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Rev. bras. med. esporte ; 29: e2022_0166, 2023. tab, graf
Article in English | LILACS | ID: biblio-1394840


ABSTRACT Introduction: Physical training for the elderly is extremely popular. However, there is a lack of analysis on sports injuries in the elderly. Objective: Study the analysis of movement in sports training techniques and preventing sports injuries in the elderly. Methods: Participating in a 15-minute running and warm-up activity before using the standard FMS test kit, they followed seven test movements, each repeated three times; they did so during six weeks of training based on the recommendations for the prevention of sports injuries presented in this paper. Results: Among the 14 elderly subjects with a total FMS score <14 points, most functional motor scores were 15-16 points, of which 19 points were high, and 9 points were low. In the intervention based on the perspective of sports injuries, the FMS measurement value of the elderly was much better than before, and the evaluation of the technical analysis of movement after the correction was significantly higher than before. Conclusion: The prevention of sports injuries proposed in this paper can effectively help the elderly to prevent sports injuries. This paper considers the FMS trial design as an example for analyzing movements in sports training of the elderly and formulating standards. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O treinamento físico em idosos é extremamente popular, entretanto, carece de análise sobre as lesões esportivas em idosos. Objetivo: Estudar a análise do movimento nas técnicas de treinamento esportivo e a prevenção de lesões esportivas em idosos. Métodos: Participando de uma atividade de 15 minutos de corrida e aquecimento antes de utilizar o kit de teste padrão FMS, seguiram-se sete movimentos de teste, cada um deles repetidos 3 vezes; fizeram-no durante seis semanas de treinamento com base nas recomendações de prevenção de lesões esportivas apresentadas neste trabalho. Resultados: Entre os 14 sujeitos idosos com pontuação total de FMS <14 pontos, a maioria das pontuações motoras funcionais foram de 15-16 pontos, dos quais 19 pontos foram altos e 9 pontos foram baixos. Na intervenção baseada sob a ótica das lesões esportivas, o valor de medição FMS dos idosos foi muito melhor do que anteriormente, e a avaliação da análise técnica do movimento após a correção foi significativamente maior do que aquela antes da correção. Conclusão: A prevenção de lesões esportivas proposta neste trabalho pode efetivamente ajudar os idosos a prevenir as lesões esportivas. Este documento considera o projeto de ensaio do FMS como um exemplo para analisar os movimentos no treinamento esportivo das pessoas idosas e para formular padrões. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El entrenamiento físico en las personas mayores es muy popular, sin embargo, hay una falta de análisis sobre las lesiones deportivas en las personas mayores. Objetivo: Estudiar el análisis del movimiento en las técnicas de entrenamiento deportivo y la prevención de lesiones deportivas en las personas mayores. Métodos: Participando en una actividad de carrera y calentamiento de 15 minutos antes de utilizar el kit de prueba estándar de FMS, se siguieron siete movimientos de prueba, cada uno repetido 3 veces; lo hicieron durante seis semanas de entrenamiento basado en las recomendaciones para la prevención de lesiones deportivas presentadas en este trabajo. Resultados: Entre los 14 sujetos de edad avanzada con una puntuación total de FMS <14 puntos, la mayoría de las puntuaciones motoras funcionales eran de 15-16 puntos, de los cuales 19 puntos eran altos y 9 puntos eran bajos. En la intervención basada en la perspectiva de las lesiones deportivas, el valor de medición de la FMS de los ancianos fue mucho mejor que antes, y la evaluación del análisis técnico del movimiento después de la corrección fue significativamente mayor que antes de la corrección. Conclusión: La prevención de las lesiones deportivas propuesta en este artículo puede ayudar eficazmente a las personas mayores a prevenir las lesiones deportivas. Este documento considera el diseño de la prueba FMS como un ejemplo para analizar los movimientos en el entrenamiento deportivo de las personas mayores y para formular normas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Humans , Male , Female , Aged , Athletic Injuries/prevention & control , Aged , Exercise , Exercise Test , Physical Functional Performance , Movement/physiology
Int. j. cardiovasc. sci. (Impr.) ; 35(3): 354-363, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1375637


Abstract Background: Different immune mechanisms of myocardial damage involved in the pathophysiology of Chagas disease coexist with high titers of autoantibodies induced by T. cruzi . There are few studies in the literature about the adaptive role of anti-β1 and anti-M2 antibodies in chronic Chagas cardiomyopathy (CCC). Objectives: To evaluate the association between anti-β1 and anti-M2 antibodies with heart rate variability (HRV) parameters on 24h Holter monitoring and the rate-pressure product (RPP) on cardiopulmonary exercise testing (CPET). Methods: Anti-β1 and anti-M2 antibody titers were measured by enzyme-linked immunosorbent assay (ELISA) in 64 patients affected by CCC. Analysis of HRV was performed through the time-domain indices NNs, mean NN, SDNN, SDANN, SDNN index, NNNs, RMSSD, and pNN50. Spearman's correlation coefficient was used to assess the association between antibody titers and numerical variables. The Mann-Whitney test was used for comparison between two groups. Multiple linear regression was used to identify independent variables capable of explaining anti-β1 and anti-M2 antibody titers at the 5% significance level. Results: On 24h Holter, during the period of greatest parasympathetic activation (2:00-6:00 a.m.), an inverse association was found between anti-β1 titers and SDNN (rs=-0.13, p =0.041, n=43), as well as a direct association between anti-M2 titers and SDANN ( r s=0.317, p =0.039, n=43). Regarding CPET variables, anti-β1 titers were directly associated with RPP (rs=0.371, p =0.005, n=56). The subgroup of patients with a normal chronotropic response showed higher anti-β1 titers than the subgroup with an impaired response (p=0.023). RPP was an independent explanatory variable for anti-β1 titers, although with a low coefficient of determination (R2=0.147). Conclusion: The findings of this study suggest that, in patients with CCC, anti-β1 and anti-M2 antibodies may affect HRV parameters. RPP was directly associated with higher anti-β1 titers.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Autonomic Nervous System/physiology , Chagas Cardiomyopathy/physiopathology , Receptors, Adrenergic, beta-1/physiology , Receptor, Muscarinic M2/physiology , Chronic Disease , Cross-Sectional Studies , Antibodies, Bispecific , Exercise Test
Int. j. cardiovasc. sci. (Impr.) ; 35(3): 304-315, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1375639


Abstract Background Obesity and overweight in childhood can increase the risk of developing cardiovascular disease throughout live. Objectives This study provides an update of a meta-analysis of randomized clinical trials (RCT) published in 2014, to assess the effects of physical activity interventions on preventing cardiovascular risk factors in childhood. Methods This update combines data from the previous search with new data obtained from June 2013 to June 2020. Searches were performed on PubMed, EMBASE and Cochrane CENTRAL. The RCTs enrolled used interventions with physical activity longer than six months in school children aged 6-12 years, and evaluated body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels. Data analysis was performed using a random-effects model and a P value <0.05 was considered statistically significant. Results A total of 28,603 articles were retrieved, and 17 RCTs (11,952 subjects) were included. Physical activity interventions were associated with reduction in SBP [−2.11mmHg (95%CI −3.67, −0.54), I243%], DBP [−2.08mmHg (95%CI −3.68, −0,49), I265%] and TG [-0.08mmol/L (95% CI -0.13, -0.03), I20%], and increase in TC [0.17mmol/L (95%CI 0.04, 0.30), I20%]. However, the interventions were not associated with reductions in BMI [−0.03 kg/m2 (95%CI −0.17, 0.10), I20%]. Conclusion This update confirms and reinforces the beneficial effects of physical activity intervention in reducing systolic and diastolic blood pressure and TG levels.

Humans , Male , Female , Child , Cardiovascular Diseases/prevention & control , Exercise , Heart Disease Risk Factors , Sports , Students , Exercise Test , Pediatric Obesity , Physical Conditioning, Human
Int. j. cardiovasc. sci. (Impr.) ; 35(2): 191-201, Mar.-Apr. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364978


Abstract Background Physical Fitness Tests (PFTs) are part of military routines and are usually administered to applicants for the Brazilian corps member, including the civil police. Objective To identify in the literature, scientific articles aimed at assessing physical fitness of police and military personnel in Brazil, using PFTs. Methods This was a systematic review, using the PRISMA systematization, using the following search keywords "police", "military", "physical fitness test" and " PFT", in English and Portuguese. The databases used were ScienceDirect, PubMed, BVS (Lilacs) and Scielo. Only original works performed with police and military personnel in Brazil were selected, through the application of inclusion and exclusion criteria. Results After the screening process, 11 articles were selected from a total of 1,487. Conclusions The data collected from the selected articles suggest that older age is related to a decrease in physical fitness, and better performance in the tests is related to a lower risk of comorbidities. Although high-intensity training improves physical fitness and anthropometric data, it is associated with injury rates; physically active lifestyle is associated with better flexibility.

Humans , Male , Female , Adult , Middle Aged , Young Adult , Physical Fitness , Police , Exercise Test/methods , Military Personnel , Body Weights and Measures , Brazil , Exercise , Comorbidity , Risk Factors , Age Factors , Military Health , Life Style
Arq. bras. cardiol ; 118(3): 565-575, mar. 2022. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1364343


Resumo Fundamento Pacientes com anemia falciforme (AF) têm risco aumentado de complicações cardiovasculares. O teste ergométrico é usado como marcador de prognóstico em uma série de doenças cardiovasculares. Entretanto, há uma escassez de evidências sobre exercícios em pacientes com AF, especialmente em relação à sua segurança, viabilidade e possível função prognóstica. Objetivos Usamos o teste em esteira máximo para determinar a segurança e a viabilidade do teste ergométrico em pacientes com AF. Além disso, os fatores associados à duração do exercício, bem como o impacto das alterações causadas pelo exercício em resultados clínicos, também foram avaliados. Métodos 113 pacientes com AF que passaram pelo teste ergométrico e por uma avaliação cardiovascular abrangente incluindo um ecocardiograma e os níveis do peptídeo natriurético do tipo B (BNP). O desfecho de longo prazo foi uma combinação de eventos incluindo morte, crises álgicas graves, síndrome torácica aguda ou internações hospitalares por outras complicações associadas â doença falciforme. A análise de regressão de Cox foi realizada para identificar as variáveis associadas ao resultado. Um p valor <0,05 foi considerado estatisticamente significativo. Resultados A média de idade foi de 36 ± 12 anos (intervalo, 18-65 anos), e 62 pacientes eram do sexo feminino (52%). A presença de alterações isquêmicas ao esforço e resposta pressórica anormal ao exercício foram detectadas em 17% e 9 % da´população estudada respectivamente. Dois pacientes apresentaram crise álgica com necessidade de internação hospitalar no período de 48 horas da realização do exame. Fatores associados à duração do exercício foram idade, sexo, velocidade máxima de regurgitação tricúspide (RT), e relação E/e', após a padronização quanto aos marcadores da gravidade da doença. Durante o período médio de acompanhamento de 10,1 meses (variando de 1,2 a 26), 27 pacientes (23%) apresentaram desfechos clínicos adversos. Preditores independentes de eventos adversos foram a concentração de hemoglobina, velocidade do fluxo transmitral tardio (onda A), e a resposta da PA ao exercício. Conclusões A realização de testes ergométricos em pacientes com AF, clinicamente estáveis, é viável. A duração do exercício estava associada à função diastólica e a pressão arterial pulmonar. A resposta anormal da PA foi um preditor independente de eventos adversos.

Abstract Background Patients with sickle cell disease (SCD) are at increased risk for cardiovascular complications. Exercise testing is used as a prognostic marker in a variety of cardiovascular diseases. However, there is a lack of evidence on exercise in SCD patients, particularly regarding its safety, feasibility, and possible prognostic role. Objectives We used the maximal treadmill test to determine safety and feasibility of the exercise testing in SCD patients. Additionally, the factors associated with exercise duration, as well as the impact of exercise-induced changes on clinical outcome, were also assessed. Methods One-hundred thirteen patients with SCD, who underwent exercise testing, were prospectively enrolled. A comprehensive cardiovascular evaluation, including echocardiography and B-type natriuretic peptide (BNP) levels, were obtained. The long-term outcome was a composite endpoint of death, severe acute painful episodes, acute chest syndrome, or hospitalization for other SCD-related complications. Cox regression analysis was performed to identify the variables associated with the outcome. A p-value<0.05 was considered to be statistically significant. Results The mean age was 36 ± 12 years (range, 18-65 years), and 62 patients were women (52%). Ischemic electrocardiogram and abnormal blood pressure (BP) response to exercise were detected in 17% and 9%, respectively. Two patients experienced pain crises within 48 hours that required hospitalization. Factors associated with exercise duration were age, sex, tricuspid regurgitation (TR) maximal velocity, and E/e' ratio, after adjustment for markers of disease severity. During the mean follow-up of 10.1 months (ranging from 1.2 to 26), the endpoint was reached in 27 patients (23%). Independent predictors of adverse events were hemoglobin concentration, late transmitral flow velocity (A wave), and BP response to exercise. Conclusions Exercise testing in SCD patients who were clinically stable is feasible. Exercise duration was associated with diastolic function and pulmonary artery pressure. Abnormal BP response was an independent predictor of adverse events.

Humans , Female , Adult , Young Adult , Exercise Test , Anemia, Sickle Cell/complications , Prognosis , Echocardiography , Feasibility Studies , Middle Aged
Int. j. cardiovasc. sci. (Impr.) ; 35(1): 28-36, Jan.-Feb. 2022. graf, tab
Article in English | LILACS, SES-SP, CONASS, SESSP-IDPCPROD, SES-SP | ID: biblio-1356316


BACKGROUND: Exercise tests are an important tool in the investigation of myocardial ischemia. The ramp protocol has gained increasing importance in clinical practice because of the possibility of individualizing its exercise intensity. OBJECTIVE: To assess and compare the sensitivity, specificity, and accuracy of Bruce and ramp protocols for exercise testing in the diagnosis of myocardial ischemia considering myocardial perfusion scintigraphy as the reference standard. Secondary objectives included the assessment of hemodynamic profiles, functional capacity, and the incidence of arrhythmias in each of the protocols. METHODS: Participants underwent exercise testing using the ramp and Bruce protocols, and the tests' diagnostic power was assessed. For testing the difference between data provided by both protocols, we used a paired Student's t-test or Wilcoxon test, depending on the assumption of data normality. The level of significance adopted for all tests was 5%. RESULTS: The ramp protocol showed sensitivity, specificity, and accuracy values of 55.6%, 82.4%, and 76.7%, respectively, whereas the Bruce protocol had results of 77.8%, 64.7%, and 67.4%, respectively. The maximum heart rate and double product at peak exercise were significantly higher in the Bruce protocol (p = 0.043 and p = 0.040, respectively). No differences were observed between the incidence of arrhythmias in both protocols. CONCLUSION: The Bruce protocol presented higher sensitivity for detecting ischemia on the exercise test, while the ramp protocol presented higher specificity and accuracy.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Coronary Artery Disease/diagnosis , Myocardial Ischemia/diagnosis , Exercise Test , Myocardial Perfusion Imaging/methods , Exercise , Predictive Value of Tests , Hemodynamics
Afr. j. lab. med. (Print) ; 11(1): 1-9, 2022. tables, figures
Article in English | AIM | ID: biblio-1379112


Background: The Northern Cape is South Africa's largest province with an HIV prevalence of 7.1% versus a 13.5% national prevalence. CD4 testing is provided at three of five National Health Laboratory Service district laboratories, each covering a 250 km precinct radius. Districts without a local service report prolonged CD4 turn-around times (TAT).Objective: This study documented the impact of a new CD4 laboratory in Tshwaragano in the remote John Taolo Gaetsewe district of the Northern Cape, South Africa.Methods: CD4 test volumes and TAT (total, pre-analytical, analytical, and post-analytical) data for the Northern Cape province were extracted for June 2018 to October 2019. The percentage of CD4 results within the stipulated 40-h TAT cut-off and the median and 75th percentiles of all TAT parameters were calculated. Pre-implementation, samples collected at Tshwaragano were referred to Kimberley or Upington, Northern Cape, South Africa.Results: Pre-implementation, 95.4% of samples at Tshwaragano were referred to Kimberley for CD4 testing (36.3% of Kimberley's test volumes). Only 7.5% of Tshwaragano's total samples were referred post-implementation. The Tshwaragano laboratory's CD4 median total TAT decreased from 24.7 h pre-implementation to 12 h post-implementation (p = 0.003), with >95.0% of results reported within 40 h. The Kimberley laboratory workload decreased by 29.0%, and testing time significantly decreased from 10 h to 4.3 h.Conclusion: The new Tshwaragano CD4 service significantly decreased local TAT. Upgrading existing community laboratories to include CD4 testing can alleviate provincial service load and improve local access, TAT and efficiency in the centralised reference laboratory

Humans , Male , Female , CD4 Antigens , HIV , Allergy and Immunology , Exercise Test , Hospitals, District , Laboratories , Operations Research
In. Soeiro, Alexandre de Matos; Leal, Tatiana de Carvalho Andreucci Torres; Accorsi, Tarso Augusto Duenhas; Gualandro, Danielle Menosi; Oliveira Junior, Múcio Tavares de; Caramelli, Bruno; Kalil Filho, Roberto. Manual da residência em cardiologia / Manual residence in cardiology. Santana de Parnaíba, Manole, 2 ed; 2022. p.921-927, ilus, tab.
Monography in Portuguese | LILACS | ID: biblio-1353766
In. Soeiro, Alexandre de Matos; Leal, Tatiana de Carvalho Andreucci Torres; Accorsi, Tarso Augusto Duenhas; Gualandro, Danielle Menosi; Oliveira Junior, Múcio Tavares de; Caramelli, Bruno; Kalil Filho, Roberto. Manual da residência em cardiologia / Manual residence in cardiology. Santana de Parnaíba, Manole, 2 ed; 2022. p.966-973, ilus, tab.
Monography in Portuguese | LILACS | ID: biblio-1353818
Arq. bras. cardiol ; 118(2): 411-419, 2022. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1364315


Resumo Fundamento Apesar de avanços em técnicas cirúrgicas e cuidados pós-operatórios em cardiopatia congênita, a morbidade cardiovascular permanece elevada. Objetivo Avaliar a associação do condicionamento pré-operatório de crianças e adolescentes com cardiopatias, mensurado por teste de caminhada de 6-minutos (TC6M) e variabilidade da frequência cardíaca (VFC), com a ocorrência de choque cardiogênico, séptico e morte no período pós-operatório. Métodos Estudo clínico prospectivo e observacional de 81 pacientes de 8 a 18 anos. No período pré-operatório foram realizados o TC6M (distância caminhada e SpO2) e a VFC. O escore de risco ajustado para cirurgia de cardiopatia congênita ( RACHS-1 ) foi aplicado para predizer o fator de risco cirúrgico para mortalidade. A ocorrência de pelo menos uma das complicações citadas foi considerada como evento combinado. Valores de p<0,05 foram considerados significantes. Resultados Dos 81 pacientes, 59% eram do sexo masculino, com idade média de 12 anos; 33% eram cianóticos; e 72% já tinham realizado cirurgias prévias. O choque cardiogênico foi a complicação mais comum, e 31% apresentaram evento combinado. Cirurgia prévia, tipo de cardiopatia atual, RACHS-1 , SpO2 em repouso, durante e após recuperação do TC6M foram selecionados para o estudo multivariado. A SpO2 após o TC6M permaneceu como fator de risco independente para aumentar a ocorrência de evento combinado no pós-operatório (OR: 0,93, IC95% [0,88 - 0,99], p=0,02). Conclusão O SpO2 após o TC6M no período pré-operatório foi o fator independente preditor de prognóstico no pós-operatório em crianças e adolescentes submetidos à correção cirúrgica; a distância caminhada e as variáveis da VFC não tiveram a mesma associação.

Abstract Background Despite advances in surgical technique and postoperative care in congenital heart disease, cardiovascular morbidity is still high. Objective To evaluate the association between preoperative cardiovascular fitness of children and adolescents, measured by the 6-minute walk test (6MWT) and Heart Rate Variability (HRV), and the occurrence of cardiogenic, septic shock and death in the postoperative period. Methods Prospective, observational clinic study including 81 patients aged from 8 to 18 years. In the preoperative period, the 6MWT (distance walked and SpO2) and HRV were performed. The adjusted risk score for surgeries for congenital heart disease (RACHS-1) was applied to predict the surgical risk factor for mortality. The occurrence of at least one of the listed complications was considered as a combined event. P values < 0.05 were considered as significant. Results Of the patients, 59% were male, with mean age of 12 years; 33% were cyanotic; and 72% had undergone previous cardiac surgery. Cardiogenic shock was the most common complication, and 31% had a combined event. Prior to surgery, type of current heart disease, RACHS-1, SpO2at rest, during the 6MWT and recovery were selected for the multivariate analysis. The SpO2at recovery by the 6MWT remained as an independent risk factor (OR 0.93, 95%CI [0.88 - 0.99], p=0.02) for the increasing occurrence of combined events. Conclusion SpO2after the application of the 6MWT in the preoperative period was an independent predictor of prognosis in children and adolescents undergoing surgical correction; the walked distance and the HRV did not present this association.

Humans , Male , Child , Adolescent , Walking/physiology , Exercise Test , Postoperative Period , Prospective Studies , Walk Test
Motriz (Online) ; 28: e1022005221, 2022. tab, graf
Article in English | LILACS | ID: biblio-1365160


Abstract Aim: This systematic review aimed to investigate the acute effects of cardiovascular exercise on motor learning of non-disabled individuals. Methods: Forty studies were identified through database searching (PsycINFO, CENTRAL, Google Scholar, Scielo, and PUBMED). The studies demonstrated heterogeneity and were classified into two categories to guide the analyses: (1) - studies that investigated the effects of exercise-induced fatigue during practice on the performance in the retention test; (2) - studies that verified the acute impact of the cardiovascular exercise in close temporal proximity to the task practice on motor learning. Results: The studies demonstrated that (1) - the practice under fatigue conditions did not impair motor learning and that (2) - the cardiovascular exercise bout performed in close temporal proximity to task practice enhances the motor learning processes. Conclusion: Cardiovascular exercise enhances motor learning processes; however, these priming effects are dependents on the timing between practice and exercise, type of exercise, and task characteristics.

Humans , Exercise/physiology , Exercise Test , Fatigue/etiology , Motor Activity/physiology
Motriz (Online) ; 28: e10220005921, 2022. tab, graf
Article in English | LILACS | ID: biblio-1365159


Abstract Aim: To compare muscular and cardiorespiratory parameters between Brazilian professional futsal athletes from different competitive levels (national versus regional). A secondary aim was to explore the correlation of physical fitness variables between both competitive levels. Methods: Twenty-two futsal players (24.7 ± 3.7 years), 11 from a regional team and 11 from a national team, were evaluated with countermovement jump test (lower limbs muscle power), square test (the speed with change direction), RSSA (anaerobic power), and YOYOIR1 (aerobic power). Tests were performed in the middle of the season for both teams. Results: The speed with change direction (p = 0.001) and mean anaerobic power (p = 0.04) were higher for national than the regional players. Sprint performance decreased similarly for national and regional level players (p < 0.001), but the latter had poorer performance (p = 0.044). From the fourth sprint on, sprints for the national level players were slower than the first three, while for the regional level players, each sprint speed was slower than the subsequent. A significant correlation was found between anaerobic power with jump height (r = −0.50; p = 0.01), speed with change direction (r=0.65; p = 0.001) and distance covered in the YOYOIR1 (r = −0.54; p = 0.01). Conclusion: National-level athletes were more agile and presented a higher mean anaerobic power than regional ones. Moreover, national-level athletes presented better performance along with repeated sprint tests, maintaining this performance for a longer time during the test.

Humans , Aptitude , Soccer/physiology , Exercise Test , Athletic Performance , Athletes
Chinese Journal of Cardiology ; (12): 471-479, 2022.
Article in Chinese | WPRIM | ID: wpr-935172


Objective: To investigate the postoperative cardiopulmonary fitness of children with congenital heart diseases (CHD). Methods: This is a retrospective study. A total of 136 children after cardiac correction undergoing cardiopulmonary exercise test (CPET) in Shanghai Children's Medical Center from March 1 to June 30, 2021 were selected. According to the surgical procedure, the children were divided into two groups: the biventricular correction group (BV group) (n=75) and single ventricular correction group (SV group) (n=61). The BV group was divided into two subgroups: simple congenital heart disease (S-CHD) group (n=35) and complex congenital heart disease (C-CHD) group (n=40). CPET parameters, including VO2 max, VO2/kg max, VO2/kg@AT, O2/HR max, HRR, PetCO2 max, CI, HRR at 1 min, VE/VCO2 slope, OUES/kg and EOV, were analyzed. CPET parameters of patients underwent different procedure were compared. In the subgroup analysis, CPET parameters of patients in S-CHD group and C-CHD group were compared. The parameters of the BV group were compared with the normal value. Linear correlation analysis was used to identify the correlation between the CPET parameters. Results: A total of 136 children with CHD after surgery were enrolled. The age was (9.4±3.1) (ranged 6.2-16.0) years, and there was 84 (61.8%) male. All the children completed CPET examination safely without experiencing serious circulation abnormalities. Compared with the SV group, the VO2/kg max ((32.6±6.9) ml·kg-1·min-1 vs. (23.5±5.9) ml·kg-1·min-1, P<0.001), O2/HR max ((7.24±2.93) ml/beat vs. (6.35±2.17)ml/beat, P=0.030), HRR at 1 min ((32.5±13.9) beat/min vs. (26.3±12.5) beat/min, P=0.036), OUES/kg (36.9±8.8 vs. 29.7±11.8, P=0.001) were significantly higher, VE/VCO2 slope (29.1±5.20 vs. 35.1±8.0, P<0.001) and incidence of EOV (32.0%(24/75) vs. 57.4%(31/61), P=0.027) were significantly lower in BV group. Compared with the simple CHD subgroup, VE/VCO2 slope and the incidence of EOV were higher, VO2/kg max, O2/HR max, HRR at 1 min and OUES/kg were lower in the complex CHD subgroup (all P<0.05). Cardiopulmonary function parameters of the BV group were lower than the normal value. Linear correlation analysis showed that VO2/kg@AT was strongly correlated with VO2/kg max (r=0.86, P<0.001), VO2/kg max was strongly correlated with OUES/kg (r=0.63, P<0.001), HRR was strongly correlated with CI (r=0.91, P<0.001), and VO2/kg max was strongly correlated with OUES/kg (r=0.63, P<0.001). VE/VCO2 slope was strongly correlated with PetCO2 max (r=1.00, P<0.001). Conclusions: The exercise cardiopulmonary function of children after single ventricular correction is weaker than that of biventricular correction, and the exercise tolerance of children after biventricular correction is lower than that of normal children. Among the children after biventricular correction, the exercise tolerance of children with complex CHD is lower than that of children with simple CHD. Postoperative CPET is of important realistic significance for CHD children.

Adolescent , Child , China , Exercise Test/methods , Female , Heart Defects, Congenital/surgery , Humans , Male , Oxygen Consumption , Retrospective Studies
Ciênc. cogn ; 26(2): 233-243, 31 dez. 2021. tab
Article in Portuguese | LILACS | ID: biblio-1353090


A aptidão física e parâmetros antropométricos têm sido associados ao aproveitamento acadêmico e melhoria da função cognitiva. Neste sentido, o objetivo do presente estudo foi de associar a função executiva, antropometria e aptidão física de escolares com idades entre 11 e 15 anos. Para tanto, 179 estudantes (85 meninas e 94 meninos) (13,18 ± 1,26 anos; 49,73 ± 12,30 kg; 159,21 ± 9,40 cm; 19,46 ± 3,79 kg/m²) foram submetidos a mensurações antropométricas (massa corporal, estatura e circunferência da cintura, com posterior cálculo de índice de massa corporal e relação cintura-estatura), realizaram dois testes cognitivos (Teste de Stroop e Teste de Trilhas) e realizaram uma bateria de testes físicos (PROESP-BR). Os dados foram analisados no SPSS versão 22.0 por meio de estatística descritiva e Correlação de Spearman. O nível de significância adotado foi de p<0,05. Os resultados indicaram que a maior parte dos escolares apresentou baixo desempenho nos testes de aptidão física. Nenhuma associação significativa foi encontrada entre as variáveis antropométricas e o tempo para completar os testes cognitivos. Por outro lado, correlações significativas negativas foram observadas na associação entre os testes de aptidão física e os testes cognitivos, indicando que participantes com melhor aptidão física necessitam de menos tempo para completar os testes cognitivos. Conclui-se que escolares com idades entre 11 e 15 anos apresentam baixa aptidão física. Ademais, foram observadas correlações negativas significativas entre a aptidão física e o tempo para completar os testes cognitivos.

Physical fitness and body composition parameters have been associated with academic performance and improved cognitive function. Thus, the aim of the present study was to associate executive function, anthropometry and physical fitness of students aged 11 to 15 years. In order to do so, 179 participants (85 girls and 94 boys) (13.18 ± 1.26 years; 49.76 ± 12.30 kg; 159.21 ± 9.40 cm; 19.46 ± 3.79 kg/m²) underwent anthropometric measurements (body mass, stature and waist circumference. Body mass index and waist-to-height ratio were also calculated), performed two cognitive tests (Stroop test and Trail making test) and performed physical fitness tests (PROESP-BR). Data were analyzed using descriptive statistics and Spearman's Correlation. The level of significance adopted was p<0.05. Results showed that the majority of the participants presented a weak performance in the physical fitness tests. No statistically significant associations were found between anthropometric indicators and time to complete the cognitive tests. However, significantly negative correlations occurred when associating the physical tests with the cognitive tests, indicating that students with better physical fitness need less time to complete the cognitive tests. School students aged 11 to 15 years presented low physical fitness. Moreover, negatively statistically significant correlations were found between the physical fitness tests and time to complete the cognitive tests.

Humans , Child , Adolescent , Child , Anthropometry , Adolescent , Exercise Test , Stroop Test
J. bras. nefrol ; 43(4): 470-477, Dec. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1350897


Abstract Introduction: The outcomes of Acute Kidney Injury (AKI) remain dismal even today, owing in part due to the lack of an ideal biomarker for detecting renal damage early enough. We conducted this pilot study to determine the clinical significance of Frusemide Stress Test (FST) to predict the severity of AKI. Methods: A total of 80 patients with AKI-KDIGO (Kidney Disease: Improving Global Outcomes) stage 1 or stage 2 underwent FST by administering a bolus dose of frusemide (1mg/kg for frusemide naïve and 1.5mg/kg for prior frusemide exposure in the past week), and urine output was then measured for the next two hours with volume replacement as desirable. The progression to AKI-KDIGO stage 3 within 14 days of FST was studied as the primary outcome. The composite end point of achieving AKI-KDIGO stage 3 or death within 14 days of FST was studied as the secondary outcome. Results: Out of 80 patients, 28(35%) patients met the primary outcome, and 34(42.5%) patients met the secondary composite outcome. Except for baseline Chronic Kidney Disease (CKD) status (p=0.018), other demographic characteristics were comparable between progressors and non-progressors group. Using receiver operating characteristics (ROC) curve analysis, a cumulative 2-hour post-FST urine output of ≤300 mL predicted progression to stage 3 AKI with 82.14% sensitivity, 82.69% specificity, and AUC of 0.89±0.03 (p<0.0001). Conclusion: The FST showed promising results as a novel tubular biomarker to identify progression to severe AKI with good predictive ability.

Resumo Introdução: Os desfechos da Lesão Renal Aguda (LRA) permanecem desanimadores ainda hoje, em parte pela falta de um biomarcador ideal para detectar danos renais com a devida antecedência. Realizamos este estudo piloto para determinar a importância clínica do Teste de Estresse com Furosemida (TEF) em prever a gravidade da LRA. Métodos: Um total de 80 pacientes com LRA-KDIGO estágio 1 ou 2 foram submetidos ao TEF pela administração de uma dose em bolus de furosemida (1mg/kg para pacientes virgens de furosemida e 1,5mg/kg para exposição prévia à furosemida na semana anterior). O débito urinário foi então medido durante as duas horas seguintes com reposição de volume conforme desejável. A progressão para LRA-KDIGO estágio 3 dentro de 14 dias de TEF foi estudada como principal desfecho. O desfecho composto de atingir a LRA-KDIGO estágio 3 ou óbito em 14 dias após TEF foi estudado como desfecho secundário. Resultados: Dos 80 pacientes, 28 (35%) atingiram desfecho primário, e 34 (42,5%) pacientes atingiram o desfecho composto secundário. Exceto pelo estado basal da Doença Renal Crônica (DRC) (p=0,018), outras características demográficas foram comparáveis entre o grupo progressores e não progressores. Usando a análise da Curva Característica de Operação do Receptor (ROC), um débito urinário cumulativo de 2 horas pós-TEF de ≤300 mL previu a progressão para estágio 3 da LRA com 82,14% de sensibilidade, 82,69% de especificidade, e AUC de 0,89±0,03 (p<0,0001). Conclusão: O TEF mostrou resultados promissores como novo biomarcador tubular para identificar progressão para LRA grave com boa capacidade preditiva.

Humans , Acute Kidney Injury/diagnosis , Furosemide , Biomarkers , Pilot Projects , ROC Curve , Exercise Test
Fisioter. Bras ; v.22(4): 502-515, Nov 2, 2021.
Article in Portuguese | LILACS | ID: biblio-1353367


A dinapenia da musculatura ventilatória relaciona-se com as complicações respiratórias pós-operatórias e aos óbitos de idosos submetidos a procedimentos cirúrgicos de etiologia toracoabdominal. Objetivo: Verificar o efeito crônico do treinamento cardiorrespiratório sobre a força dos músculos ventilatórios de idosas. Métodos: Amostra (n = 24) randomizada nos grupos: controle (n = 8), treinamento ventilatório (n = 7) e treinamento cardiorrespiratório (n = 9). O desfecho primário (PImáx e PEmáx) foi medido por um manovacuômetro digital MDV®300 (MDI/Brasil). Rodou-se a estatística descritiva (média e desvio padrão), seguida de uma ANOVA 3x3 e o testes post-hoc de Bonferroni, todos com significância de (P ≤ 0,05). Resultados: O teste Post Hoc atestou diferença estatisticamente significativa do grupo treinamento cardiorrespiratório no reteste 1 e 2 quando comparados ao teste inicial (PImáx; P = 0,000001 e P = 0,0000001 respectivamente) e (PEmáx; P = 0,000000 em ambas as comparações). Conclusão: O treinamento cardiorrespiratório proposto foi capaz de aumentar significativamente a PImáx, PEmáx, resistência aeróbica e a força de membros inferiores das participantes deste ECR. (AU)

Aged , Aged, 80 and over , Respiratory Function Tests , Muscle Strength , Respiratory Tract Infections , Biomechanical Phenomena , Respiratory Muscles , Aged , Exercise , Exercise Test