Machine learning-based predictive modeling of resilience to stressors in pregnant women during COVID-19: A prospective cohort study.

During the COVID-19 pandemic, pregnant women have been at high risk for psychological distress. Lifestyle factors may be modifiable elements to help reduce and promote resilience to prenatal stress. We used Machine-Learning (ML) algorithms applied to questionnaire data obtained from an international cohort of 804 pregnant women to determine whether physical activity and diet were resilience factors against prenatal stress, and whether stress levels were in turn predictive of sleep classes. A support vector machine accurately classified perceived stress levels in pregnant women based on physical activity behaviours and dietary behaviours. In turn, we classified hours of sleep based on perceived stress levels. This research adds to a developing consensus concerning physical activity and diet, and the association with prenatal stress and sleep in pregnant women. Predictive modeling using ML approaches may be used as a screening tool and to promote positive health behaviours for pregnant women.

High-dose versus low-dose angiotensin converting enzyme inhibitors in heart failure: systematic review and meta-analysis.

OBJECTIVE: To systematically review evidence comparing the effect of low-dose versus high-dose ACE inhibitors (ACEIs) on all-cause and cardiovascular mortality and hospitalisation, functional capacity and side effects in patients with heart failure (HF). METHODS: We searched PubMed, Embase, Cochrane CENTRAL and LILACS up to January 2019. We included randomised controlled trials (RCTs) comparing low-dose versus high-dose ACEIs in adults with HF with reduced left ventricular ejection fraction (HFrEF). Study selection and data extraction were performed by two independent reviewers. Risk of bias was assessed with RoB 2.0, and quality of evidence with Grading of Recommendations Assessment, Development and Evaluation (GRADE). We conducted random effects meta-analysis and trial sequential analysis. RESULTS: We included eight RCTs (5829 patients with HF). In comparison with low-dose ACEIs, high-dose ACEIs showed a non-significant effect on all-cause mortality (8 RCTs, n=5828, relative risk (RR) 0.95, 95% CI 0.88 to 1.02; moderate quality of evidence), cardiovascular mortality (6 RCTs, n=4048, RR 0.93, 95% CI 0.85 to 1.01; moderate quality of evidence), all-cause hospitalisation (5 RCTs, n=5394, RR 0.95, 95% CI 0.82 to 1.10; moderate quality of evidence) and cardiovascular hospitalisation (4 RCTs, n=5242, RR 0.98, 95% CI 0.83 to 1.17; low quality of evidence). High-dose ACEI increased functional capacity (4 studies, n=555, standardised mean difference 0.38, 95% CI 0.20 to 0.55; low quality of evidence) and the risk of hypotension (4 RCTs, n=3783, RR 1.64, 95% CI 1.30 to 2.05; moderate quality of evidence). High-dose ACEI had no effect on dizziness (3 RCTs, n=4994, RR 1.37, 95% CI 0.97 to 1.93; low quality of evidence), but decreased the risk of cough (4 RCTs, n=5146, RR 0.85, 95% CI 0.73 to 0.98; moderate quality of evidence). CONCLUSIONS: The magnitude of benefit of using high dose versus low to intermediate doses of ACEIs might be less than traditionally suggested in clinical guidelines. These findings might help clinicians address the complex task of HF management in a more rational and timely fashion, saving efforts to implement strategies with the greatest net clinical benefit.

Acute Hemodynamic Responses to Repetitions to Failure Using Different Resistance Exercises and Protocols in Normotensive Men: A crossover study.

The present crossover design study investigated acute hemodynamic responses to two sets of leg press (LP) and bench press (BeP) at 10 and 20 repetition maximum (RM) in ten normotensive young men. At the end of each set, an increase in systolic blood pressure (SBP), heart rate (HR), and rate pressure product (RPP) was observed (p < .01), with no differences between intensities, but SBP was greater during the LP exercise (p < .01). Lower resting values of diastolic blood pressure (DBP) were observed in the post-BeP exercise period (p < .05), suggesting that DBP post-exercise hypotension may be more evident after upper-limb exercise.

Sequential Introduction of Exercise First Followed by Nutrition Improves Program Adherence During Pregnancy: a Randomized Controlled Trial.

BACKGROUND: Adhering to nutrition and exercise recommendations simultaneously during pregnancy may be challenging. The purpose was to examine adherence to the sequential introduction of nutrition and exercise behaviors during pregnancy in comparison with a simultaneous approach. METHOD: A randomized controlled trial including nutrition and exercise was executed. Using a stratified body mass index (BMI) randomization, participants (n = 88) were allocated to one of three groups at 12-18 weeks gestation. Group A received nutrition and exercise simultaneously. Group B received nutrition first and Group C received exercise first, and the second behavior was added at 25 weeks gestation for both groups. The program included weekly weighing, supervised walking sessions, and/or nutrition counseling. Adherence (primary outcome) was measured by scoring women on meeting the intervention goals (3 nutrition and 3 exercise goals) and converted to a percentage. Secondary health outcomes were gestational weight gain (GWG) and excessive GWG on the program, birthweight, macrosomia (birthweight > 4000 g), and low birthweight (birthweight < 2500 g). RESULTS: Group C (n = 23) had the highest adherence to the program (80.2 ± 14.7%) compared with Groups A (n = 17; 60.9 ± 17.9%) and B (n = 20; 66.8 ± 16.7%; p < 0.05, ηp2 = 0.26). There was a significant effect for gestational weight gain (p < 0.05; ηp2 = 0.10) as Group C gained less weight (7.7 ± 2.2 kg) over Group B (9.8 ± 2.8 kg; p = 0.04), however, not Group A (9.1 ± 3.5, p = 0.35). Non-significant small effects favored Group C for the prevention of EGWG (Cramer's V = 0.13). CONCLUSION: Introducing exercise first followed by nutrition at 25 weeks gestation can improve adherence to multiple behavior change programs and thus have a positive effect on health outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02804061.

Water-based exercises in pregnancy: Apparent weight in immersion and ground reaction force at third trimester.

BACKGROUND: The morphological alterations during pregnancy may affect the biomechanical loads during exercise practice. Aquatic exercises may suit pregnant women, who are recommended to exercise with low vertical ground reaction force loads. Therefore, the study aimed to determine the apparent weight reduction during immersion and the vertical ground reaction force of three specific water-based exercises in pregnant women at the third trimester. METHODS: Eleven pregnant women volunteered to take part in the study [32.0 (SD 1.3) weeks, 28.1 (SD 5.7) years, 72.5 (SD 10.1) kg]. The protocol started with the participants immersed to the xiphoid process depth for the apparent weight assessment. Then, three water-based exercises (stationary running, frontal kick and butt kick) were randomly performed at a pre-selected cadence, with 5-min interval. The vertical ground reaction force was measured in each exercise and peak, impulse, contact time and swing time were determined. Repeated measures ANOVA was used (α = 0.05). FINDINGS: The apparent weight reduction resulted a mean of 82.9 (SD 6.5)% of body weight. Peak, impulse, contact time and swing time revealed no significant difference between exercises (P > 0.05). Values of peak of vertical ground reaction force ranged from 0.67 to 0.72 units of body weight. INTERPRETATION: Pregnant women at the third trimester can benefit from the apparent weight reduction during immersion for exercising. The three water-based exercises presented similar vertical ground reaction force values, which are considered as low odds for musculoskeletal injuries. Therefore, these findings highlight the safety of the water-based exercise program during pregnancy.

Is supine exercise associated with adverse maternal and fetal outcomes? A systematic review.

OBJECTIVE: Theoretical concerns regarding the supine position at rest due to the gravid uterus obstructing aorta and vena caval flow may impinge uterine blood flow (UBF) to the fetus and maternal venous return. DESIGN: Systematic review. DATA SOURCES: Online databases up to 11 December 2017. STUDY CRITERIA: Eligible population (pregnant without contraindication to exercise), intervention (frequency, intensity, duration, volume or type of supine exercise), comparator (no exercise or exercise in left lateral rest position, upright posture or other supine exercise), outcomes (potentially adverse effects on maternal blood pressure, cardiac output, heart rate, oxygen saturation, fetal movements, UBF, fetal heart rate (FHR) patterns; adverse events such as bradycardia, low birth weight, intrauterine growth restriction, perinatal mortality and other adverse events as documented by study authors), and study design (except case studies and reviews) published in English, Spanish, French or Portuguese. RESULTS: Seven studies (n=1759) were included. 'Very low' to 'low' quality evidence from three randomised controlled trials indicated no association between supervised exercise interventions that included supine exercise and low birth weight compared with no exercise. There was 'very low' to 'low' quality evidence from four observational studies that showed no adverse events in the mother; however, there were abnormal FHR patterns (as defined by study authors) in 20 of 65 (31%) fetuses during an acute bout of supine exercise. UBF decreased (13%) when women moved from left lateral rest to acute dynamic supine exercise. CONCLUSION: There was insufficient evidence to ascertain whether maternal exercise in the supine position is safe or should be avoided during pregnancy.

Translation and cultural adaptation of the short-form food frequency questionnaire for pregnancy into Brazilian portuguese / Tradução e adaptação cultural da versão curta do questionário de frequência alimentar para gestantes em português do Brasil

Abstract Objective To translate and culturally adapt the short-formFood Frequency Questionnaire (SFFFQ) for pregnant women, which contains 24 questions, into Brazilian Portuguese. Methods Description of the process of translation and cultural adaptation of the SFFFQ into Brazilian Portuguese. The present study followed the recommendation of the International Society for Pharmacoeconomics and Outcomes Research for translation and cultural adaptation with the following steps: 1) preparation; 2) first translation; 3) reconciliation; 4) back translation; 5) revision of back translation; 6) harmonization; 7) cognitive debriefing; 8) revision of debriefing results; 9) syntax and orthographic revision; and 10) final report. Five obstetricians, five dietitians and five pregnant women were interviewed to contribute with the language content of the SFFFQ. Results Few changes were made to the SFFFQ compared with the original version. These changes were discussed with the research team, and differences in language were adapted to suit all regions of Brazil. Conclusion The SFFFQ translated to Brazilian Portuguese can now be validated for use in the Brazilian population.

Resumo Objetivo Traduzir e adaptar culturalmente, para o português do Brasil, a versão curta do Questionário de Frequência Alimentar (VCQFA), que contém 24 questões, voltado para gestantes brasileiras. Métodos Este estudo descreve o processo de tradução e adaptação cultural do VCQFA para o Português do Brasil. Este estudo seguiu as diretrizes da Sociedade Internacional para Farmacoeconomia e Pesquisa de Resultados para tradução e adaptação cultural, e foram realizadas as seguintes etapas: 1) preparação; 2) primeira tradução; 3) reconciliação; 4) tradução retrógrada; 5) revisão da tradução retrógrada; 6) harmonização; 7) discussão cognitiva; 8) análise dos resultados do desdobramento; 9) revisão de sintaxe e ortografia; e 10) relatório final. Cinco obstetras, cinco nutricionistas e cinco gestantes foram entrevistadas para contribuírem com o conteúdo de linguagem do VCQFA. Resultados Poucas mudanças foram realizadas no VCQFA em comparação com a versão original. Essas mudanças foram discutidas com a equipe de pesquisa, e as diferenças de linguagem foram adaptadas para que o questionário seja adequado a todas as regiões do Brasil. Conclusão A versão traduzida do VCQFA para o português do Brasil pode ser validada para a população brasileira.

Translation and Cultural Adaptation of the Short-Form Food Frequency Questionnaire for Pregnancy into Brazilian Portuguese.

OBJECTIVE: To translate and culturally adapt the short-form Food Frequency Questionnaire (SFFFQ) for pregnant women, which contains 24 questions, into Brazilian Portuguese. METHODS: Description of the process of translation and cultural adaptation of the SFFFQ into Brazilian Portuguese. The present study followed the recommendation of the International Society for Pharmacoeconomics and Outcomes Research for translation and cultural adaptation with the following steps: 1) preparation; 2) first translation; 3) reconciliation; 4) back translation; 5) revision of back translation; 6) harmonization; 7) cognitive debriefing; 8) revision of debriefing results; 9) syntax and orthographic revision; and 10) final report. Five obstetricians, five dietitians and five pregnant women were interviewed to contribute with the language content of the SFFFQ. RESULTS: Few changes were made to the SFFFQ compared with the original version. These changes were discussed with the research team, and differences in language were adapted to suit all regions of Brazil. CONCLUSION: The SFFFQ translated to Brazilian Portuguese can now be validated for use in the Brazilian population.

OBJETIVO: Traduzir e adaptar culturalmente, para o português do Brasil, a versão curta do Questionário de Frequência Alimentar (VCQFA), que contém 24 questões, voltado para gestantes brasileiras. MéTODOS: Este estudo descreve o processo de tradução e adaptação cultural do VCQFA para o Português do Brasil. Este estudo seguiu as diretrizes da Sociedade Internacional para Farmacoeconomia e Pesquisa de Resultados para tradução e adaptação cultural, e foram realizadas as seguintes etapas: 1) preparação; 2) primeira tradução; 3) reconciliação; 4) tradução retrógrada; 5) revisão da tradução retrógrada; 6) harmonização; 7) discussão cognitiva; 8) análise dos resultados do desdobramento; 9) revisão de sintaxe e ortografia; e 10) relatório final. Cinco obstetras, cinco nutricionistas e cinco gestantes foram entrevistadas para contribuírem com o conteúdo de linguagem do VCQFA. RESULTADOS: Poucas mudanças foram realizadas no VCQFA em comparação com a versão original. Essas mudanças foram discutidas com a equipe de pesquisa, e as diferenças de linguagem foram adaptadas para que o questionário seja adequado a todas as regiões do Brasil. CONCLUSãO: A versão traduzida do VCQFA para o português do Brasil pode ser validada para a população brasileira.

Psychometric Properties of the Brazilian Portuguese Version of the PARmed-X for Pregnancy.

BACKGROUND: The Physical Activity Readiness Medical Examination (PARmed-X) for Pregnancy aims to facilitate the communication between the health care provider, the fitness professional and the pregnant woman. The purpose of the current study was to test the psychometric properties of the Brazilian Portuguese version of the PARmed-X for Pregnancy. METHODS: Reliability and validity of psychometric properties of the Brazilian Portuguese version of the PARmed-X for Pregnancy were tested in 107 women recruited from the Hospital de Clínicas de Porto Alegre. Participants completed the first page of the instrument twice with a minimal interval of 1 week for test-retest reliability analysis. The absolute and relative contraindications to exercise on page 2 of the document were completed by the obstetrician. RESULTS: Results indicated good evidence of construct validity. The isolated items in the PARmed-X document presented a large heterogeneity in kappa coefficients ranging from very low estimates to perfect estimates. The overall indication of prescription of physical activity, nonetheless, presented a good kappa coefficient of 0.749. CONCLUSIONS: The Brazilian Portuguese version of the PARmed-X for Pregnancy can be applied as a valid tool for medical screening by health care providers to help inform safe exercise prescription during pregnancy.

Effects of weekly supervised exercise or physical activity counseling on fasting blood glucose in women diagnosed with gestational diabetes mellitus: A systematic review and meta-analysis of randomized trials.

BACKGROUND: Exercise is an important part of gestational diabetes mellitus (GDM) lifestyle management. However, no meta-analysis has analyzed the effects of exercise programs on fasting blood glucose (FBG) in women with GDM. A systematic review with meta-analysis was performed to evaluate the effects of weekly supervised exercise (EXE) or physical activity counseling (PA) in women with GDM compared with usual prenatal care (UPN) on glycemic control. METHODS: Eligible trials were identified from Medline, EMBASE, Web of Science, Scopus and SportDiscus up to December 2016. Data were retrieved from randomized controlled trials comparing UPN with UPN plus weekly supervised (at least once a week) prenatal exercise or PA counseling for which FBG values before and after intervention were available. Random-effects meta-analysis was performed for mean difference in FBG after exercise intervention. RESULTS: The search yielded 781 publications, of which 82 were assessed for eligibility and eight were included in the meta-analysis. The overall effect on absolute FBG concentrations was not significant (P = 0.11) compared with UPN. However, PA versus UPN showed a significant reduction in absolute FBG concentrations (weighted mean difference -3.88 mg/dL; 95% confidence interval -7.33, -0.42 mg/dL; I 2 48%; P heterogeneity < 0.15). CONCLUSIONS: Physical activity counseling in women with GDM showed a significant effect compared with UPN on FBG concentrations, possibly due to a longer follow-up time compared with the EXE groups. This result highlights the importance of an early intervention that lasts to delivery for best practice of GDM management.

Physical activity and sedentary behavior in people with major depressive disorder: A systematic review and meta-analysis.

BACKGROUND: Low levels of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality in people with major depressive disorder (MDD). AIMS: Investigate levels of PA and SB and their predictors in people with MDD. METHODS: Electronic databases were searched from inception till 04/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in people with MDD. Random-effects meta-analyses and meta-regression analyses were conducted. RESULTS: Twenty-four eligible studies were identified including 2901 people with MDD (78.4% female, mean age=54 years; range: 21-77 years). People with MDD spent 126.0min (95%CI=91.9-160.1) per day engaging in all types of PA and spent 8.5hours (95%CI=7.51-9.62) during their waking day being sedentary. Compared to controls, people with MDD spent less time in total PA (SMD=-0.25, 95%CI=-0.03 to 0.15) and moderate to vigorous PA (SMD=-0.30, 95%CI=-0.40 to 0.21) and engaged in higher levels of SB (SMD=0.09, 95%CI=0.01-0.18). The proportion of people with MDD not meeting the recommended PA guidelines was 67.8% (n=13 studies), which was higher in studies relying on objective versus self-report measures (85.7% v 62.1%, p=0.04). People with MDD were more likely than controls to not meeting the recommended PA guidelines (OR = 1.50, 95%CI = 1.10­2.10). LIMITATIONS: Heterogeneity was evident in most analyses. CONCLUSIONS: Adults with MDD engage in low levels of PA and high levels of SB. PA and SB are independent predictors of mortality, therefore, future lifestyle interventions targeting both the prevention of SB and adoption and maintenance of PA are warranted.

Efeitos do treinamento em meio aquático no consumo de oxigênio máximo de idosos: revisão sistemática com metanálise de ensaios clínicos randomizados / Effects of water-based exercise in maximal oxygen uptake in elderly: a systematic review and meta-analysis of randomized clinical trials

O objetivo do presente estudo foi conduzir uma revisão sistemática com metanálise de ensaios clínicos randomizados para avaliar o efeito do treinamento em meio aquático no consumo de oxigênio máximo (VO2máx) de idosos. Os estudos elegíveis foram identificados a partir das bases de dados MEDLINE, PEDro, Biblioteca Virtual da Saúde (BVS), Scopus e SportDiscus até o dia 23 de agosto de 2016. Os dados foram extraídos de estudos randomizados que incluíram idosos (maior ou igual a 60 anos) e que compararam treinamento no meio aquático, na posição vertical, com o grupo controle que não realizou treinamento ou realizou treinamento em meio terrestre. A metanálise foi conduzida utilizando as diferenças entre as médias dos valores pós-intervenção dos grupos controle e experimental com o modelo de efeitos randômicos e a heterogeneidade estatística foi avaliada pelo teste Q de Cochran e inconsistência (I2). De um total de 2200 artigos, sete ensaios clínicos randomizados foram incluídos com 227 sujeitos. Os resultados do desfecho principal indicaram um efeito significativo do VO2máx a favor do exercício no meio aquático em comparação ao grupo controle (95%IC: 7,04 (3,29; 10,79); I2 98%; p<0,05). A partir destes resultados, conclui-se que a hidroginástica é um exercício efetivo para a melhora do condicionamento cardiorrespiratório e pode ser indicada como uma forma de melhorar a capacidade aeróbia de idosos.

The aim of the present study was to conduct a systematic review with meta-analyses of randomized controlled trials to evaluate the effect of a water-based exercise training in the maximal oxygen uptake (VO2máx) in elderly. The eligible studies were identified in the databases MEDLINE, PEDro, Biblioteca Virtual da Saúde (BVS), Scopus and SportDiscus up to August 23rd 2016. Data were extracted from randomized controlled trials that included elderly people (greater or equal than 60 years old) and that compared water-based exercise training, in the upright position, with a control group that did not trained or that performed a land-based exercise training. Meta-analyses were conducted using the differences between the averages of the post-intervention values of intervention and control groups, using the random effect model and the statistical heterogeneity was assessed by Cochran's Q test and inconsistency (I2). Of a total of 2200 trials, seven were included with a total of 227 subjects. The results of the primary outcome indicated a significant effect of the VO2máx in favor to the water-based exercise compared to control group (95%CI: 7.04 (3.29; 10.79); I2 98%; p<0.05). It can be concluded that water-based exercise training is an effective exercise to improve cardiorespiratory conditioning and can be indicated as a modality to improve aerobic capacity in elderly people.

Translation and cross-cultural adaptation of the PARmed-X for Pregnancy into Brazilian Portuguese.

We describe the translation and cross-cultural adaptation of the PARmed-X for Pregnancy for use in Brazilian Portuguese. The original instrument was developed in English for health screening prior to and guidelines for prenatal exercise. We followed the ten steps according to the Translation and Cultural Adaptation International Society for Pharmacoeconomics and Outcomes Research guidelines. Our template can be used by other health professionals for translation and verification of the original tool into their native language.

Fetal heart rate responses during maternal resistance exercise: a pilot study.

PURPOSE: To determine fetal heart rate (FHR) responses to maternal resistance exercise for the upper and lower body at two different volumes, and after 25 minutes post-exercise. METHODS: Ten pregnant women (22-24 weeks gestation, 25.2±4.4 years of age, 69.8±9.5 kg, 161.6±5.2 cm tall) performed, at 22-24, 28-32 and 34-36 weeks, the following experimental sessions: Session 1 was a familiarization with the equipment and the determination of one estimated maximum repetition. For sessions 2, 3, 4 and 5,FHR was determined during the execution of resistance exercise on bilateral leg extension and pec-deck fly machines, with 1 and 3 sets of 15 repetitions; 50% of the weight load and an estimated repetition maximum. FHR was assessed with a portable digital cardiotocograph. Results were analyzed using Student's t test, ANOVA with repeated measures and Bonferroni (α=0.05; SPSS 17.0). RESULTS: FHR showed no significant differences between the exercises at 22-24 weeks (bilateral leg extension=143.8±9.4 bpm, pec-deck fly=140.2±10.2 bpm, p=0.34), 28-30 weeks (bilateral leg extension=138.4±12.2 bpm, pec-deck fly=137.6±14.0 bpm, p=0.75) and 34-36 weeks (bilateral leg extension=135.7±5.8 bpm, pec-deck fly=139.7±13.3 bpm, p=0.38), between the volumes(bilateral leg extension at 22-24 weeks: p=0.36, at 28-30 weeks: p=0.19 and at 34-36 weeks: p=0.87; pec-deck fly at 22-24 weeks: p=0.43, at 28-30 weeks: p=0.61 and at 34-36 weeks: p=0.49) and after 25 minutes post-exercise. CONCLUSION: Results of this pilot study would suggest that maternal resistance exercise is safe for the fetus.

Fetal heart rate responses during maternal resistance exercise: a pilot study / Respostas da frequência cardíaca fetal durante exercício de força materno: um estudo piloto

PURPOSE: To determine fetal heart rate (FHR) responses to maternal resistance exercise for the upper and lower body at two different volumes, and after 25 minutes post-exercise. METHODS: Ten pregnant women (22-24 weeks gestation, 25.2±4.4 years of age, 69.8±9.5 kg, 161.6±5.2 cm tall) performed, at 22-24, 28-32 and 34-36 weeks, the following experimental sessions: Session 1 was a familiarization with the equipment and the determination of one estimated maximum repetition. For sessions 2, 3, 4 and 5,FHR was determined during the execution of resistance exercise on bilateral leg extension and pec-deck fly machines, with 1 and 3 sets of 15 repetitions; 50% of the weight load and an estimated repetition maximum. FHR was assessed with a portable digital cardiotocograph. Results were analyzed using Student's t test, ANOVA with repeated measures and Bonferroni (α=0.05; SPSS 17.0). RESULTS: FHR showed no significant differences between the exercises at 22-24 weeks (bilateral leg extension=143.8±9.4 bpm, pec-deck fly=140.2±10.2 bpm, p=0.34), 28-30 weeks (bilateral leg extension=138.4±12.2 bpm, pec-deck fly=137.6±14.0 bpm, p=0.75) and 34-36 weeks (bilateral leg extension=135.7±5.8 bpm, pec-deck fly=139.7±13.3 bpm, p=0.38), between the volumes(bilateral leg extension at 22-24 weeks: p=0.36, at 28-30 weeks: p=0.19 and at 34-36 weeks: p=0.87; pec-deck fly at 22-24 weeks: p=0.43, at 28-30 weeks: p=0.61 and at 34-36 weeks: p=0.49) and after 25 minutes post-exercise. CONCLUSION: Results of this pilot study would suggest that maternal resistance exercise is safe for the fetus. .

OBJETIVO: O objetivo do presente estudo foi determinar a frequência cardíaca fetal (FCF) enquanto gestantes realizavam exercícios de força para os membros superiores e inferiores, com dois volumes diferentes, e 25 minutos pós-exercício. MÉTODOS: Dez gestantes (22-24 semanas, 25,2±4,4 anos, 69,8±9,5 kg, 161,6±5,2 cm) realizaram as seguintes sessões experimentais com 22-24, 28-32 e 34-36 semanas de gestação: A Sessão 1 foi a familiarização com os equipamentos e determinação de uma repetição máxima estimada. Para as Sessões 2, 3, 4 e 5, foi determinada a FCF durante a execução do exercício de força nos equipamentos extensão de joelhos bilateral e voador, com 1 e 3 séries de 15 repetições e carga de 50% de uma repetição máxima estimada. A FCF foi avaliada com um cardiotocógrafo digital portátil. Os resultados foram analisados com teste t de Student, ANOVA com medidas repetidas e Bonferroni (α=0,05; SPSS 17.0). RESULTADOS: A FCF não demonstrou diferença significativa entre os exercícios com 22-24 semanas (extensão de joelhos bilateral=143,8±9,4 bpm, voador=140,2±10,2 bpm, p=0,34), 28-30 semanas (extensão de joelhos bilateral=138,4±12,2 bpm, voador=137,6±14,0 bpm, p=0,75) e 34-36 semanas (extensão de joelhos bilateral=135,7±5,8 bpm, voador=139,7±13,3 bpm, p=0,38), entre os volumes (extensão de joelhos bilateral com 22-24 semanas: p=0,36, 28-30 semanas: p=0,19 e 34-36 semanas: p=0,87; voador com 22-24 semanas: p=0,43, 28-30 semanas: p=0,61 e 34-36 semanas: p=0,49) e 25 minutos pós-exercícios. CONCLUSÃO: Os resultados deste estudo piloto podem sugerir que o exercício de força materno é seguro para o feto. .

Cardiorespiratory responses of pregnant and nonpregnant women during resistance exercise.

The purpose of this study was to determine cardiorespiratory responses in pregnant and nonpregnant women during the execution of resistance exercises for upper and lower body. Twenty healthy women (10 pregnant: 22-24 weeks, 25.20 ± 4.44 years, 69.80 ± 9.52 kg, 161.60 ± 5.21 cm and 10 nonpregnant: 25.20 ± 3.73 years, 62.36 ± 8.60 kg, 162.40 ± 3.97 cm) performed 5 experimental sessions. Session 1: familiarization with the equipments and the determination of 1 estimated maximum repetition. Sessions 2, 3, 4, and 5: determination of the cardiorespiratory responses during the execution of resistance exercise on the bilateral leg extension and pec-deck fly, with 1 and 3 sets of 15 repetitions, 50% of 1 estimated maximum repetition. Systolic, diastolic, and mean blood pressure (BP) responses were lower (p = 0.029, 0.018, 0.009, respectively) in the pregnant group. When the exercises were performed with a single set, heart rate showed increased values for bilateral leg extension (pregnant: 109.40 ± 10.75 b·min, nonpregnant: 108.51 ± 19.05 b·min) compared with pec-deck (pregnant: 101.59 ± 14.83 b·min, nonpregnant: 100.37 ± 12.36 b·min); however, when the exercises were performed with 3 sets, bilateral leg extension showed increased values for the heart rate (pregnant: 114.70 ± 13.58 b·min, nonpregnant: 121.29 ± 10.86 b·min), systolic (pregnant: 124.50 ± 17.32 mm Hg, nonpregnant: 136.00 ± 17.79 mm Hg), diastolic (pregnant: 68.10 ± 8.23 mm Hg, nonpregnant: 77.89 ± 15.25 mm Hg), and mean BP (pregnant: 86.90 ± 10.38 mm Hg, nonpregnant: 97.73 ± 12.64 mm Hg), ventilation (pregnant: 12.88 ± 4.05 L·min, nonpregnant: 15.02 ± 4.19 L·min), and oxygen consumption (pregnant: 0.41 ± 0.08 L·min, nonpregnant: 0.42 ± 0.09 L·min) compared with pec-deck fly exercise. We concluded that the pressure response was unaffected by pregnancy and showed to be safe during the performance of resistance exercises.

Treinamento aeróbico e de força no tratamento do diabetes gestacional: uma revisão sistemática / Influence of aerobic and strength training in the gestational diabetes treatment: a systematic review

O diabetes mellitus gestacional (DMG) é uma complicação comum cuja prevalência tem crescido constantemente. Evidências sugerem que intervenções em gestantes com DMG podem reduzir a ocorrência de desfechos adversos. Apesar de o exercício físico ser bem aceito como uma terapia complementar no manejo do diabetes tipo 2 fora da gestação, no DMG ainda não se sabe qual a melhor prescrição para obter os melhores resultados. Portanto, este estudo teve como objetivo revisar as evidências científicas sobre o efeito de diferentes tipos de treinamento físico no tratamento do DMG. Foram consultadas as bases de dados, Scopus, Pubmed e Scielo. Foram excluídos os estudos de revisão sistemática, editoriais, cartas ao editor, relatos de caso, estudos laboratoriais e artigos que não avaliassem dos efeitos de intervenção através de exercício aeróbico ou de força, em mulheres diagnosticadas com DMG. Foram identificados 661 estudos e incluídos 6 na análise final. Foram encontrados estudos que utilizaram o treinamento físico como parte do tratamento do DMG, a maioria demonstrou efeito benéfico, como melhora do controle glicêmico e diminuição das necessidades de insulina. O tipo de exercício escolhido pela maioria dos pesquisadores foi o aeróbico, entretanto os estudos que utilizaram o exercício de força também demonstraram melhor controle glicêmico. Considerando os achados desses estudos, o treinamento físico tanto aeróbico como de força, apresentou efeitos benéficos para mulheres com DMG, uma vez que ajudou a controlar a glicemia e reduzir as necessidades de insulina.

The gestational diabetes mellitus (GDM) is a common complication whose prevalence has steadily grown. Evidence suggests that interventions in pregnant women with GDM may reduce the occurrence of adverse outcomes. Although exercise is well accepted as a complementary therapy in type 2 diabetes in non-pregnant women, but is still unclear what is the best prescription for best results in the management of GDM. Therefore, this study aimed to review the scientific evidence on the effect of different types of exercise training in the treatment of GDM. Databases such as Scopus, Pubmed e Scielo were consulted. Systematic reviews, editorials, letters to the editor, case reports, laboratory studies and articles that do not evaluated the effects of intervention through aerobic or strength exercise in women diagnosed with GDM were excluded. 661 studies were first identified and 6 were included in the final analysis. Studies using exercise as part of GDM treatment demonstrated beneficial effects, such as improved glycemic control and decreased insulin requirements. The type of exercise chosen by most researchers was aerobic, however studies using strength exercise also demonstrated to improve glycemic control. The studies founded in the present systematic review, showed beneficial effects of aerobic and strength training for women with GDM, once helped to control blood sugar and to reduce insulin requirements.

Comparação do índice de esforço percebido e consumo de oxigênio em exercício em cicloergômetro entre gestantes e não-gestantes e entre o exercício aquático e terrestre / Comparison of the rating of perceived exertion and oxygen uptake during exercise between pregnant and non-pregnant women and between water and land-based exercises

O objetivo do presente estudo foi comparar o índice de esforço percebido (IEP) e o consumo de oxigênio (VO2) durante o exercício aquático e terrestre, na intensidade do primeiro limiar ventilatório entre gestantes e não-gestantes. Sete gestantes (idade gestacional entre 27ª e 30ª semanas) e sete não-gestantes realizaram dois testes contínuos em cicloergômetro (água e terra) na intensidade do primeiro limiar ventilatório. Durante os testes, os gases respiratórios foram coletados com um analisador de gases portátil KB1-C da marca Aerosport. A frequência cardíaca (FC) foi obtida através de um Polar modelo F1. Os dados foram coletados a cada 20s. O IEP era indicado ao término do exercício através da escala RPE de Borg (6-20). Utilizou-se ANOVA para medidas repetidas de 1 FATOR, com post hoc de Bonferroni (p < 0,05). Não foram encontradas diferenças significativas para o VO2 e para o IEP comparando os exercícios aquático e terrestre. Além disso, não foram encontradas diferenças significativas entre gestantes e não-gestantes. Concluímos que o IEP pode ser usado para prescrição do exercício aquático e terrestre e para gestantes e não-gestantes, quando este for realizado na intensidade do primeiro limiar ventilatório e em cicloergômetro.

The purpose of the present study was to assess the differences in ratings of perceived exertion (RPE) and oxygen uptake (VO2) behavior during water and land-based exercise, performed in the exercise intensity of the first ventilatory threshold between pregnant and non-pregnant women. Seven pregnant (gestational ages between the 27th and 30th week) and seven non-pregnant women performed two continuous cycle ergometer tests (water and land-based) at the first ventilatory threshold intensity. During all sessions, respiratory gases were collected with a portable AEROSPORT KB1-C mixing box gas analyzer. A pneumotach was used with a neoprene mask. Heart rate (HR) measurements were obtained with a POLAR F1. Data were collected every 20s. RPE on Borg scale from 6 to 20 was derived at the end of the exercise. One-way ANOVA was applied for repeated measures using the post-hoc Bonferroni test (p<0.05). No significant differences were found in VO2 or RPE when comparing water with land-based exercise. In the same way, no significant difference was found between pregnant and non-pregnant subjects. We suggest that RPE can be used for water and land-based exercise prescription on cycle ergometer at the intensity of first ventilatory threshold, for both pregnant and non-pregnant women.

The reliability of the one maximum repetition in sedentary, active and strength-trained subjects / Reprodutibilidade de uma repetição máxima em sujeitos sedentários, ativos e treinados em força

The aim of the study was to verify the reliability of one maximum repetition (1-RM) in three different groups, according levels of physical fitness. The sample was composed for thirty subjects (aged 18 to 34 years old) divided in three groups with ten subjects each: sedentary (SG), physical active (PAG) and strength-trained (STG). The subjects were submitted to two familiarization sessions and two sessions of maximum strength test (1-RM1 and 1-RM2) at the following exercises: bench press and 45¨¬ leg press. The comparison between 1-RM values was made by two-way ANOVA (test and group) and association between both by intraclass coefficient correlation (p ¡Â 0.05). Data presented high correlation values between both tests (from 0.922 to 0.997; p < 0.001), however, significant differences (p < 0.05) was observed between 1-RM1 and 1-RM2 at bench press exercise in SG (56.40 ¡¾ 8.00 kg e 57.60 ¡¾ 7.89 kg, respectively), PAG (68,80 ¡¾ 9,26 kg e 69,40 ¡¾ 8,78 kg, respectively) and STG (87.20 ¡¾ 19.94 kg e 88.60 ¡¾ 19.86 kg, respectively), as well in the leg press in SG (222,5 ¡¾ 38,24 kg e 229,50 ¡¾ 38,55 kg, respectively), PAG (238.50 ¡¾ 26.25 kg e 244.00 ¡¾ 24.70, respectively) and STG (321.50 ¡¾ 46.19 kg e 336.40 ¡¾ 40.44 kg, respectively). It can be concluded that the subject¡¯s level of physical fitness does not appear to be a critical behavior at 1-RM reliability.

O objetivo deste estudo foi verificar a reprodutibilidade do teste de 1-RM em três diferentes grupos, conforme seu histórico de prática de exercícios. A amostra foi composta por trinta sujeitos (entre 18 e 34 anos): sedentários (GSE, n = 10), fisicamente ativos (GFA, n = 10) e treinados em força (GTF, n = 10) e foram submetidos a duas sessões de familiarização e a duas sessões de testes de força máxima (1-RM1 e 1-RM2) nos exercícios supino reto e pressão de pernas 45¡Æ. Foi utilizado a ANOVA two-way (teste e grupo) e o teste de correlação intra-classe (p < 0,05). Verificaram-se altos valores de correlação entre os testes (de 0,922 a 0,997; p < 0,001), contudo, diferenças significativas (p < 0,05) foram encontradas entre 1-RM1 e 1-RM2 no exercício supino para o GSE (56,40 ¡¾ 8.00 kg e 57,60 ¡¾ 7,89 kg, respectivamente), GPA (68,80 ¡¾ 9,26 kg e 69,40 ¡¾ 8,78 kg, respectivamente) e GTF (87,20 ¡¾ 19,94 kg e 88,60 ¡¾ 19,86 kg, respectivamente), assim como no exercício pressão de pernas para o GSE (222,5 ¡¾ 38,24 kg e 229,50 ¡¾ 38,55 kg, respectivamente), GPA (238,50 ¡¾ 26,25 kg e 244,00 ¡¾ 24,70 kg, respectivamente) e GTF (321,50 ¡¾ 46,19 kg e 336,40 ¡¾ 40,44 kg, respectivamente). Logo, pode-se concluir que o perfil do histórico de prática de exercícios dos sujeitos parece não ser um fator decisivo no comportamento da reprodutibilidade dos testes de 1-RM.