Cascade of care for hypertension among apparently healthy and unhealthy individuals of 25-64 years in the Czech Republic.

BACKGROUND: Despite accessible diagnostics and treatment of hypertension, a high proportion of patients worldwide remain unaware of their diagnosis, and even more remain untreated. Several studies suggest that absence of comorbidities is a predictive factor for unawareness and consequently non-treatment of hypertension. There are only a few studies that have assessed the hypertension prevalence and management among apparently healthy individuals. OBJECTIVE: The aim of the study was to assess and compare hypertension prevalence, awareness, treatment and control among apparently healthy individuals, patients with internal diseases, and patients with non-internal diseases. METHODS: Data from standardised blood pressure measurements conducted during the Czech European Health Examination Survey 2014 and information on health status and health care use collected during the Czech European Health Interview Survey 2014 were analyzed. We focused on participants aged 25-64. Data were weighted on sex and age to ensure an appropriate sex and age structure of the population. The χ2-test and binary logistic regression analyses were used to compare distribution of cascade of care for hypertension between the health-status groups of respondents. RESULTS: The final eligible sample consisted of 1121 participants. The prevalence of hypertension was 32.8% in the healthy group, 29.8% in the non-internal disease group and 52.4% in the internal disease group, (p < 0.001). Awareness was 54.1%, 59.1% and 85.2% respectively, (p < 0.001). Treatment was 44.2%, 52.6% and 86.4%, respectively, (p < 0.001). Among apparently healthy respondents 62.6% had their blood pressure measured by a medical professional in the last year, compared to 71.1% in the non-internal disease group and 91.7% in the internal disease group, (p < 0.001). Differences in hypertension control were not statistically significant. CONCLUSIONS: Generally, our data show a discordance in hypertension management within the Czech population. Apparently healthy individuals are the least aware of their diagnosis and the highest proportion of them remain untreated.

Sugar-sweetened beverages and childhood abnormal adiposity in the Czech Republic - narrative literature review.

OBJECTIVES: In Czech children, the burden related to the high body-mass index is rising. In the last three decades, Western eating patterns have influenced Czech children's diet, including the high consumption of sugar-sweetened beverages. This narrative review aims to evaluate evidence of the trend of sugar-sweetened beverages consumption in Czech children and its impact on the prevalence of childhood abnormal adiposity. METHODS: A comprehensive literature review in MEDLINE (PubMed) and a hand search using references in identified articles were performed. The inclusion criteria were population-based studies of randomly selected samples of children from 0 to 18 years old, data involving the Czech population, published from 1990 to 2021. The results were organized into three sections - childhood abnormal adiposity, SSBs consumption, and the association between SSBs consumption and abnormal adiposity. RESULTS: The studies showed a significant increase in abnormal adiposity in both genders and all age categories. The highest prevalence of abnormal adiposity was observed in boys and younger children. On the contrary, sugar-sweetened beverages showed a significant decline in daily consumption among Czech children of both genders and all age categories. No results were found for consequences of abnormal adiposity concerning sugar-sweetened beverages consumption. CONCLUSION: Findings from this review could serve public health experts to detect the areas of a gap in research and establish potential interventions in vulnerable groups. Observation of potential obesogenic contributors - including sugar-sweetened beverages - should be an integral part of effective action against the obesity pandemic.

Comparison of social gradient in cardiometabolic health in Czechia and Venezuela: a cross-sectional study.

OBJECTIVES: This study compared the relationships of social determinants with cardiometabolic risk in different socioeconomic contexts: sociopolitically unstable Venezuela (VE) and stable Czechia (CZ). DESIGN: cross-sectional analysis involving two population-based studies. SETTING: Brno, Czechia and 23 cities of Venezuela. PARTICIPANTS: 25-64 years old subjects from CZ (2013-2014, n=1579, 56% females) and VE (2014-2017, n=1652, 70% females). MAIN OUTCOME MEASURES: The composite cardiometabolic risk score (CMRS) (scaled 0-8) was calculated using eight biomarkers (body mass index, waist circumference, blood glucose, systolic and diastolic blood pressure, total and high-density lipoprotein-cholesterol, triglycerides). Social characteristics included education in both countries, income in CZ and a composite measure of social position (SP) in VE. Sex stratified ordinal regression examined the social gradient in having less favourable CMRS. RESULTS: In CZ, men and women with low education and women with low income had higher odds of higher CMRS compared with those with high education and income with OR 1.45 (95% CI 1.01 to 2.21), 2.29 (95% CI 1.62 to 3.24) and 1.69 (95% CI 1.23 to 2.35). In VE, women with low education and low SP had higher odds to have higher CMRS OR 1.47 (95% CI 1.09 to 1.97) and 1.51 (95% CI 1.16 to 1.97), while men with low education and low SP had lower odds to have higher CMRS OR 0.64 (95% CI 0.41 to 1.00) and 0.61 (95% CI 0.40 to 0.97), compared with those with high education and high SP. Independently of age, sex and socioeconomic characteristics, Venezuelans had higher odds to have higher CMRS than Czechs (OR 2.70; 95% CI 2.37 to 3.08). CONCLUSIONS: The results suggest that the associations of socioeconomic status indices and cardiometabolic risk differed between CZ and VE, likely reflecting differences in the social environment among countries. Further research is needed to confirm and quantify these differences.

Association of Self-Reported Depression Symptoms with Physical Activity Levels in Czechia.

Worldwide, depressive disorder is one of the leading determinants of disability-adjusted life years. Although there are benefits associated with a higher physical activity (PA) level, there is a lack of information related to this relationship, especially in countries such as Czechia, where modern approaches to mental health care only recently emerged. The present study aimed to evaluate the association between the level of depression and different PA levels following the World Health Organization (WHO) PA guidelines and according to specific symptoms that indicate depression. Multivariable-adjusted Poisson regression models were used to calculate the prevalence rate (PR) in a sample of 2123 participants (45.3% men, median 48 years). Compared to subjects with insufficient PA, moderate and high PA levels were inversely associated with continuous depression scores (PR = 0.85; 95% CI: 0.75-0.97; and PR = 0.80; 95% CI: 0.70-0.92). Depressed mood and worthlessness were the symptoms associated with moderate and high PA. Tiredness, change in appetite, and concentration problems were related to high PA. The results suggest that reaching the minimum PA target according to the guidelines seems to be effective, and this could stimulate adherence. However, more specific improvements in symptomatology will require a subsequent gradual increase in PA levels.

Associations between Per- and Polyfluoroalkyl Substances (PFAS) and Cardiometabolic Biomarkers in Adults of Czechia: The Kardiovize Study.

Even though there is evidence of decreasing trends of per- and polyfluoroalkyl substances (PFAS) in Czechia, there are still major sources of PFAS pollution. Regarding the still-inconsistent results of the relationship between cardiometabolic health and PFAS, the present study sought to determine the association between PFAS levels and the presence of cardiometabolic biomarkers, including blood pressure and dysglycemia drivers in the Czech population. A cross-sectional study with 479 subjects (56.4% women, median: 53 years, range: 25-89) was conducted. Four PFAS were measured in serum: perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluorooctane sulfonate (PFOS). The associations between natural log (ln)-transformed PFAS and cardiometabolic biomarkers were assessed through generalized additive models using linear regression and smoothing thin plate splines, adjusted for potential confounders. There were positive and significant (p < 0.05) associations between the ln-transformed PFOA and glucose (ß = 0.01), systolic (ß = 0.76) and diastolic blood pressure (ß = 0.65); total cholesterol (ß = 0.07) and LDL-c (ß = 0.04); and PFOS with glucose (ß = 0.03), BMI (ß = 2.26), waist circumference (ß = 7.89), systolic blood pressure (ß = 1.18), total cholesterol (ß = 0.13), and HDL-c (ß = 0.04). When significant, the correlations of PFNA and PFDA were negative. Of the four PFAS, only PFOA and PFOS showed a positive association, even in serum levels not as high as the values from the literature.

The Combined Effects of Television Viewing and Physical Activity on Cardiometabolic Risk Factors: The Kardiovize Study.

The aim of the present study was to evaluate the association between television viewing/physical activity (TVV/PA) interactions and cardiometabolic risk in an adult European population. A total of 2155 subjects (25-64 years) (45.2% males), a random population-based sample were evaluated in Brno, Czechia. TVV was classified as low (<2 h/day), moderate (2-4), and high (≥4). PA was classified as insufficient, moderate, and high. To assess the independent association of TVV/PA categories with cardiometabolic variables, multiple linear regression was used. After adjustments, significant associations were: High TVV/insufficient PA with body mass index (BMI) (ß = 2.61, SE = 0.63), waist circumference (WC) (ß = 7.52, SE = 1.58), body fat percent (%BF) (ß = 6.24, SE = 1.02), glucose (ß = 0.25, SE = 0.12), triglycerides (ß = 0.18, SE = 0.05), and high density lipoprotein (HDL-c) (ß = -0.10, SE = 0.04); high TVV/moderate PA with BMI (ß = 1.98, SE = 0.45), WC (ß = 5.43, SE = 1.12), %BF (ß = 5.15, SE = 0.72), triglycerides (ß = 0.08, SE = 0.04), total cholesterol (ß = 0.21, SE = 0.10), low density protein (LDL-c) (ß = 0.19, SE = 0.08), and HDL-c (ß = -0.07, SE = 0.03); and moderate TVV/insufficient PA with WC (ß = 2.68, SE = 1.25), %BF (ß = 3.80, SE = 0.81), LDL-c (ß = 0.18, SE = 0.09), and HDL-c (ß = -0.07, SE = 0.03). Independent of PA levels, a higher TVV was associated with higher amounts of adipose tissue. Higher blood glucose and triglycerides were present in subjects with high TVV and insufficient PA, but not in those with high PA alone. These results affirm the independent cardiometabolic risk of sedentary routines even in subjects with high-levels of PA.

Prevalence of adiposity-based chronic disease in middle-aged adults from Czech Republic: The Kardiovize study.

AIMS/HYPOTHESIS: The need for understanding obesity as a chronic disease, its stigmatization, and the lack of actionability related to it demands a new approach. The adiposity-based chronic disease (ABCD) model is based on adiposity amount, distribution, and function, with a three stage complication-centric rather than a body mass index (BMI)-centric approach. The prevalence rates and associated risk factors are presented. METHODS: In total, 2159 participants were randomly selected from Czechia. ABCD was established as BMI ≥ 25 kg/m2 or high body fat percent, or abdominal obesity and then categorized by their adiposity-based complications: Stage 0: none; Stage 1: mild/moderate; Stage 2: severe. RESULTS: ABCD prevalence was 62.8%. Stage 0 was 2.3%; Stage 1 was 31.4%; Stage 2 was 29.1%. Comparing with other classifiers, participants in Stage 2 were more likely to have diabetes, hypertension, and metabolic syndrome than those with overweight, obesity, abdominal obesity, and increased fat mass. ABCD showed the highest sensitivity and specificity to detect participants with peripheral artery disease, increased intima media, and vascular disease. CONCLUSION/INTERPRETATION: The ABCD model provides a more sensitive approach that facilitates the early detection and stratification of participants at risk compared to traditional classifiers.

Prediction of Cardiorespiratory Fitness in Czech Adults: Normative Values and Association with Cardiometabolic Health.

Cardiorespiratory fitness (CRF) is a strong independent predictor of morbidity and mortality. However, there is no recent information about the impact of CRF on cardiometabolic risk specifically in Central and Eastern Europe, which are characterized by different biological and social determinants of health. In this cross-sectional study normative CRF values were proposed and the association between CRF and cardiometabolic outcomes was evaluated in an adult Czechian population. In 2054 participants (54.6% females), median age 48 (IQR 19 years), the CRF was predicted from a non-exercise equation. Multivariable-adjusted logistic regressions were carried out to determine the associations. Higher CRF quartiles were associated with lower prevalence of hypertension, type 2 diabetes (T2D) and dyslipidemia. Comparing subjects within the lowest CRF, we see that those within the highest CRF had decreased chances of hypertension (odds ratio (OR) = 0.36; 95% CI: 0.22-0.60); T2D (OR = 0.16; 0.05-0.47), low HDL-c (OR = 0.32; 0.17-0.60), high low-density lipoprotein (OR = 0.33; 0.21-0.53), high triglycerides (OR = 0.13; 0.07-0.81), and high cholesterol (OR = 0.44; 0.29-0.69). There was an inverse association between CRF and cardiometabolic outcomes, supporting the adoption of a non-exercise method to estimate CRF of the Czech population. Therefore, more accurate cardiometabolic studies can be performed incorporating the valuable CRF metric.

Dysglycemia and Abnormal Adiposity Drivers of Cardiometabolic-Based Chronic Disease in the Czech Population: Biological, Behavioral, and Cultural/Social Determinants of Health.

In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.

Visceral fat area and cardiometabolic risk: The Kardiovize study.

BACKGROUND: Visceral fat is associated with adiposity-based complications. Bioimpedance measurement allows estimation of visceral fat area (VFA) in an easy manner. However, a validated cut-off value for VFA by bioimpedance associated with cardiometabolic risk is lacking in European population. AIM: To determine cut-off values of VFA measured via bioimpedance associated with cardiometabolic risk. METHODS: Random cross-sectional Czech population-based sample of 25-64 years old subjects. Receiver Operating Characteristic (ROC) curves were used and the area under the curve (AUC), sensitivity, and specificity were calculated. The Cardiometabolic Disease Staging System (CMDS) was used to classify cardiometabolic risk: Stage 1 - 1 or 2 metabolic syndrome (MetS) components, without impaired fasting glucose (IFG); Stage 2 - MetS or IFG; Stage 3 - MetS with IFG; Stage 4 - type 2 diabetes and/or cardiovascular disease. RESULTS: 2052 participants (54.5% females, median age 49 years) were included. Median VFA (inter-quartile range) were 82.2 cm2 (54.8) in men and 89.8 cm2 (55.6) in women. The best VFA cut-offs associated with Stage 1 in men and women were 71 cm2 (sensitivity = 0.654; specificity = 0.427) and 83 cm2 (sensitivity = 0.705; specificity = 0.556) ; Stage 2: 84 cm2 (sensitivity = 0.673; specificity = 0.551) and 98 cm2 (sensitivity = 0.702; specificity = 0.628) ; Stage 3: 90 cm2 (sensitivity = 0.886; specificity = 0.605) and 109 cm2 (sensitivity = 0.755; specificity = 0.704); Stage 4: 91 cm2 (sensitivity = 0.625; specificity = 0.611) and 81 cm2 (sensitivity = 0.695; specificity = 0.448), respectively. CONCLUSION: A cut-off value of VFA of 71 cm2 in men and 83 cm2 in women exhibited the earliest stage of cardiometabolic risk, and 90 cm2 in men and 109 cm2 in women showed the best performance to detect risk.

Arterial Stiffness and Cardiometabolic-Based Chronic Disease: The Kardiovize Study.

OBJECTIVE: Arterial stiffness (ArSt) describes a loss of arterial wall elasticity and is an independent predictor of cardiovascular events. A cardiometabolic-based chronic disease model integrates concepts of adiposity-based chronic disease (ABCD), dysglycemia-based chronic disease (DBCD), and cardiovascular disease. We assessed if ABCD and DBCD models detect more people with high ArSt compared with traditional adiposity and dysglycemia classifiers using the cardio-ankle vascular index (CAVI). METHODS: We evaluated 2070 subjects aged 25 to 64 years from a random population-based sample. Those with type 1 diabetes were excluded. ABCD and DBCD were defined, and ArSt risk was stratified based on the American Association of Clinical Endocrinologists criteria. RESULTS: The highest prevalence of a high CAVI was in stage 2 ABCD (18.5%) and stage 4 DBCD (31.8%), and the lowest prevalence was in stage 0 ABCD (2.2%). In univariate analysis, stage 2 ABCD and all DBCD stages increased the risk of having a high CAVI compared with traditional classifiers. After adjusting for age and gender, only an inverse association between obesity (body mass index ≥30 kg/m2) and CAVI remained significant. Nevertheless, body mass index was responsible for only 0.3% of CAVI variability. CONCLUSION: The ABCD and DBCD models showed better performance than traditional classifiers to detect subjects with ArSt; however, the variables were not independently associated with age and gender, which might be explained by the complexity and multifactoriality of the relationship of CAVI with the ABCD and DBCD models, mediated by insulin resistance.

Association between type 2 diabetes and non-exercise estimated cardiorespiratory fitness among adults: evidences from a middle-income country.

OBJECTIVE: The objective of this study is to assess the association between type 2 diabetes (T2D) and cardiorespiratory fitness (CRF) estimated through a non-exercise model in a large representative group of Brazilian adults. STUDY DESIGN: The study design of this study is a cross-sectional population-based study. METHODS: The presence of T2D was assessed through self-report in 42,631 individuals aged 20-59 years. The CRF was predicted from a non-exercise equation containing the following data: sex, age, body mass index, and physical activity level. The corresponding metabolic equivalent (MET) value was used to classify participants into the following four groups based on the cutpoints: <6, 6-9, 10-11, and ≥12 METs. Crude and multivariable-adjusted logistic regressions were carried out to determine the association between CRF and the presence of diabetes. RESULTS: Significant linear trends were observed in diabetes across different categories of CRF in men. In women, however, linear trends were not observed in T2D across '10-11' and '≥12' categories. A 1-MET increase in estimated CRF was associated with 29% lower odds of diabetes in men and 14% in women after adjusting all the potential confounders (P < 0.001). CONCLUSIONS: The presence of T2D was inversely associated with every CRF level in men and with 6-9 METs when comparing with <6 METs in women, through a non-exercise model in Brazilian adults. This finding suggests that a practical, viable, and low-cost measurement of CRF could be applied in lower income countries to assess the relationship between CRF and T2D. However, new non-exercise models are needed to better detect T2D in women.

Can caffeine intake combined with aerobic exercise lead to improvement in attentional and psychomotor performance in trained individuals?

To evaluate the acute effects of ingestion of 500 mg of caffeine in addition to aerobic exercise on the optimization of cognitive attention tasks and simple reaction time. Twenty men were randomly divided into two groups, caffeine (CAF) and placebo (PLA), and underwent cardiopulmonary exercise testing and cognitive testing (D2SLK, D2GZ, D2F% and TRS). Then, both ingested 500 mg of caffeine or placebo (double blind), and after 60 min performed a 30-minute continuous exercise session at 70 % VO2Max. Cognitive tests were repeated immediately after exercise, and after 30 min. D2SLK, D2GZ, D2F% and TRS scores were compared by repeated measures ANOVA. The magnitude of the effect was established, and it was considered meaningful p = 0.05. CAF is able to alter D2SLK and also reduce D2F% (0.001 - moderate effect, 0.82) and improve the task after 30 min of exercise (p = 0.014 - moderate effect 0.95). The TRS showed significant gains for the CAF group compared to PLA (0.000 - high effect 1.76). Caffeine induces significant effects in attention and reaction time domains independent of the effect of aerobic exercise.

Correction: Acute effects of single dose transcranial direct current stimulation on muscle strength: A systematic review and meta-analysis.

[This corrects the article DOI: 10.1371/journal.pone.0209513.].

É a estimulação transcraniana de corrente contínua anódica um potencial recurso ergogênico para força muscular e percepção de esforço? Uma revisão crítica / Es la estimulación transcraneal de corriente continua anódica un potencial recurso ergogénico para fuerza muscular y percepción de esfuerzo? Una revisión crítica / Is anodal transcranial direct current stimulation a potential ergogenic resource for muscle strength and effort perception? A critical review

Nas últimas décadas, vários estudos estão investigando a dose-resposta ideal em termos de frequência, intensidade e volume de treinamento para alcançar o aumento da força muscular, tanto em atletas quanto em não atletas. A dose-resposta é fundamental para a prescrição do treinamento, uma vez que sua manipulação equivocada pode acarretar alto risco de desenvolvimento de lesões por esforços repetitivos, bem como pelo não desenvolvimento da força esperada. Em indivíduos com nível avançado de treinamento de força, é extremamente importante aumentar sua intensidade e volume de treinamento. Nesse sentido, com os avanços encontrados na área de treinamento de força e a necessidade de novas estratégias para otimizar ganhos de força, um novo método vem ganhando força na literatura, a estimulação transcraniana por corrente contínua (ETCC). Portanto, o objetivo deste estudo é analisar criticamente os efeitos do ETCC como potencial recurso ergogênico para a realização de força muscular e percepção de esforço, bem como se seu uso é ético ou não. Para tanto, foram pesquisadas as bases de dados Pubmed/Medline, ISI Web of Knowledge e Scielo, apenas em inglês, e com as palavras-chave: força muscular, resistência muscular, estimulação transcraniana por corrente contínua, ETCC. Nós comparamos o efeito do ETCC anódico (ETCC-a) com uma condição sham/controle nos resultados de força muscular e percepção de esforço. Nenhum estudo menciona efeitos colaterais negativos da intervenção. Os dados mostram diferenças entre os estudos que investigam os estudos de avaliação da força muscular e resistência muscular, em termos do uso bem sucedido de ETCC. Estudos que investigaram a eficiência do ETCC na melhora da força muscular demonstraram efeitos positivos do ETCC-a em 66,7% dos parâmetros testados. Amaioria dos dados mostra consistentemente a influência do ETCC-a na força muscular, mas não no desempenho de resistência

En las últimas décadas, diversos estudios están investigando la dosis-respuesta ideal en cuanto a la frecuencia, intensidad y volumen de entrenamiento para alcanzar el aumento de fuerza muscular, sea en atletas y no atletas. La dosis-respuesta es fundamental para la prescripción de entrenamiento, pues su manipulación equivocada puede llevar a un alto de riesgo de desarrollo de lesiones por esfuerzo repetitivo, así como para el no desarrollo de la fuerza esperada. En sujetos con nivel avanzado de entrenamiento de fuerza es extremadamente importante aumentar su intensidad y volumen de entrenamiento. En este sentido, con los avances encontrados en el área de entrenamiento de fuerza y la necesidad de nuevas estrategias para optimizar las ganancias de fuerza, un nuevo método está ganando fuerza en la literatura, la estimulación transcraneal por corriente continua (ETCC). Por lo tanto, el objetivo del presente estudio es analizar de forma crítica los efectos de la ETCC como potencial recurso ergogénico al desempeño de fuerza muscular y percepción de esfuerzo, así como si su uso es ético o no. Por lo tanto, se realizó una búsqueda en las bases de datos Pubmed/Medline, ISI Web of Knowledge y Scielo, solamente en inglés y con las palabras clave: fuerza muscular, resistencia muscular, estimulación transcraneal de corriente continua, ETCC. Comparamos el efecto de la ETCC anódica (ETCC-a) a una condición sham/control sobre los resultados de la fuerza muscular y percepción de esfuerzo. Ningún estudio menciona efectos secundarios negativos de la intervención. Los datos muestran diferencias entre los estudios que investigan la fuerza muscular y los estudios de evaluación de resistencia muscular, en lo que se refiere al uso exitoso de la ETCC. Los estudios que investigan la eficiencia de la ETCC en la mejora de la fuerza muscular demuestran efectos positivos de la ETCC-a en el 66,7% de los parámetros probados. La mayoría de los datos muestran consistentemente influencia de la ETCC-a en la fuerza muscular, pero no en el rendimiento de resistencia

In the last decades, several studies are investigating the optimal dose-response in terms of frequency, intensity and volume of training to achieve increased muscle strength in both athletes and non-athletes. Dose-response is critical to the prescription of training, since its mismanagement may pose a high risk of developing repetitive strain injuries as well as failure to develop the expected strength. In individuals with advanced level of strength training, it is extremely important to increase their intensity and training volume. In this sense, with the advances in the area of strength training and the need for new strategies to optimize force gains, a new method is gaining strength in the literature, the transcranial direct current stimulation (tDCS). Therefore, the purpose of this study is to critically analyze the effects of tDCS as a potential ergogenic resource for achieving muscle strength and perceived exertion, as well as whether its use is ethical or not. To do so, we searched the databases Pubmed/Medline, ISI Web of Knowledgeand Scielo, in English only, and with the keywords: muscle strength, muscular endurance, transcranial direct current stimulation, tDCS. We compared the effect of anodic tDCS (a-tDCS) with a sham/control condition on muscle strength and perceived exertion results. No study mentions the negative side effects of the intervention. The data show differences between studies investigating studies of muscle strength and muscle endurance in terms of the successful use of tDCS. Studies that investigated tDCS efficiency in improving muscle strength demonstrated positive effects of a-tDCS on 66.7% of the parameters tested. Most data consistently show the influence of a-tDCS on muscle strength, but not on resistance performance

Effects of Transcranial Direct Current Stimulation With Caffeine Intake on Muscular Strength and Perceived Exertion.

Lattari, E, Vieira, LAF, Oliveira, BRR, Unal, G, Bikson, M, de Mello Pedreiro, RC, Marques Neto, SR, Machado, S, and Maranhão-Neto, GA. Effects of transcranial direct current stimulation with caffeine intake on muscular strength and perceived exertion. J Strength Cond Res 33(5): 1237-1243, 2019-The aim of this study was to investigate the acute effects of transcranial direct current stimulation (tDCS) associated with caffeine intake on muscular strength and ratings of perceived exertion (RPE). Fifteen healthy young males recreationally trained (age: 25.3 ± 3.2 years, body mass: 78.0 ± 6.9 kg, height: 174.1 ± 6.1 cm) were recruited. The experimental conditions started with the administration of caffeine (Caff) or placebo (Pla) 1 hour before starting the anodal tDCS (a-tDCS or sham). There was an intake of 5 mg·kg of Caff or 5 mg·kg of Pla. After the intake, a-tDCS or sham was applied in the left dorsolateral prefrontal cortex with intensity of 2 mA and 20 minutes of duration. The experimental conditions were defined as Sham + Pla, a-tDCS + Pla, Sham + Caff, and a-tDCS + Caff. After the conditions, muscular strength and RPE were verified. Muscular strength was determined by volume load performed in bench press exercise. Muscular strength in Sham + Pla condition was lower compared with all others conditions (p < 0.05). The RPE in the Sham + Pla was greater compared with a-tDCS + Caff (p < 0.05). Muscular strength was greater in all experimental conditions, and a-tDCS + Caff had lower RPE compared with placebo. When very little gains in muscle strength are expected, both caffeine and tDCS were effective in increasing muscle strength. Besides, the improvement in RPE of the caffeine associated with a-tDCS could prove advantageous in participants experienced in strength training. In fact, coaches and applied sport scientists quantitating the intensity of training based on RPE.

Acute effects of single dose transcranial direct current stimulation on muscle strength: A systematic review and meta-analysis.

Previous studies investigating the effects of transcranial direct current stimulation (tDCS) on muscle strength showed no consensus. Therefore, the purpose of this article was to systematically review the literature on the effects of single dose tDCS to improve muscle strength. A systematic literature search was conducted on PubMeb, ISI Web of Science, SciELO, and Scopus using search terms regarding tDCS and muscle strength. Studies were included in accordance with Population, Intervention, Comparison, Outcomes, and Setting (PICOS) including criteria. Healthy men and women, strength training practitioners or sedentary were selected. The acute effects of single dose anode stimulus of tDCS (a-tDCS) and the placebo stimulus of tDCS (sham) or no interventions were considered as an intervention and comparators, respectively. Measures related to muscle strength were analyzed. To conduct the analyses a weighted mean difference (WMD) and the standardized mean difference (SMD) were applied as appropriate. A total of 15 studies were included in this systematic review and 14 in meta-analysis. Regarding the maximal isometric voluntary contraction (MIVC), a small effect was seen between tDCS and Sham with significant difference between the conditions (SMD = 0.29; CI95% = 0.05 to 0.54; Z = 2.36; p = 0.02). The muscular endurance measured by the seconds sustaining a percentage of MIVC demonstrated a large effect between tDCS and Sham (WMD = 43.66; CI95% = 29.76 to 57.55; Z = 6.16; p < 0.001), showing an improvement in muscular endurance after exposure to tDCS. However, muscular endurance based on total work showed a trivial effect between tDCS and Sham with no significant difference (SMD = 0.22; CI95% = -0.11 to 0.54; Z = 1.32, p = 0.19). This study suggests that the use of tDCS may promote increase in maximal voluntary contraction and muscular endurance through isometric contractions.

The Role of Physical Activity on Mood State and Functional Skills of Elderly Women.

INTRODUCTION: Ageing is associated with several physical, psychological and behavioral changes. These changes are closely related with global health and functional capacity in the elderly. Mood disturbances are common among the elderly and may significantly increase apathy, resulting in decreased habitual physical activity levels. MATERIALS AND METHODS: The purpose of this cross-sectional study was to evaluate the mood state and functional motor capacities of elderly women engaged in a public physical activity program in Brazil and compare them with physically inactive elderly. Thirty elderly women were included in the study and categorized into two groups: physically active group, composed of participants enrolled on a public physical activity program (n = 16, 69±5 years) and physically inactive group (n = 14, 68±4 years). Total mood disturbance was assessed using the Profile of Mood States, whereas functional motor capacity was evaluated with the Sitting and Rising test. Independent t test and Mann-Whitney U] were used to compare groups. RESULTS: The physically active group had lower total mood disturbance (p=0.02), confusion (p<0.01), tension (p<0.01), hostility (p=0.05) and fatigue (p=0.01) compared to the physically inactive group. There were no group differences regarding vigor, depression and sitting and rising performance (p>0.05). CONCLUSION: Lack of difference in functional motor capacity between the physically active and inactive elderly may be explained by the absence of exercise systematization in these programs.

Prediction of cardiorespiratory fitness from self-reported data in elderly / Predição da aptidão cardiorrespiratória através de dados auto-relatados em idosos

Abstract Cardiorespiratory fitness (CRF) is associated with several health outcomes. Some non-exercise equations are available for CRF estimation. However, little is known about the validation of these equations among elderly. The aim of this study was to exam the validity of non-exercise equations with self-reported information in elderly. Participants (n= 93) aged 60 to 91 years measured CRF using maximal cardiopulmonary exercise test. Five non-exercise equations were selected. Data included in the equations (age, sex, weight, height, body mass index, physical activity and smoking) were self-reported. Coefficient of determination (R2) of linear regressions with laboratory-measured VO2 peak ranged from 0.04 to 0.64. The Bland-Altman plots showed higher agreement between achieved and predicted CRF obtained by Jackson and colleagues, and Wier and colleagues equations. On the other hand, the other equations showed lower agreement and overestimation. Our findings provide evidences that two non-exercise equations, previously developed, could be used on the prediction of CRF among elderly.

Resumo A aptidão cardiorrespiratória (ACR) está associada a vários desfechos de saúde. Algumas equações sem exercício estão disponíveis para estimar a ACR. No entanto, pouco se sabe sobre a validação dessas equações entre os idosos. Objetivo: O estudo foi desenvolvido com o objetivo de examinar a validade de equações sem exercício com informações auto-relatadas em idosos. Métodos: Os participantes (n = 93) com idades entre 60 e 91 anos foram submetidos ao teste de exercício cardiopulmonar máximo para avaliar a ACR. Cinco equações sem exercício foram selecionadas. Os dados incluídos nas equações (idade, sexo, peso, altura, índice de massa corporal, atividade física e tabagismo) foram auto-relatados. Resultados: O coeficiente de determinação (R2) das regressões lineares com o VO2 pico, medido em laboratório, variou de 0,04 a 0,64. Os gráficos de Bland-Altman mostraram maior concordância entre a ACR obtida e prevista por Jackson e colaboradores, e equações de Wier e colaboradores. Por outro lado, as demais equações mostraram menor concordância e superestimação. Conclusões: Nossos resultados fornecem evidências de que duas equações sem exercício, previamente desenvolvidas, poderiam ser usadas na estimação da ACR em idosos.

Normalizing handgrip strength in older adults: An allometric approach.

PURPOSE: Handgrip strength is an important variable to assess as part of any health intervention among older adults. Although the use of allometric normalization is the appropriate approach for removing the body size effect in handgrip performance, the best body size variable for this normalization is still unclear. Therefore, the aim of the present study was to compare the use of three body size variables (body mass, fat-free mass and body height) in allometric normalization for Handgrip strength among older adults. METHODS: Data from individuals admitted to the Elderly Care Center of the Open University of the Third Age were used, the sample consisting of 263 individuals (140 women), aged between 60-87. RESULTS: The results provided allometric exponents for normalization of HGS in each body size variable (body mass: 0.31; fat-free mass: 0.11; body height: 0.46). The correlations between normalized HGS and body size variables were significant (p<0.05) when HGS were normalized by body mass or fat-free mass. On the contrary, no significant correlations were found when HGS were normalized by body height. CONCLUSIONS: Body height seems to be the best body size variable for performing allometric normalization of HGS among older adults.