Effect of Combined Training on Body Image, Body Composition and Functional Capacity in Patients with Breast Cancer: Controlled Clinical Trial / Efeito do treinamento combinado na imagem corporal, composição corporal e capacidade funcional em pacientes com câncer de mama: ensaio clínico controlado

Abstract Objective Evaluate the effect of combined training on body image (BI), body composition and functional capacity in patients with breast cancer. As also the relationship of BI with body composition and functional capacity. Methods This was a Controlled Clinical Trial study, this study including 26 patients with breast cancer (30 to 59 years). The training group (n = 13) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20s. The Control Group (n = 13) received only the standard hospital treatment. Participants were evaluated at baseline and after 12 weeks. BI (primary outcomes) was assessed using the Body Image After Breast Cancer Questionnaire; Body composition was estimated with the indicators: Body mass index; Weight, Waist hip Ratio; Waist height ratio; Conicity index; Reciprocal ponderal index; Percentage of fat; Circumference of the abdomen and waist; Functional capacity by cardiorespiratory fitness (cycle ergometer) and strength (manual dynamometer). The statistic was performed in the Biostatistics and Stata 14.0 (α = 5%). Results The patients in the training group showed a reduction in the limitation dimension (p = 0.036) on BI, However, an increase in waist circumference was observed in both groups. In addition an increase in VO2max (p < 0.001) and strength in the right (p = 0.005) and left arms (p = 0.033). Conclusion Combined training demonstrates to be an effective and non-pharmacological strategy to patients with breast cancer, with improvement on BI and functional capacity, changing related variables negatively when there is no physical training.

Resumo Objetivo Avaliar o efeito do treinamento combinado na imagem corporal (IB), composição corporal e capacidade funcional em pacientes com câncer de mama. Assim como a relação do IB com a composição corporal e capacidade funcional. Métodos Este foi um estudo de Ensaio Clínico Controlado, este estudo incluiu 26 pacientes com câncer de mama (30 a 59 anos). O grupo de treinamento (n = 13) foi submetido a 12 semanas de treinamento, incluindo três sessões de 60 min de exercício aeróbio e treinamento de resistência, e duas sessões de treinamento de flexibilidade por semana; cada exercício de flexibilidade durou 20s. O Grupo Controle (n = 13) recebeu apenas o tratamento hospitalar padrão. Os participantes foram avaliados no início e após 12 semanas. O IB (desfechos primários) foi avaliado por meio do Body Image After Breast Cancer Questionnaire; A composição corporal foi estimada com os indicadores: índice de massa corporal; Peso, relação cintura-quadril; Relação da altura da cintura; Índice de conicidade; Índice ponderal recíproco; Porcentagem de gordura; Circunferência do abdômen e cintura; Capacidade funcional por aptidão cardiorrespiratória (cicloergômetro) e força (dinamômetro manual). A estatística foi realizada na Bioestatística e no Stata 14.0 (α = 5%). Resultados Os pacientes do grupo de treinamento apresentaram redução da dimensão da limitação (p = 0,036) no IB, porém, foi observado aumento da circunferência da cintura em ambos os grupos. Além disso, um aumento do VO2máx (p <0,001) e da força nos braços direito (p = 0,005) e esquerdo (p = 0,033). Conclusão O treinamento combinado demonstra ser uma estratégia eficaz e não farmacológica para pacientes com câncer de mama, com melhora do IB e da capacidade funcional, alterando variáveis relacionadas negativamente quando não há treinamento físico.

Combined Aerobic and Strength Training Improves Dynamic Stability and can Prevent against Static Stability Decline in Postmenopausal Women: A Randomized Clinical Trial / O treinamento de força e aeróbio combinado melhora a estabilidade dinâmica e pode prevenir contra o declínio da estabilidade estática em mulheres na pósmenopausa: um ensaio clínico randomizado

Abstract Objective To analyze the effect of combined training (CT) in postural control and gait parameters in postmenopausal women. Methods A parallel-group, randomized, control study was conducted with 16 weeks of combined training (n = 16) versus a non-training control group (n = 12) in postmenopausal women (aged 59.3 ± 8.0). Pre and postintervention assessments included postural control (using an AMTI force platform - Advanced Mechanical Technology, Inc., Watertown, MA, USA) and gait impairments (using baropodometry). In addition, the upper limb strength and abdominal tests, as well as aerobic capacity, assessed functional indicators. Results The CT intervention in postmenopausal women resulted in improved gait (stride length (p = 0.006); speed (p = 0.013); double support time (p = 0.045); and improved postural control (displacement area of postural sway in a normal base of support with eyes open (p = 0.006). Combined training increased functional indicators (abdominal - p = 0.031; aerobic capacity - p = 0.002). Conclusion In conclusion, combined aerobic plus strength training effectively improved gait and balance control in older women. The postmenopausal women from the CT group walked faster and with bigger steps after the intervention than the control group. In addition, they presented decreased postural sway in standing and decreased the percentage of double support time while walking, which means improved static and dynamic balance control and functional indicators.

Resumo Objetivo Analisar o efeito do treinamento combinado (TC) no controle postural e nos parâmetros da marcha em mulheres na pós-menopausa. Métodos Foi realizado um estudo controlado randomizado de grupos paralelos com 16 semanas de treinamento combinado (n = 16) versus um grupo controle sem treinamento (n = 12) em mulheres na pós-menopausa (59,3 ± 8,0 anos). As avaliações pré e pós-intervenção incluíram controle postural (usando a plataforma de força AMTI) e deficiências da marcha (usando baropodometria). Além disso, os testes de força de membros superiors e abdominal, bem como a capacidade aeróbica, avaliaram indicadores funcionais. Resultados A intervenção do TC em mulheres na pós-menopausa resultou em melhora da marcha (comprimento da passada (p = 0,006), velocidade (p = 0,013), tempo de apoio duplo (p = 0,045) e controle postural aprimorado (área de deslocamento da oscilação postural em base de apoio normal com olhos abertos (p = 0,006). O TC aumentou os indicadores funcionais (abdominal - p = 0,031; capacidade aeróbia - p = 0,002). Conclusão Em conclusão, o TC de força e aeróbico melhorou efetivamente o controle da marcha e do equilíbrio em mulheres idosas. As mulheres na pós-menopausa do grupo CT caminharam mais rápido e com passos maiores após a intervenção do que o grupo controle. Além disso, elas apresentaram redução da oscilação postural em pé e do percentual de tempo de apoio duplo durante a caminhada, o que significa melhora no controle do equilíbrio estático e dinâmico e dos indicadores funcionais.

Is body perception associated with specific adaptations to static and dynamic tasks? / ¿Está la percepción del cuerpo asociada con adaptaciones específicas a tareas estáticas y dinâmicas? / A percepção corporal está associada a adaptações específicas a tarefas estáticas e dinâmicas?

Este estudio examinó a las mujeres universitarias en busca de asociaciones entre el perfil somatotipo, la percepción corporalde su propio cuerpo y la percepción del cuerpo de otras mujeres, evaluadas a través de tareas dinámicas y estáticas. Participaron 142 estudiantes universitarios (21.81 ± 3.014 años), evaluados para el índice de masa corporal y el somatotipo por los protocolos de la Organización Mundial de la Salud y Heath-Carter, respectivamente. La percepción de la imagen estática se evaluó mediante la Escala Brasileña de Clasificación de Figuras Fotográficas (BPFRS) y la percepción dinámica de la imagen, mediante la tareapsicofísica Estimación de categoría. Este último se llevó a cabo en dos contextos: percepción del cuerpo mismo y percepción de los cuerpos de cuatro modelos desconocidos. La prueba no paramétrica de Kruskal-Wallis se realizó para el análisis de varianza. Los valores de percepción de imagen dinámica y estática se emparejaron a cero(precisión perceptiva total) y se analizaron mediante la prueba de Mann-Whitney para determinar la tendencia perceptiva. La correlación de Spearman se realizó para detectar asociaciones entre variables. La asociación entre variables categóricas (tareas estáticas y dinámicas) se realizó mediante la prueba de Chi-cuadrado. Se encontró que el perfil del somatotipo no está asociado con la autopercepción estática y dinámica de la imagen corporal o con la percepción de imágenes corporales desconocidas. Aun así, mirar la imagen estática en sí no está asociado con la observación en movimiento, lo que indica que estos procesos de percepción son diferentes e independientes.Palabras clave: imagen corporal; percepción del tamaño del cuerpo; autopercepción del cuerpo; somatotipo. (AU)

This study examined university women for associations between somatotype profile and body self-perception, and perception of other women’s bodies, in dynamic and static tasks. The sample comprised 142 female undergraduate students (21.81 ± 3.014 years) assessed for body mass index and somatotype by World Health Organization and Heath-Carter protocols, respectively. Perception of static image was evaluated using the Brazilian Photographic Figure Rating Scale (BPFRS), and dynamic image perception, by the Category Estimation psychophysical task. The latter was performed in two regards: body self-image and images of four unknown models’ bodies. We performed the Kruskal-Wallis nonparametric test for analysis of variance. Dynamic and static image perception valueswere paired to zero (total accuracy) and analyzed by Mann-Whitney test for perceptual tendency. Spearman correlation was performed to detect associations between variables. Association between categorical variables (static and dynamic tasks) was by Chi-Square test. Somatotypical profile was found not to be associated with static and dynamic body image self-perception or with perception of unknown body images. Furthermore, looking at one’s static image is not associated with watching oneself in movement, indicating that these perceptual processes are different and independent of body shape. (AU)

Este estudo examinou mulheres universitárias em busca de associações entre o perfilsomatotípico, a percepção corporal do próprio corpo e percepção do corpo de outras mulheres, avaliadas por meio de tarefas dinâmicas e estáticas. Participaram 142 estudantes de graduação (21,81 ± 3,014 anos) avaliadas quanto ao índice de massa corporal e somatotipo pelos protocolos da Organização Mundial da Saúde e da Heath-Carter, respectivamente. A percepção da imagem estática foi avaliada por meio da Escala Brasileira de Classificação de Figuras Fotográficas (BPFRS) e percepção dinâmica da imagem, pela tarefa psicofísica Estimação de Categoria. Este último foi realizado em dois contextos: percepção do próprio corpo e percepção dos corpos de quatro modelos desconhecidas. Foi realizado o teste não paramétrico de Kruskal-Wallis para análise de variância. Osvalores de percepção de imagem dinâmica e estática foram pareados a zero (acurácia percetiva total) e analisados pelo teste de Mann-Whitney quanto à tendência perceptiva. A correlação de Spearman foi realizada para detectar associações entre variáveis. A associação entre variáveis categóricas (tarefas estáticas e dinâmicas) foi realizada pelo teste do Qui-quadrado. Verificou-se que o perfil somatotípico não está associado à autopercepção estática e dinâmica da imagem corporal ou à percepção de imagens corporais desconhecidas. Ainda, olhar a própria imagem estática não está associado a se observar em movimento, indicando que esses processos perceptivos são diferentes e independentes. (AU)

Effect of concurrent training (aerobic+resistance) more static stretching on flexibility in women with breast cancer / Efeito do treinamento concorrente (aeróbio + resistência) mais alongamento estático na flexibilidade em mulheres com câncer de mama

Objective. was to assess flexibility in women with breast cancer who underwent concurrent training (aerobic+resistance) (CT) more static stretching. Methods. This was a controlled pilot study, with 31 women (age 30 to 59) under breast cancer treatment, 14 women were allocated to a training group (TG) who underwent CT more static stretching, concomitant to hospital treatment and 17 women for the control group (CG) who only underwent hospital treatment. The CT more static stretching was performed in 12 weeks with 5 sessions per week, three sessions (aerobic+resistance) and two sessions (stretching exercises) on alternate days. The flexibility of the shoulder was measured by means of the 360º Sanny pendulum goniometer and the flexibility of the lower limbs was assessed through the sit-and-reach test. Data were analyzed using repeated measures ANOVA Test and Bonferroni Post-hoc using SPSS 21 software, with α of 5%. Results. The TG presented increased flexibility in the horizontal abduction of the right shoulder (p=0.001) and in the lower limbs (p<0.001), but the CG showed a reduction in the horizontal abduction of the right shoulder (p=0.003). The effect size for horizontal abduction of the right shoulder was medium (p=0.508) and for the lower limbs was large (p=0.839). Conclusion. CT more static stretching may be a therapeutic intervention to increase flexibility of upper and lower limbs in women with breast cancer. (AU)

Objetivo. Avaliar a flexibilidade em mulheres com câncer de mama que realizaram treinamento concorrente (aeróbio + resistência) (TC) mais alongamento estático. Métodos. Este foi um estudo piloto controlado, com 31 mulheres (de 30 a 59 anos) em tratamento para câncer de mama, 14 mulheres foram alocadas em um grupo de treinamento (GT) que realizaram TC mais alongamento estático, concomitante a tratamento hospitalar e 17 mulheres para o grupo de controle (GC) que somente realizaram tratamento hospitalar. O TC mais alongamento estático foram realizados em 12 semanas com 5 sessões semanais, três sessões (aeróbia + resistência) e duas sessões (exercícios de alongamento) em dias alternados. A flexibilidade do ombro foi medida por meio do goniômetro de pêndulo 360º Sanny e a flexibilidade de membros inferiores foi avaliada por meio do teste de sentar e alcançar. Os dados foram analisados usando o Teste ANOVA de medidas repetidas e Post-hoc de Bonferroni no software SPSS 21, com α de 5%. Resultados. O GT apresentou aumento da flexibilidade na abdução horizontal do ombro direito (p=0,001) e nos membros inferiores (p<0,001), mas o GC apresentou redução da abdução horizontal do ombro direito (p=0,003). O tamanho do efeito para abdução horizontal do ombro direito foi médio (p=0,508) e para membros inferiores foi grande (p=0,839). Conclusão. O TC mais alongamento estático podem ser uma intervenção terapêutica para aumentar a flexibilidade de membros superiores e inferiores em mulheres com câncer de mama. (AU)

Dance practice modifies functional fitness, lipid profile, and self-image in postmenopausal women.

OBJECTIVE: The aim of the present study was to analyze the effects of dance practice on body composition, metabolic profile, functional fitness, and self-image/self-esteem in postmenopausal women. METHODS: A total of 36 postmenopausal participants (mean age 57 years) danced three times per week for 90 minutes each day and were evaluated before and after 16 weeks. The parameters evaluated were body composition (body fat and lean mass), blood lipids, functional fitness, self-image, and self-esteem. RESULTS: Statistical analysis was done using Student t test for paired samples and the Wilcoxon test with P values less than 0.05 considered statistically significant. Lower triglycerides (baseline = 156.5 ±â€Š17.0 mg/dL; after 16-weeks = 131.5 ±â€Š12.9 mg/dL; P < 0.01), higher high-density lipoprotein cholesterol (baseline = 55.4 ±â€Š15.9 mg/dL; after 16 weeks = 60.0 ±â€Š15.4 mg/dL; P < 0.001), and higher total cholesterol (baseline = 199.5 ±â€Š26.8 mg/dL; after 16 weeks = 211.8 ±â€Š35.7 mg/dL; P < 0.01) levels were observed in postmenopausal women. Dance intervention improved coordination (baseline = 8.6 ±â€Š2.6; after 16 weeks = 6.7 ±â€Š1.6; P < 0.001), agility (baseline = 55.9 ±â€Š8.8; after 16 weeks = 64.1 ±â€Š8.3; P < 0.001), and aerobic capability (baseline = 446.8 ±â€Š63.4; after 16 weeks = 377.4 ±â€Š53.8; P < 0.001). Classification of general function fitness index (GFFI) was considered regular at baseline (GFFI of 200-299), but improved after 16 weeks of dance practice (GFFI of 300-399, P < 0.001). CONCLUSION: The 16-week dance intervention was effective in improving not only the lipid profile and functional fitness of postmenopausal women, but also self-image and self-esteem.

Are there differences between male and female badminton athletes in sleep, physical activity and sedentary time? / ¿existen diferencias entre atletas de basdminton masculinos y femeninos en el sueño, actividad física y tiempo de sedentarismo? / Existem diferenças entre atletas de badminton masculinos e femininos no sono, atividade física e tempo de sedentarismo?

ABSTRACT Introduction: High-performance athletes often undergo periods of exhaustive training and insufficient recovery, which can lead to decreased performance, but it is not clear whether there are any differences between the sexes in the level of habitual physical activity, sedentary time or sleep quantity and quality in young highly trained badminton athletes. Objectives: The aim of this study was to compare the habitual physical activity (PA), sedentary time and sleep quantity and quality of highly trained young male and female badminton athletes and non-athletes. Methods: Twenty-seven young badminton athletes and twenty-one non-athletes (control group) were recruited. Sleep duration and quality (total time in bed, total sleep time, wake after sleep onset, sleep efficiency and latency), total counts, vigorous activity time and sedentary time were measured using a tri-axial accelerometer. Results: Male athletes spent less sedentary time (p=0.028), more time in vigorous activity (p=0.016) and had higher total counts (p<0.001) than the male control group. There were no significant differences in sedentary time (p=0.702) or vigorous activity time (p=0.205) between the female athletes and non-athletes, but the female athletes accumulated higher total counts than the female control group (p=0.003). There were no significant differences between the sexes or groups for time in bed, total sleep time, sleep efficiency, wake after sleep onset and latency (p> 0.05). Conclusion: Among males but not females, young highly trained badminton athletes had less sedentary time and more time in vigorous activity than the non-athletes, however, there were no significant differences between the sexes or groups in sleep quantity and quality. Level of evidence III; Case-control study .

RESUMEN Introducción: Los atletas de alto rendimiento con frecuencia son sometidos a períodos de entrenamiento exhaustivo y recuperación insuficiente, lo que puede llevar a una disminución del desempeño, pero no está claro si hay diferencia entre los sexos en cuanto al nivel de actividad física habitual, tiempo sedentario, cantidad y calidad del sueño en jóvenes atletas de bádminton altamente entrenados. Objetivos: El objetivo de este estudio fue comparar la actividad física habitual (AF), el tiempo de sedentarismo y la duración y calidad del sueño en jóvenes atletas de bádminton altamente entrenados y de no atletas, del sexo femenino y masculino. Métodos: Fueron reclutados veintisiete jóvenes atletas de bádminton y veintiuno no atletas (grupo control). La duración y la calidad del sueño (tiempo total en la cama, tiempo total de sueño, vigilia después del inicio del sueño, eficiencia y latencia del sueño), counts totales, el tiempo en actividad vigorosa y el tiempo de sedentarismo fueron medidos con un acelerómetro triaxial. Resultados: Los atletas del sexo masculino tuvieron menos tiempo de sedentarismo (p = 0,028), más tiempo de actividad vigorosa (p = 0,016) y mayor cantidad de counts totales (p <0,001) que el grupo control masculino. No hubo diferencias significativas en el tiempo de sedentarismo (p = 0,702) o tiempo de actividad vigorosa (p = 0,205), entre las atletas y no atletas, pero las atletas del sexo femenino acumularon mayor cantidad de counts totales que el grupo control femenino (p = 0,003). No hubo diferencias significativas entre los sexos o grupos para tiempo en la cama, tiempo total de sueño, eficiencia del sueño, vigilia después del inicio del sueño y latencia (p> 0,05). Conclusiones: Entre hombres, pero no entre mujeres, los jóvenes atletas de bádminton altamente entrenados tuvieron menor tiempo de sedentarismo y mayor tiempo en actividades vigorosas que los no atletas; entretanto, no hubo diferencia significativa entre los sexos o grupos en la cantidad y calidad del sueño. Nivel de evidencia III; Estudio de caso control .

RESUMO Introdução: Atletas de alto rendimento com frequência são submetidos a períodos de treinamento exaustivo e recuperação insuficiente, o que pode levar à diminuição do desempenho, mas não está claro se há diferença entre os sexos quanto ao nível de atividade física habitual, tempo sedentário, quantidade e qualidade do sono em jovens atletas de badminton altamente treinados. Objetivos: O objetivo deste estudo foi comparar a atividade física habitual (AF), o tempo de sedentarismo e a duração e qualidade do sono em jovens atletas de badminton altamente treinados e de não atletas, do sexo masculino e feminino. Métodos: Vinte e sete jovens atletas de badminton e vinte e um não atletas (grupo controle) foram recrutados. A duração e a qualidade do sono (tempo total na cama, tempo total de sono, vigília após o início do sono, eficiência e latência do sono), counts totais, tempo em atividade vigorosa e tempo de sedentarismo foram medidos com um acelerômetro triaxial. Resultados: Atletas do sexo masculino tiveram menos tempo de sedentarismo (p = 0,028), mais tempo de atividade vigorosa(p = 0,016) e maior quantidade de counts totais (p < 0,001) do que o grupo controle masculino. Não houve diferença significante no tempo de sedentarismo (p = 0,702) ou tempo de atividade vigorosa (p = 0,205) entre as atletas e não atletas, mas as atletas do sexo feminino acumularam maior quantidade de counts totais que o grupo controle feminino (p = 0,003). Não houve diferença significante entre os sexos ou grupos para tempo na cama, tempo total de sono, eficiência do sono, vigília após o início do sono e latência (p> 0,05). Conclusões: Entre homens, mas não entre mulheres, os jovens atletas de badminton altamente treinados tiveram menor tempo de sedentarismo e maior tempo em atividades vigorosas do que os não atletas; entretanto, não houve diferença significante entre os sexos ou grupos na quantidade e qualidade do sono. Nível de evidência III; Estudo de caso controle .

Impact of home-based aerobic training combined with food orientation on food consumption, daily physical activity and cardiorespiratory fitness among breast cancer survivors: six-month clinical trial

ABSTRACT BACKGROUND: Anticancer treatment gives rise to adverse effects such as increased pain and changes to body weight and menstrual cycles, with negative effects on activities of daily living. OBJECTIVE: To analyze the effect of food orientation combined with supervised (face-to-face, FF) versus home-based (HB) aerobic training on lifestyle (food consumption and daily physical activity (PA) levels), body composition, metabolic profile and cardiorespiratory fitness, among breast cancer survivors. DESIGN AND SETTING: Clinical trial study (six months) conducted at a public university in Presidente Prudente, Brazil. METHODS: Twenty-three female breast cancer survivors (40-75 years old) were allocated to aerobic training groups, either FF or HB. Both groups were trained and received food orientation. They were evaluated through a dietary record, ergometric treadmill test and blood test and the Baecke questionnaire. RESULTS: After six months, both groups had reduced their lipid levels, total energy consumption and polyunsaturated fat intake, and had increased their PA levels and treadmill test durations. However, only the HB showed reduced carbohydrate percentage and increased folic acid; and only the FF showed reduced lipid, saturated fat and sodium levels, along with increased carbohydrate and protein levels. No differences in body composition or metabolic profile were found. CONCLUSIONS: These results demonstrated the feasibility of HB aerobic training. In isolation, HB showed greater regulation of carbohydrate percentage and increased folic acid levels. Moreover, these breast cancer survivors presented improvements in food consumption, PA levels and cardiorespiratory fitness, while also maintaining their body composition and metabolic profile after the intervention, independent of the group.

Impact of home-based aerobic training combined with food orientation on food consumption, daily physical activity and cardiorespiratory fitness among breast cancer survivors: six-month clinical trial.

BACKGROUND: Anticancer treatment gives rise to adverse effects such as increased pain and changes to body weight and menstrual cycles, with negative effects on activities of daily living. OBJECTIVE: To analyze the effect of food orientation combined with supervised (face-to-face, FF) versus home-based (HB) aerobic training on lifestyle (food consumption and daily physical activity (PA) levels), body composition, metabolic profile and cardiorespiratory fitness, among breast cancer survivors. DESIGN AND SETTING: Clinical trial study (six months) conducted at a public university in Presidente Prudente, Brazil. METHODS: Twenty-three female breast cancer survivors (40-75 years old) were allocated to aerobic training groups, either FF or HB. Both groups were trained and received food orientation. They were evaluated through a dietary record, ergometric treadmill test and blood test and the Baecke questionnaire. RESULTS: After six months, both groups had reduced their lipid levels, total energy consumption and polyunsaturated fat intake, and had increased their PA levels and treadmill test durations. However, only the HB showed reduced carbohydrate percentage and increased folic acid; and only the FF showed reduced lipid, saturated fat and sodium levels, along with increased carbohydrate and protein levels. No differences in body composition or metabolic profile were found. CONCLUSIONS: These results demonstrated the feasibility of HB aerobic training. In isolation, HB showed greater regulation of carbohydrate percentage and increased folic acid levels. Moreover, these breast cancer survivors presented improvements in food consumption, PA levels and cardiorespiratory fitness, while also maintaining their body composition and metabolic profile after the intervention, independent of the group.

Association between handgrip strength and bone mineral density of Brazilian children and adolescents stratified by sex: a cross-sectional study.

BACKGROUND: To examine the association of handgrip strength (HGS) and bone mineral density (BMD) of Brazilian children and adolescents. METHODS: The sample included 243 children and adolescents aged from 4 to 15 years (9.3 ± 2.2 years), 171 males and 72 females. The following measurements were performed: weight, height, trunk length, and years to the peak height velocity (PHV). The percentage lean soft tissue (PLST), percentage fat mass (PFM), and BMD were obtained using Dual Energy X-ray Absorptiometry (DXA) and HGS using a dynamometer. RESULTS: In girls, HGS was positively associated with higher BMD, even after the adjustments, by arms [ß = 0.006; p < 0.001], legs [ß = 0.014; p < 0.001], pelvis [ß = 0.019; p < 0.001], trunk [ß = 0.013; p < 0.001], spine [ß = 0.013; p = 0.008], and total body [ß = 0.009; p < 0.001]. The same occurred in the boys, even after the adjustments a positive relationship was observed, whereas higher HGS was related to greater BMD in arms [ß = 0.006; p < 0.001], legs [ß = 0.017; p < 0.001], pelvis [ß = 0.014; p < 0.001], trunk [ß = 0.009; p < 0.001], spine [ß = 0.008; p < 0.001], and total body [ß = 0.007; p < 0.001]. CONCLUSION: HGS was positively associated to BMD in boys and girls, regardless of age, PHV, PLST, and PFM.

COVID-19 pandemic impacts physical activity levels and sedentary time but not sleep quality in young badminton athletes.

PURPOSE: Regular physical activity is a good strategy to maintain the health of athletes, and prevent pain and decreased joint flexibility during the pandemic. On the other hand, higher sedentary time during the pandemic period can have deleterious effects. The objective of this study was to compare physical activity levels, sedentary time, and sleep parameters during the pre-COVID period and the COVID-19 pandemic period in young badminton athletes. METHODS: Fifteen young badminton athletes were evaluated during a pre-COVID period (July 2019) and during the COVID-19 period (July 2020). Sleep parameters, physical activity level, and sedentary time were measured using a tri-axial accelerometer. Participants wore the accelerometer on their dominant wrist for 7 days consecutively. In addition, the average of each sleep parameter [time in bed and total sleep time in hours per day, sleep efficiency (%), wake after sleep onset (WASO, total per day), and sleep latency (minutes per day)] was reported over the 7-day period. RESULTS: Athletes presented increased sedentary time (pre-COVID = 7.0 ± 1.1 vs.COVID-19 = 8.9 ± 1.9 h/day, p = 0.004, d = 1.30) and significant decreases in the total PA observed in counts per day (pre-COVID = 2,967,064.4 ± 671,544.1 vs. COVID-19 = 1,868,210.2 ± 449,768.4 counts/day, p = 0.001, d = 1.99), time in vigorous PA (pre-COVID = 7.7 ± 0.9 vs. COVID-19 = 6.1 ± 1.2 h/day, p = 0.001, d = 1.56), and time in moderate-to-vigorous PA (pre-COVID = 8.1 ± 0.9 vs. COVID-19 = 6.5 ± 1.3 h/day, p = 0.001, d = 1.48). There were no significant differences for time in light and moderate PA or in sleep parameters (p > 0.05). CONCLUSION: Young badminton athletes presented increased sedentary time, and decreased total physical activity, time in MVPA, and time in vigorous activities during the COVID-19 pandemic compared to the pre-COVID period, however, there were no significant differences in sleep parameters.

Study protocol and baseline characteristics of "SCHOOL IN ACTION" program on support to physical activity and healthy lifestyles in adolescents.

Physical activity promotes positive effects on people's health, but most adolescents do not engage in sufficient physical activity to receive the benefits. Studies suggest that school-based interventions can be effective in increasing physical activity in adolescents. However, the literature is inconsistent on the effect size and the type of intervention. This paper presents the design of the SCHOOL IN ACTION program to increase physical activity engagement and healthy eating habits. The cluster randomized controlled trial was performed during a period of six months of intervention and 12 months of follow-up in adolescents from four Brazilian public schools. The theoretical model is based on health promoting schools and the social-ecological and self-determination theory. The action strategies were: improvement of exercises intensity during physical education classes and during lunch breaks; vegetable gardening experience; active breaks in non-physical education classes; counselling health to parents and adolescents and changes in the school environment to promote physical activity and healthy eating. Primary variables were physical activity and sedentary behavior (both assessed by accelerometers). Secondary variables were body composition (assessed by dual-energy x-ray absorptiometry) and eating habits (assessed by questionnaire and 3-day food recall). Questionnaires were used to assess other information related to life satisfaction, health behavior and socioeconomic information. Statistical analysis will follow the principles of intention-to-treat and will explore the composition data analysis and mediating factors of lifestyle-related behaviors. We propose that SCHOOL IN ACTION program will be effective to provide evidence to increase physical activity and food healthy habits in adolescents' students. ClinicalTrials.gov registration: NCT03153176. TRIAL STATUS: Follow-up and data analysis.

Constructing a logical model in school health: experience on the Lower Amazon region.

OBJECTIVE: This experience report presents the construction of the theoretical and logic model for intervention to promote physical activity and healthy eating habits of the public schools students in the city of Parintins, Amazonas, Brazil. METHOD: We carried out a theoretical research and also a documentary research on the School Health Program (PSE - Programa Saúde na Escola) on the national and local level, in addition to meetings with the PSE management committee for strategic planning of the actions. RESULT: The municipality had no systematic structure of health practices at school. A theoretical and logical model that involved prerogatives of practice from the management of the municipality in PSE was developed. Actions to promote physical activity and healthy nutrition of primary and secondary school students were planned and promoted in schools of the PSE. Final considerations: Thus, the collective construction of this proposal contributed to the research of multi-sectoral practices related to the PSE principles and strategies, considering the particularities of the Lower Amazon context.

Constructing a logical model in school health: experience on the Lower Amazon region / Construcción de modelo lógico en la salud del escolar: experiencia en el Bajo Amazonas / Construção de modelo lógico na saúde do escolar: experiência do Baixo Amazonas

ABSTRACT Objective: This experience report presents the construction of the theoretical and logic model for intervention to promote physical activity and healthy eating habits of the public schools students in the city of Parintins, Amazonas, Brazil. Method: We carried out a theoretical research and also a documentary research on the School Health Program (PSE - Programa Saúde na Escola) on the national and local level, in addition to meetings with the PSE management committee for strategic planning of the actions. Result: The municipality had no systematic structure of health practices at school. A theoretical and logical model that involved prerogatives of practice from the management of the municipality in PSE was developed. Actions to promote physical activity and healthy nutrition of primary and secondary school students were planned and promoted in schools of the PSE. Final considerations: Thus, the collective construction of this proposal contributed to the research of multi-sectoral practices related to the PSE principles and strategies, considering the particularities of the Lower Amazon context.

RESUMEN Objetivo: Este relato de experiencia presenta la construcción del modelo teórico-lógico para intervención en la promoción de la actividad física y alimentación saludable de los escolares de la red pública de enseñanza en el municipio de Parintins, en el estado de Amazonas (Brasil). Método: Se realizó una investigación teórica y también una investigación documental sobre el Programa Salud en la Escuela (PSE) en el ámbito nacional y local, además de reuniones con el comité gestor del PSE para planificación estratégica de las acciones. Resultado: El municipio no presentaba una estructura de sistematización de las prácticas de salud en la escuela. Se elaboró un modelo teórico-lógico que implicó prerrogativas de actuación de la gestión sectorial municipal en el PSE. Se planearon y fomentaron, en las escuelas del PSE, acciones de promoción de la actividad física y de la alimentación saludable de los escolares de la enseñanza básica. Consideraciones finales: La construcción colectiva de esta propuesta contribuyó a la prospección de acciones intersectoriales prácticas relacionadas con los principios y estrategias del PSE, teniendo en cuenta las peculiaridades inminentes al contexto del Bajo Amazonas.

RESUMO Objetivo: Este relato de experiência apresenta a construção do modelo teórico-lógico para intervenção na promoção da atividade física e alimentação saudável dos escolares da rede pública de ensino no município de Parintins, Amazonas. Método: Realizou-se uma investigação teórica e também uma pesquisa documental sobre o Programa Saúde na Escola (PSE) no âmbito nacional e local, além de reuniões com o comitê gestor do PSE para planejamento estratégico das ações. Resultado: O município não apresentava uma estrutura de sistematização das práticas de saúde na escola. Foi elaborado um modelo teórico-lógico que envolveu prerrogativas de atuação da gestão setorial municipal no PSE. Ações de promoção da atividade física e alimentação saudável dos escolares do ensino básico foram planejadas e fomentadas nas escolas do PSE. Considerações finais: Sendo assim, a construção coletiva desta proposta contribuiu na prospecção de ações intersetoriais práticas relacionadas com os princípios e estratégias do PSE, considerando às peculiaridades iminentes ao contexto do Baixo Amazonas.

Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over / Relação entre obesidade, sarcopenia, obesidade sarcopênica e densidade mineral óssea em idosos com 80 anos ou mais

ABSTRACT Objective This study sought to analyze the relationship between the components and aggravations of body composition (obesity, sarcopenia, and sarcopenic obesity) and bone mineral density in elderly subjects aged ≥80 years. Methods A cross-sectional study design was utilized to assess 128 subjects aged between 80 and 95 years. Body composition and bone mineral density were measured by dual energy X-ray absorptiometry. Gait speed was assessment by walking test. The statistical analyses included Spearman's correlation, one-way analysis of variance, the chi-squared test, and binary logistic regression analysis. Results The elderly subjects with sarcopenia had lower bone mineral density compared to the obesity group, with higher risk for presence of osteopenia/osteoporosis in the spine (OR: 2.81; CI: 1.11-7.11) and femur (OR: 2.75; CI: 1.02-7.44). Obesity was shown to be a protective factor for osteopenia/osteoporosis in the spine (OR: 0.43; CI: 0.20-0.93) and femur (OR: 0.27; CI: 0.12-0.62). Conclusion It was found that lean mass is more directly related to bone mineral density (total, femur, and spine) and sarcopenia is associated with osteopenia/osteoporosis. Obesity represents a possible protective factor for osteopenia/osteoporosis in elderly subjects aged 80 years and over.

RESUMO Objetivo Analisar a relação entre os componentes e agravos da composição corporal (obesidade, sarcopenia e obesidade sarcopênica) com a densidade mineral óssea em idosos com idade ≥ 80 anos. Métodos Estudo com delineamento transversal que avaliou 128 sujeitos entre 80 e 95 anos. A composição corporal e densidade mineral óssea foram mensuradas por meio da técnica de absorciometria de raios X de dupla energia. A velocidade de caminhada foi avaliada pelo teste de caminhada usual. Para análise estatística foram feitos os testes de correlação de Spearman, análise de variância com um fator, teste qui-quadrado e análise de regressão logística binária. Resultados Os idosos com sarcopenia apresentaram valores menores de DMO quando comparados com o grupo obesidade com maior chance de risco para a presença de osteopenia/osteoporose na coluna (OR: 2,81; IC: 1,11-7,11) e fêmur (OR: 2,75 IC: 1,02-7,44). Obesidade apresentou fator de proteção para osteopenia/osteoporose na coluna (OR: 0,43; IC: 0,20-0,93) e fêmur (OR: 0,27; IC: 0,12-0,62). Conclusão Observou-se que a massa magra está diretamente relacionada com a DMO (total, fêmur e coluna) e que a sarcopenia está associada à osteopenia/osteoporose em idosos com 80 anos ou mais.

Relationship between total and segmental bone mineral density and different domains of physical activity among children and adolescents: cross-sectional study

ABSTRACT BACKGROUND: This study aimed to investigate the relationship between total and segmental bone mineral density (BDM) and physical activity (PA) in different domains (school, leisure and sports) among adolescents and children. DESIGN AND SETTING: Cross-sectional study in the Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP). METHODS: The study sample consisted of 173 children and adolescents (10.31 ± 1.87 years). The BMDs for the whole body (WB) and the regions of the trunk and legs were measured using dual energy X-ray absorptiometry (DXA). PA was measured using the Baecke questionnaire. A regression model was used to analyze the relationship between all the BMDs and the different domains of PA. RESULTS: 41.5% of the adolescents had high percentages of body fat. Regarding the comparison between physically active and insufficiently active adolescents, there were no statistically significant differences in any BMD variables (P > 0.05). The BMD of the legs showed positive relationships with the total PA (β = 0.009; P = 0.013) and sports PA (β = 0.010; P = 0.049) after insertion of the confounders. Similarly, the WB BMD showed the same relationships (total PA: β = 0.005; P = 0.045; and sports PA: β = 0.008; P = 0.049). No relationship was found between leisure and school PA and any of the BMDs (P > 0.05). CONCLUSION: The results indicated that practice of sport was related to higher BMD values, independent of sex, age and body fatness.

Can hepatic steatosis compromise the effect of physical exercise on body composition in obese children and adolescents? / Esteatose hepática pode comprometer o efeito do exercício físico sobre a composição corporal em crianças e adolescentes obesos?

Abstract Physical exercise is one of the forms of prevention and treatment of obesity and associated diseases such as hepatic steatosis. The aim of this study was to analyze whether hepatic steatosis interferes in the effect of physical exercise on the body composition of obese children and adolescents. The sample consists of 40 obese individuals, 13 children (8.17±1.33 years) and 27 adolescents (12.28±1.36 years). Total and segmental body composition was estimated by DEXA. Anthropometric measurements were performed, as well as ultrasound examination of the liver to measure intra-abdominal and subcutaneous fat, and to diagnose hepatic steatosis (HS). The intervention consisted of 20 weeks, with recreational/competitive activities being applied to children and, for adolescents, concurrent training (aerobic and resistance). The Levene's, repeated-measures ANOVA and effect size tests (ES) by Eta-Squared were performed. It was observed that, although not statistically significant, analyzing the effect size, physical activity in both children (body fat ES effect time= 0.210 and ES effect group= 0.208; fat mass ES effect group= 0.338; fat android ES effect Interaction= 0.267), and adolescents (intra-abdominal fat ES effect group= 0.230) regardless of whether or not HS was effective in reducing body fat. Therefore, exercise was effective in improving the body composition of obese children and adolescents, regardless of HS.

Resumo O exercício físico é uma das formas de prevenção e tratamento da obesidade e doenças associadas como a esteatose hepática. Objetivou-se analisar se a esteatose hepática interfere no efeito do exercício físico sobre a composição corporal de crianças e adolescentes obesos. A amostra consiste em 40 indivíduos obesos, sendo 13 crianças (8,17±1,33 anos) e 27 adolescentes (12,28±1,36 anos). A composição corporal total e por segmento foi estimada pelo DEXA. Realizou-se medidas antropométricas, bem como, o exame de ultrassom do fígado para mensurar a gordura intra-abdominal e subcutânea, assim, diagnosticar a esteatose hepática (EH). A intervenção foi composta por 20 semanas, sendo aplicadas nas crianças, atividades lúdico-recreativas/competitivas e para os adolescentes, treinamento concorrente (aeróbio e resistido). Foram realizados os testes de Levene, ANOVA de medidas repetidas e o tamanho do efeito (TE) pelo Eta-Squared. Observou-se que, apesar de não obter significância estatística, analisando o tamanho do efeito, o exercício físico tanto nas crianças (gordura corporal TE efeito tempo= 0,210 e TE efeito grupo= 0,208; massa gorda TE efeito grupo= 0,338; gordura andróide TE efeito interação= 0,267), quanto nos adolescentes (gordura intra-abdominal TE efeito grupo=0,230), independentemente se tinham ou não a EH foi eficaz para reduzir a gordura corporal. Observa-se que o exercício físico foi eficaz na melhora da composição corporal de crianças e adolescentes obesos independente da EH.

Factors Associated With Levels of Physical Activity in Chronic Kidney Disease Patients Undergoing Hemodialysis: The Role of Dialysis Versus Nondialysis Day.

BACKGROUND: Patients on hemodialysis (HD) report lower physical activity (PA) levels. We analyzed factors associated with low levels of PA in patients with chronic kidney disease (CKD) and compared PA on HD day and non-HD. METHODS: 79 patients wore an accelerometer and were classified according to time spent on moderate-to-vigorous PA (MVPA). Demographic data, BMI, comorbidities, clinical status, and health-related quality of life (HRQoL) were checked for association with PA. In addition, PA level was compared between days of HD and non-HD. RESULTS: Accelerometer compliance was 78.5% [33 men and 29 women (53.96 ± 15.71 yrs) were included in analysis]. 35.5% of sample achieved ≥150min/week on MVPA. Lower MVPA was associated with older age (OR = 5.80, 95% CI = 1.11 to 30.19, P = .04), and lower score of physical function HRQoL (OR = 4.33, 95% CI = 1.23 to 15.23, P = .02). In addition, patients spent 9.73% more time on sedentary behavior, 38.9% less on light PA and 74.9% less on MVPA on HD day versus non-HD day. CONCLUSION: Age and physical function HRQoL were the main factors associated to lower PA levels. In addition, lower time spent on PA during HD day suggest that strategies for increasing physical activity levels during HD day such exercising during HD session could help CKD patients to reach current PA recommendations.

Factors associated with mobility of the oldest old / Fatores associados à mobilidade de idosos longevos

Abstract Introduction: Several factors can be associated to the reduction of mobility among the elderly. Early identification of these factors is crucial, since it may lead to prevention of functional dependencies. Objective: To analyze the association between mobility, sociodemographic factors and the prevalence of noncommunicable chronic diseases (NCDs) in oldest old. Methods: The sample consisted of 120 elderly persons aged (80 and 95 years), with 76 of them being women (83 ± 3 years) and 44 of them men (83 ± 3 years). Sociodemographic factors and NCDs which we studied were: age, gender, marital status, education, nutritional status, ethnicity, hypertension, diabetes and osteoarticular diseases. Mobility was analyzed using a battery of Physical Performance Tests. For statistical analysis we used the chi-square test and binary logistic regression to examine the relationship between sociodemographic factors, NCDs and mobility. SPSS (17.0) software was used for this and the significance level was set at 5%. Results: Level of education (p ≤ 0.001) and age (p = 0.034) are the two factors related to low mobility. However, the model built by multiple logistic regression analysis revealed that age is independently related to limited mobility in oldest old people (OR 3.29; 95% CI 1.09 to 9.87). Conclusion: Thus, oldest old >85 years are at a greater risk of decreased mobility independent of their education, marital and nutritional statuses and gender. We encourage further studies in this area. Studies which will not only address those facts considered in this study but that also examine family-related aspects, especially using longitudinal studies.

Resumo Introdução: A redução da mobilidade pode estar relacionada a vários fatores e a identificação precoce desses fatores torna-se fundamental, uma vez que pode auxiliar na prevenção da dependência funcional de idosos. Objetivo: analisar a relação entre mobilidade, fatores sociodemográficos e prevalência de doenças crônicas não transmissíveis (DCNT) em idosos longevos. Métodos: A amostra foi constituída por 120 idosos com idade entre 80 e 95 anos (83 ± 3 anos), sendo 76 mulheres (83 ± 3 anos) e 44 homens (83 ± 3 anos). Os fatores sociodemográficos e DCNT investigados foram: idade, sexo, estado civil, escolaridade, etnia, estado nutricional, hipertensão, diabetes e doenças osteoarticulares. A mobilidade foi analisada por meio da bateria Physical Perfomance Tests. Para tratamento estatístico foram empregados os testes qui-quadrado e regressão logística binária para analisar a associação entre fatores sociodemográficos, DCNT e a mobilidade. O software utilizado foi o SPSS (17.0) e o nível de significância estabelecido foi de 5%. Resultados: Os fatores relacionados à baixa mobilidade foram a escolaridade (p ≤ 0,001) e idade (p = 0,034). Contudo, o modelo múltiplo construído pela análise de regressão logística revelou que a idade está independentemente relacionada à limitação da mobilidade em idosos longevos (OR 3,29; IC95% 1,09-9,87). Conclusão: Dessa forma, idosos longevos com idade >85 anos apresentam mais chance de risco para limitação da mobilidade independente da escolaridade, dos estados civil e nutricional, e do sexo. Incentiva-se a futuros estudos além de abordar os aspectos trabalhados no presente estudo, averiguar também aspectos familiares, e principalmente, em estudos longitudinais.

Effect of judo practice on the body composition of children and adolescents: A 9 month intervention

Abstract Aims: To analyze the effects of 9 months of judo training on the body composition of children and adolescents. Methods: 105 children and adolescents aged between 5 and 15 years were divided into two groups: control (n=40) and Judo (n=65), all participants of one Philanthropic institution. Anthropometric measurements, total body composition, and body composition per region were performed using DEXA. The judo intervention lasted 9 months, held twice a week for one hour. The control group did not perform any type of training. Repeated measures ANOVA with adjustments for age, sex, and maturation, and the effect size by Eta Squared were performed. SPSS software version 13.0 was used and the statistical significance adopted was p-value<5%. Results: After the intervention, statistical significance was observed in body fat (kg) (p-value=0.031). There was an increase in BF in both groups; however this increase was much higher in the control group. Conclusion: The practice of 9 months of judo was effective for the maintenance of body fat in children and adolescents.

The effect of different training modalities on physical fitness in women over 50 years of age

Abstract It is not yet clear which physical exercise protocols have greater potential to mitigate the functional decline in physical fitness (coordination, flexibility, strength, agility and cardiorespiratory capacity). Thus, the objective of this study was to compare different training modalities on physical fitness in women over 50 years of age and understand which training protocol is more effective for promoting significant improvements in physical fitness. The initial sample consisted of 79 subjects, of which 17 dropped out, resulting in a total of 62 subjects who completed the study and are included in the analysis (n = 62). The average age of the study population was 60.1±5.4 years, divided into five groups: aerobic training, concurrent training, multimodal training, functional training and control group. Physical fitness was analyzed through AAHPERD (American Alliance for Health, Physical Education, Recreation and Dance) tests (0 and eighth weeks). The ANOVA analyses (aleatory effect) show a main effect of time for coordination (p<0.001), strength (p = 0.004), agility (p<0.001) and cardiorespiratory capacity (p<0.001), and statistically significant interactions for coordination (p = 0.003) and cardiorespiratory capacity (p = 0.033). When comparing the average relative differences between the group (Δ%), significant improvement was observed in coordination and agility (p<0.001) in the multimodal and functional training groups. For cardiorespiratory fitness, there was a significant improvement in the aerobic, concurrent and multimodal training groups (p<0.001) and strength increased in the functional training group (p = 0.04). Functional training was demonstrated to be more effective at promoting significant improvements in physical fitness than the other investigated exercise protocols.