas Gerais, Brasil / Clinical, and anthropometric profile of patients suffering from systemic arterial hypertension assisted by the cardiovascular attention program in Minas Gerais, Brazil

Objetivos: Caracterizar o perfil clínico e antropométrico de indivíduos hipertensos e verificar a associação entre o estado nutricional e a hipertensão arterial sistêmica (HA). Metodologia: foram realizadas avaliações clínicas, bioquímicas (perfil lipídico e glicemia) e antropométricas (peso, estatura, circunferência da cintura e do quadril) em hipertensos atendidos pelo Programa de Atenção à Saúde Cardiovascular da Universidade Federal de Viçosa —MG. Resultados: Foram avaliados 74 indivíduos com distribuição eqüitativa por sexo. A maioria estava na faixa etária dos 40-59 anos; 80,6% das mulheres e 78,4% dos homens apresentavam antecedentes familiares com HA. Em ambos os sexos, foram encontradas elevadas proporções de excesso de peso e de inadequações da circunferência da cintura e da relação cintura-quadril (p<0,05). Os hipertensos com excesso de peso apresentaram mais altas medianas das pressões arteriais sistólica (p<0,05) e diastólica (p<0,01). Não houve diferença estatística significativa no uso de medicamentos anti-hipertensivos segundo o índice de massa corpórea (IMC). Os hipertensos com excesso de peso e com inadequação da circunferência da cintura apresentaram níveis glicêmicos mais altos (p<0,05) e para o perfil lipídico não houve diferença estatisticamente significativa. Conclusões: os fatores de risco identificados nesses pacientes, passíveis de intervenção por meio de modificações no estilo de vida, demonstram a importância da orientação nutricional como forma de diminuir os riscos de morbimortalidade e de melhorar a qualidade de vida desses indivíduos.