Effect of pursed-lip breathing in patients with COPD: Linear and nonlinear analysis of cardiac autonomic modulation.

OBJECTIVE: The aim of the present study was to evaluate the effect of pursed-lip breathing (PLB) on cardiac autonomic modulation in individuals with chronic obstructive pulmonary disease (COPD) while at rest. METHODS: Thirty-two individuals were allocated to one of two groups: COPD (n = 17; 67.29 ± 6.87 years of age) and control (n = 15; 63.2 ± 7.96 years of age). The groups were submitted to a two-stage experimental protocol. The first stage consisted of the characterization of the sample and spirometry. The second stage comprised the analysis of cardiac autonomic modulation through the recording of R-R intervals. This analysis was performed using both nonlinear and linear heart rate variability (HRV). In the statistical analysis, the level of significance was set to 5% (p ≤ 0.05). RESULTS: PLB promoted significant increases in the SD1, SD2, RMSSD and LF (ms(2)) indices as well as an increase in α1 and a reduction in α2 in the COPD group. A greater dispersion of points on the Poincaré plots was also observed. The magnitude of the changes produced by PLB differed between groups. CONCLUSION: PLB led to a loss of fractal correlation properties of heart rate in the direction of linearity in patients with COPD as well as an increase in vagal activity and impact on the spectral analysis. The difference in the magnitude of the changes produced by PLB between groups may be related to the presence of the disease and alterations in the respiration rate.

Complexity of autonomic nervous system function in individuals with COPD.

OBJECTIVE: To evaluate autonomic modulation in individuals with COPD, compared with healthy controls, via recurrence plots (RPs) and linear heart rate variability (HRV) indices. METHODS: We analyzed data on 74 volunteers, who were divided into two groups: COPD (n = 43) and control (n = 31). For calculation of HRV indices, heart rate was measured beat-by-beat during 30 min of supine rest using a heart-rate meter. We analyzed linear indices in the time and frequency domains, as well as indices derived from the RPs. RESULTS: In comparison with the control group, the COPD group showed significant increases in the indices derived from the RPs, as well as significant reductions in the linear indices in the time and frequency domains. No significant differences were observed in the linear indices in the frequency domains expressed in normalized units or in the low frequency/high frequency ratio. CONCLUSIONS: Individuals with COPD show a reduction in both sympathetic and parasympathetic activity, associated with decreased complexity of autonomic nervous system function, as identified by RPs, which provide important complementary information in the detection of autonomic changes in this population.

Sensitivity, Specificity and Predictive Value of Heart Rate Variability Indices in Type 1 Diabetes Mellitus.

BACKGROUND: Heart rate variability (HRV) indices may detect autonomic changes with good diagnostic accuracy. Type diabetes mellitus (DM) individuals may have changes in autonomic modulation; however, studies of this nature in this population are still scarce. OBJECTIVE: To compare HRV indices between and assess their prognostic value by measurements of sensitivity, specificity and predictive values in young individuals with type 1 DM and healthy volunteers. METHODS: In this cross-sectional study, physical and clinical assessment was performed in 39 young patients with type 1 DM and 43 young healthy controls. For HRV analysis, beat-to-beat heart rate variability was measured in dorsal decubitus, using a Polar S810i heart rate monitor, for 30 minutes. The following indices were calculated: SDNN, RMSSD, PNN50, TINN, RRTri, LF ms2, HF ms2, LF un, HF un, LF/HF, SD1, SD2, SD1/SD2, and ApEn. RESULTS: Type 1 DM subjects showed a decrease in sympathetic and parasympathetic activities, and overall variability of autonomic nervous system. The RMSSD, SDNN, PNN50, LF ms2, HF ms2, RRTri, SD1 and SD2 indices showed greater diagnostic accuracy in discriminating diabetic from healthy individuals. CONCLUSION: Type 1 DM individuals have changes in autonomic modulation. The SDNN, RMSSD, PNN50, RRtri, LF ms2, HF ms2, SD1 and SD2 indices may be alternative tools to discriminate individuals with type 1 DM.

Effects of functional training on geometric indices of heart rate variability.

BACKGROUND: Geometric methods provide an analysis of autonomic modulation using the geometric properties of the resulting pattern, and represent an interesting tool in the analysis of heart rate variability (HRV). The aim of this study was to evaluate the impact of functional training on cardiac autonomic modulation in healthy young women using the geometric indices of HRV. METHODS: Data were analyzed from 29 women, and were stratified into a functional training group (FTG, n = 13; 23.00 ± 2.51 years; 21.90 ± 2.82 kg/m2) and a control group (CG, n = 16; 20.56 ± 1.03 years; 22.12 ± 3.86 kg/m2). The FTG received periodized functional training for 12 weeks. The cardiac autonomic modulation of both groups was evaluated before and after this training, and a qualitative analysis was performed using the Poincaré plot. RESULTS: There was a significant increase in the difference of the triangular index (RRTri), SD1, SD2, and RR intervals in the FTG as compared to the CG, and the qualitative analysis from the Poincaré plot showed an increase in the dispersion of beat-to-beat and long-term RR intervals in the functional group after training. No changes were observed in the triangular interpolation of RR interval histogram (TINN) or SD1/SD2. CONCLUSION: Functional training had a beneficial impact on autonomic modulation, as characterized by increased parasympathetic activity and overall variability, thus highlighting the clinical usefulness of this type of training.

Impact of functional training on cardiac autonomic modulation, cardiopulmonary parameters and quality of life in healthy women.

Functional training (FT) promotes benefits in various physical abilities; however, its effect on autonomic modulation, cardiorespiratory parameters and quality of life in the healthy adult population is unknown, and thus, the aim of this study was to evaluate the influence of  FT on these variables in healthy young women. The study consisted of 29 women, distributed into two groups: the FT Group (FTG; n = 13; 23 ± 2·51 years; 21·90 ± 2·82 kg m(-) ²) and the Control Group (CG; n = 16; 20·56 ± 1·03 years; 22·12 ± 3·86 kg m(-) ²). The FTG performed periodized FT for 12 weeks, three times a week. The following were evaluated: autonomic modulation (heart rate variability), cardiorespiratory parameters and quality of life (SF-36 Questionnaire). The Student's t-test for unpaired data or the Mann-Whitney test was used to compare the differences obtained between the final moment and the initial moment of the studied groups (P<0·05). The FTG demonstrated significant improvements in quality of life and autonomic modulation (P<0·05), but not in the cardiorespiratory parameters. Functional training was able to produce improvements in autonomic modulation and quality of life.

Impact of obesity on autonomic modulation, heart rate and blood pressure in obese young people.

INTRODUCTION: Obesity can be understood as a comorbidity of increasing systemic impact, including a deficit in the autonomic nervous system. OBJECTIVE: To analyze cardiac autonomic behavior and hemodynamic parameters in obese young people. METHODS: 92 individuals (20.58±1.48 years) were evaluated, divided into two groups: obese and eutrophic. Heart rate (HR) was captured for 30 min in the supine position whilst breathing spontaneously. Blood pressure (BP) values were obtained prior to performance of the protocol. For the autonomic analysis, 1000 beats were used for the calculation of heart rate variability indices in the time (Mean RR, SDNN and RMSSD) and frequency (LF, HF and LF/HF) domains, in addition to the Poincaré plot (SD1, SD2, SD1/SD2 and qualitative visual analysis). RESULTS: The obese group presented higher baseline BP and HR values compared to the eutrophic. Regarding autonomic modulation a significant decrease was observed in the RMSSD; SD1, HFms and HFnu indices in the obese group, indicating a decrease in vagal activity and reduced SDNN and SD2 rates, with statistical significance for the former, suggesting a reduction in overall variability. The high value of the LFnu index and decrease in Mean RR in the obese group pointed to relative sympathetic predominance in these individuals. The visual analysis of the Poincaré plot showed less dispersion of the points in the obese group. CONCLUSION: The obese group presented higher BP and HR values at rest and autonomic impairment, characterized by a reduction in parasympathetic activity and relative predominance of sympathetic activity.

HRV Analysis: A Clinical and Diagnostic Tool in Chronic Obstructive Pulmonary Disease.

This study's aim is to analyze heart rate dynamics in subjects with chronic obstructive pulmonary disease (COPD) by measures of heart rate variability (HRV). HRV is a simple and noninvasive measure of autonomic impulses. 38 adults were divided into two equal groups based on respiratory function: COPD and normal. HRV was monitored in the supine position for 30 minutes. After tests of normality, Kruskal-Wallis was used for the statistical analysis, with the level of significance set at P < 0.05. Principal component analysis identified two components representing 99.5% of total variance. Furthermore, it is suggested that the chaos forward parameter (CFP) which applies all three "chaotic globals" is the most influential, although others are statistically more significant. The COPD subjects exhibited a decrease in the CFP. COPD can be termed a dynamical condition, decreasing the chaotic response. The perceived benefits of such analysis include quantitative assessment and suitable pharmacological intervention in the respiratory condition, especially of other related dynamical diseases such as cardiac failure.

Cardiac risk stratification in cardiac rehabilitation programs: a review of protocols.

OBJECTIVE: Gather and describe general characteristics of different protocols of risk stratification for cardiac patients undergoing exercise. METHODS: We conducted searches in LILACS, IBECS, MEDLINE, Cochrane Library, and SciELO electronic databases, using the following descriptors: Cardiovascular Disease, Rehabilitation Centers, Practice Guideline, Exercise and Risk Stratification in the past 20 years. RESULTS: Were selected eight studies addressing methods of risk stratification in patients undergoing exercise. CONCLUSION: None of the methods described could cover every situation the patient can be subjected to; however, they are essential to exercise prescription.

Heart rate variability in children with type 1 diabetes mellitus.

OBJECTIVE: To gather current information about the effects of type 1 diabetes mellitus on children's cardiac autonomic behavior. DATA SOURCES: The search of articles was conducted on PubMed, Ibecs, Medline, Cochrane, Lilacs, SciELO and PEDro databases using the MeSH terms: "autonomic nervous system", "diabetes mellitus", "child", "type 1 diabetes mellitus", "sympathetic nervous system" and "parasympathetic nervous system", and their respective versions in Portuguese (DeCS). Articles published from January 2003 to February 2013 that enrolled children with 9-12 years old with type 1 diabetes mellitus were included in the review. DATA SYNTHESIS: The electronic search resulted in four articles that approached the heart rate variability in children with type 1 diabetes mellitus, showing that, in general, these children present decreased global heart rate variability and vagal activity. The practice of physical activity promoted benefits for these individuals. CONCLUSIONS: Children with type 1 diabetes mellitus present changes on autonomic modulation, indicating the need for early attention to avoid future complications in this group.

Influence of risk behavior aggregation in different categories of physical activity on the occurrence of cardiovascular risk factors.

BACKGROUND: We aimed to verify the association of risk behavior aggregation in different categories of physical activity (PA) with the presence of cardiovascular risk factors (RF) employees at a public university. METHOD: We analyzed data of 376 employees, which were visited in their workplace for measurement of weight, height and questionnaires to identify the risk behaviors and risk factors. Chi-square test was used to analyze the association between the dependent and independent variables and binary logistic regression was used to construct a multivariate model for the observed associations. RESULTS: Associations were found between the aggregation of following risk behaviors: smoking, alcohol consumption and physical inactivity, considered in different categories of PA, and the increase in RF, except for the presence of hypertriglyceridemia. Individuals with two or more risk behaviors in occupational PA category are more likely to be hypertensive (3.04 times) and diabetes (3.44 times). For the free time PA category, these individuals were 3.18 times more likely to have hypercholesterolemia and for locomotion PA, more likely to be hypertensive (2.42 times) and obese (2.51 times). CONCLUSION: There are association between the aggregation of two or more risk behaviors and the presence of cardiovascular RF.

Complexity of autonomic nervous system function in individuals with COPD / Complexidade do sistema nervoso autônomo em indivíduos com DPOC

ABSTRACT Objective: To evaluate autonomic modulation in individuals with COPD, compared with healthy controls, via recurrence plots (RPs) and linear heart rate variability (HRV) indices. Methods: We analyzed data on 74 volunteers, who were divided into two groups: COPD (n = 43) and control (n = 31). For calculation of HRV indices, heart rate was measured beat-by-beat during 30 min of supine rest using a heart-rate meter. We analyzed linear indices in the time and frequency domains, as well as indices derived from the RPs. Results: In comparison with the control group, the COPD group showed significant increases in the indices derived from the RPs, as well as significant reductions in the linear indices in the time and frequency domains. No significant differences were observed in the linear indices in the frequency domains expressed in normalized units or in the low frequency/high frequency ratio. Conclusions: Individuals with COPD show a reduction in both sympathetic and parasympathetic activity, associated with decreased complexity of autonomic nervous system function, as identified by RPs, which provide important complementary information in the detection of autonomic changes in this population.

RESUMO Objetivo: Avaliar a modulação autonômica de indivíduos com DPOC, comparados com um grupo controle saudável, por meio do plot de recorrência (PR) associado a métodos lineares da variabilidade da frequência cardíaca (VFC). Métodos: Foram avaliados dados de 74 voluntários, os quais foram divididos em grupos DPOC (n = 43) e controle (n = 31). Para a análise dos índices de VFC, a frequência cardíaca dos voluntários foi registrada, batimento a batimento, por meio de um cardiofrequencímetro com os voluntários em repouso na posição supina por 30 min. Foram avaliados índices lineares nos domínios de tempo e de frequência, assim como índices obtidos por meio do PR. Resultados: No grupo DPOC, em comparação com o grupo controle, houve aumentos significativos em índices obtidos do PR, assim como houve reduções significativas nos índices lineares nos domínios de tempo e de frequência. Não foram observadas diferenças significativas nos índices lineares nos domínios de frequência em unidades normalizadas e na relação entre os componentes de alta e baixa frequência. Conclusões: Indivíduos com DPOC apresentam uma diminuição tanto da atividade simpática quanto da parassimpática, associada a uma redução da complexidade do sistema nervoso autônomo, identificada pelo PR, que fornece informações complementares importantes na detecção de alterações autonômicas nessa população.

Noninvasive mechanical ventilation in the postoperative cardiac surgery period: update of the literature.

This study aimed to update knowledge regarding to noninvasive ventilation (NVI) on postoperative of cardiac surgery in addition at investigating if exists superiority of any modalities NVI in relation to the others. The literature review was performed on the period between 2006 and 2011, on PubMed, SciELO and Lilacs databases crossing the keywords: artificial respiration, continuous positive airway pressure, intermittent positive-pressure ventilation, cardiac surgery and their corresponding in English. Based on the criteria adopted, nine articles were selected being six of them use NVI, through the modalities such as continuous positive airway pressure, positive pressure with bilevel pressure and intermittent positive-pressure ventilation in postoperative of cardiac surgery; only three of them performed comparisons between different modalities. The NVI modalities that were described on the literature had showed satisfactory results. A few studies compare different NVI modalities; however some of them showed superiority in relation to the others, such as the intermittent positive-pressure ventilation to threat hypoxemia and to positive pressure with bilevel pressure to increase oxygenation, respiratory rate and heart rate in these patients, when compared with other modalities.

Sensitivity, Specificity and Predictive Value of Heart Rate Variability Indices in Type 1 Diabetes Mellitus / Sensibilidade, Especificidade e Valor Preditivo dos Índices da Variabilidade da Frequência Cardíaca no Diabetes Mellitus Tipo 1

Abstract Background: Heart rate variability (HRV) indices may detect autonomic changes with good diagnostic accuracy. Type diabetes mellitus (DM) individuals may have changes in autonomic modulation; however, studies of this nature in this population are still scarce. Objective: To compare HRV indices between and assess their prognostic value by measurements of sensitivity, specificity and predictive values in young individuals with type 1 DM and healthy volunteers. Methods: In this cross-sectional study, physical and clinical assessment was performed in 39 young patients with type 1 DM and 43 young healthy controls. For HRV analysis, beat-to-beat heart rate variability was measured in dorsal decubitus, using a Polar S810i heart rate monitor, for 30 minutes. The following indices were calculated: SDNN, RMSSD, PNN50, TINN, RRTri, LF ms2, HF ms2, LF un, HF un, LF/HF, SD1, SD2, SD1/SD2, and ApEn. Results: Type 1 DM subjects showed a decrease in sympathetic and parasympathetic activities, and overall variability of autonomic nervous system. The RMSSD, SDNN, PNN50, LF ms2, HF ms2, RRTri, SD1 and SD2 indices showed greater diagnostic accuracy in discriminating diabetic from healthy individuals. Conclusion: Type 1 DM individuals have changes in autonomic modulation. The SDNN, RMSSD, PNN50, RRtri, LF ms2, HF ms2, SD1 and SD2 indices may be alternative tools to discriminate individuals with type 1 DM.

Resumo Fundamento: Alguns índices da variabilidade da frequência cardíaca (VFC) podem ser capazes de detectar alterações autonômicas com boa acurácia diagnóstica. Indivíduos com Diabetes Mellitus (DM) tipo 1 podem apresentar alterações na modulação autonômica, contudo, estudos dessa natureza são incipientes nesses sujeitos. Objetivo: Comparar diferentes índices da VFC e avaliar seu valor prognóstico por medidas da sensibilidade, especificidade e valores preditivos em jovens com DM tipo 1 e jovens controles saudáveis. Métodos: Neste estudo transversal, foram realizadas avaliações físicas e clínicas em 39 jovens com DM tipo 1 e 43 jovens saudáveis. Para análise da VFC, a frequência cardíaca foi captada batimento a batimento usando um monitor de frequência acardíaca, PolarS810i, por 30 minutos com os voluntários em decúbito dorsal. Foram calculados os índices: SDNN, RMSSD, PNN50, TINN, RRTri, LF ms2, HF ms2, LF un, HF um, LF/HF, SD1, SD2, SD1/SD2, ApEn. Resultados: Indivíduos com DM tipo 1 apresentam redução na atividade simpática, parassimpática e na variabilidade global do sistema nervoso autônomo. Índices RMSSD, SDNN, PNN50, LF ms2, HF ms2, RRTri, SD1 e SD2 representam melhor acurácia diagnóstica para discriminar indivíduos diabéticos de saudáveis. Conclusão: Indivíduos com DM tipo 1 apresentam alterações na modulação autonômica e os índices SDNN, RMSSD, PNN50, RRtri, LF ms2, HF ms2, SD1 e SD2 podem ser uma opção utilizada para discriminar indivíduos com DM tipo 1.

Automedicação em Indivíduos com Osteoartrose Atendidos em uma Unidade Básica de Saúde / Self-Medication in Individuals with Osteoarthritis Assisted in a Primary Care Facility

Osteoartrose (OA) é uma das perturbaçõesmusculoesqueléticas com o maior complexo sintomatológico. Osindivíduos acometidos utilizam a automedicação como método maisacessível e prático para os sintomas, porém esse ato pode promovergastos desnecessários, atraso no diagnóstico e na terapêutica.Objetivo: verificar a prevalência da automedicação em portadores deOA, além de comparar entre os indivíduos que fazem ou não aautomedicação, características pessoais, da patologia e daautomedicação. Material e métodos: 58 indivíduos com OA foramdivididos em dois grupos de acordo com a automedicação. Voluntáriosresponderam um questionário para caracterização da população, dapatologia e hábito da automedicação. Foram avaliados peso, estatura,circunferência de abdômen, cintura e quadril. Estatística descritiva,teste de Goodman e teste t de Student foram utilizados para análiseestatísticas com p<0,05. Resultados: 60,4% dos voluntários seautomedicam. Nessa população o diagnóstico de OA foi relatado emmais de uma articulação (48,7%), maior presença de dor constante enoturna. Não houve diferenças entre os grupos para locais anatômicos,medicamentos utilizados, valores da escala visual analógica (EVA) eclasse socioeconômica. Voluntários que se automedicam apresentammenores valores de peso, estatura e circunferência abdominal. Nãoforam encontradas associações entre os grupos e os valores de EVAe classe socioeconômica. Conclusão: existe alta prevalência deautomedicação. Aqueles que se automedicam apresentam níveis dedor entre 6 e 8, e os analgésicos e antinflamátórios são os maisutilizados, seguidos de variadas técnicas para controle da dor. Não háassociação entre utilização da automedicação e os valores de escalade dor e as classes socioeconômicas...

Osteoarthritis is considered one of the mostsymptomatically complex musculoskeletal disorders. Affectedindividuals often use self-medication as a more accessible and practicalmethod to alleviate their symptoms. However, this act can promoteunnecessary spending, as well as delay in diagnosis and treatment.Objective: To verify the prevalence of self-medication in patients withosteoarthritis, and perform a comparative analysis between theseindividuals and those who do not self-medicate. The analysis addressedtopics concerning personal features, pathology and self-medicationprofile. Material and Methods: A total of 58 individuals with osteoarthritiswere divided into two groups according to self-medication. Volunteersanswered a questionnaire addressing the study population profile,characteristics of the disease and self-medication habits. Weight,height, abdominal circumference, waist circumference and hipcircumference were evaluated. Descriptive statistics, Goodman testand Student’s t test were used for statistical analysis, with p <0.05.Results: 60.4% of the volunteers reported the habit of self-medication.In this population, osteoarthritis was diagnosed in more than one joint(48.7%), with greater constant, nocturnal pain. There were nodifferences between groups concerning anatomical sites, used drugs,visual analogic scale (VAS) values and socioeconomic profile. Thevolunteers who self-medicate showed lower weight, height and waistcircumference measurements. There were no associations betweenthe groups and the VAS values and socioeconomic class. Conclusions:A high prevalence of self-medication was found. The individuals whoself-medicate showed pain levels between 6 and 8. They usually takeanalgesics and anti-inflammatory drugs, followed by various techniquesfor pain control. There was no association between self-medicationand the pain scale values and socioeconomic class...

Cardiac risk stratification in cardiac rehabilitation programs: a review of protocols / Estratificação de risco cardíaco em programas de reabilitação cardíaca: revisão de protocolos

Objective: Gather and describe general characteristics of different protocols of risk stratification for cardiac patients undergoing exercise. Methods: We conducted searches in LILACS, IBECS, MEDLINE, Cochrane Library, and SciELO electronic databases, using the following descriptors: Cardiovascular Disease, Rehabilitation Centers, Practice Guideline, Exercise and Risk Stratification in the past 20 years. Results: Were selected eight studies addressing methods of risk stratification in patients undergoing exercise. Conclusion: None of the methods described could cover every situation the patient can be subjected to; however, they are essential to exercise prescription. .

Objetivo: Reunir e descrever características gerais dos diferentes protocolos de estratificação de risco existentes para cardiopatas submetidos ao exercício. Métodos: Realizou-se busca nas bases eletrônicas LILACS, IBECS, MEDLINE, Biblioteca Cochrane, SciELO, por meio dos descritores: Doenças cardiovasculares, Centros de Reabilitação, Guia de Prática Clínica, Exercício e Estratificação de Risco e a palavra-chave "Risk Stratification", nos últimos 20 anos. Resultados: Foram selecionados oito trabalhos abordando métodos de estratificação de risco em indivíduos submetidos a exercício. Conclusão: Nenhum dos métodos descritos conseguiu abranger todas as situações de risco a que o paciente está sujeito, porém eles são fundamentais para prescrição do exercício. .

Heart rate variability in children with type 1 diabetes mellitus / Variabilidad de la frecuencia cardiaca en niños con diabetes mellitus tipo 1 / Variabilidade da frequência cardíaca em crianças com diabetes melito tipo 1

To gather current information about the effects of type 1 diabetes mellitus on children's cardiac autonomic behavior. DATA SOURCES: The search of articles was conducted on PubMed, Ibecs, Medline, Cochrane, Lilacs, SciELO and PEDro databases using the MeSH terms: "autonomic nervous system", "diabetes mellitus", "child", "type 1 diabetes mellitus", "sympathetic nervous system" and "parasympathetic nervous system", and their respective versions in Portuguese (DeCS). Articles published from January 2003 to February 2013 that enrolled children with 9-12 years old with type 1 diabetes mellitus were included in the review. DATA SYNTHESIS: The electronic search resulted in four articles that approached the heart rate variability in children with type 1 diabetes mellitus, showing that, in general, these children present decreased global heart rate variability and vagal activity. The practice of physical activity promoted benefits for these individuals. CONCLUSIONS: Children with type 1 diabetes mellitus present changes on autonomic modulation, indicating the need for early attention to avoid future complications in this group...

Reunir informaciones actuales sobre los efectos de la diabetes mellitus tipo 1 sobre el comportamiento cardiaco de niños. FUENTES DE DATOS: La búsqueda de artículos se realizó en las bases de datos PubMed, Ibecs, Medline, Cochrane, Lilacs y PEDro por medio de los descriptores del área de salud (DeCS) a continuación: "sistema nervioso autónomo", "diabetes mellitus", "niño", "diabetes mellitus tipo 1", "sistema nervioso simpático" y "sistema nervioso parasimpático" sus respectivas versiones en lengua inglesa (MeSH).Los artículos fueron publicados de enero de 2003 a febrero de 2013, implicando a niños de nueve a 12 años portadores de diabetes mellitus tipo 1. SÍNTESIS DE LOS DATOS: La búsqueda resultó en cuatro artículos que trataban la variabilidad de la frecuencia cardiaca en niños con diabetes mellitus tipo 1, demostrando que, por lo general, esos niños presentan reducción de la variabilidad de la frecuencia cardiaca global y de la actividad vagal. La práctica de actividad física promueve beneficios al organismo de niños con diabetes mellitus tipo 1. CONCLUSIONES: Niños diabéticos tipo 1 presentan modificaciones en la modulación autonómica, lo que demuestra la necesidad de atención temprana a esa población para evitar complicaciones futuras...

Reunir informações atuais acerca dos efeitos do diabetes melito tipo 1 sobre o comportamento autonômico cardíaco de crianças. FONTES DE DADOS: A busca dos artigos foi realizada nas bases de dados PubMed, Ibecs, Medline, Cochrane, Lilacs, SciELO e PEDro por meio dos seguintes descritores da área da saúde (DeCS): "sistema nervoso autônomo", "diabetes mellitus", "criança", "diabetes mellitus tipo 1", "sistema nervoso simpático" e "sistema nervoso parassimpático" e suas respectivas versões em língua inglesa (MeSH). Os artigos foram publicados de janeiro de 2003 a fevereiro de 2013, envolvendo crianças de nove a 12 anos portadoras de diabetes melito tipo 1. SÍNTESE DOS DADOS: A busca resultou em quatro artigos que abordam a variabilidade da frequência cardíaca em crianças com diabetes melito tipo 1, demonstrando que, em geral, essas crianças apresentam redução da variabilidade da frequência cardíaca global e da atividade vagal. A prática de atividade física promove benefícios no organismo de crianças com diabetes melito tipo 1. CONCLUSÕES: Crianças diabéticas tipo 1 apresentam modificações na modulação autonômica, o que demonstra a necessidade de atenção precoce a essa população para evitar complicações futuras...

Associação entre atividade física e fatores de risco cardiovasculares em indivíduos de um programa de reabilitação cardíaca / Association between physical activity and cardiovascular risk factors in individuals undergoing cardiac rehabilitation program

INTRODUÇÃO: A prática de atividade física (AF) apresenta relação inversa com fatores de risco (FR) de doenças cardiovasculares, com efeitos positivos na qualidade de vida e em outras variáveis físicas e psicológicas. Contudo, não estão estabelecidos os benefícios das atividades cotidianas. OBJETIVO: Investigar a prevalência e a associação entre dos fatores de risco cardiovasculares e diversas categorias de atividade física de pacientes de um programa de reabilitação cardíaca. MÉTODOS: Avaliou-se 69 participantes e foram verificados peso, altura e pressão arterial. Logo após, os pacientes responderam aos questionários autorreferidos para avaliar o nível de atividade física, nível de estresse e verificar a presença dos FR. Utilizou-se regressão logística para estimar a razão de chance. RESULTADOS: Encontrou-se alta prevalência de FR nos indivíduos, sendo idade e hipertensão arterial mais prevalentes, enquanto tabagismo e estresse apresentaram menor prevalência. A maioria foi classificada como sedentária, exceto para AF de locomoção (AFL). CONCLUSÃO: Há alta prevalência de FR em pacientes que frequentam programas de reabilitação cardíaca e os sedentários possuem maior chance de apresentarem os FR hipertensão arterial, obesidade, tabagismo, álcool e estresse que os ativos, dependendo da categoria de AF.

INTRODUCTION: Physical activity (PA) practice presents an inverse relation with risk factors (RF) of cardiovascular disease, with positive effects in quality of life and other physical and psychological variables. However, the benefits of daily activities have not been established. OBJECTIVE: To investigate the prevalence and association of cardiovascular risk factors and physical activity in different categories of patients under a cardiac rehabilitation program. METHODS: 69 participants of a cardiac rehabilitation program were evaluted and weigth, heigth and blood pressure were checked. Afterwards, the patients answered questionnaires to assess self-reported physical activity level, stress level and verify the presence of RF. Logistic regression ws used to estimate odds ratio. RESULTS: High prevalence of RF was found in the subjects, age and hypertension were more prevalent while smoking and stress had lower prevalence. Most individuals were classified as sedentary, except for locomotion PA (LPA). CONCLUSION: That there is high prevalence of RF in patients attending cardiac rehabilitation programs, while sedentary ones are more likely to have the RF hypertension, obesity, smoking, alcohol and stress than the active ones, depending on the PA category.

Variabilidade da frequência cardíaca como recurso em fisioterapia: análise de periódicos nacionais / Heart rate variability as a resource in physical therapy: analysis of national journal

INTRODUÇÃO: O sistema nervoso autônomo (SNA) pode ser investigado de forma não invasiva a partir da análise da variabilidade da frequência cardíaca (VFC) e sua utilização para avaliação do SNA tem contribuído com várias áreas da saúde, dentre elas, a fisioterapia. OBJETIVOS: Reunir estudos publicados em periódicos de circulação nacional da área que abordassem a utilização da VFC em fisioterapia, a fim de fornecer uma atualização dos achados para a área. MATERIAIS E MÉTODOS: Foram selecionados, na lista de periódicos do WebQualis da área 21, todos os periódicos de circulação nacional que utilizam a palavra fisioterapia em seu título, com disponibilidade livre e textos completos em algum sítio da internet e que possuíssem classificação maior ou igual a B2. Com esses critérios, foram selecionados artigos das seguintes revistas: Revista Brasileira de Fisioterapia, Fisioterapia e Pesquisa e Fisioterapia em Movimento. Para essa busca, foram utilizados os descritores: "sistema nervoso autônomo", "sistema nervoso simpático", "fisioterapia" e "variabilidade da frequência cardíaca". RESULTADOS: A busca resultou em 19 artigos, sendo 17 ensaios clínicos e dois relatos de caso. CONCLUSÃO: A VFC tem sido utilizada no âmbito da fisioterapia como recurso para avaliação de intervenções fisioterapêuticas, como forma de investigação de condições patológicas comuns à prática clínica e para interpretação de condições fisiológicas. A sua utilização é feita principalmente pela especialidade de fisioterapia cardiorrespiratória.

INTRODUCTION: The autonomic nervous system (ANS) could be investigated in a noninvasive way by the heart rate variability analysis (HRV) which has contributed to several health areas such as physiotherapy. OBJECTIVE: To gather information regarding the use of HRV on physiotherapy aims at providing an update of the findings for the area on journals of national circulation. MATERIALS AND METHODS: The journals of national circulation classified as greater than B2 or B2 and with free access and complete texts in some internet sites were searched on 21 area WebQualis resulting on selection of Revista Brasileira de Fisioterapia, Fisioterapia e Pesquisa and Fisioterapia em Movimento using the keywords: autonomic nervous system, sympathetic nervous system, physiotherapy and heart rate variability. RESULTS: The search resulted in 19 articles being 17 clinical trials and two case reports. CONCLUSION: The HRV has been used as a resource of interventions evaluation, as pathological conditions common to clinical practice investigation and to physiological conditions interpretation in physiotherapy. The HRV is principally used to the cardiorespiratory specialty of physiotherapy.

Caracterização das categorias de atividade física e associação com variáveis antropométricas de funcionários universitários / Characterization of physical activity categories and association with anthropometric variables of university employees

Os efeitos da atividade física (AF) representam uma proteção para o sistema cardiovascular e podem estar associadas às medidas antropométricas. Assim, o objetivo do estudo foi caracterizar as categorias de AF de funcionários de uma Universidade e comparar e associar com as variáveis antropométricas. Avaliou-se 311 funcionários divididos em três grupos: docente (n = 136), técnico-administrativo (tec/adm) (n = 110) e operacional (n = 65). Os mesmos foram visitados no próprio local de trabalho e coletou-se o peso, a altura e a circunferência abdominal. As categorias de AF foram avaliadas pelo inventário de Baecke aplicado em forma de entrevista. A comparação das categorias de AF e das variáveis antropométricas entre os grupos de funcionários foi realizada por meio de análise de variância (ANOVA ONE-WAY) seguida da aplicação do teste de Tukey para dados com distribuição normal ou teste de Kruskal-Wallys seguido da aplicação do teste de Dunn para dados com distribuição não normal. Para análise da chance dos grupos ativo e sedentário apresentarem obesidade e risco cardiovascular foi utilizado o teste de Odds Ratio com intervalo de confiança de 95%. Os resultados mostram que o grupo docente apresentou menores escores para AF ocupacional (2,20 ± 0,44; p = 0,0042) e de locomoção (2,10 ± 0,54; p = 0,0761), enquanto o grupo tec/adm para AF total (6,35 ± 1,58; p = 0,0012) e operacional para AF de tempo livre (2,03 ± 0,95; p = 0,0111). Encontraram-se maiores valores antropométricos para o grupo operacional (índice massa corporal: p = 0,0045; circunferência abdominal: p = 0,0111) e não houve associação entre os níveis de AF e as variáveis antropométricas (p > 0,05). Assim, conclui-se que existe diferença entre categorias de AF e variáveis antropométricas dos grupos estudados. Não houve associação significante entre as variáveis, porém os sedentários apresentaram mais chance de serem obesos e terem risco cardiovascular aumentado.

The effects of physical activity (PA) represent a protection for the cardiovascular system and may be associated with anthropometric measurements. The aim of this study was to characterize the categories of PA of employees from a university and compare and associate these categories with anthropometric variables. We evaluated 311 employees and divided them into three groups: teachers (n =136), technical / administrative (tce / adm) (n = 110) and operational group (n = 65). They were visited in the workplace and collected the weight, height and waist circumference. The categories of PA were assessed by inventory Baecke applied as an interview. The comparison of categories of PA with anthropometric variables between employee’s groups was performed by variance’s analysis (ANOVA ONE-WAY) followed by the Tukey test for normally distributed data or Kruskal-Wallys followed the Dunn test for non-normally distributed data. To analyze the chance of active and sedentary groups to present obesity and cardiovascular risk the test odds ratio was used with a confidence interval of 95%. The results showed that the teachers group had lower scores for occupational PA (2.20 ± 0.44, p = 0.0042) and transport (2.10 ± 0.54, p = 0.0761), while the tec / adm group had total physical activity (6.35 ± 1.58, p = 0.0012) and operational PA free time (2.03 ± 0.95, p = 0.0111). It were observed higher values of anthropometric variables for operational group (body mass index: p = 0.0045; abdominal circumference: p = 0.0111) and there was no association between PA levels and anthropometric variables (p> 0.05). Therefore, in conclusion there are differences between categories of PA and anthropometric variables for the studied groups. There was no significant association between the anthropometric variables, but sedentary people had more chance to being obese and having increased cardiovascular risk.