Upper-Body Muscular Endurance and Its Association with Aerobic Capacity in University Students of Physical Culture, Sport, and Recreation / Fuerza resistencia de miembros superiores y su asociación con la capacidad aeróbica en universitarios de cultura física, deporte y recreación / Resistência Muscular do Corpo Superior e sua Associação com Capacidade Aeróbica em Estudantes Universitários de Cultura Física, Esporte e Recreação

Abstract Introduction: Upper-body muscular endurance (UBME) and aerobic capacity (AC) are essential components of physical fitness. Low levels of these components are related to cardiovascular disease. Purpose: To assess the association between UBME and AC levels in college students of physical culture. Methodology: Analytical cross-sectional study carried out in 192 students (169 men, 23 women; median age 20 years). Every participant of the study signed written consent. UMBE was the dependent variable assessed by the push-up test, and AC was the main independent variable assessed using the 20 m shuttle run test. To analyze differences by sex, and academic semester, Fischer exact, Student's T, and U Mann-Whitney tests were applied. Descriptive, as well as bivariate and multivariate analysis, were realized using logistic regression models. Results: 82.29 % of participants had healthy levels of UBME. Respecting the academic semester, students had a higher probability of having healthy levels of UBME as semesters increased (OR: 1.23, 95 % CI: 1.06 to 1.44, p = 0.007). Concerning AC, 58.33 % of participants registered healthy levels. After adjusting by sex, age, socioeconomic level, and academic semester, maximum oxygen consumption (VO2max), was associated with healthy levels of UBME (OR: 1.157, CI 95 %: 1.O71 - 1.249, p=<0.001). Conclusions: Students had a higher probability of presenting healthy levels of UBME as semesters of study increased, and those with a higheVO2max were more likely to have healthy levels of UBME.

Resumen Introducción: La fuerza resistencia de miembros superiores (FRMS) y la capacidad aeróbica (CA) son componentes esenciales de la condición física. Bajos niveles de estos componentes están relacionados con la enfermedad cardiovascular. Propósito: El objetivo de este estudio fue evaluar la asociación entre los niveles de FRMS y la CA en estudiantes universitarios de cultura física. Metodología: Estudio transversal analítico realizado en 192 estudiantes (169 hombres, 23 mujeres; mediana de edad, 20 años). Cada participante firmó el consentimiento informado. FRMS fue la variable dependiente y se valoró con la prueba de flexiones de brazo, y la CA fue la variable independiente y se evaluó usando la prueba de ida y vuelta de 20 m. Para analizar las diferencias por sexo y semestre académico, fueron utilizadas las pruebas exacta de Fischer, T de Student y U de Mann-Whitney. Se realizaron análisis descriptivos, bivariados y múltiples, usando modelos de regresión logística. Resultados: El 82.29 % de los participantes registraron niveles saludables de FRMS. Respecto al semestre académico, se evidenció una probabilidad más alta de tener niveles saludables de FRMS al incrementarse los semestres de estudio (OR: 1.23, 95 % CI: 1.06 to 1.44, p = 0.007). En lo concerniente a la CA, el 58.33 % de los participantes registro niveles saludables. Después de realizar ajustes por sexo, edad, nivel socioeconómico y semestre académico, el consumo máximo de oxígeno (VO2máx), estuvo asociado con niveles saludables de FRMS (OR: 1.157, CI 95 % 1.O71 - 1.249, p=<0.001). Conclusiones: Los participantes presentaron una mayor probabilidad de tener niveles saludables de FRMS, a medida que incrementaron los semestres de estudio, y aquellos con niveles de VO2máx más alto, fueron más proclives a tener niveles saludables de FRMS.

Resumo Introdução: A resistência muscular do corpo superior (UBME) e a capacidade aeróbica (AC) são componentes essenciais da aptidão física. Baixos níveis desses componentes estão relacionados a doenças cardiovasculares. Propósito: Avaliar a associação entre os níveis de UBME e AC em estudantes universitários de cultura física. Metodologia: Estudo transversal analítico realizado com 192 estudantes (169 homens, 23 mulheres; idade média 20 anos). Todos os participantes do estudo assinaram consentimento por escrito. UBME foi a variável dependente avaliada pelo teste de flexão de braço, e AC foi a principal variável independente avaliada pelo teste de corrida de vaivém de 20 m. Para analisar diferenças por sexo e semestre acadêmico, foram aplicados testes exatos de Fischer, t de Student e U de MannWhitney. Análises descritivas, bivariadas e multivariadas foram realizadas usando modelos de regressão logística. Resultados: 82,29 % dos participantes apresentaram níveis saudáveis de UBME. Respeitando o semestre acadêmico, os estudantes tiveram uma probabilidade maior de ter níveis saudáveis de UBME conforme os semestres aumentavam (OR: 1,23, IC 95 %: 1,06 a 1,44, p = 0,007). Em relação à AC, 58,33 % dos participantes registraram níveis saudáveis. Após ajuste por sexo, idade, nível socioeconômico e semestre acadêmico, o consumo máximo de oxigênio (VO2max) foi associado a níveis saudáveis de UBME (OR: 1,157, IC 95 %: 1,071 - 1,249, p <0,001). Conclusões: Os estudantes tiveram uma probabilidade maior de apresentar níveis saudáveis de UBME conforme os semestres de estudo aumentaram, e aqueles com um VO2max mais alto tiveram maior probabilidade de ter níveis saudáveis de UBME.

Ineficiência Ventilatória Comparável no Desempenho Máximo e Submáximo em Indivíduos com DPOC e ICC: Uma Abordagem Inovadora / Comparable Ventilatory Inefficiency at Maximal and Submaximal Performance in COPD vs. CHF subjects: An Innovative Approach

Resumo Fundamento: Atualmente, o excesso de ventilação tem sido fundamentado na relação entre ventilação-minuto/produção de dióxido de carbono ( V ˙ E − V ˙ CO 2). Alternativamente, uma nova abordagem para eficiência ventilatória ( η E V ˙) tem sido publicada. Objetivo: Nossa hipótese principal é que níveis comparativamente baixos de η E V ˙ entre insuficiência cardíaca crônica (ICC) e doença pulmonar obstrutiva crônica (DPOC) são atingíveis para um nível semelhante de desempenho aeróbico máximo e submáximo, inversamente aos métodos estabelecidos há muito tempo (inclinação V ˙ E − V ˙ CO 2 e intercepto). Métodos: Ambos os grupos realizaram testes de função pulmonar, ecocardiografia e teste de exercício cardiopulmonar. O nível de significância adotada na análise estatística foi 5%. Assim, dezenove indivíduos elegíveis para DPOC e dezenove indivíduos elegíveis para ICC completaram o estudo. Com o objetivo de contrastar valores completos de V ˙ E − V ˙ CO 2 e η E V ˙ para o período de exercício (100%), correlações foram feitas com frações menores, como 90% e 75% dos valores máximos. Resultados: Os dois grupos tiveram características correspondentes para a idade (62±6 vs 59±9 anos, p>.05), sexo (10/9 vs 14/5, p>0,05), IMC (26±4 vs 27±3 Kg m2, p>0,05), e pico V ˙ O 2 (72±19 vs 74±20 % pred, p>0,05), respectivamente. A inclinação V ˙ E − V ˙ CO 2 e intercepto foram significativamente diferentes para DPOC e ICC (207,2±1,4 vs 33,1±5,7 e 5,3±1,9 vs 1,7±3,6, p<0,05 para ambas), mas os valores médios da η E V ˙ foram semelhantes entre os grupos (10,2±3,4 vs 10,9±2,3%, p=0,462). As correlações entre 100% do período do exercício com 90% e 75% dele foram mais fortes para η E V ˙ (r>0,850 para ambos). Conclusão: A η E V ˙ é um método valioso para comparação entre doenças cardiopulmonares, com mecanismos fisiopatológicos até agora distintos, incluindo restrições ventilatórias na DPOC.

Abstract Background: Currently, excess ventilation has been grounded under the relationship between minute-ventilation/carbon dioxide output ( V ˙ E − V ˙ CO 2). Alternatively, a new approach for ventilatory efficiency ( η E V ˙) has been published. Objective: Our main hypothesis is that comparatively low levels of η E V ˙ between chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are attainable for a similar level of maximum and submaximal aerobic performance, conversely to long-established methods ( V ˙ E − V ˙ CO 2 slope and intercept). Methods: Both groups performed lung function tests, echocardiography, and cardiopulmonary exercise testing. The significance level adopted in the statistical analysis was 5%. Thus, nineteen COPD and nineteen CHF-eligible subjects completed the study. With the aim of contrasting full values of V ˙ E − V ˙ CO 2 and η V ˙ E for the exercise period (100%), correlations were made with smaller fractions, such as 90% and 75% of the maximum values. Results: The two groups attained matched characteristics for age (62±6 vs. 59±9 yrs, p>.05), sex (10/9 vs. 14/5, p>0.05), BMI (26±4 vs. 27±3 Kg m2, p>0.05), and peak V ˙ O 2 (72±19 vs. 74±20 %pred, p>0.05), respectively. The V ˙ E − V ˙ CO 2 slope and intercept were significantly different for COPD and CHF (27.2±1.4 vs. 33.1±5.7 and 5.3±1.9 vs. 1.7±3.6, p<0.05 for both), but η V ˙ E average values were similar between-groups (10.2±3.4 vs. 10.9±2.3%, p=0.462). The correlations between 100% of the exercise period with 90% and 75% of it were stronger for η V ˙ E (r>0.850 for both). Conclusion: The η V ˙ E is a valuable method for comparison between cardiopulmonary diseases, with so far distinct physiopathological mechanisms, including ventilatory constraints in COPD.

Adaptation and reliability of tests of functional mobility and muscle strength using telehealth for older people with dementia / Adaptação e confiabilidade de testes de mobilidade funcional e força muscular para idosos com demência por meio de telessaúde

Objective: Adapt functional mobility and muscle strength tests for older people with dementia to be performed remotely in the home environment; determine intra-rater and inter-rater reliability of functional mobility and strength tests for older people with dementia; and correlate the performance on the physical tests executed remotely and the Timed Up and Go (TUG) test, which was validated remotely in healthy older people. Methods: We included 43 people with dementia. The Short Physical Performance Battery (SPPB), TUG, TUG Dual Task (TUG-DT), and 30-Second Sit-to-Stand Test (SST30s) were performed through videocalls. Test performance was documented to facilitate the subsequent determination of inter- and intra-rater reliability. The intra-rater reliability was determined at a 2-week interval from the real-time videocall to analysis of the recording. Results: Intra-rater reliability ranged from good to excellent for all tests performed (ICC 0.862­1.000). Inter-rater reliability values were fair for gait speed (ICC = 0.223), moderate for some of the SPPB items (ICC = 0.706­0.801), good for the SPPB two-foot balance (ICC = 0.860) and the SPPB total score (ICC = 0.831), and excellent for the rest of the tests. Conclusion: Functional mobility and muscle strength tests proved reliable and feasible for remote, at-home assessments of older people with dementia when assisted by their respective caregivers, providing an additional alternative for assessment of this patient population. (AU)

Mapeamento do Potencial da Superfície Corporal durante a Despolarização Ventricular em Atletas com Intervalo PQ Prolongado após Exercício / Body Surface Potential Mapping during Ventricular Depolarization in Athletes with Prolonged PQ Interval after Exercise

Resumo Fundamento: O prolongamento do intervalo PQ, geralmente associado a um atraso na condução atrioventricular, pode estar relacionado a alterações na propagação do impulso intraventricular. Objetivo: Avaliar, por meio do mapeamento do potencial de superfície corporal (BSPM), o processo de despolarização ventricular em atletas com intervalos PQ prolongados em repouso e após o exercício. Métodos: O estudo incluiu 7 esquiadores cross-country com intervalo PQ superior a 200 ms (grupo PQ Prolongado) e 7 com intervalo PQ inferior a 200 ms (grupo PQ Normal). O BSPM de 64 derivações unipolares do tronco foi realizado antes (Pré-Ex) e após o teste ergométrico de bicicleta (Pós-Ex). Mapas equipotenciais da superfície corporal foram analisados durante a despolarização ventricular. O nível de significância foi de 5%. Resultados: Comparado com atletas com PQ Normal, o primeiro e o segundo períodos de posição estável dos potenciais cardíacos na superfície do tronco foram mais longos, e a formação da distribuição de potencial "sela" ocorreu mais tarde, no Pré-Ex, nos atletas com PQ Prolongado. No Pós-Ex, o grupo PQ Prolongado apresentou um encurtamento do primeiro e segundo períodos de distribuições de potencial estáveis e uma diminuição no tempo de aparecimento do fenômeno "sela" em relação ao Pré-Ex (para valores próximos aos do Normal -Grupo PQ). Além disso, no Pós-Ex, a primeira inversão das distribuições de potencial e a duração total da despolarização ventricular em atletas com PQ Prolongado diminuíram em comparação com o Pré-Ex e com valores semelhantes em atletas com PQ Normal. Em comparação com atletas com PQ Normal, a segunda inversão foi mais longa no Pré-Ex e Pós-Ex em atletas com PQ Prolongado. Conclusão: Atletas com PQ prolongado apresentaram diferenças significativas nas características temporais do BSPM durante a despolarização ventricular, tanto em repouso quanto após o exercício, em comparação com atletas com PQ normal.

Abstract Background: Prolongation of the PQ interval, generally associated with an atrioventricular conduction delay, may be related to changes in intraventricular impulse spreading. Objective: To assess, using body surface potential mapping (BSPM), the process of ventricular depolarization in athletes with prolonged PQ intervals at rest and after exercise. Methods: The study included 7 cross-country skiers with a PQ interval of more than 200 ms (Prolonged-PQ group) and 7 with a PQ interval of less than 200 ms (Normal-PQ group). The BSPM from 64 unipolar torso leads was performed before (Pre-Ex) and after the bicycle exercise test (Post-Ex). Body surface equipotential maps were analyzed during ventricular depolarization. The significance level was 5%. Results: Compared to Normal-PQ athletes, the first and second periods of the stable position of cardiac potentials on the torso surface were longer, and the formation of the "saddle" potential distribution occurred later, at Pre-Ex, in Prolonged-PQ athletes. At Post-Ex, the Prolonged-PQ group showed a shortening of the first and second periods of stable potential distributions and a decrease in appearance time of the "saddle" phenomenon relative to Pre-Ex (to the values near to those of the Normal-PQ group). Additionally, at Post-Ex, the first inversion of potential distributions and the total duration of ventricular depolarization in Prolonged-PQ athletes decreased compared to Pre-Ex and with similar values in Normal-PQ athletes. Compared to Normal-PQ athletes, the second inversion was longer at Pre-Ex and Post-Ex in Prolonged-PQ athletes. Conclusion: Prolonged-PQ athletes had significant differences in the temporal characteristics of BSPM during ventricular depolarization both at rest and after exercise as compared to Normal-PQ athletes.

Application evaluation of cardiopulmonary exercise test to guide comprehensive pulmonary rehabilitation in patients with pneumoconiosis / 环境与职业医学

Background At present, the practice of pulmonary rehabilitation for pneumoconiosis in China is in a primary stage. The basis for formulating an individualized comprehensive pulmonary rehabilitation plan is still insufficient, which is one of the factors limiting the development of community-level rehabilitation work. Objective To formulate an exercise prescription based on maximum heart rate measured by cardiopulmonary exercise test (CPET), conduct an individualized comprehensive pulmonary rehabilitation program with the exercise prescription for patients with stable pneumoconiosis, and evaluate its role in improving exercise endurance and quality of life, thus provide a basis for the application and promotion of pulmonary rehabilitation. Methods A total of 68 patients were recruited from the Occupational Disease Prevention Hospital of Jinneng Holding Coal Industry Group Co., Ltd. from April to August 2022 , and were divided into an intervention group and a control group by random number table method, with 34 cases in each group. All the pneumoconiosis patients participated in a baseline test. The control group was given routine drug treatment, while the intervention group received multidisciplinary comprehensive pulmonary rehabilitation treatment on the basis of routine drug treatment, including health education, breathing training, exercise training, nutrition guidance, psychological intervention, and sleep management, whose exercise intensity was determined according to the maximum heart rate provided by CPET. The rehabilitation training lasted for 24 weeks. Patients were evaluated at registration and the end of study respectively. CPET was used to measure peak oxygen uptake per kilogram (pVO2/kg), anaerobic threshold (AT), carbon dioxide equivalent of ventilation (EqCO2), maximum metabolic equivalent (METs), and maximum work (Wmax). The modified British Medical Research Council Dyspnea Questionnaire (mMRC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Short Form of Health Survey (SF-36) were used to evaluate the potential effect of the comprehensive pulmonary rehabilitation program. Results Among the included 68 patients, 63 patients were having complete data, then 31 cases were assigned in the control group and 32 cases in the interventional group. Before the intervention, there was no significant difference in pVO2/kg, AT, EqCO2, METs, or Wmax between the two groups (P>0.05). At the end of the trail, the indicators like pVO2/kg [(19.81±2.38) mL·(min·kg)−1], AT [(14.48±2.33) mL·(min·kg)−1], METs (5.64±0.69), and Wmax [(85.25±14) W] of patients in the intervention group were all higher than those [(13.90±2.37) mL·(min·kg)−1, (11.70±1.94) mL·(min kg)−1, (3.97±0.70), and (61.77±14.72) W, respectively] in the control group (P<0.001); there was no significant difference in EqCO2 between the two groups (P=0.083). Before the trial, there was no significant difference in mMRC, SAS, SDS, PSQI, or CAT scores between the two groups (P>0.05). At the end of the trail, the mMRC score (1.16±0.57), SAS score (27.93±2.12), SDS score (26.48±1.44), PSQI score (1.08±0.88), and CAT score (4.34±3.28) of patients in the intervention group were lower than those [(2.03±0.83), (35.87±6.91), (34.23±6.65), (5.37±3.03), and (13.87±7.53), respectively] in the control group (P<0.001). The SF-36 scores of bodily pain (94.13±10.72), general health (87.50±5.68), vitality (95.31±5.53), mental health (99.88±0.71), and health changes (74.22±4.42) in the intervention group were higher than those [(71.87±32.72), (65.81±15.55), (74.52±16.45), (86.97±16.56), and (29.84±13.50), respectively] in the control group (P<0.001), and no significant difference was found in social functioning and role emotional scores (P>0.05). Conclusion Comprehensive pulmonary rehabilitation can increase the oxygen intake and exercise endurance of pneumoconiosis patients, ameliorate dyspnea symptoms, elevate psychological state and sleep quality, and improve the quality of life.

Effects of mask-wearing exercise on heart rate,blood oxygen saturation and end-expiratory carbon dioxide:a Meta-analysis / 中国组织工程研究

OBJECTIVE:Masks are one of the most important defenses against the virus.However,the impact of wearing masks during daily activities or sports on respiratory and circulatory function remains controversial.A comprehensive quantitative evaluation of the effects of mask-wearing on human heart rate,oxygen saturation and end-expiratory carbon dioxide by Meta-analysis was conducted.The effects of wearing different types of masks at different exercise intensities and time of exercise on the human respiratory and circulatory system were explored. METHODS:By February 2023,with"mask,face mask,N95,training,sports,running,walking,cycling"as the Chinese search terms and"masks,respiratory protective devices,N95 respirators,surgical face masks,exercise,resistance training,explosive training,muscle exercises"as English search terms,the experimental studies addressing the influence of exercise with a mask on hemodynamic indexes were retrieved from CNKI,Web of Science,PubMed,Cochrane Library and WanFang databases.The outcome indicators included three continuous variables-exercise center rate,blood oxygen saturation and end-expiratory carbon dioxide.Stata16.0 software was used to analyze the outcome indicators of the included literature.The PEDro scale was used as a quality assessment tool,and the funnel plot was used to analyze the impact of publication bias. RESULTS:Totally 25 articles involving 857 healthy children and adults were included in this Meta-analysis.The overall methodological quality was high,with 22 studies scoring 6 points on the PEDro scale,2 studies scoring 7 points and 1 study scoring 8 points.The meta-analysis results showed that compared with the control group,exercise with masks had no significant effect on heart rate(SMD=0.02,95%CI:-0.11 to 0.15,P=0.81),but increased end-expiratory carbon dioxide(SMD=0.60,95%CI:0.37 to 0.83,P=0.00),decreased oxygen saturation(SMD=-0.28,95%CI:-0.47 to-0.09,P=0.03).Intensity and duration were the factors that affected the heterogeneity between studies.Wearing a mask during high-intensity exercise significantly increased heart rate(SMD=-0.20,95%CI:-0.36 to-0.04,P=0.02).The effect of high-intensity and short-time exercise on blood oxygen saturation was significantly higher than that of other exercises(SMD=-0.40,95%CI:-0.70 to-0.10;SMD=-0.25,95%CI:-0.45 to-0.04).For end-expiratory carbon dioxide,maintaining a certain intensity and increasing the exercise time or increasing the intensity further increased the index significantly,reaching a moderate effect size(SMD=0.61,95%CI:0.06 to 1.15;SMD=0.58,95%CI:0.04 to 1.13). CONCLUSION:Existing evidence suggests that exercise with masks may have the adverse effect of increasing end-expiratory carbon dioxide and decreasing blood oxygen saturation.The influence of different exercise test time and intensities on the three outcome indexes was different.Wearing a mask during high-intensity exercise can significantly increase heart rate and decrease blood oxygen saturation.Maintaining moderate intensity for a long period or further increasing the intensity of exercise will lead to increased end-expiratory carbon dioxide levels.

Step tests are feasible, safe, and can be used to evaluate exercise capacity at home after hospitalization for COVID-19 / Os testes do degrau são viáveis, seguros e podem ser utilizados para avaliar a capacidade de exercício no domicílio após hospitalização por COVID-19

Abstract Introduction: Step-based tests are commonly utilized to assess the exercise capacity of individuals with respiratory diseases. However, the feasibility and safety of the step tests have not yet been studied in individuals after COVID-19. Objective: To investigate the feasibility and safety of the six-minute step test (6MST) and the modified incremental step test (MIST) in assessing exercise capacity at home in individuals after hospitalization for COVID-19, and to identify factors associated with performance in these tests. Methods: Cross-sectional multicenter study with individuals hospitalized for COVID-19 fifteen days after hospital discharge. Participants performed spirometry, 6MST, and MIST during a single home visit. Adverse events were registered during and immediately after the tests. Results: Sixty-five participants were studied (50 ± 10 years old, 55% male). The feasibility was 96.9% and the incidence of adverse events was 13.8% in 6MST and 6.2% in MIST. The individuals performed 76.9% of the predicted on the 6MST, with 40% of the participants reaching 80% of the maximum HR and 31% presenting exercise-induced oxygen desaturation. In the MIST, the individuals performed 20% of the predicted, 23% of the participants reached 80% of the maximum heart rate, and 17% presented exercise-induced oxy-gen desaturation. Length of hospital stay and the use of mechanical ventilation were associated with test performance. Conclusion: 6MST and MIST are feasible, safe, and can be used to assess exercise capacity in a home environment in individuals after hospitalization for COVID-19. The performance in these tests was associated with a prolonged hospital stay and the use of mechanical ventilation.

Resumo Introdução: Testes baseados em degraus são comumente utilizados para avaliar a capacidade de exercício de indivíduos com doenças respiratórias. No entanto, a viabilidade e segu-rança dos testes de degrau ainda não foram estudadas em indivíduos após hospitalização por COVID-19. Objetivo: In-vestigar a viabilidade e segurança do teste do degrau de seis minutos (TD6) e do teste do degrau incremental modificado (TDIM) na avaliação da capacidade de exercício no domicílio em indivíduos após hospitalização por COVID-19, e identificar fatores associados ao desempenho nesses testes. Métodos: Estudo transversal multicêntrico com indivíduos internados por COVID-19 quinze dias após a alta hospitalar. Os participantes realizaram espirometria, TD6 e TDIM durante uma única visita domiciliar. Eventos adversos foram registrados durante e ime-diatamente após os testes. Resultados: Foram estudados 65 participantes (50 ± 10 anos, 55% do sexo masculino). A via-bilidade foi de 96,9% e a incidência de eventos adversos foi de 13,8% no 6MST e 6,2% no TDIM. Os indivíduos realizaram 76,9% do previsto no TD6, sendo que 40% dos participantes atingiram 80% da frequência cardíaca máxima e 31% apresen-taram dessaturação de oxigênio induzida pelo exercício. No TDIM, os indivíduos realizaram 20% do previsto, 23% dos participantes atingiram 80% da frequência cardíaca máxima e 17% apresentaram dessaturação de oxigênio induzida pelo exercício. O tempo de internação e o uso de ventilação mecâni-ca estiveram associados ao desempenho do teste. Conclusão: O TD6 e o TDIM são viáveis, seguros e podem ser usados para avaliar a capacidade de exercício em ambiente domiciliar em indivíduos após hospitalização por COVID-19. O desempenho nesses testes esteve associado ao tempo prolongado de internação e ao uso de ventilação mecânica.

Chronotropic incompetence is associated with reduced aerobic conditioning and sedentary behavior in patients with post-acute COVID-19 syndrome

ABSTRACT Post-acute COVID-19 syndrome, or long COVID, presents with persistent symptoms, including cough, dyspnea, and fatigue, extending beyond one month after SARS-CoV-2 infection. Cardiac complications such as chest pain and arrhythmias have raised concerns, with chronotropic incompetence (CI), an inadequate heart rate increase during exercise, emerging as a significant condition contributing to diminished exercise tolerance and quality of life. This study estimated the prevalence of CI and explored its association with aerobic capacity and physical activity levels in long COVID patients. A cross-sectional study was conducted at a private hospital in Sergipe, Brazil, involving 93 patients over 18 years old with persistent post-COVID-19 symptoms after confirmed SARS-CoV-2 infections. Exclusion criteria included beta-blocker use, inadequate respiratory exchange ratio, and inability to complete cardiopulmonary exercise testing (CPET). Clinical histories, CPET results, and chronotropic index calculation were used to identify CI, with logistic regression analyzing associated factors. Of the participants (mean age 45 years; average duration since COVID-19 diagnosis 120 days), 20.4% were diagnosed with CI. Logistic regression identified a strong association between CI and sedentary behavior (OR 11.80; 95% CI 2.54 to 54.78; p=0.001). Patients with CI showed lower predicted peak heart rates and maximal oxygen uptake. The prevalence of CI among long COVID patients in this study was approximately 20%, associated with decreased aerobic capacity and increased sedentary behavior. These findings highlight the need for timely diagnosis and therapeutic interventions, including cardiopulmonary rehabilitation, to enhance the quality of life in post-COVID patients with CI. The study's cross-sectional design and its specific context have limited causality inference and generalizability, underscoring the importance of further research in diverse settings.

Cardiorespiratory optimal point in post-COVID-19 patients: a cross-sectional study

ABSTRACT The varied clinical presentations of SARS-CoV-2 infection have raised concerns about long-term consequences, especially "long-COVID" or "post-COVID-19 syndrome." In this context, the cardiorespiratory optimal point (COP) within the Cardiopulmonary Exercise Test (CPET) emerges as a crucial metric for evaluating functional capacities and detecting cardiovascular and pulmonary anomalies post-COVID-19. This study aimed to assess COP values among post-COVID-19 patients and categorized them based on the initial severity of their disease. In this cross-sectional study conducted in the Northeast Brazil, 80 patients (26 females and 54 males) previously infected with SARS-CoV-2 underwent CPET. We clinically stratified patients into mild, moderate, or severe COVID-19 categories and assessed COP values and other cardiorespiratory metrics. We found differences in the predicted COP between patients with mild and severe COVID-19 (p=0.042). Additionally, patients with moderate and severe COVID-19 record had an average COP value exceeding 22. Other parameters, including respiratory exchange ratio, heart rate, and oxygen uptake efficiency slope, did not differ across the groups. Patients with a history of severe COVID-19 showed altered COP values, suggesting potential discrepancies in cardiovascular and respiratory system integration. The outcomes emphasize the importance of continuous monitoring and assessment of the cardiorespiratory domain for post-COVID-19 patients. Further research is needed to understand the relationship between elevated COP in post-severe COVID-19 and its long-term prognostic implications.

Incremental Ramp Load Protocol to Assess Inspiratory Muscle Endurance in Healthy Individuals: Comparison with Incremental Step Loading Protocol

ABSTRACT Introduction: Protocols for obtaining the maximum threshold pressure have been applied with limited precision to evaluate inspiratory muscle endurance. In this sense, new protocols are needed to allow more reliable measurements. The purpose of the present study was to compare a new incremental ramp load protocol for the evaluation of inspiratory muscle endurance with the most used protocol in healthy individuals. Methods: This was a prospective cross-sectional study carried out in a single center. Ninety-two healthy individuals (43 men [22 ± 3 years] and 49 women [22 ± 3 years]) were randomly allocated to perform: (i) incremental ramp load protocol and (ii) incremental step loading protocol. The sustained pressure threshold (or maximum threshold pressure), maximum threshold pressure/dynamic strength index ratio, time until task failure, as well as difference between the mean heart rate of the last five minutes of baseline and the peak heart rate of the last 30 seconds of each protocol were measured. Results: Incremental ramp load protocol with small increases in the load and starting from minimum values of strength index was able to evaluate the inspiratory muscle endurance through the maximum threshold pressure of healthy individuals. Conclusion: The present study suggests that the incremental ramp load protocol is able to measure maximum threshold pressure in a more thorough way, with less progression and greater accuracy in the load stratification compared to the limited incremental step loading protocol and with a safe and expected cardiovascular response in healthy individuals.

Correlation analysis of cardiopulmonary exercise test indices and conditions of overweight patients with obstructive sleep apnea: a retrospective study

ABSTRACT BACKGROUND: The cardiopulmonary function of patients with obstructive sleep apnea (OSA) is significantly lower than that of patients with simple snoring and is significantly related to the severity of OSA. Currently, only a few studies have been conducted on cardiopulmonary exercise testing in overweight patients with OSA. OBJECTIVE: To analyze the correlation between cardiopulmonary exercise test (CPET) indices and the condition of overweight patients with OSA. DESIGN AND SETTING: Retrospective study in Guangdong Provincial Hospital of Chinese Medicine. METHODS: This study included 73 hospitalized overweight patients. The patients were divided into no, mild, moderate, and severe OSA groups. Differences in the CPET indices among the four groups were compared. The correlation between the CPET indices and conditions was analyzed. RESULTS: No, mild, moderate, and severe OSA groups had 18 men and 5 women, 11 men and 3 women, 12 men and 2 women, and 21 men and 1 woman, respectively (P > 0.05). No significant difference was observed in resting pulmonary function among the four groups (P > 0.05). In the CPET, the anaerobic threshold, maximum oxygen uptake, and oxygen pulse were significantly lower in the severe OSA group than those in the normal OSA group (P < 0.05). Moreover, CPET indices negatively correlated with the apnea-hypopnea index. CONCLUSION: Changes in CPET indices occurred earlier than changes in resting pulmonary function in patients with OSA. CPET might be a potential method for evaluating the severity of OSA combined with overweight status.

Predição do Consumo de Oxigênio de Pico em Pacientes Cardiopatas com Base no Desempenho no Teste Timed Up and Go / Prediction of Peak Oxygen Consumption in Patients with Heart Disease Based on Performance on the Timed Up and Go Test

Resumo Fundamento A utilização do teste timed up and go (TUG) na avaliação da aptidão cardiorrespiratória em cardiopatas não está bem definida na literatura. Objetivos Testar a associação entre o TUG e o consumo de oxigênio de pico (VO2pico), construir uma equação com base no TUG para prever o VO2pico e determinar um ponto de corte para estimar um VO2pico ≥ 20 mL.kg−1.min−1. Métodos Estudo transversal com 201 indivíduos portadores de doença arterial coronariana ou insuficiência cardíaca, com idade entre 36 e 92 anos, submetidos ao TUG e ao teste cardiopulmonar de exercício. Foram realizadas análises de correlação, curva ROC, regressão linear múltipla e Bland-Altman. Um p < 0,05 foi adotado como significante. Resultados A média de idade da amostra total foi 67 ± 13 anos, e 70% dos participantes eram do sexo masculino. A média de VO2pico foi de 17 ± 6 mL.kg−1.min−1 e a média de desempenho no TUG foi de 7 ± 2,5 segundos. A correlação entre o VO2pico e o TUG foi r = −0,54 (p < 0,001) e R2 de 0,30. Foi desenvolvida a equação com base no TUG: V O 2 pico = 33 , 553 + ( − 0 , 149 ∗ idade ) + ( − 0 , 738 ∗ T U G ) + ( − 2 , 870 ∗ sexo ); sendo atribuído o valor 0 ao sexo masculino e 1 ao sexo feminino (R ajustado: 0,41; R2 ajustado: 0,40). O VO2pico estimado pela equação foi 18,81 ± 3,2 mL.kg−1.min−1 e o determinado pelo teste cardiopulmonar de exercício foi 18,18 ± 5,9 mL.kg−1.min−1 (p > 0,05). O melhor ponto de corte para o VO2pico ≥ 20 mL.kg−1.min−1 foi de ≤ 5,47 segundos (área sob a curva: 0,80; intervalo de confiança de 95%: 0,74 a 0,86). Conclusões O TUG e o VO2pico apresentaram associação significativa. A equação preditiva do VO2pico foi desenvolvida e validada internamente com bom desempenho. O ponto de corte no TUG para prever um VO2pico ≥ 20 mL.kg−1.min−1 foi ≤ 5,47 segundos.

Abstract Background The use of the timed up and go (TUG) test to assess cardiorespiratory fitness in patients with heart disease has not been well defined in the literature. Objectives Test the association between TUG and peak oxygen consumption (VO2peak), construct an equation based on TUG to predict VO2peak, and determine a cutoff point to estimate VO2peak ≥ 20 mL/kg/min. Methods This cross-sectional study included 201 patients with coronary artery disease or heart failure, between 36 and 92 years of age, who underwent TUG and cardiopulmonary exercise test. Correlation, ROC curve, multiple linear regression, and Bland-Altman analyses were performed. The significance level was set at p < 0.05. Results The mean age of the total sample was 67 ± 13 years, and 70% of participants were male. The mean VO2peak was 17 ± 6 mL/kg/min, and the mean TUG time was 7 ± 2.5 seconds. The correlation between VO2peak and TUG was r = −0.54 (p < 0.001), and R2 was 0.30. The following equation was developed based on TUG: V O 2 peak = 33.553 + ( − 0.149 × age ) + ( − 0.738 × TUG ) + ( − 2.870 × sex ); a value of 0 was assigned to the male sex and 1 to the female sex (adjusted R: 0.41; adjusted R2: 0.40). The VO2peak estimated by the equation was 18.81 ± 3.2 mL/kg/min, and the VO2peak determined by cardiopulmonary exercise test was 18.18 ± 5.9 mL/kg/min (p > 0.05). The best cutoff point in the TUG for VO2peak ≥ 20 mL/kg/min was ≤ 5.47 seconds (area under the curve: 0.80; 95% confidence interval: 0.74 to 0.86). Conclusions TUG and VO2peak showed a significant association. A prediction equation for VO2peak was developed and validated internally with good performance. The cutoff point in the TUG to predict VO2peak ≥ 20 mL/kg/min was ≤ 5.47 seconds.

Reduced peripheral and respiratory muscle strength in pediatric patients after kidney transplantation / Redução da força muscular periférica e respiratória em pacientes pediátricos após transplante renal

Abstract Introduction: Reduced muscle strength and low-exercise capacity are well documented in adults, but there are few studies examining those impairments in children and adolescents after kidney transplantation. The objective of this study was to evaluate peripheral and respiratory muscle strength and the association with submaximal exercise capacity in children and adolescents after kidney transplant. Methods: Forty-seven patients between six and 18 years of age clinically stable after transplantation were included. Peripheral muscle strength (isokinetic and hand-grip dynamometry), respiratory muscle strength (maximal inspiratory and expiratory pressure), and submaximal exercise capacity (six-minute walk test - 6MWT) were assessed. Results: Patients had a mean age of 13.1 ± 2.7 years and an average of 34 months had elapsed since the transplantation. Flexors of the knee showed a significant reduction in muscle strength (77.3% of predicted) and knee extensors had normal values (105.4% of predicted). Hand-grip strength and maximal respiratory pressures (inspiratory and expiratory) also were significantly lower than expected (p < 0.001). Although distance walked in the 6MWT was significantly lower than predicted (p < 0.001), no significant correlation was found with peripheral and respiratory muscle strength. Conclusion: Children and adolescents after kidney transplantation have reduced peripheral muscle strength of knee flexors, hand-grip, and maximal respiratory pressures. No associations were found between peripheral and respiratory muscle strength and submaximal exercise capacity.

Resumo Introdução: Força muscular reduzida e baixa capacidade de exercício encontram-se bem documentadas em adultos mas há poucos estudos examinando essas alterações em crianças e adolescentes após transplante renal. O objetivo deste estudo foi avaliar a força muscular periférica e respiratória e a associação com a capacidade submáxima de exercício em crianças e adolescentes após o transplante renal. Métodos: Foram incluídos 47 pacientes entre 6 e 18 anos de idade clinicamente estáveis após o transplante. Avaliou-se a força muscular periférica (dinamometria isocinética e de preensão manual), a força muscular respiratória (pressão inspiratória e expiratória máximas) e a capacidade submáxima de exercício (teste de caminhada de seis minutos - TC6M). Resultados: Os pacientes apresentaram média de idade de 13,1 ± 2,7 anos e uma média de 34 meses desde o transplante. Os flexores de joelho mostraram uma redução significativa na força muscular (77,3% do previsto) e os extensores de joelho apresentaram valores normais (105,4% do previsto). A força de preensão manual e as pressões respiratórias máximas (inspiratória e expiratória) foram significativamente inferiores ao esperado (p < 0,001). Embora a distância percorrida no TC6M tenha sido significativamente menor do que o previsto (p < 0,001), não encontramos nenhuma correlação significativa com a força muscular periférica e respiratória. Conclusão: Crianças e adolescentes submetidos ao transplante renal apresentam força muscular periférica reduzida de flexores de joelho e de preensão manual, bem como das pressões respiratórias máximas. Não foram encontradas associações entre força muscular periférica e respiratória e a capacidade submáxima de exercício.

La prueba cardiopulmonar de ejercicio contribuye a determinar con precisión el riesgo en pacientes con hipertensión pulmonar de bajo riesgo / Cardiopulmonary Exercise Testing Contributes to Accurate Risk Assessment in Patients with Low-risk Pulmonary Hypertension

RESUMEN Introducción : Las guías europeas de hipertensión arterial pulmonar (HAP) estratifican el riesgo valiéndose de características clínicas y estudios complementarios entre los cuales está la prueba cardiopulmonar de ejercicio (PCPE), de la cual toma en cuenta 3 parámetros: el consumo de O2 (VO2) pico, su porcentaje respecto del predicho y la pendiente ventilación minuto/ producción de dióxido de carbono (VE/VCO2). Sin embargo, ninguno de los modelos que validaron esta forma de estratificar el riesgo incluyeron la PCPE entre sus variables. Objetivos : Determinar qué proporción de pacientes con HAP del grupo I considerados de bajo riesgo y que caminan >440 metros en la prueba de caminata de 6 minutos (PC6M) tienen en la PCPE parámetros considerados de riesgo moderado o alto. Material y métodos : Se incluyeron pacientes >18 años con diagnóstico de HAP del grupo I considerados de bajo riesgo con una PC6M >400 metros a los que se les realizó una PCPE en la que se registró el VO2 pico, su porcentaje respecto del VO2 predicho y la pendiente VE/VCO2. Se determinó qué proporción de pacientes presentaban estos parámetros en un estrato de riesgo mayor a bajo riesgo (VO2 pico <15 ml/kg/min, su porcentaje respecto del predicho <65% y la pendiente VE/VCO2 >36). Resultados : Se incluyeron 18 pacientes. A pesar de ser pacientes de bajo riesgo y con buena clase funcional todos presentaron un VO2 pico menor al 85% del predicho, lo cual determina un deterioro al menos leve de la capacidad funcional. Un único paciente (6%) presentó los tres parámetros evaluados en bajo riesgo, 8 pacientes (44%) tuvieron al menos un parámetro alterado, 7 pacientes (39%) presentaron 2 parámetros alterados y en 2 pacientes (11%) todos los parámetros estuvieron alterados. Los parámetros que más frecuentemente se vieron alterados fueron el porcentaje respecto del VO2 predicho y la pendiente VE/VCO2, en el 67% de los casos. Solo 4 pacientes presentaron un VO2 pico <15 ml/k/m. Ningún paciente presentó valores de VO2 pico o porcentaje respecto del predicho en la categoría de alto riesgo. Sin embargo, 6 pacientes (33%) presentaron una pendiente VE/VCO2 considerada de alto riesgo. Conclusión : El 94% de los pacientes considerados de bajo riesgo presentaron al menos una variable en la PCPE que no corresponde a un perfil de riesgo bajo. La pendiente VE/VCO2 y el porcentaje de VO2 pico respecto del predicho fueron las variables más frecuentemente alteradas. La pendiente VE/VCO2 fue la única que mostró valores considerados de alto riesgo. La PCPE podría tener un lugar en la estratificación de precisión de pacientes de bajo riesgo. El valor de este hallazgo deberá ser evaluado en estudios prospectivos, al tiempo que genera las bases para el planteo de hipótesis respecto de la estratificación de riesgo y la intensidad del tratamiento en pacientes que aparentan estar en bajo riesgo.

ABSTRACT Background : European guidelines for pulmonary arterial hypertension (PAH) stratify the risk using clinical characteristics and complementary studies, including the cardiopulmonary exercise test (CPET). This takes into account 3 parameters: peak O2 consumption (peak VO2), its percentage with respect to the predicted VO2, and the minute ventilation/carbon dioxide production (VE/VCO2) slope. However, none of the models that validated this way of stratifying risk included PCPE among their variables. Objectives : To determine what proportion of patients with group I PAH considered to be at low risk and who walk >440 meters in the 6-minute walk test (6MWT) have parameters considered to be of moderate or high risk in the PCPE. Methods : Patients >18 years of age, diagnosed with group I PAH at low risk of events, who walked >440 meters in the 6MWT and had NT-proBNP value <300 pg/dL were included. A CPET was performed in which the peak VO2, its percentage with respect to the predicted VO2, and the VE/VCO2 slope were recorded. It was determined what proportion of patients presented these parameters in a higher than low risk stratum (peak VO2 consumption ≤15 ml/min/Kg, its percentage with respect to the predicted VO2 ≤65% and the VE/VCO2 slope ≥36). Results : Eighteen patients were included. Despite being low-risk patients with a good functional class, all patients presented a peak VO2 less than 85% of predicted, which determines a deterioration of functional capacity. A single patient (6%) presented the three parameters evaluated at low risk, 8 patients (44%) had at least one altered parameter, 7 patients (39%) presented 2 altered parameters and in 2 patients (11%) all parameters were altered. The parameters that were most frequently altered were the percentage of predicted peak VO2 and the VE/VCO2 slope in 67% of the cases. Only 4 patients presented a peak VO2 <15 ml/kg/m. No patient presented peak VO2 values or percentage of predicted VO2 in the high-risk category. However, 6 patients (33%) presented a high-risk VE/VCO2 slope. Conclusion : Majority (92%) of the patients considered low risk and who walk more than 440 meters in 6 minutes presented at least one altered variable in the CPET. The VE/VCO2 slope and the percentage of predicted peak VO2 consumption were the most frequently altered variables. The VE/VCO2 slope was the only one that showed values considered high risk. CPET could have a place in the precision stratification of low-risk patients. The value of this finding should be evaluated in prospective studies.

Assessment of physical activity and physical fitness among undergraduate medical students

Background: In a nationwide survey conducted in the Indian Council of Medical Research- INdia DIABetes study (Phase-1) 2014 on physical activity and inactivity patterns, overall, 392 million individuals in India are physically inactive. Physically active medical students tend to recommend physical activity for patients or at-risk individuals in their future practice. Exercise is a subset of physical activity that is planned, structured, and repetitive which helps in achieving physical fitness. Aim and Objectives: The aim of the study was to assess the prevalence of physical activity (PA) and physical fitness among medical students and to correlate both. Materials and Methods: This is a cross-sectional study, in which physical activity level was assessed using Global Physical Activity Questionnaire. Physical fitness using Harvard step test, hand grip dynamometer, sit-up and push-up test, shoulder – flexibility test, body mass index, and body adiposity index was assessed among 150 medical students in a tertiary care hospital. Results: Physical activity level when analyzed, 16% of students performed low PA, 74% belonged to moderate PA Group, and 10% in high PA group. When mean metabolic equivalent of task min/week attained by study population in three domains of physical activity (work/travel/recreation) was analyzed, results showed no significant difference between males and females in different domains of physical activity. Conclusion: Although the students met the recommended physical activity as per the World Health Organization, physical fitness was not achieved up to the desired level. No correlation was noted between physical activity and physical fitness among medical students.

Hibiscus increases functional capacity and the anti-obesity effect in trained obese rats / El hibiscus aumenta la capacidad funcional y el efecto antiobesidad en ratas obesas entrenadas / O hibiscus aumenta a capacidade funcional e o efeito antiobesidade em ratos obesos treinados

ABSTRACT Introduction Hibiscus sabdariffa (Hs) has been widely used for weight loss and in the fight against obesity-associated comorbidities. Objective To evaluate the effects of Hs and physical training on the functional capacity of normal-weight and obese rats. Methods Wistar rats were distributed into eight experimental groups: control (C, n = 8) , Hibiscus Sabdariffa (Hs, n = 8), high-intensity interval training (IT, n = 8), high-intensity interval training + Hibiscus Sabdariffa (ITHs, n = 8), obese (O, n = 8), obese + continuous aerobic training (OAT, n = 8), obese + Hibiscus Sabdariffa (OHs, n = 8), , and obese + continuous aerobic training + Hibiscus Sabdariffa (OATHs, n = 8). Hibiscus Sabdariffa extract was administered for 60 days in a dose of 150 mg/kg of body weight. The maximum progressive effort test (MPET) was performed on a treadmill at the beginning and end of the study. The variables analyzed were maximum speed Vmáx time, and distance covered. Lactate was measured immediately after the MPET. Functional capacity was evaluated by the distance/adiposity index. The ANOVA with Bonferroni post hoc and Pearson's correlation tests were used at a 5% significance level. Results After both types of training, moderate-intensity continuous and high-intensity interval performed on the treadmill, final body weight, weight gain, and the adiposity index decreased, and Vmax, time, and distance covered in the MPET increased, in addition to an improvement in functional capacity. Hs supplementation reduced the adiposity index in normal-weight and obese rats. Hs associated with aerobic training reduced final body weight and increased functional capacity. Conclusion Hs supplementation promoted a reduction in the adiposity index in normal-weight and obese rats and an increase in the functional capacity of trained obese rats. Level of Evidence III; Therapeutic Studies - Outcome Investigation. Case study - control.

RESUMEN Introducción El Hibiscus Sabdariffa (Hs) ha sido ampliamente utilizado para promover la pérdida de peso y tratar las comorbilidades asociadas a la obesidad. Objetivos Evaluar los efectos del Hs y el entrenamiento físico sobre la capacidad funcional de ratas eutróficas y obesas. Métodos Se distribuyeron ratas Wistar en ocho grupos experimentales: Control (C, n=8), Hibiscus Sabdariffa (Hs, n=8), , entrenamiento de intervalos de alta intensidad (EI, n=8)), entrenamiento de intervalos de alta intensidad + Hibiscus Sabdariffa (EIHs, n=8), obeso (O, n=8)), obeso + entrenamiento continuo aeróbico (OEA, n=8), obeso + Hibiscus Sabdariffa (OHs, n=8), obeso + entrenamiento continuo aeróbico + Hibiscus Sabdariffa (OEAHs, n=8). Se administró extracto de Hibiscus Sabdariffa durante 60 días a una dosis de 150 mg / kg de peso corporal. Se realizó una prueba de esfuerzo progresivo máximo (PEPM) en una cinta rodante al principio y al final del estudio. Las variables analizadas fueron: velocidad máxima Vmáx, tiempo y distancia recorrida. El nivel de lactato se midió inmediatamente después de la PEPM. La capacidad funcional se evaluó mediante el índice de distancia / adiposidad. Se empleó el método ANOVA con post hoc de Bonferroni y las pruebas de correlación de Pearson, a un nivel de significancia del 5%. Resultados Después de ambos tipos de entrenamiento, el entrenamiento continuo a intensidad moderada y el entrenamiento de intervalos de alta intensidad realizados en cinta rodante, las ratas presentaron disminución del peso corporal final, aumento de peso e índice de adiposidad, así como aumentaron la Vmax, el tiempo y la distancia recorrida en la PEPM, y mejoraron la capacidad funcional. La suplementación con Hs disminuyó el índice de adiposidad en ratas eutróficas y obesas. El Hibiscus asociado al entrenamiento aeróbico redujo el peso corporal final y aumentó la capacidad funcional. Conclusión La suplementación con Hs redujo el índice de adiposidad en ratas eutróficas y obesas y aumentó la capacidad funcional de ratas obesas entrenadas. Nivel de Evidencia III; Estudios Terapéuticos - Investigación de Resultados. Estudio de caso - control.

RESUMO Introdução O Hibiscus Sabdariffa (Hs) tem sido amplamente utilizado para emagrecimento e no combate às comorbidades associadas à obesidade. Objetivos Avaliar os efeitos do Hs e do treinamento físico sobre a capacidade funcional de ratos eutróficos e obesos. Métodos Ratos Wistar foram distribuídos em oito grupos experimentais: Controle (C, n = 8), Hibiscus Sabdariffa (Hs, n = 8), treinamento intervalado de alta intensidade (TI, n = 8), treinamento intervalado de alta intensidade + Hibiscus Sabdariffa (TIHs, n = 8), obeso (O, n = 8), obeso + treinamento contínuo aeróbico (OTA, n = 8), obeso+ Hibiscus Sabdariffa (OHs, n = 8), obeso + treinamento contínuo aeróbico + Hibiscus Sabdariffa (OTAHs, n = 8). O extrato de Hibiscus Sabdariffa foi administrado por 60 dias na dose de 150 mg/kg de peso corporal. Foi realizado teste de esforço progressivo máximo (TEPM) em esteira no início e no final do estudo. As variáveis analisadas foram: velocidade máxima (Vmáx), tempo e distância percorrida. O lactato foi mensurado imediatamente depois do TEMP. A capacidade funcional foi avaliada pela distância/índice de adiposidade. Empregou-se ANOVA com post hoc de Bonferroni e correlação de Pearson, adotando-se o nível de significância de 5%. Resultados Depois de ambos os tipos de treinamento, o contínuo em moderada intensidade e o intervalado de alta intensidade realizados em esteira, reduziram o peso corporal final, o ganho de peso e o índice de adiposidade, bem como aumentaram a Vmáx, tempo e distância percorrida no TEPM, além de melhora da capacidade funcional. A suplementação de Hs diminuiu o índice de adiposidade nos ratos eutróficos e obesos. O Hs associado ao treinamento aeróbico reduziu o peso corporal final e aumentou a capacidade funcional. Conclusão A suplementação de Hs promoveu redução no índice de adiposidade em ratos eutróficos e obesos e aumentou a capacidade funcional de ratos obesos treinados. Nível de evidência III; Estudos Terapêuticos - Investigação de Resultados. Estudo caso controle .

Prediction equations for maximal heart rate in obese and nonobese children and adolescents: a systematic review and meta-analysis / Equações preditivas da frequência cardíaca máxima em crianças e adolescentes obesos e não obesos: uma revisão sistemática e metanálise

Abstract Objective: The aim of this study was to analyze which equation best estimates maximal heart rate (HRmax) for the pediatric population according to body mass. Data source: We performed a meta-analysis (PROSPERO No. CRD42020190196) of cross-sectional studies that aimed to validate or develop HRmax equations and that had children and adolescents as samples. The search was conducted in Scopus, Science Direct, Web of Science, PubMed, and Biblioteca Virtual em Saúde with the descriptors "prediction or equation," "maximal heart rate," "maximum heart rate," "determination of heart rate," children, and adolescent. The TRIPOD Statement tool was used to assess the methodological quality and the relevant data were extracted for analysis. The meta-analysis was conducted in the Comprehensive Meta-Analysis, adopting p<0.05 and a 95% confidence interval (CI). Data synthesis: In total, 11 studies were selected, of which 3 developed predictive equations, 10 performed external validity of the preexisting models, and 1 incremented values related to equations already developed. The results of the methodological quality analysis showed a moderate rating in most studies. The 164 + (0.270 × HRres) - (0.155 × body mass) + (1.1 × METs) + (0.258 × body fat percent) (r=0.500, 95%CI 0.426-0.567, p<0.001) and 166.7+ (0.46 × HRres) + (1.16 × maturation) (r=0.540, 95%CI 0.313-0.708, p<0.001) equations presented stronger correlations with measured HRmax in nonobese adolescents. The predictive model developed by 208 - (0.7 × age) showed a greater accuracy among the possible models for analysis (SDM=-0.183, 95%CI -0.787 to -0.422, p=0.554). No specific predictive equation was found for obese adolescents. Conclusions: Future research should explore new possibilities for developing predictive equations for this population as a tool to control exercise intensity in the therapeutic management of childhood and adolescent obesity.

Resumo Objetivo: Analisar qual equação melhor estima a frequência cardíaca máxima (FCmáx) na população pediátrica conforme a massa corporal. Fontes de dados: Foi realizada uma metanálise (PROSPERO no CRD42020190196) de estudos transversais que visavam validar ou desenvolver equações da FCmáx para crianças e adolescentes. As bases de dados foram Scopus, Science Direct, Web of Science, PubMed e Biblioteca Virtual em Saúde. Utilizaram-se os descritores "prediction or equation", "maximal heart rate", "maximum heart rate", "determination of heart rate", "children" e "adolescents". A ferramenta TRIPOD Statement foi utilizada para avaliar a qualidade metodológica e os dados relevantes foram extraídos para análise. A metanálise foi conduzida no Comprehensive Meta-Analysis, adotando-se valor de p<0,05 e intervalo de confiança de 95%. Síntese dos dados: Foram selecionados 11 estudos, dos quais três desenvolveram equações preditivas, dez realizaram a validade externa de modelos preexistentes e um a incrementação de valores relacionados com equações já desenvolvidas. Em sua maioria, os estudos foram classificados com qualidade moderada. As equações 164 + (0.270 × FCrep) - (0.155 × massa corporal) + (1.1 × METs) + (0.258 × percentual de gordura) (2017) (r=0,500; p<0,001) e 166.7+ (0.46 × FCrep + (1.16 × maturação) (r=0,540; p<0,001) apresentaram correlações mais fortes com a FCmáx medida em adolescentes não obesos. O modelo de 208 - (0.7 × idade) mostrou a maior precisão entre os modelos possíveis para análise (SDM=-0,183; p=0,554). Não foi encontrada nenhuma equação preditiva específica para adolescentes obesos. Conclusões: Pesquisas futuras devem explorar novas possibilidades de desenvolvimento de equações preditivas para essa população, uma vez que elas são uma ferramenta para controlar a intensidade do exercício na gestão terapêutica da obesidade infantil e do adolescente.

Cardiopulmonary capacity under endurance running training / Capacidade cardiopulmonar sob o treinamento da corrida de resistência / Capacidad cardiopulmonar bajo entrenamiento de carrera de resistencia

ABSTRACT Introduction Inversely to increasingly rich material life, the physical quality of Chinese people is in a steady decline. The most convenient sport that greatly impacts the cardiopulmonary system is endurance running. It has become a form of mass activity promoting physical fitness. Objective Explore the relationship between the efficiency of endurance running training and the function of cardiopulmonary capacity. Methods 320 male and female volunteers were trained in endurance running. The load degree was adjusted according to the endurance running experience by the ergometric treadmill's gradient. The experimental and control group subjects exercised for 30 minutes, and parameters such as resting heart rate, maximum heart rate, and maximum lung capacity were recorded before and after the intervention. Results Extending the duration of resistance running and its load improves cardiopulmonary capacity. Conclusion There is a positive correlation between the efficiency of resistance running training and the promotion of cardiopulmonary capacity. Therefore, the appropriate increase of load and duration time of resistance running is beneficial to promote the cardiopulmonary capacity of individuals and improve the overall fitness index of the population. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução Inversamente a uma vida material cada vez mais rica, a qualidade física das pessoas chinesas encontra-se em um declínio constante. O esporte mais conveniente e com grande impacto no sistema cardiopulmonar é a corrida de resistência. Ela tornou-se uma forma de atividade massiva promotora da aptidão física. Objetivo Explorar a relação entre a eficiência do treinamento da corrida de resistência física e a função da capacidade cardiopulmonar. Métodos 320 voluntários masculinos e femininos foram treinados na corrida de resistência. O grau de carga foi ajustado segundo a experiência na corrida de resistência pelo gradiente da esteira ergométrica. Os sujeitos do grupo experimental e controle exercitaram-se durante 30 minutos e parâmetros como a frequência cardíaca em repouso, a frequência cardíaca máxima e a capacidade pulmonar máxima dos sujeitos foram registradas antes e após a intervenção. Resultados O prolongamento da duração da corrida de resistência e sua carga são benéficos para melhorar o nível de capacidade cardiopulmonar. Conclusão Há uma correlação positiva entre a eficiência do treinamento da corrida de resistência e a promoção da capacidade cardiopulmonar. Portanto, o aumento adequado da carga e do tempo de duração da corrida de resistência é benéfico para promover a capacidade cardiopulmonar dos indivíduos e melhorar o índice de aptidão física geral da população. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción En contraposición a una vida material cada vez más rica, la calidad física de los chinos está en constante declive. El deporte más conveniente con gran impacto en el sistema cardiopulmonar es la carrera de resistencia. Se ha convertido en una forma de actividad masiva que promueve la aptitud física. Objetivo Explorar la relación entre la eficacia del entrenamiento de carrera de resistencia y la función de la capacidad cardiopulmonar. Métodos 320 voluntarios masculinos y femeninos fueron entrenados en carreras de resistencia. El grado de carga se ajustó de acuerdo con la experiencia en la carrera de resistencia mediante el gradiente de la cinta ergométrica. Los sujetos del grupo experimental y del grupo de control hicieron ejercicio durante 30 minutos y se registraron parámetros como la frecuencia cardíaca en reposo, la frecuencia cardíaca máxima y la capacidad pulmonar máxima de los sujetos antes y después de la intervención. Resultados La prolongación de la duración de la carrera de resistencia y su carga son beneficiosas para mejorar el nivel de capacidad cardiopulmonar. Conclusión Existe una correlación positiva entre la eficacia del entrenamiento de carrera de resistencia y el fomento de la capacidad cardiopulmonar. Por lo tanto, el aumento adecuado de la carga y el tiempo de duración de la carrera de resistencia es beneficioso para promover la capacidad cardiopulmonar de los individuos y mejorar el índice de aptitud física general de la población. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Influences of gymnastics on body composition and cardiopulmonary function of athletes / Influências da ginástica na composição corporal e na função cardiopulmonar de atletas / Influencias de la gimnasia en la composición corporal y en la función cardiopulmonar de atletas

ABSTRACT Introduction: Aerobics is a recreational, ornamental, rhythmic, and expressive sport. It is widely used in physical education in colleges and universities because it is also believed that this sport benefits the cardiopulmonary function and the body composition of the practitioners. Objective: Study the influences of aerobic gymnastics on body composition and cardiopulmonary function in its practitioners. Methods: 40 college students volunteered for the research sample. The living conditions and learning level of the subjects were the same. The students were divided into two groups for research. There was no significant difference between the groups comparing the volunteers' age, height, and weight. The high-load group performed exercises with a maximum heart rate of 220, while the low-load group performed the same protocol under a maximum heart rate of 195 beats per minute. The intervention took place over 40 and 60 minutes of exercise, respectively, for eight weeks. The POLAR monitor was used to check the kinematic performance of the athletes. The data were processed statistically. Results: Aerobic gymnastics influenced the body composition of college students with significant differences in bust circumference, waist, hip, thigh, and skinfold thickness (P<0.05). The athletes' heart rate, pulmonary ventilation, and diastolic pressure increased significantly after aerobic gymnastics. The study showed that the resting heart rate of the volunteers decreased significantly after exercise, and their lung function returned to normal (P<0.05). Conclusion: Aerobic exercise can improve the body composition, physiology, and cardiopulmonary function of its practitioners, and its greater encouragement in colleges and universities is recommended. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A ginástica aeróbica é um esporte recreativo, ornamental, rítmico e expressivo. É amplamente utilizado na educação física em faculdades e universidades pois também se acredita que esse esporte beneficie a função cardiopulmonar e a composição corporal dos praticantes. Objetivo: Estudar as influências da ginástica aeróbica sobre a composição corporal e sobre a função cardiopulmonar em seus praticantes. Métodos: 40 estudantes universitários foram voluntários para a amostra de pesquisa. As condições de vida e nível de aprendizagem das disciplinas foram as mesmas. Os estudantes foram divididos em dois grupos para pesquisa. Não houve diferença significativa entre os grupos na comparação da idade, altura e peso dos voluntários. O grupo de alta carga efetuou exercícios com um ritmo cardíaco máximo de 220 enquanto o grupo de baixa carga executou o mesmo protocolo sob ritmo cardíaco máximo de 195 batimentos por minuto. A intervenção deu-se em 40 e 60 minutos de exercício, respectivamente, durante oito semanas. O monitor POLAR foi usado para verificar o desempenho cinemático dos atletas. Os dados foram processados estatisticamente. Resultados: A ginástica aeróbica influenciou a composição corporal dos estudantes universitários com diferenças significativas na circunferência de busto, cintura, quadril, coxa e espessura de prega cutânea (P<0,05). A frequência cardíaca, a ventilação pulmonar e a pressão diastólica dos atletas aumentaram significativamente logo após a ginástica aeróbica. O estudo mostrou que a frequência cardíaca em repouso dos voluntários diminuiu significativamente após o exercício, e sua função pulmonar voltou ao normal (P<0,05). Conclusão: O exercício aeróbico aperfeiçoou a composição corporal, a fisiologia e a função cardiopulmonar de seus praticantes sendo recomendado o seu maior incentivo nas faculdades e universidades. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La gimnasia aeróbica es un deporte recreativo, ornamental, rítmico y expresivo. Se utiliza mucho en la educación física en colegios y universidades porque también se cree que este deporte beneficia la función cardiopulmonar y la composición corporal de los practicantes. Objetivo: Estudiar las influencias de la gimnasia aeróbica sobre la composición corporal y sobre la función cardiopulmonar en sus practicantes. Métodos: 40 estudiantes universitarios se ofrecieron como voluntarios para la muestra de la investigación. Las condiciones de vida y el nivel de aprendizaje de los sujetos eran los mismos. Los estudiantes se dividieron en dos grupos para la investigación. No hubo diferencias significativas entre los grupos al comparar la edad, la altura y el peso de los voluntarios. El grupo de alta carga realizó los ejercicios con una frecuencia cardíaca máxima de 220, mientras que el grupo de baja carga realizó el mismo protocolo con una frecuencia cardíaca máxima de 195 pulsaciones por minuto. La intervención tuvo lugar durante 40 y 60 minutos de ejercicio, respectivamente, durante ocho semanas. El monitor POLAR se utilizó para verificar el rendimiento cinemático de los atletas. Los datos se procesaron estadísticamente. Resultados: La gimnasia aeróbica influyó en la composición corporal de los estudiantes universitarios con diferencias significativas en la circunferencia del busto, la cintura, la cadera, el muslo y el grosor de los pliegues cutáneos (P<0,05). La frecuencia cardíaca, la ventilación pulmonar y la presión diastólica de los atletas aumentaron significativamente inmediatamente después de la gimnasia aeróbica. El estudio mostró que la frecuencia cardíaca en reposo de los voluntarios disminuyó significativamente después del ejercicio, y su función pulmonar volvió a ser normal (P<0,05). Conclusión: El ejercicio aeróbico puede mejorar la composición corporal, la fisiología y la función cardiopulmonar de sus practicantes siendo recomendable su mayor fomento en colegios y universidades. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.