Association of parent-child health parameters and lifestyle habits - the "epi-family health" longitudinal study protocol.

BACKGROUND: Lifestyle and habits, cardiovascular risk factors (CRF), bone and mental health, dietary habits, physical activity, among others are developed in childhood and adolescence. Family environment has shown to play an important role in these outcomes. However, whether the parent-child relationship lifestyle habits and health parameters can be influenced by physical activity patterns still unclear. The objective of this study will be to monitor and investigate the associations between lifestyle habits between parents and their children longitudinally, as well as verify whether in more active parents, the possible associations with lifestyle habits are different from those of parents considered less active. METHODS: The sample will consist of parents (father, mother, or both) and their children /adolescents. The participants will be recruited through public call by flyers spread across all the regions of the city and also through social media. The health parameters will include cardiovascular (cardiac autonomic modulation, blood pressure and resting heart rate), bone mineral density, anthropometric indices, handgrip strength, mental health (quality of life, anxiety and depression symptoms and stress), self-reported morbidities and musculoskeletal pain. Lifestyle habits will include physical activity levels, sedentary behavior, sleep parameters, eating patterns, smoking and alcohol consumption. Sociodemographic variables of age, sex, ethnicity and socioeconomic status will be considered as covariates. The follow-up visits of data collection will be scheduled after a period of 12 months from the baseline assessment during every twelve months. DISCUSSION: The family environment has great potential to determine lifestyle habits in children and adolescents. Based on the results presented in the present study, we hope that health promotion actions can be better designed in the family environment.

Comparison of Quality of Life in Breast Cancer Survivors with and without Persistent Depressive Symptoms: A 12-Month Follow-Up Study.

Although breast cancer treatments reduce mortality, their adverse effects can increase depression which impacts one's quality of life (QoL). Physical activity (PA) seems to improve the QoL of breast cancer survivors (BCS). However, an unanswered question is the influence of PA on the QoL in BCS with depressive symptoms. Thus, we analyzed the influence of PA on the QoL in BCS with persistent depressive symptoms during 12 months of follow-up. The sample included 70 female BCS. Depression and QoL domains (i.e., functional capacity, physical limitations, body pain, general health status, vitality, social and emotional aspects, and mental health) were assessed at baseline and follow-up periods by the Hospital Anxiety and Depression Scale and SF-36, respectively. Habitual PA was assessed by Baecke's questionnaire. Our results indicate a prevalence of 17.1% of depressive symptoms. Non-depressives BCS improved their physical limitations and general health status domains over time, but there were no observed differences in depressive BCS. BCS with persistent depressive symptoms (baseline and follow-up) showed worse QoL scores than non-depressives in all domains, regardless of confounding factors. When adjusted for PA, the difference between BCS depressives and non-depressives lost its significance in the functional capacity domain. In conclusion, habitual PA practice positively influenced the functional capacity domain of the QoL in BCS.

Analysis of Barriers to Public and Private Cardiac Rehabilitation Programs in Patients with Low and High Adherence.

INTRODUCTION: Participants in cardiac rehabilitation programs have low adherence to their sessions, which makes extremely important to recognize the barriers that cause non-adherence, identifying whether the type of service and level of adherence influence these barriers. METHODS: This is a cross-sectional observational study, in which 220 individuals (66.80±11.59 years) of both genders who are members of public and private exercise-based cardiac rehabilitation programs participated. The volunteers were divided according to the level of adherence, considering patients with low adherence (PLA) those with < 70% of attendance and high adherence (PHA) those with > 70%. Then, initial evaluation, Cardiac Rehabilitation Barriers Scale, analysis of socioeconomic level, Hospital Anxiety and Depression Scale, and Mini-Mental State Examination were applied. RESULTS: Higher total barriers were found in PLA in the public service compared to PHA in the private service (P=0.023). In the subscale "perceived need", PHA in the public service showed higher values than PLA and PHA in the private service (P≤0.001). The "access" barrier was higher for PHA in the public service when compared to PHA in the private service (P=0.024). PHA in the public service exhibited a higher barrier regarding questions about distance, transportation problems, cost, and time constraints. CONCLUSION: The public program presents higher barriers in the questions and categories compared to the private program, mainly the PHA. Furthermore, there are differences in the profile of the participants regarding socioeconomic and anxiety levels, treatment time, ethnicity, and city where they live.

Analysis of Barriers to Public and Private Cardiac Rehabilitation Programs in Patients with Low and High Adherence

ABSTRACT Introduction: Participants in cardiac rehabilitation programs have low adherence to their sessions, which makes extremely important to recognize the barriers that cause non-adherence, identifying whether the type of service and level of adherence influence these barriers. Methods: This is a cross-sectional observational study, in which 220 individuals (66.80±11.59 years) of both genders who are members of public and private exercise-based cardiac rehabilitation programs participated. The volunteers were divided according to the level of adherence, considering patients with low adherence (PLA) those with < 70% of attendance and high adherence (PHA) those with > 70%. Then, initial evaluation, Cardiac Rehabilitation Barriers Scale, analysis of socioeconomic level, Hospital Anxiety and Depression Scale, and Mini-Mental State Examination were applied. Results: Higher total barriers were found in PLA in the public service compared to PHA in the private service (P=0.023). In the subscale "perceived need", PHA in the public service showed higher values than PLA and PHA in the private service (P≤0.001). The "access" barrier was higher for PHA in the public service when compared to PHA in the private service (P=0.024). PHA in the public service exhibited a higher barrier regarding questions about distance, transportation problems, cost, and time constraints. Conclusion: The public program presents higher barriers in the questions and categories compared to the private program, mainly the PHA. Furthermore, there are differences in the profile of the participants regarding socioeconomic and anxiety levels, treatment time, ethnicity, and city where they live.

Physical load and heart rate behavior in workers in the slaughterhouse and meat packing industries / Carga física e comportamento da frequência cardíaca em trabalhadores de frigorífico

Abstract High physical overload during the workday and some conditions present in the workplace can generate several losses in the worker's health. The use of tools capable of identifying physical load (PL), such as heart rate (HR) analysis, is essential. The aim of the study was to evaluate the physical load and heart rate behavior of workers in the slaughterhouse. The cardiovascular load reached by two individuals was 12% and 24%. In relation to the PL rating, they fit as moderately heavy to heavy work. The HR, was higher at the end of the work when compared to the beginning. Furthermore, it was pointed out that the temperature, noise, and body mass index were above normality values. The physical workload was classified as moderately heavy to heavy. The limit HR was reached in some moments of the work by one of the workers and two of them reached higher HR values at the end of the work.

Resumo A elevada sobrecarga física durante a jornada de trabalho e algumas condições presentes no ambiente de trabalho podem gerar diversos prejuízos na saúde do trabalhador. A utilização de ferramentas capazes de identificar a carga física (CF), como a análise da frequência cardíaca (FC), é fundamental. O objetivo do estudo foi avaliar o comportamento da carga física e da frequência cardíaca dos trabalhadores de frigorífico. A carga cardiovascular alcançada por dois indivíduos foi de 12% e 24%. Em relação à classificação da CF, enquadram-se como trabalhos moderadamente pesados ​​a pesados. A FC, foi maior no final do trabalho quando comparado ao início. Além disso, apontou-se que a temperatura, o ruído e o índice de massa corporal estavam acima dos valores da normalidade. A CF de trabalho foi classificada como moderadamente pesada a pesada. A FC limite foi atingida em alguns momentos do trabalho por um dos trabalhadores e dois deles atingiram valores maiores de FC ao final do trabalho.

Autonomic and cardiorespiratory responses to the active tilt test in individuals with Parkinson disease: cross-sectional study / Respostas autonômicas e cardiorrespiratórias ao teste ativo de inclinação em indivíduos com doença de Parkinson: estudo transversal

Abstract Background The Parkinson disease (PD) is frequently associated with autonomic dysfunctions. However, data regarding the influence of PD on the autonomic responses to postural changes is limited. Objective To analyze and compare the autonomic responses, evaluated through linear and non-linear methods of heart rate variability, and cardiorespiratory parameters in two groups: Parkinson disease (PDG) and control (CG), at rest and during the active tilt test. Methods A total of 48 participants were analyzed (PDG: n = 25;73.40 ± 7.01 years / CG: n = 23;70.17 ± 8.20 years). The autonomic modulation and cardiorespiratory parameters were evaluated at rest and during the active tilt test. To assess the autonomic modulation the linear indices, at the time (rMSSD, SDNN) and frequency (LF, HF, LF/HF) domains, and the non-linear indices, obtained through the Poincaré plot (SD1, SD2, SD1/SD2), were calculated. The cardiorespiratory parameters evaluated were heart rate (HR), systolic (SBP), and diastolic blood pressure (DBP), peripheral oxygen saturation (SpO2), and respiratory rate. Results At rest, the PDG presented significantly lower values of rMSSD, SDNN, LF, HF, SD1, SD2, and DBP, and higher values of SpO2. During test, in the PD group, modifications were observed in HR, and SBP, besides a reduced parasympathetic response, and an increased global modulation. The qualitative analysis of the Poincaré plot showed that the PDG has a lower dispersion of the RR intervals during rest and the active tilt test. Conclusion Individuals with PD present reduced global variability and parasympathetic modulation at rest, and reduced parasympathetic response and damage in HR regulation when performing the active tilt test, compared with controls.

Resumo Antecedentes A doença de Parkinson (DP) está frequentemente associada a disfunções autonômicas. Porém, dados sobre a influência da DP nas respostas autonômicas às mudanças posturais são limitados. Objetivos Analisar e comparar as respostas autonômicas, avaliadas por métodos lineares e não lineares de variabilidade da frequência cardíaca e parâmetros cardiorrespiratórios em dois grupos: DP (GDP) e controle (CG), em repouso e durante o tilt test ativo. Métodos Foram analisados 48 participantes (GDP: n = 25;73,40 ± 7,01 anos/GC: n = 23; 70,17 ± 8,20 anos). A modulação autonômica e os parâmetros cardiorrespiratórios foram avaliados em repouso e durante o tilt test ativo. Para avaliar a modulação autonômica foram calculados os índices lineares, nos domínios do tempo (rMSSD, SDNN) e frequência (LF, HF, LF/HF), e os índices não lineares, obtidos através do plot de Poincaré (SD1, SD2, SD1/SD2). Os parâmetros cardiorrespiratórios avaliados foram frequência cardíaca (FC), pressão arterial sistólica (PAS), diastólica (PAD), saturação periférica de oxigênio (SpO2) e frequência respiratória. Resultados Em repouso, o GDP apresentou valores menores de rMSSD, SDNN, LF, HF, SD1, SD2 e PAD, e maiores valores de SpO2. No teste, foram observadas modificações na FC e na PAS, redução da resposta parassimpática e aumento da modulação global no GDP. A análise qualitativa do plot de Poincaré mostrou que o GDP apresentou menor dispersão dos intervalos RR no repouso e no tilt test ativo. Conclusão Indivíduos com DP apresentam redução da variabilidade global e modulação parassimpática em repouso, redução da resposta parassimpática e prejuízo na regulação da FC ao realizar o tilt test ativo, em comparação aos controles.

Does length of time since diagnosis in Parkinson's disease influence heart rate variability? A cross-sectional study / O tempo de diagnóstico na doença de Parkinson influencia a variabilidade da frequência cardíaca? Um estudo transversal

ABSTRACT Background: Intrinsic changes in Parkinson's disease (PD) affect the autonomic nervous system, and the disease course can aggravate the initial condition. Although the impact of time since disease onset on autonomic modulation has already been studied in other populations, this has not yet been investigated in PD. Objective: To investigate the impact of the length of time since diagnosis on the cardiac autonomic modulation of individuals with PD and compare with healthy individuals. Methods: Fifty participants were divided into three groups: a control group (CG; n = 24) and two groups with PD, divided according to the median length of time since diagnosis (median = 5.5 years): below the median (PG1; n = 13) and above the median (PG2; n = 13). To evaluate cardiac autonomic modulation, heart rate was obtained beat-to-beat in the supine position over a 30-min period, and heart rate variability (HRV) indices were calculated using linear methods in the time and frequency domains. Results: There were no significant differences in HRV indices between the PG groups, or between the three groups regarding Mean RR, LFun, HFun and LF/HF ratio. Significant reductions in the RMSSD, SDNN, pNN50, LFms2 and HFms2 indices were observed in PG1 and PG2, compared with CG. Conclusions: The cardiac autonomic modulation of individuals with PD was not influenced by the time since diagnosis. However, reduced parasympathetic and global modulation were observed in these individuals, compared with controls. These results emphasize the importance of aerobic exercise for improving autonomic modulation among individuals with PD.

RESUMO Antecedentes: As alterações intrínsecas da doença de Parkinson (DP) afetam o sistema nervoso autônomo, e a evolução da doença pode agravar o quadro inicial. Em outras populações, o impacto do tempo desde o início da doença na modulação autonômica já foi estudado, mas na DP isso ainda não foi investigado. Objetivo: Investigar o impacto do tempo de diagnóstico na modulação autonômica cardíaca de indivíduos com DP e comparar os valores aos de indivíduos saudáveis. Métodos: Cinquenta participantes foram divididos em três grupos: grupo controle (GC; n=24) e dois grupos com DP, divididos de acordo com a mediana do tempo de diagnóstico (5,5 anos): abaixo (GP1; n=13) e acima da mediana (GP2; n=13). Para a avaliação da modulação autonômica cardíaca, a frequência cardíaca foi captada batimento a batimento em posição supina durante 30 minutos, e os índices de variabilidade da frequência cardíaca (VFC) foram calculados utilizando métodos lineares nos domínios do tempo e frequência. Resultados: Não houve diferenças significativas para os índices de VFC entre os grupos GP, ou entre os três grupos para Mean RR, LFun, HFun e relação LF/HF. Foram observadas reduções significativas em RMSSD, SDNN, pNN50, LFms2 e HFms2, para GP1 e GP2 em comparação ao GC. Conclusões: A modulação autonômica cardíaca de indivíduos com DP não foi influenciada pelo tempo de diagnóstico, contudo, foi observada redução da modulação parassimpática e global nesses indivíduos em relação aos controles. Esses resultados reforçam a importância do exercício aeróbio para a melhora da modulação autonômica de indivíduos com DP.

Do heart rate variability indices present potential to predict late postmenopausal? A retrospective study

SUMMARY OBJECTIVES: This study aimed to compare heart rate variability indices in early and late postmenopausal women and assess their correlation and prognostic value to predict late postmenopausal. METHODS: An observational and retrospective study was performed with the medical records of patients from Hospital das Clínicas, Faculdade de Medicina da Universidade de Sao Paulo between 2018 and 2019. We selected medical records of women with menopause, over 40 years old, which were divided into two groups, according to postmenopausal time, i.e., early and late postmenopausal. RESULTS: We analyzed data from 123 women (55 in the early and 68 in the late postmenopausal group). RRtri (triangular index) was lower in the late postmenopausal group (8.68 vs. 7.15, p=0.040). There was a significant weak negative correlation in SDNN, RRtri, and SD2 and postmenopausal time. RRtri presented the potential to predict late postmenopausal. CONCLUSION: The increase in postmenopausal time decreases global heart rate variability indices. The geometric index RRtri was significantly lower in late postmenopausal women and presented the potential to predict late postmenopausal.

Relationship between the number of comorbidities, quality of life, and cardiac autonomic modulation in patients with coronary disease: a cross-sectional study

SUMMARY OBJECTIVE: The aim of this study was to evaluate if there is a relationship between the number of comorbidities, autonomic modulation, and quality of life in patients diagnosed with coronary artery disease. METHODS: A cross-sectional study was conducted at an outpatient rehabilitation center in Presidente Prudente-SP, Brazil. A total of 27 participants (65.33±9.23 years) diagnosed with coronary artery disease were assessed, from a cardiac rehabilitation program, independent of sex or age. The number of comorbidities was evaluated using the Self-Administered Comorbidity Questionnaire, and quality of life was evaluated using the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) (eight domains: functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects, and mental health). To evaluate the cardiac autonomic modulation, the heart rate was registered beat to beat using an heart rate monitor in the supine position during rest for 30 min. A total of 1000 RR intervals were considered to calculate linear (time domain: RMSSD, SDNN; frequency domain: LF, HF, LF/HF) and nonlinear indices (SD1, SD2, SD1/SD2) of heart rate variability. RESULTS: A negative correlation was observed between the aggregation of comorbidities and the pain domain of the SF-36 (r=-0.427; p=0.03). No significant correlations were observed between other variables (p>0.05). CONCLUSION: The number of comorbidities is inversely related to the pain domain of the SF-36, suggesting that a higher pain level is related to a higher number of comorbidities in coronary artery disease patients.

Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study

ABSTRACT BACKGROUND: Cardiac rehabilitation (CR) barriers are well-understood in high-resource settings. However, they are under-studied in low-resource settings, where access is even poorer and the context is significantly different, including two-tiered healthcare systems and greater socioeconomic challenges. OBJECTIVE: To investigate differences in characteristics of patients attending publicly versus privately funded CR and their barriers to adherence. DESIGN AND SETTING: Observational, cross-sectional study in public and private CR programs offered in Brazil. METHODS: Patients who had been attending CR for ≥ 3 months were recruited from one publicly and one privately funded CR program. They completed assessments regarding sociodemographic and clinical characteristics and the CR Barriers Scale. RESULTS: From the public program, 74 patients were recruited, and from the private, 100. Participants in the public program had significantly lower educational attainment (P < 0.001) and lower socioeconomic status (P < 0.001). Participants in the private program had more cognitive impairment (P = 0.015), and in the public program more anxiety (P = 0.001) and depressive symptoms (P = 0.008) than their counterparts. Total barriers among public CR participants were significantly higher than those among private CR participants (1.34 ± 0.26 versus 1.23 ± 0.15/5]; P = 0.003), as were scores on 3 out of 5 subscales, namely: comorbidities/functional status (P = 0.027), perceived need (P < 0.001) and access (P = 0.012). CONCLUSION: Publicly funded programs need to be tailored to meet their patients' requirements, through consideration of educational and psychosocial matters, and be amenable to mitigation of patient barriers relating to presence of comorbidities and poorer health status.

Association Between Different Domains of Physical Activity and Body Adiposity Indicators in Breast Cancer Survivors.

BACKGROUND: To analyze the relationship between different physical activity (PA) domains and adiposity indicators in breast cancer survivors. METHODS: This is a cross-sectional study, composed of 115 breast cancer (BC) survivors. Measurements of weight, height, waist circumference (WC), and hip circumference were objectively collected, as well as the analysis of body fat percentage through bioelectrical impedance analysis. The PA level was assessed by the Baecke questionnaire including domains related to occupational activity, leisure-time activity, and transportation, while the time spent in sedentary behavior was assessed through self-reported screen-time. Socioeconomic status was assessed through the Brazilian criteria for economic classification and considered as a covariate. RESULTS: BC survivors with higher PA levels in leisure-time activity/sport presented reductions in body fat percentage (ß = 1.13%; CI = -2.06; -0.21), BMI (ß = 0.80 kg/m²; CI = -1.50; -0.11), WC (ß = 1.89 cm; CI = -3.54; -0.23), and waist-to-height ratio (ß = 0.13 cm; CI = -0.23; -0.02). Similar values were observed in PA during transportation and in total. There was no correlation between PA at work and adiposity indicators. CONCLUSION: Different PA domains were inversely related to body adiposity in BC survivors.

Outcomes between different validated questionnaires to assess the level of physical activity in cardiac patients adhering to a rehabilitation program / Desfechos entre diferentes questionários validados para a avaliação do nível de atividade física em cardiopatas adeptos a um programa de reabilitação

Abstract Introduction The International Physical Activity Ques-tionnaire (IPAQ) and Baecke inventory are commonly used in cardiovascular rehabilitation routines. Thus, it is understood that investigations on the equivalence of outcomes between these two tools may be relevant to measure the magnitude of possible reproducibility and correlations between them. Objective To compare in cardiac patients the level of physical activity obtained through the IPAQ and Baecke inventory and correlate outcomes obtained with a 6-minute walk test. Methods In total, 65 heart disease patients included in a cardiovascular rehabilitation program (40 male and 25 female) were included, with a mean age of 65.8 ± 10.5 years. The data were obtained from the application of a standardized form, containing the proposed study objects, which were the IPAQ and Baecke inventory. In addition, data regarding anthropometric measurements (body mass, height, and body mass index - BMI), waist-to-hip ratio, blood pressure, and performance in the 6-minute walk test were measured. Results The main outcomes refer to the weak association between the instruments evaluated, which showed a strong relationship only between free time physical activity (r = 1), while in the other categories and when compared to the 6-minute walk test, the verified agreement was not significant. Conclusion The questionnaires are strongly equivalent only for free time physical activity, in the other categories and when compared to the 6-minute walk test, the agreement was not significant. Thus, based on the results, implementation in clinical practice considering the use of these tools with equivalence is not recommended.

Resumo Introdução O Questionário Internacional de Atividade Física (IPAQ) e o inventário de Baecke são comumente utilizados em rotinas de reabilitação cardiovascular. Assim, entende-se que investigações sobre a equiva-lência de desfechos entre essas duas ferramentas possam ser relevantes para mensurar a magnitude da possível reprodutibilidade e correlação entre tais métodos. Objetivo Comparar em cardiopatas o nível de atividade física obtido por meio do IPAQ e do Baecke e correlacionar desfechos obtidos com o teste de cami-nhada de 6 minutos (TC6). Métodos Foram incluídos no estudo 65 cardiopatias inseridos em um programa de reabilitação cardiovascular, sendo 40 do sexo masculino e 25 do sexo feminino, com idade média correspondente a 65,8 ± 10,5 anos. Os dados foram obtidos a partir de um formulário padronizado, contendo os objetos de estudo propostos (IPAQ e Baecke). Além disso, dados referentes a medidas antropométricas (massa corporal, estatura e índice de massa corpórea), relação de cintura quadril, pressão arterial e TC6 foram avaliados. Resultados Os principais desfechos se referem à fraca associação entre os instrumentos avaliados, que demonstraram relação forte somente entre atividade física de tempo livre (r = 1), sendo que nas demais categorias e quando comparadas ao TC6 a concordância verificada não apresentou significância estatística. Conclusão Os questionários se equivalem fortemente somente quando diz respeito à atividade física de tempo livre. Desta forma, não faz sentido a implementação de prática clínica que considere a utilização das ferramentas IPAQ e Baecke com equivalência, o que verificou-se não existir.

Dance therapy as an alternative for cardiac rehabilitation in women population: autonomic and hemodynamic acute responses - a crossover clinical trial protocol

Abstract Aim: The objective of this study is to 1. Investigate in women with cardiac risk factors the acute responses of cardiac autonomic modulation and hemodynamic parameters during and after a dance-based cardiac rehabilitation session and II. Compare these responses with a conventional exercise-based cardiac rehabilitation session. Methods: This will be a crossover-clinical trial that will enroll women with at least one cardiac risk factor. The interventions consist of one dance-based (DB) and one traditional exercise-based (EB) session of cardiac rehabilitation, both composed of initial rest, warm-up, moderate-intensity physical exercise, fast recovery evaluation in orthostatic position, and slow recovery evaluation. The main outcomes are 1. Autonomic modulation, evaluated through heart rate variability linear and non-linear methods, and II. Hemodynamic parameters (heart rate, blood pressure, peripheral oxygen saturation, and respiratory rate). All measures will be evaluated in specific moments during the initial rest, physical exercise, and recovery. Conclusion: The results will allow the safe inclusion of dance-based sessions in cardiac rehabilitation programs opening an important field of research to investigate the long-term effects on physical fitness and cardiac risk factors, as well as adherence and motivation to attend cardiac rehabilitation in the women population.

Autonomic modulation at rest and in response to postural change in adolescents with Duchenne muscular dystrophy: a cross-sectional study / Modulação autonômica em repouso e em resposta a mudanças posturais em adolescentes com distrofia muscular de Duchenne: um estudo transversal

ABSTRACT Background: Analysis of autonomic modulation after postural change may inform the prognosis and guide treatment in different populations. However, this has been insufficiently explored among adolescents with Duchenne muscular dystrophy (DMD). Objective: To investigate autonomic modulation at rest and in response to an active sitting test (AST) among adolescents with DMD. Methods: Fifty-nine adolescents were included in the study and divided into two groups: 1) DMD group: adolescents diagnosed with DMD; 2) control group (CG): healthy adolescents. Participants' weight and height were assessed. Lower limb function, motor limitations and functional abilities of the participants in the DMD group were classified using the Vignos scale, Egen classification and motor function measurement, respectively. The following variables were assessed before, during and after AST: systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (f), oxygen saturation and heart rate (HR). To analyze the autonomic modulation, the HR was recorded beat-by-beat. Heart rate variability (HRV) indices were calculated in the time and frequency domains. Results: Differences in relation to groups were observed for all HRV indices, except LF/HF, oxygen saturation, HR and f (p < 0.05). Differences in relation to time and the interaction effect between group and time were observed for RMSSD, SD1, SD2, SD1/SD2, LFms2 and LFnu, HFun, SBP and DBP (p < 0.05). Differences in relation to time were also observed for the indice SDNN, FC and f (p < 0.05). Conclusions: Performing the AST promoted reduced autonomic modulation and increased SBP, DBP and HR in adolescents with DMD.

Resumo Antecedentes: A análise da modulação autonômica após mudanças posturais pode gerar informações prognósticas e orientar o tratamento em diferentes populações. Porém, isso não foi suficientemente explorado em adolescentes com DMD. Objetivo: Investigar a modulação autonômica em repouso e em resposta ao teste ativo sentado (TAS) em adolescentes com DMD. Métodos: 59 adolescentes foram incluídos no estudo e divididos em dois grupos: 1) Grupo DMD: adolescentes com diagnóstico de DMD; 2) Grupo controle: adolescentes saudáveis. O peso e a altura dos participantes foram avaliados. No grupo DMD, a funcionalidade de membros superiores, limitações motoras, e habilidades funcionais foram classificadas pela escala de Vignos, Egen Klassification, e motor function measure respectivamente. Pressão arterial sistólica (PAS), pressão arterial diastólica (PAD), frequência respiratória (f), saturação de oxigênio, e frequência cardíaca (FC) foram avaliadas em repouso, durante e após o TAS. Para analisar a modulação autonômica, a FC foi registrada batimento a batimento. Os índices de variabilidade da frequência cardíaca (VFC) foram calculados nos domínios do tempo e da frequência. Resultados: Diferenças entre os grupos foram observadas para todos os índices da VFC, exceto LF/HF, saturação de oxigênio, FC e f (p<0,05). Diferenças em relação ao tempo e interação entre grupo e tempo foram observadas para RMSSD, SD1, SD2, SD1/SD2, LFms2, LFun, HFnu, SBP e DBP (p<0,05). Diferenças em relação ao tempo foram também observadas para o índice SDNN, FC e f (p<0,05). Conclusões: A realização do TAS promoveu redução da modulação autonômica e aumento da PAS, PAD e FC em adolescentes com DMD.

Short-Term Effects of a Resistance Training Program Using Elastic Tubing in Patients with Heart Disease

Abstract Background Resistance training is effective in cardiac rehabilitation; however, it is conventionally performed using free weights or machines, which can pose logistic challenges to patients with restricted mobility. For its ease of access and cost-effectiveness, elastic tubing is a particularly appealing alternative, but it remains underutilized for this purpose. Objective To evaluate muscle strength, functional capacity, aerobic capacity, and quality of life in patients with heart disease in phase II of cardiovascular rehabilitation after a resistance training intervention based solely on elastic tubing. Methods Thirteen patients with heart disease (age 63.33±10.80 years) trained with elastic tubing twice weekly for 6 weeks, with progressive load increase every 15 days. The following muscle groups were evaluated and trained: shoulder abductors and flexors, elbow flexors, and knee flexors and extensors. Muscle strength was evaluated using a dynamometer; functional capacity, with a 6-minute walk test and cardiopulmonary exercise test; and quality of life, using the SF-36 questionnaire. Data normality was assessed using the Shapiro-Wilk test. The paired Student's t-test was used for comparisons before and after training, at a significance level of <5%. Results There were significant differences in muscle strength (except for elbow flexion) and functional capacity (485.5 ± 123.3 vs 578.7 ± 110.5; p=0.0399) after the intervention. No statistical differences were found in cardiorespiratory fitness or quality of life. Conclusions Short-term resistance training with elastic tubing improved peripheral muscle strength and functional capacity in patients with heart disease, and should be encouraged for this population. (Int J Cardiovasc Sci. 2020; xx(x):xxx-xxx)

Supplementation of polyunsaturated fatty acids (PUFAs) and aerobic exercise improve functioning, morphology, and redox balance in prostate obese rats.

The high-fat diet (HFD) stimulates an increase in lipids and can be prejudicial for harmful to prostatic morphogenesis. Polyunsaturated fatty acid (PUFAs) have anti-inflammatory and antioxidant action in some types of cancer. The combination of aerobic physical exercise and PUFA can be more effective and reduce the risk of death. The study evaluates the effects of aerobic physical exercise associated with omega-3 (fish and chia oils), on the ventral prostate of Wistar rats those fed with HFD. Here, we report that HFD modified the final body weight and the weight gain, decreased the expression of the androgen receptor and increased prostatic inflammation via TNF-α produced damage prostatic like intraepithelial neoplasia. The supplementation with fish oil decreases final body weight, reduced BCL-2 and inflammation compared to chia oil; aerobic physical exercise associated with fish oil reduced lipids circulant and prostatic, increased proteins pro-apoptotic expression and reduced IL-6 (p < 0.0001) and TNF-α potentiating the CAT (p = 0.03) and SOD-1 (p = 0.001) expression. Additionally, the chia oil increased the NRF-2 (p < 0.0001) and GSS (p = 0.4) genes. PUFAs reduced the damage caused by excessive high-fat diet in the prostate so that there is greater effectiveness in omega-3 intake, it is necessary to associate with aerobic physical exercise.

Parkinson's disease effect on autonomic modulation: an analysis using geometric indices / Efeito da doença de Parkinson na modulação autonômica: análise por meio de índices geométricos

ABSTRACT Background: Parkinson's disease (PD) produces autonomic changes, indicating lower parasympathetic modulation and global variability, but these changes need further studying regarding geometric methods. Objective: To investigate the autonomic modulation in individuals with PD using heart rate variability (HRV) indices obtained through geometric methods. Methods: This is a cross-sectional study that assessed 50 individuals, split into two groups: PD group (PDG; n=26; 75.36±5.21 years) and control group (CG; n=24; 75.36±5.21 years). We evaluated the autonomic modulation by measuring the heart rate beat-to-beat for 30 min with the individual in supine rest using a heart rate monitor and assessed geometric indices (RRtri, TINN, SD1, SD2, SD1/SD2 ratio, and qualitative analysis of the Poincaré plot). Results: Significant reductions were found in RRtri, TINN, SD1, and SD2 indices among PDG compared to CG. Regarding the SD1/SD2 ratio, no significant changes were detected between the groups. The Poincaré plot demonstrated that individuals with PD had lower beat-to-beat dispersion in RR intervals, in addition to greater long-term dispersion of RR intervals compared to CG. Conclusions: The results suggest a reduction in the parasympathetic autonomic modulation and global variability in individuals with PD compared to controls, regardless of sex, age, and body mass index.

RESUMO Introdução: A doença de Parkinson (DP) produz alterações autonômicas, que indicam menor modulação parassimpática e variabilidade global, mas que devem ser investigadas quanto aos métodos geométricos. Objetivo: Investigar a modulação autonômica em indivíduos com DP, por meio de índices de variabilidade da frequência cardíaca (VFC) obtidos pelos métodos geométricos. Métodos: Estudo transversal, no qualforam avaliados 50 voluntários, divididos em dois grupos: o grupo doença de Parkinson (GDP; n=26; 75,36±5,21 anos) e o grupo controle (GC; n=24; 75,36±5,21 anos). Para a avaliação da modulação autonômica a frequência cardíaca foi captada batimento a batimento por meio de um cardiofrequencímetro com os indivíduos em decúbito dorsal por 30 min e índices geométricos da VFC foram avaliados (RRtri, TINN, SD1, SD2 e plot de Poincaré). Resultados: Houve reduções nos índices RRtri, TINN, SD1 e SD2 para o GDP em comparação ao GC. Para a relação SD1/SD2, diferenças significantes não foram observadas entre os grupos. O plot de Poincaré mostrou que indivíduos com DP têm menor dispersão batimento a batimento dos intervalos RR, bem como maior dispersão dos intervalos RR a longo prazo em relação ao GC. Conclusão: Os resultados sugerem haver diminuição da modulação autonômica parassimpática e da variabilidade global em indivíduos com DP em relação a indivíduos sem a doença, as quais são independentes de sexo, idade e índice de massa corporal.

Qualidade do Sono Associada ao Nível Habitual de Atividade Física e Sistema Nervoso Autônomo de Fumantes / Sleep Quality Associated with Habitual Physical Activity Level and Autonomic Nervous System of Smokers

Resumo Fundamento Poucos estudos já examinaram a relação do nível habitual de atividade física e a modulação do sistema nervoso autônomo (SNA) na qualidade do sono de fumantes. Objetivos O objetivo deste estudo foi identificar alterações na qualidade do sono de fumantes e sua relação com nível habitual de atividade física e modulação do SNA. Métodos Um total de 42 fumantes foram divididos em dois grupos de acordo com o 50º percentil de atividade física de moderada a vigorosa (AFMV). A qualidade do sono foi avaliada utilizando-se o Mini-Sleep Questionnaire (mini questionário do sono), e a modulação do SNA foi avaliada por índices de variabilidade de frequência cardíaca (VFC). Para a análise de possíveis diferenças de média, foi utilizada a análise de covariância (ANCOVA) para ajuste de idade, gênero, composição corporal, maços-ano, betabloqueadores, ansiedade, e depressão, em log base 10, exceto por dados qualitativos, tais como gênero e betabloqueadores. Foram estabelecidas correlações utilizando-se a correlação de postos de Spearman. A significância estatística foi definida em 5%. Resultados Os fumantes que eram menos ativos demonstraram pior qualidade do sono (p=0,048) e insônia (p=0,045). Além disso, o grupo menos ativo apresentou redução na modulação parassimpática [HF (un; p=0,049); RMSSD (ms; p=0,047) e SD1 (ms; p=0,047)] e aumento do índice de LF (un) index (p=0,033) e razão LF/HF (p=0,040). Houve correlação positiva entre a pontuação total no Mini-sleep com o índice de LF (un) (r=0,317, p=0,041) e razão LF/HF (r=0,318, p=0,040) e correlação negativa com o índice de HF (un) (r= -0,322, p=0,038). Conclusões Fumantes com baixo nível de atividade física habitual apresentaram baixa qualidade do sono e alterações na modulação do sistema nervoso autônomo. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Abstract Background Few studies have examined the relationship of one's habitual physical activity level and autonomic nervous system (ANS) modulation on sleep quality in smokers. Objective The aim of this study was to identify changes in the sleep quality of smokers and its relation with their habitual physical activity level and ANS modulation. Methods Forty-two smokers were divided into two groups according to the 50th percentile of the moderate-to-vigorous physical activity (MVPA). Sleep quality was assessed using the Mini-sleep Questionnaire, and ANS modulation was assessed by indices of heart rate variability (HRV). To examine the possible mean differences, the analysis of covariance (ANCOVA) was used, adjusted for age, sex, body composition, pack-years, beta-blockers, anxiety, and depression in log base 10, not including qualitative data, such as sex and beta-blockers. Correlations were made by using the Spearman rank correlation. The statistical significance was set at 5% Results The smokers who were less active showed poor sleep quality (p=0.048) and insomnia (p=0.045). Furthermore, the less active group presented decreased parasympathetic modulation [HF (un; p=0.049); RMSSD (ms; p=0.047) and SD1 (ms; p=0.047)] and an increased LF (un) index (p=0.033) and LF/HF ratio (p=0.040). A positive correlation between the total Mini-sleep score with LF (un) index (r=0.317, p=0.041) and LF/HF ratio (r=0.318, p=0.040) and negative correlation with HF (un) index (r= -0.322, p=0.038). Conclusions Smokers with lower levels of habitual physical activity showed poor sleep quality and alterations in autonomic nervous system modulation; (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Sleep Quality Associated with Habitual Physical Activity Level and Autonomic Nervous System of Smokers. / Qualidade do Sono Associada ao Nível Habitual de Atividade Física e Sistema Nervoso Autônomo de Fumantes.

BACKGROUND: Few studies have examined the relationship of one's habitual physical activity level and autonomic nervous system (ANS) modulation on sleep quality in smokers. OBJECTIVE: The aim of this study was to identify changes in the sleep quality of smokers and its relation with their habitual physical activity level and ANS modulation. METHODS: Forty-two smokers were divided into two groups according to the 50th percentile of the moderate-to-vigorous physical activity (MVPA). Sleep quality was assessed using the Mini-sleep Questionnaire, and ANS modulation was assessed by indices of heart rate variability (HRV). To examine the possible mean differences, the analysis of covariance (ANCOVA) was used, adjusted for age, sex, body composition, pack-years, beta-blockers, anxiety, and depression in log base 10, not including qualitative data, such as sex and beta-blockers. Correlations were made by using the Spearman rank correlation. The statistical significance was set at 5. RESULTS: The smokers who were less active showed poor sleep quality (p=0.048) and insomnia (p=0.045). Furthermore, the less active group presented decreased parasympathetic modulation [HF (un; p=0.049); RMSSD (ms; p=0.047) and SD1 (ms; p=0.047)] and an increased LF (un) index (p=0.033) and LF/HF ratio (p=0.040). A positive correlation between the total Mini-sleep score with LF (un) index (r=0.317, p=0.041) and LF/HF ratio (r=0.318, p=0.040) and negative correlation with HF (un) index (r= -0.322, p=0.038). CONCLUSIONS: Smokers with lower levels of habitual physical activity showed poor sleep quality and alterations in autonomic nervous system modulation; (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).

FUNDAMENTO: Poucos estudos já examinaram a relação do nível habitual de atividade física e a modulação do sistema nervoso autônomo (SNA) na qualidade do sono de fumantes. OBJETIVOS: O objetivo deste estudo foi identificar alterações na qualidade do sono de fumantes e sua relação com nível habitual de atividade física e modulação do SNA. MÉTODOS: Um total de 42 fumantes foram divididos em dois grupos de acordo com o 50º percentil de atividade física de moderada a vigorosa (AFMV). A qualidade do sono foi avaliada utilizando-se o Mini-Sleep Questionnaire (mini questionário do sono), e a modulação do SNA foi avaliada por índices de variabilidade de frequência cardíaca (VFC). Para a análise de possíveis diferenças de média, foi utilizada a análise de covariância (ANCOVA) para ajuste de idade, gênero, composição corporal, maços-ano, betabloqueadores, ansiedade, e depressão, em log base 10, exceto por dados qualitativos, tais como gênero e betabloqueadores. Foram estabelecidas correlações utilizando-se a correlação de postos de Spearman. A significância estatística foi definida em 5%. RESULTADOS: Os fumantes que eram menos ativos demonstraram pior qualidade do sono (p=0,048) e insônia (p=0,045). Além disso, o grupo menos ativo apresentou redução na modulação parassimpática [HF (un; p=0,049); RMSSD (ms; p=0,047) e SD1 (ms; p=0,047)] e aumento do índice de LF (un) index (p=0,033) e razão LF/HF (p=0,040). Houve correlação positiva entre a pontuação total no Mini-sleep com o índice de LF (un) (r=0,317, p=0,041) e razão LF/HF (r=0,318, p=0,040) e correlação negativa com o índice de HF (un) (r= -0,322, p=0,038). CONCLUSÕES: Fumantes com baixo nível de atividade física habitual apresentaram baixa qualidade do sono e alterações na modulação do sistema nervoso autônomo. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).