Sports Participation and Health Care Costs in Older Adults Aged 50 Years or Older.

The objective of the study was to analyze the relationship between sports participation and health care costs in older adults. The sample was composed of 556 participants (145 men and 411 women) who were followed from 2010 to 2014. The engagement in sports considered three different components (intensity, volume, and previous time). Health care costs were assessed annually through medical records. Structural equation modeling (longitudinal relationship between sport and costs) and analysis of variance for repeated measures (comparisons over time) were used. Health care costs increased significantly from 2010 to 2014 (analysis of variance; p value = .001). Higher baseline scores for intensity were related to lower health care costs (r = -.223, 95% confidence interval [-.404, -.042]). Similar results were found to volume (r = -.216, 95% confidence interval [-.396, -.036]) and time of engagement (r = -.218, 95% confidence interval [-.402, -.034]). In conclusion, higher sports participation is related to lower health care costs in older adults.

Factors associated with leisure-time physical activity among patients undergoing hemodialysis.

BACKGROUND: End-stage renal disease patients are characterized by low levels of physical activity, especially during leisure time. However, the recognition of variables associated with patterns of physical activity in this population has been little explored. Thus, the objective was to assess factors associated with levels of physical activity during leisure time among patients on haemodialysis. METHODS: Ninety-eight patients (51.6 ± 15.7 years, 57 M/41 F) from two dialysis centres in São Paulo, Brazil participated in this cross-sectional study. Participants were divided into those who never exercised during leisure-time (inactive) and those who exercised at least once a week (active). The independent factors assessed were: socio-demographic data, comorbidities, personal barriers to exercise and physical activity records from childhood to adulthood (tracking of physical activity). RESULTS: Only 27 % of patients were engaged in PA during their leisure time at least once a week. Patients who engaged in regular physical activity during adulthood before the initiation of the hemodialysis treatment (adjusted OR: 7.24 95 % IC: 1.99; 26.50), those who developed the renal disease through diseases other than diabetes or hypertension (adjusted OR: 4.82; 95 % IC: 1.48; 15.68), and those who had no cardiovascular diseases (adjusted OR: 11.33; 95 % IC: 1.23; 103.8) where more likely to be active during their leisure-time. CONCLUSION: Comorbidities such as cardiovascular disease, hypertension and diabetes mellitus as well as the level of physical activity prior to end-stage renal disease could predict leisure-time physical activity among patients receiving hemodialysis therapy.

Agreement between the EWGSOP2 and SDOC consensuses for sarcopenia in patients receiving hemodialysis: Findings of a cross sectional analysis from the SARC-HD study.

BACKGROUND: Differences in definitions and operational diagnoses for sarcopenia create difficulties in understanding the epidemiology of the disease. We examined the prevalences of sarcopenia using the revised European Working Group on Sarcopenia in Older People (EWGSOP2) and the Sarcopenia Definitions and Outcomes Consortium (SDOC) consensuses and analyzed their level of agreement in patients receiving hemodialysis. METHODS: Data from the SARCopenia trajectories and associations with clinical outcomes in patients receiving hemodialysis (SARC-HD) multicenter study in Brazil were analyzed. Muscle strength was assessed using handgrip strength, muscle mass by calf circumference, and physical performance by the 4-m gait speed test. Sarcopenia was diagnosed according to both the EWGSOP2 (low muscle strength plus low muscle mass) and the SDOC (low muscle strength plus low physical performance). The Cohen kappa statistic was used to determine the level of agreement between the consensuses. RESULTS: 838 patients (57.8 ± 15.0 years; 61% men) from 19 dialysis units were included. We found similar prevalences of sarcopenia between the consensuses (EWGSOP2, n = 128, 15.3%; SDOC, n = 105, 12.5%) but with weak agreement (50 of 233 patients, 21.5%; κ = 0.34, 95% CI 0.25-0.43). Agreement was also weak within age categories (≥60 years, κ = 0.34; <60 years, κ = 0.15; both P < 0.001). Of the 51 patients diagnosed by the EWGSOP2 criterion as having severe sarcopenia, all but 1 (98.0%) met the SDOC criterion for sarcopenia (κ = 0.61, 95% CI 0.52-0.70). Low muscle strength was more frequently diagnosed using the SDOC than with the EWGSOP2 (52.3% vs 25.9%). CONCLUSION: We found a weak agreement between the EWGSOP2 and SDOC consensuses for the diagnosis of sarcopenia in patients receiving hemodialysis. Although still weak, agreement was marginally better for older patients. These findings highlight the importance of a global and standardized conceptual diagnosis of sarcopenia.

The burden of physical activity on type 2 diabetes public healthcare expenditures among adults: a retrospective study.

BACKGROUND: Determinants of public healthcare expenditures in type 2 diabetics are not well investigated in developing nations and, therefore, it is not clear if higher physical activity decreases healthcare costs. The purpose of this study was to analyze the relationship between physical activity and the expenditures in public healthcare on type 2 diabetes mellitus treatment. METHODS: Cross-sectional study carried out in Brazil. A total of 121 type 2 diabetics attended to in two Basic Healthcare Units were evaluated. Public healthcare expenditures in the last year were estimated using a specific standard table. Also evaluated were: socio-demographic variables; chronological age; exogenous insulin use; smoking habits; fasting glucose test; diabetic neuropathy and anthropometric measures. Habitual physical activity was assessed by questionnaire. RESULTS: Age (r = 0.20; p = 0.023), body mass index (r = 0.33; p = 0.001) and waist-to-hip ratio (r = 0.20; p = 0.025) were positively related to expenditures on medication for the treatment of diseases other than diabetes. Insulin use was associated with increased expenditures. Higher physical activity was associated with lower expenditure, provided medication for treatment of diseases other than diabetes (OR = 0.19; p = 0.007) and medical consultations (OR = 0.26; p = 0.029). CONCLUSIONS: Type 2 diabetics with higher enrollment in physical activity presented consistently lower healthcare expenditures for the public healthcare system.

Arrhythmia classification from single-lead ECG signals using the inter-patient paradigm.

BACKGROUND AND OBJECTIVES: Arrhythmia is a heart disease characterized by the change in the regularity of the heartbeat. Since this disorder can occur sporadically, Holter devices are used for continuous long-term monitoring of the subject's electrocardiogram (ECG). In this process, a large volume of data is generated. Consequently, the use of an automated system for detecting arrhythmias is highly desirable. In this work, an automated system for classifying arrhythmias using single-lead ECG signals is proposed. METHODS: The proposed system uses a combination of three groups of features: RR intervals, signal morphology, and higher-order statistics. To validate the method, the MIT-BIH database was employed using the inter-patient paradigm. Besides, the robustness of the system against segmentation errors was tested by adding jitter to the R-wave positions given by the MIT-BIH database. Additionally, each group of features had its robustness against segmentation error tested as well. RESULTS: The experimental results of the proposed classification system with jitter show that the sensitivities for the classes N, S, and V are 93.7, 89.7, and 87.9, respectively. Also, the corresponding positive predictive values are 99.2, 36.8, and 93.9, respectively. CONCLUSIONS: The proposed method was able to outperform several state-of-the-art methods, even though the R-wave position was synthetically corrupted by added jitter. The obtained results show that our approach can be employed in real scenarios where segmentation errors and the inter-patient paradigm are present.

Metabolic Syndrome, Physical Activity, and Medication-Related Expenditures: A Longitudinal Analysis.

BACKGROUND: Metabolic syndrome (MetS) is a combination of risk factors for cardiovascular disease and type 2 diabetes mellitus. The prevalence of MetS worldwide is increasing. There is no study investigating the economic burden of MetS, especially in developing countries, on medication-related expenditure. The aim of this study was to investigate the association of medication-related expenditures with MetS and to explore how physical activity (PA) may influence this association. METHODS: A total of 620 participants, 50 years or older, randomly selected in the city of Bauru, Brazil. Participants were followed from 2010 to 2014, and data on health care expenditure were collected annually. PA questionnaire was applied at baseline, 2 (2012), and 4 (2014) years later. RESULTS: Mean age was 64.7 (95% confidence interval, 64.1-65.3). MetS was associated with higher medication expenditure related to diseases of the circulatory (P <.01) and endocrine (P <.01) systems. MetS explained 17.2% of medication-related expenditures, whereas PA slightly attenuated this association, explaining 1.1% of all health care costs. CONCLUSION: This study demonstrates that MetS has a significant burden on health care expenditures among adults, whereas PA seems to affect this phenomenon significantly, but in low magnitude.

The hypotensive effect of Yoga's breathing exercises: A systematic review.

The aim of this review was to evaluate the effect of pranayama (Yoga's breathing exercises) on BP and its applicability in the treatment of hypertension. Thirteen trials, assessing acute (eight studies) and chronic (five studies) BP response to pranayama were included. Significant BP reductions after pranayama were found in both acute (2-10 mmHg mean SBP reduction, N = 5 studies; 1 mmHg mean DBP reduction, N = 1 study) and chronic studies (4-21 mmHg mean SBP reduction, N = 3 studies; 4-7 mmHg mean DBP reduction, N = 2 studies). The pranayama's effect on BP were not robust against selection bias due to the low quality of studies. But, the lowering BP effect of pranayama is encouraging. The pranayama with slower rhythms and manipulation of the nostrils, mainly with breaths by the left, present better results when compared with the other types and should be the main pranayama applied when the goal is to reduce blood pressure especially in hypertensive patients.

Association of Different Physical Activity Domains on All-Cause Mortality in Adults Participating in Primary Care in the Brazilian National Health System: 4-Year Follow-up.

BACKGROUND: Evidence has shown that physical activity (PA) is associated with low mortality risk. However, data about reduced mortality due to PA are scarce in developing countries and the dose-response relationship between PA from different domains and all-cause mortality remains unclear. Thus, the aim of this study is to investigate the association of PA from different domains on all-cause mortality among Brazilian adults. METHODS: 679 males and females composed the study sample. Participants were divided into quartile groups according to PA from different domains (occupational, sports, and leisure-time). Medical records were used to identify the cause of the death. Cox regression analysis was performed to determine the independent associations of PA from different domains and all-cause mortality. RESULTS: During the follow-up period, 59 participants died. The most prevalent cause of death was circulatory system diseases (n = 20; 33.9% [21.8%-45.9%]). Higher scores of occupational (HR= 0.45 [95% CI: 0.20-0.97]), sports (HR= 0.44 [95% CI: 0.20-0.95]) and overall PA (HR= 0.40 [95% CI: 0.17-0.90]) were associated with lower mortality, even after adjustment for confounders. CONCLUSIONS: The findings in this study showed the importance of being active in different domains to reduce mortality risk.

Influence of Estimated Training Status on Anti and Pro-Oxidant Activity, Nitrite Concentration, and Blood Pressure in Middle-Aged and Older Women.

The purpose of this study was to compare the association between anti and pro-oxidant activity, nitrite concentration, and blood pressure (BP) in middle-aged and older women with different levels of estimated training status (TS). The sample consisted of 155 females (50-84 years) who were submitted to a physical examination to evaluate estimated TS through the "Functional Fitness Battery Test," BP measurements, and plasma blood samples to evaluate pro-oxidant and antioxidant activity and nitrite concentrations. Participants were separated by age into a middle-aged group (<65 years) and an older (≥65 years) group and then subdivided in each group according to TS. Blood biochemistry was similar between groups. On the other hand, protein oxidation was lower in participants with higher TS, independent of age. Older females with higher TS presented higher nitrite concentrations, lower lipoperoxidation, and lower values of BP compared with those with lower TS. Lower GPx activity was observed in participants with higher TS compared with middle-aged with lower TS. Thus, our results suggest that good levels of TS may be associated with lower oxidative stress and higher nitrite concentration and may contribute to maintain normal or reduced blood pressure values.

The burden of abdominal obesity with physical inactivity on health expenditure in Brazil

The purpose of this study was to analyze the association between the clustering of physical inactivity with abdominal obesity and public health care expenditure in Brazilian adults. The sample was composed of 963 patients of both genders, randomly selected in the Brazilian Public Health care System during 2010. Entire health care expenditures during the last year were computed and stratified into: medical consultations, medication dispensing, laboratory tests and overall expenditure. Waist circumference was used to diagnose abdominal obesity and physical activity was assessed by previously validated questionnaire. Sedentary and abdominally obese patients (OR= 3.01 [OR95%CI= 1.81-4.99]) had higher likelihood be inserted in the group of higher expenditures than only abdominally obese patients (OR= 1.66 [OR95%CI= 1.07-2.59]). There is a synergic effect between abdominal obesity and physical inactivity on overall health care expenditures.

O objetivo deste estudo foi analisar a associação entre a agregação de inatividade física com a obesidade abdominal e despesas de saúde pública em adultos brasileiros. A amostra foi composta de 963 pacientes de ambos os sexos, selecionados aleatoriamente no Sistema Único de Saúde em 2010. Gastos com saúde durante o último ano foram computados e estratificados em: consultas médicas, distribuição de medicamentos, exames laboratoriais e gasto total. A circunferência da cintura foi usada para diagnosticar a obesidade abdominal e atividade física foi avaliada através de um questionário previamente validado. Pacientes sedentários e com obesidade abdominal (OR = 3.01 [IC95% = 1.81-4.99]) apresentaram maior probabilidade de ser inserido no grupo de despesas mais elevadas do que apenas os pacientes com obesidade abdominal (OR= 1.66 [IC95%= 1.07-2.59]). Existe um efeito sinérgico entre a obesidade abdominal e sedentarismo em despesas totais de saúde.

El objetivo de este estudio fue analizar la asociación entre la agregación de la inactividad física con la obesidad abdominal y el gasto público en salud en adultos brasileños. La muestra consistió en 963 pacientes de ambos sexos, seleccionados al azar en el Sistema de la Salud en 2010. El gasto en salud en el último año se calcula y se estratificó en: consultas médicas, medicamentos, exámenes de laboratorio y el gasto total. Circunferencia de la cintura se utiliza para diagnosticar la obesidad abdominal y la actividad física se evaluó mediante un cuestionario previamente validado. Pacientes sedentarios y con obesidad abdominal (OR= 3,01 [IC95%= 1,81-4,99]) tenían más probabilidades de ser incluido en el grupo de los mayores gastos que sólo los pacientes con obesidad abdominal (OR= 1,66 [IC95%= 1,07-2,59]). Existe un efecto sinérgico entre la obesidad abdominal y la inactividad física en el gasto total en salud.

Relação entre a prática da caminhada não supervisionada e fatores de risco para as doenças cardiovascular em adultos e idosos / Relationship between the practice of unsupervised walking and riskfactors for cardiovascular disease in adults and elderly

A adoção de um estilo de vida ativo através da prática da caminhada é altamente recomendada pelos profissionais de saúde com o intuito de evitar, minimizar ou reverter diversos agravos de saúde que podem comprometer a qualidade de vida da população. Objetivo: Verificar se a prática da caminhada não supervisionada possui estímulo suficiente para a redução de fatores de risco de doenças cardiovasculares em adultos e idosos. Métodos: Participaram deste estudo 225 homens e mulheres saudáveis que foram divididos em 4 grupos: sedentário (G0), caminhada (G1), caminhada e uma atividade extra (G2) e, caminhada e duas atividades extras (G3). Todos os participantes realizaram as seguintes avaliações: International Physical Activity Questionnaire (IPAQ) - versão curta, bateria de testes de aptidão física (AAHPERD), pressão arterial, perfil lipídico e composição corporal. Resultados: Os resultados apontaram que a prática da caminhada não supervisionada (G1) promoveu benefícios limitados à saúde quando comparado ao grupo G3 (índice de aptidão funcional geral = 273,4±111 vs340,6±92; pressão arterial diastólica = 80,0±8 vs 75,4±7 mmHg; HDL colesterol = 44,3±10 vs 50,1±10mg/dL respectivamente). Conclusão: Participar de maior número de atividades foi benéfico para diminuir os fatores de risco de doenças cardiovasculares quando comparados ao grupo sedentário e praticantes apenas de caminhadas...

Remain physically active through the practice of walking is highly recommended by health professionals in order to avoid, minimize or reverse various health disorders that can compromise a good quality of life for the population. Objective: To verify if the non supervised walk has enough stimulation to reduce risk factors of cardiovascular disease in adults and the elderly. Methods: This study included 225 healthy men and women who were divided in 4 groups: sedentary (G0), walk (G1), walk an extra activity (G2), and walk and 2 extra activities (G3). All participants performed the following assessments: questionnaire IPAQ, AAHPERD battery tests, blood pressure, lipid profile and body composition. Results: The results suggest that practice of non supervised walk (G1) promotes limited benefits to the health when compared to G3 (general functional fitness index = 273.4±111 vs 340.6±92; diastolic blood pressure = 80.0±8vs 75.4±7 mmHg; HDL cholesterol = 44.3±10 vs 50.1±10 mg/dL respectively). Conclusions: The increased number of activities (G3) was considered beneficial to reduce the risk factors of cardiovascular disease compared to sedentary (G0) and walk (G1) groups...

Caracterização do tratamento medicamentoso com estatinas em unidade básica de saúde / Characterization of statin treatment in basic healthcare unit

Modelo do Estudo: Estudo retrospectivo. Objetivo do Estudo: Caracterizar as condutas frente às alterações lipídicas e efeitos colaterais durante o tratamento com estatinas em unidades básicas de saúde. Metodologia: Foram analisados os prontuários médicos de mulheres atendidas em uma unidade básica de saúde, dos quais foram obtidos: presença de doenças, medicamentos em uso, tipo e dose de estatina, resultados de exames bioquímicos, queixas osteomusculares, e cessação do uso da estatina, retroagindo as anotações até a consulta médica da prescrição inicial. Resultados: As estatinas prescritas foram sinvastatina e atorvastatina em doses baixas (10-20 mg). As modificações da dose(48,4%) e/ou do tipo (25,4%) ocorreram para adequação do perfil lipídico. Houve redução dos níveis lipídicos sem elevação dos valores de creatina quinase. A cessação de uso do medicamento (30,6%) foi prioritariamente por conta própria (74%), a qual apresentou forte associação com os relatos de desconfortos osteomusculares (Odds Ratio: 6,40[1,53-26,78]). Conclusão: A terapêutica com estatina foi eficaz para redução dos níveis séricos de lipídeos, e os autorrelatos de dor foram subestimados, caracterizando-se como o maior fator limitante da aderência ao tratamento.

Study Model: Retrospective study. Study Objective: To characterize statin treatment management due to lipid alterations and side effects throughout statin treatment in basic healthcare unit. Methods: Medical reports of women from a basic healthcare unit were analyzed, obtaining: disease presence, regular medication prescription, statin type and dosage, biochemical exams results, musculoskeletal complaints, and statin use cessation, going back the information until the medical consultation of first prescription. Results: Prescribed statins were Simvastatin and Atorvastatin at low doses (10-20 mg). Dose(48,4%) and/or type (25,4%) alterations occurred for lipid profile adequacy. Lipid levels were reducedc without creatine kinase elevation. Treatment with drawn (30,6%) was mainly due to their own decision(74%), which was strongly associated with records of musculoskeletal complaints (Odds Ratio: 6,40[1,53-26,78]). Conclusion: Statin treatment was effective in reducing serum lipid levels and self-reported pain was underestimated, characterizing the major limiting factor for treatment adherence.

Avaliação funcional pré e pós-programa de exercício físico de pacientes em hemodiálise / Functional evaluation pre and post physical exercise program for patients in hemodialysis

Modelo do estudo: Estudo experimental. Introdução: A Doença Renal Crônica (DRC) refere-se a um diagnóstico sindrômico de perda progressiva e irreversível da função renal. O paciente submetido à hemodiálise pode apresentar limitações na capacidade funcional, função pulmonar e força muscular respiratória, com consequentes prejuízos na qualidade de vida. Objetivo: Avaliar os efeitos de um programa de exercício físico sobre a função pulmonar, capacidade funcional, qualidade de vida e dor, em pacientes que realizam hemodiálise. Metodologia: Participaram do estudo 28 pacientes de ambos os sexos, com idade entre 40 e 60 anos, em programa de hemodiálise no Instituto do Rim da Santa Casa de Misericórdia de Presidente Prudente-SP. A força muscular respiratória foi avaliada pela manovacuometria, a capacidade funcional, pelo TC6', a qualidade de vida, pelo questionário KDQOLSF, a função pulmonar, pela espirometria e a dor, pela EVA. Após as avaliações, os pacientes iniciaram o programa de exercícios, que foi desenvolvido três vezes por semana, durante 40 minutos em hemodiálise, por oito semanas. Ao final do programa, os pacientes foram reavaliados. Resultados: Não houve diferença significativa dos valores da CVF e VEF1 pré e pós-programa de exercícios, assim como do Índice de Tiffenau. O valor da PImax pós-programa foi significativamente maior que o obtido na avaliação pré-programa. Para a variável PEmax, não foi encontrada diferença significativa. As avaliações da capacidade funcional inicial e final não apresentaram diferenças significativas (p>0,05)...

Model Study: An experimental study Introduction: Chronic Kidney Disease (CKD) refers to a syndromic diagnosis which leads to a progressive and irreversible loss of renal function. A hemodialysis patient may have limitations in functional capacity, pulmonary function and respiratory musclular strength impacting in quality of life. Objective: To evaluate the effects of an exercise program on pulmonary function,functional capacity, quality of life and pain in patients undergoing hemodialysis. Methodology: The study included 28 patients of both genders, women and men aged between 40 and 60 years undergoing dialysis at the Kidney Institute, Santa Casa de Misericordia in Presidente Prudente-SP. Primary outcomes included respiratory muscular strength measurements assessed by manovacuometry. The functional capacity was evaluated by a six minute walking test. A life quality questionnaire was applied to evaluate quality of life (SF36-KDQOL). Lung function was evaluated by spirometry. Pain was assessed by a visual analogue scale. The exercise program consisted of training 3 times a week for 40 minutes on hemodialysis during eight weeks. At the end of the program all patients were reassessed. Results: There was no significant difference in the values of FVC and FEV1 before and after the exercise programas well as the index Tiffenau. The value of post MIP was significantly higher than the value obtained in the pre program. For variable MEP no significant difference was found. Functional capacity evaluations showed that there were no significant differences (p> 0.05). The evaluation of quality of life, about the domains of specific areas of CKD showed statistical significance when comparing the list of symptoms and problems with overloading of renal disease and professional role. Indicators related to pain were significantly reduced after the program (P <0.05)...

Associação entre nível de atividade física e perfil bioquímico de nipo-brasileiros / Association between physical activity and biochemical profile of nipo-brazilian

Descendentes de imigrantes japoneses que vivem no Brasil apresentam alterações das concentrações plasmáticas de glicose e lipídios. Este estudo transversal teve por objetivo verificar a associação entre o perfil bioquímico e suas alterações com o nível de atividade física (AF) de nipo-brasileiros de segunda geração. Foram avaliados 371 participantes (58,8% mulheres) com idade média de 53±9 anos. Os indivíduos foram categorizados de acordo com o International Physical Activity Questionnaire (IPAQ) em baixa AF (GB), AF moderada (GM) e AF vigorosa (GV). Foram dosadas as concentrações plasmáticas de colesterol total (CT), LDL-colesterol (LDL-C), HDL-colesterol (HDL-C), triglicerídeos (TG), glicemia de jejum (GJ) e realizada avaliação antropométrica. Após verificar a normalidade dos dados (Kolmogorov-Smirnov), as variáveis foram comparadas de acordo com o sexo (t de student) e entre os níveis de AF (ANOVA one way) e as associações entre os grupos e as alterações bioquímicas (qui-quadrado). O GB representou 64% da amostra e o GV, 7%. Os homens apresentaram valores mais elevados de GJ e TG. Níveis mais altos de AF foram associados com valores reduzidos de CT e LDL-C em homens (p<0,05). Houve predominância de indivíduos com perfil lipídico alterado no GB e GM, enquanto no GV a predominância foi de normolipidêmicos. A atividade física de intensidade vigorosa e moderada não se associou com valores reduzidos de GJ e de TG, apenas o GV masculino apresentou melhor perfil lipídico. Mudanças relacionadas ao aumento da atividade física são necessárias para essa população.

Japanese immigrants descendants living in Brazil have changes in plasma lipid and glucose levels. This cross-section study aimed to verify the association between biochemical profiles and its changes, and physical activity level (PA) in Japanese-Brazilian of the second generation. We evaluated 371 subjects (58.8% women); mean age 53±9 years. Individuals were categorized according to the International Physical Activity Questionnaire (IPAQ) in low PA (GB), moderate PA (GM) and vigorous PA (GV). The plasma concentrations of the total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), fasting plasma glucose (FPG) were measured and anthropometry evaluation realized. After checking the normality data (Kolmogorov-Smirnov), the variables were compared between sexes (Student t) and between levels of PA (ANOVA One-way) and associations between groups and biochemical changes (chi-square). The GB accounted for 64% of the sample and the GV, 7%. Men showed higher values of FPG and TG. Vigorous PA were associated with reduced values of TC and LDL-C in men (p<0.05). Individuals with altered lipid profile were predominant in GB and GM, while the predominance in the GV was of normolipidemic. The vigorous and moderate physical activity were not associated with reduced values of FPG and TG, only the men GV showed better lipid profile. Changes to increase the physical activity are needed for this population.

Comparação entre hipertensão auto-referida e pressão arterial casual e presença de fatores de risco em funcionários da saúde de Bauru e Jaú / Comparision between self-reported hypertension and casual blood pressure and presence of cardiovascular risk factors among health workers of Bauru and Jau cities

Modelo: Estudo de prevalência. Objetivos: Avaliar a presença de hipertensão arterial auto-referida e comparar com os níveis de pressão arterial aferidos. Além disso, o trabalho se propôs a avaliar o grau de informação dos funcionários da saúde e determinar se o setor onde trabalha o funcionário influencia a Pressão Arterial (PA). Métodos: Foram avaliados 349 funcionários (46±10 anos) das cidades de Bauru e Jaú, que responderam uma anamnese (dados pessoais, condição socioeconômica, presença de doenças, prática de exercícios físicos e setor ocupacional) e foram submetidos a uma avaliação da PA. Os avaliados se auto-referiram normotensos ou hipertensos. Valores de PA Sistólica ≥ 140 mmHg e/ouPA diastólica ≥ 90 mmHg foram considerados elevados. Dentre os avaliados, 198 foram submetidos à avaliações antropométricas e bioquímicas. Os resultados são apresentados como média ± desvio padrão e distribuição de frequência. Utilizou-se teste “T-student” (p<0,05)...

Model: Prevalence study. Objectives: To evaluate the presence of self-reported hypertension to comparewith blood pressure measurements. Besides, this work investigated health information level of workers and if the job position has any influence on blood pressure (BP). Methods: This study evaluated 349 health workers (44±10 years old) from Bauru and Jau cities, who answered some questions about history of health condition, use of medicines, past surgeries as well associal, scholar and physical conditions and had their blood pressure measured. Each subject self-reported as normotensive or hypertensive. Values of systolic ≥ 140 mmHg and/or diastolic PA ≥ 90mmHg were considered elevated. Among the health workers evaluated, 198 were submitted to anthropometric and biochemical evaluations. Values are presented as means ± SD and frequency of distribution.It was used T-student test (p<0.05)...

Efetividade de um programa de exercícios no condicionamento físico, perfil metabólico e pressão arterial de pacientes hipertensos / Exercise program effectiveness on physical fitness, metabolic profile and blood pressure of hypertensive patients

HISTÓRICO E OBJETIVO: Tem sido mostrado que exercícios aeróbios são úteis na redução da pressão arterial. Contudo, a efetividade de um programa de exercícios ainda é controversa e não foi bem analisada em populações de baixa renda. O objetivo do presente estudo foi estabelecer um programa de condicionamento físico individualizado - Projeto Hipertensão - focado em pessoas hipertensas, pacientes da Unidade Básica de Saúde (UBS) e, logo após, investigar os efeitos deste programa no condicionamento físico, perfil metabólico e níveis de pressão. MÉTODOS: Dezesseis mulheres hipertensas (56 ± 3 anos) sob tratamento farmacológico regular foram submetidas a 4 meses de um programa de exercícios aeróbios e de alongamento (3 sessões/semana, 90 min/sessão, 60 por cento de VO2max.) Diversas variáveis físicas e metabólicas foram comparadas antes e depois de 4 meses de treinamento. RESULTADOS: O treinamento diminuiu significativamente a pressão arterial sistólica (PAS, -6 por cento); melhorou o condicionamento cardiorrespiratório (+42 por cento do VO2max), flexibilidade (+11 por cento) e conteúdo de glicose plasmática (-4 por cento). IMC e por cento de gordura não tiveram modificação. Além de modificar o perfil metabólico, observou-se que o treinamento apresentou correlações significativas entre os valores iniciais individuais de nível de colesterol total (CT), lipoproteína de alta densidade (HDL-C) e lipoproteína de baixa densidade (LDL-C) e suas respostas após exercício. CONCLUSÕES: O estudo mostra que programas de exercício podem ser personalizados para pacientes hipertensos da UBS e confirma a efetividade do exercício na PA, condicionamento físico, flexibilidade e perfil lipídico em pacientes hipertensos. A redução expressiva de PA em sujeitos hipertensos sugere que esta intervenção de exercícios deve ser enfatizada em outros centros que assistam populações de baixa renda.

BACKGROUND AND OBJECTIVE: It has been shown that aerobic exercise is useful to reduce arterial pressure, however, the effectiveness of an exercise program is still controversial and not very well analyzed among populations with low-income. The objective of the present study was to set up an individualized physical fitness program - Projeto Hipertensão - focused on hypertensive people, patients from a Health Basic Unit (HBU) and, after that, to investigate the effects of this program on physical fitness, metabolic profile and pressure levels. METHODS: Sixteen hypertensive women (56 ± 3yrs) under regular pharmacological treatment underwent 4 months of a supervised aerobic and stretching exercise program (3 sessions/wk, 90 min/session, 60 percent of VO2 max). Several physical and metabolic variables were compared before and after 4 months of training. RESULTS: Training significantly reduced systolic arterial pressure (SAP, -6 percent), improved cardiorespiratory fitness (+42 percent of VO2max), flexibility (+11 percent) and plasma glucose content (-4 percent). BMI and percent fat did not change. Besides modifying metabolic profile, it was found that training presented significant correlations between individual initial values of cholesterol total level (CT), high density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) and its responses after exercise. CONCLUSIONS: The study shows that exercise programs can be personalized for hypertensive patients from a HBU and confirms the effectiveness of exercise on AP, physical fitness, flexibility and lipid profile on hypertensive patients. The expressive reduction of AP in hypertensive subjects suggests that this exercise intervention should be emphasized on other health centers which assist low-income population.

Agravos músculo-esqueléticos em bailarinas clássicas, não clássicas e praticantes de educação física / Musculoskeletal injuries in classical and non-classical ballerinas, and people who practice physical education: a comparative study

A literatura especializada descreve grande número de agravos que são típicos das praticantes de dança compredominância das lesões nos membros inferiores. No entanto, em nosso meio, pouco se conhece sobre oimpacto da exposição das bailarinas a esses processos mórbidos. O objetivo da presente investigaçãobuscou observar a ocorrência de Agravos Músculos-Esqueléticos (AME) em praticantes de balé e embailarinas sem formação clássica, comparando-as com escolares participantes apenas de aulas de EducaçãoFísica. Para tanto, realizou-se um estudo na cidade de Bauru - SP com 83 jovens de 12 a 17 anos dispostas emtrês grupos, a saber: i) bailarinas clássicas (27); ii) praticantes de dança sem formação clássica (19) e iii)alunas que participavam apenas de aulas escolares de Educação Física (37). A investigação ocorreu noperíodo de 225 dias, sendo que, por quinzena, cada participante foi entrevistada e as informações registradasem formulário específico. Os números médios de dias com AME nos grupos considerados foram de 42,16+59,09nas escolares, 181,80+118,65 para as bailarinas clássicas e 36,32+ 61,71 para às não-clássicas. Entre asbailarinas clássicas, 24 (89%) relataram agravos, as quais passaram, em média, 81% dos dias do período deacompanhamento com manifestações dolorosas. As bailarinas clássicas e não clássicas apresentarammovimentos de flexão como a causa situacional que mais resulta em AME. Entre as escolares os movimentosde força muscular são responsáveis por grande parte dos AME. Entre os grupos a região corporal que maisse destaca com relação a presença de AME é o joelho, com predominância de intensidade moderada. Oelevado número de dias que as bailarinas clássicas referiram queixas de dor pode estar relacionado commovimentos repetitivos resultantes de microtraumas na ultra estrutura de músculos, tendões e ligamentosque indicam o caráter crônico dos agravos.

The technical literature describes a large number of disorders typical of people who practice dance withpredominance of lower extremities injuries. Nevertheless, there is a little knowledge about the impact of theexposure of ballerinas to these morbid processes. The aim of this investigation was to observe the occurrenceof musculoskeletal injuries in ballet dancers and ballerinas with no classical formation comparing them toschool dancers, which only practice it in their physical education classes. To accomplish that, a study wascarried out in Bauru, São Paulo, Brazil, with 83 youths aging from 12 to 17 years old and divided into threegroups as follow: i) classic ballerinas (27); ii) dancers without classical formation (19) and iii) students thatparticipate in regular P.E classes (37). The evaluation was accomplished in 225 days. Each participant wasinterviewed in an interval of fifteen days and an appropriated formulary was filled to register the information.The average of days with musculoskeletal injuries in the considered groups was 42.16 + 59.09 into studentsgroup, 181.80 + 118.65 to classical ballerinas group, and 36.32 + 61.71 to non-classical ballerinas group. Amongclassical ballerinas 24 (89%) presented injuries and spend approximately 81% of the attendance days with painfulmanifestation. The classical and non-classical ballerinas presented movements with flexion as the situationalcause, which mostly results in MSI. Among the schoolgirls the movement of muscular strength is responsible formost part of MSI. Among these groups the body region where the MSI is easily recognized, with predominanceand in moderate intensity, is the knee. The high number of days in which the classical ballerinas mentioned to befeeling pain can be related to the repetitive movements resulting from micro traumas in the ultra structure of themuscles, tendons, and ligaments that indicate the chronic aspect of the injuries.